스크립트
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00:00:31can you look at this chart for me sure one in eight young men watch porn gamble and play video
00:00:38games every day or more almost one in four gamble daily more than one in four use porn daily and only
00:00:4426 do none of them what do you make of that oh what do you make of that what the issue here is
00:00:56is about once a day or more often okay um i wonder we don't know what the life of people that are
00:01:05doing this are like we don't know what the lives of them are like is this compulsion do they wish that
00:01:09they could do it less is this something that borders on an addiction or something that's kind of
00:01:15uh guiding their life taking over their life or is this just a natural response to a world that's
00:01:22maybe been tapped of meaning and this is a good coping strategy for 74 percent of men to get through
00:01:30i don't know um but you yeah work on this much more than me so you can probably see through
00:01:35the headline a little bit more deeply yeah so i i think the answer is yes brilliant so i think thanks
00:01:42for coming everybody yeah so so so you know are is it a compulsion yes is it a coping strategy yes
00:01:47are people's lives devoid of meaning yes is technology getting addictive yes so the first
00:01:52thing that i i want to kind of point out here is that there are three things right gambling pornography
00:01:58video games so generally speaking when you see multiple overlapping things they tend to have a
00:02:05shared etiology right so these are symptoms sure they have their own like diagnostic criteria and
00:02:12things like that but i think what this is what what i men are jerking off gambling and playing video games
00:02:18yes this is correct yes um and and to me if you look at sort of uh things from an addictive perspective
00:02:26so all three of these activities are addictive um what are the what's the core feature of addiction
00:02:33something that gives you pleasure and takes away pain so all of these three things do that so anytime
00:02:39you're looking at compulsive behavior this is at the root of it so then the question becomes
00:02:45what is pleasurable pleasurable about these things and more importantly what is the pain that's being
00:02:51taken away so oftentimes i think there's a a big kind of misemphasis on addiction when people talk
00:02:58about addiction they talk about dopamine predominantly but if you look at an addiction addiction has three
00:03:04stages in the first stage of your addiction it gives you pleasure and it takes away
00:03:09pain but then what happens is we develop tolerance to the pleasure so if you ask most people who
00:03:15gamble play video games or watch pornography they won't say that like this is a huge source of pleasure
00:03:23so prior to being addicted you can say oh man this weekend is coming around i'm going to play lots of
00:03:28video games it's going to be great but as you progress into this people aren't like looking forward
00:03:34to they're like man i can't wait till i vacation this at the end of the month and i'm going to just like jerk off a
00:03:39whole lot and just i'm gonna i'm gonna go to mexico and i'm gonna take a a laptop it's pathologically
00:03:45fap i'm good yeah it's a good holiday there are people who goon right we can get to the psychology
00:03:51of that which is fascinating so i i think this is largely a symptom or a manifestation of a deeper
00:03:58problem um and i think that we just have depending on what the specifics of your psychology and your
00:04:05neuroscience is you will end up in one of those quadrants and the fascinating thing is we're
00:04:12getting to the point in research where we know what the defining features of each of those quadrants
00:04:19are oh right tell me more so um pick one to start video games so video games interestingly is the
00:04:27biggest okay of the lot by a distance so for the people that just listening uh gambling on its own
00:04:34only 1.8 percent of men are doing that every day without either porn and or video games
00:04:41okay that's kind of interesting so let's start with video games 35.8 percent of men doing video games
00:04:47daily and uh 66 percent doing video games with something in total with something else daily
00:04:55are you okay if i ask you questions sure okay so what do you do you play video games no okay what do
00:05:03you know about video games i played a lot in uni and stuff and then business became my video game
00:05:07okay so so what why did you used to play video games what did video games do for you uh they were
00:05:13a way to pass time when i was bored they were a way to connect with my housemates because a lot
00:05:18of them did yep too i was living in you know like five person house in university i used to play
00:05:23borderlands and you could play borderlands co-op locally yep which was sick because it's you and
00:05:28another person doing the same thing talking shit to each other but like working on a team but
00:05:33complaining about stuff borderlands one two i'm pretty sure i completed one two and maybe even three
00:05:39with my housemates yeah so sick i love that that was great so also a massive fan of watching people
00:05:45in the house playing a video game that i'm not a part of so if i watch someone play fortnite if i
00:05:50watch someone play fifa one of my favorite things to do because i get to shit talk them while they're
00:05:55playing and i get to comment on their like so i i enjoy video games i watch a lot of uh like reviews
00:06:03of video games obviously gta has just come out i'm enjoying seeing the fallout of that but i don't
00:06:07have really any desire to play video games not now not anymore why do you think that is i i think i
00:06:14supplanted the game playing uh status seeking go after something with business okay and i i think
00:06:22content creation and youtube is basically a video game sure to me so i i think in your answer is
00:06:27everything so it's beautiful thank you so thank you for coming so so here's here's what we need to
00:06:34understand so if we look at like why things are fun right so human beings and not just human beings
00:06:40like cats too have the capacity for play do you know what the evolutionary function of play is
00:06:46testing capacity in a safe environment uh that's a good way to put it i would say it's a testing
00:06:53capacity building capacity even right so if you look at like two cats that are playing with each other
00:06:58they're not like playing chess right they're like fighting and if you look at like people who play like
00:07:03kids who play tag right so what what the reason we've designed play or the reason evolution is
00:07:09selected for play is because play trains us in the skills that are necessary for survival this is the
00:07:15first thing to understand and so if you kind of think about it from like let's say i'm evolution and
00:07:19i'm trying to create i'm trying to prepare this juvenile organism to be able to succeed what i need to do is
00:07:27create a reward circuit to encourage the skills that will be necessary for survival so if we look at what
00:07:34video games do they take all the most important like evolutionary aspects for survival and they create
00:07:43an artificial environment in which we can get those satisfied so this is something that when i um the
00:07:49first book that i wrote is how to raise a healthy gamer and i i taught this to parents because parents
00:07:53who are struggling to teach their kids or just parents who are struggling to get their kids off of video
00:07:59games need to understand that this first thing is it's not a game it's actually a substitute for life
00:08:04that's why people get addicted and so even in your answer why don't you play video games anymore
00:08:09it's because the needs that the video game used to scratch for you are no longer scratched in the video
00:08:15game yeah so the 66 percent of people who play video games every day are people who are trying to
00:08:22accelerate time and this is men who play video games every sure yep so so men are accelerating time which
00:08:29is really scary like this is something that really worries me that many human beings on the planet are
00:08:34just like hitting the fast forward button speed running their own life not speed running the exact opposite so
00:08:41speed running is accomplishing a lot in a very short amount of true that's okay yeah yeah so what they're what
00:08:47they're doing is speed running their death right so they're they're accelerating the time to the end and so video
00:08:54games give us a sense of agency they give us a sense of community um you also mentioned something that's really
00:09:00common amongst men which is the negative expression of a positive affection so when talking exactly right
00:09:06which is the way that you express approval and respect to to the dudes around you right is like you should
00:09:12talk australians say you call your mates and your mates that's right
00:09:17problem yeah so and i think that's why people play games because they're they're sure there's dopamine
00:09:26sure there's some suppression of their negative emotional circuitry and like this is what's kind
00:09:31of the scary thing about fast forwarding your life is like as you fast forward your life your life gets
00:09:36worse because you're not living it you're not doing the things that you're supposed to you're not doing
00:09:41things that involve meaning and purpose and stuff like that have you looked at uh reported or self-reported
00:09:47retrospective estimations of how much time passed when people have played games like what what how are you
00:09:54arriving at this conclusion that people who play games are kind of moving through their life more quickly because
00:09:59time is just ticking away at the same one second or 60 seconds per minute that it always does
00:10:05yeah so so so they're they're they're not moving through life quickly life is passing them by faster
00:10:11i would say say video games keep you still right so from a developmental perspective
00:10:16you're not moving forward so if you spend i mean so and and the data to support that comes from all
00:10:22kinds of places my life firstly the numerous people i've worked with who have video game
00:10:27addiction is a psychiatrist but then there's plenty of evidence that shows that you know if you look
00:10:33at purpose and direction in life it's inversely correlated with like the amount of time that you spend on
00:10:38on the screen largely um especially playing things like video games and if you look at the things that
00:10:45protect the strongest protective factor against especially things like pornography addiction is actually
00:10:51having purpose or direction in life um pornography addiction is in my opinion the root cause of it is
00:10:59directionlessness in life and there's data to support that more so than video games yeah so this is where you can get
00:11:07into the research of each of these things and you'll find slightly different things that's kind of
00:11:11fascinating right because when you look at what video games do you would think it is purpose it's
00:11:16forward momentum yes there's there's progress you've leveled up there's a new challenge that you're going
00:11:20to do you're starting the game again at a high difficulty setting whatever so you would assume
00:11:25that the purposelessness thing would be more salved by video games but it appears that porn is stepping in
00:11:34yeah so so this is where the the details of the research become important so if you take a thousand
00:11:39people who are addicted to pornography and you measure them psychologically what you'll find is that
00:11:45they have a very high rate of meaninglessness or purposelessness in life so when i work with
00:11:51people when we develop programs around porn and stuff like that a lot of people will focus on the
00:11:56behavior but if you're someone who's struggling with technology addiction it can feel like whack-a-mole
00:12:03right where it's like okay i stopped playing video games and my pornography use increases
00:12:08so that's pornography addiction where if you don't have a reason bluntly to not jerk off every day and
00:12:13watch pornography you have to have a you have to get have something that's getting you out of the house
00:12:17and away from that stuff video games is interesting because as you aptly pointed out what video games
00:12:25do is gives you a substitute for purpose so pornography is like a numbing effect
00:12:32against the lack of purpose but what we'll see with video games is that they do give you a sense of
00:12:36agency they give you a sense of progress this is huge right like you can't level up in porn there's
00:12:42no like leaderboard for gooning watch me watch me i mean we can arguably there's i guess you could
00:12:51say there's only fans but not really um but yeah i mean i don't think that there's inverse only fans
00:12:56so there's not only fans for subscribers right how many people there's not a yeah so i mean there are
00:13:02some weird edge cases actually i mean if we want to go really down the rabbit hole of a lot of intensive
00:13:07competitiveness amongst only fans subscribers right for the attention and affection of the content
00:13:15creator it's the goon equivalent of guys in a nightclub outspending each other on bottles of
00:13:20absolutely yeah vodka yeah and look at how modernized we become um but yeah i mean i think you're spot on
00:13:25so so meaninglessness leads to pornography and meaninglessness also leads to the substitute of
00:13:32meaning through video games right people try to become pro gamers which is actually a viable career
00:13:37increasingly becoming less viable every year that goes by um but you know it with a video game like
00:13:44there's a there's a sense of progress there's a sense of growth there's climbing the ladder there's
00:13:48learning things and just like you said like youtube is sort of a video game there are ways to optimize a
00:13:52video game there are ways to optimize youtube so it kind of scratches that evolutionary psychological itch yep
00:13:59then we end up with gambling which is really interesting because there's a lot of research coming out about this
00:14:07gambling is like a whole different ball game so with just different neuroscientific mechanisms and
00:14:13especially if we're talking about young men one of the um what's the right way to put this one of the
00:14:20more unique things about gambling is sometimes the reason people get addicted to gambling is because we
00:14:27live in a society where it's hard to be a successful man so the standards for men have not changed but the
00:14:37the expectations of men for men have not changed if are if any anything they've gotten arguably more
00:14:42difficult and the capabilities of men have decreased so uh many women will still want a male partner
00:14:50who makes more money than they do but if you look at like college matriculation rates and things like
00:14:55that fewer and fewer men are going to college more and more women are going to college so
00:14:59there's kind of this really rough gap between what society expects of a man and what a man is capable
00:15:05of and that gap is widening so one of the simplest ways to solve that gap is to make it big in gambling
00:15:14so this is the kind of stuff that i don't think you'll see much research about i've seen a couple of
00:15:19papers this is really more clinical experience when i when i talk to people who gamble and i get into it
00:15:24like you know how do you feel about yourself what's going on in your life they all want to make it big
00:15:30and they don't know how and then gambling enters the picture and now you you have a big problem
00:15:38because the root of gambling is i want to be someone one day i want to have what everyone says i should
00:15:45have i want to have what everyone you know what i see other people having i i want to have and it's not
00:15:51like they all they want a bunch of cocaine and and yachts and yachts and stuff like that right but they
00:15:55they want to be able to buy a house they want to be able to take their partner out they want to have
00:16:00freedom and security in life but college is all messed up because of ai and lower matriculation rates
00:16:05and things like that so there's a future that many men are grasping for that they don't know how to get
00:16:12in one really really really simple way is to win it in gambling you know it's interesting i was
00:16:18talking to paddy galloway do you know paddy youtube wizard of youtube he's employed by google to help
00:16:24them do their own youtube channel okay it's pretty hilarious he's like kind of the guy at the top of
00:16:29the tree and um he was telling me because he's got access to all of these channels behind the scenes
00:16:34and all of this proprietary data and stuff like that we were at dinner and he was saying uh
00:16:40in 2019 2018 2019 all of the biggest finance niches were uh slow investing dollar cost average s p 401k
00:16:51uh tax efficiency it was long-termism long-termist thinking and the biggest financial niches in 2026
00:16:59are all make cash fast uh prediction markets calci polymarket um crypto and i know we went through
00:17:07a crypto nft wave as well kind of in the middle of that we had a wobble but what is being talked
00:17:13about online and he he thinks that this is a um wind changing of people wanting to try and make it big
00:17:20quick uh i think maybe concerns about ai uncertainty about the future geopolitical instability stuff like
00:17:27that like i just don't know what's going on i don't know the future like i'll just yolo yeah you
00:17:30know like uh what's it called fast life strategy uh it's kind of an equivalent of that but it's fast
00:17:35money strategy in the same way but if you were to think um globally that's caused everybody to be
00:17:40like i don't know what's going on i don't know how to make it i'll just go harder that's some of those
00:17:46things are like gambling adjacent and um or direct gambling advice and that kind of plays into what
00:17:52you're talking about here too yeah so i i think it's i mean it we can go as wide or as narrow as
00:17:57you want but i think this speaks to like a broader problem which is that so things are like this
00:18:04this wasn't what i was planning on talking about today but this is something that i've been really
00:18:08mulling over things are like really reaching a critical point and something fundamental is like
00:18:14breaking in our society i think we're we're seeing like a midlife crisis of sorts in humanity like
00:18:23so i think a lot of what's happening and i think men are sort of feeling the crunch of this in a
00:18:28different way and we can talk about how women are feeling it but i think when we what's going on is
00:18:34like there used to be a path to success right there used to be this thing and especially if you look at men
00:18:42the core psychological problem that men need to solve is conquering themselves so if you look at like
00:18:49most of the advice out there most of what men need to do they struggle with themselves and it's about
00:18:54getting the most output out of yourself if you know how to bring out the best part of you you can
00:19:03do fine in life right that's what this is just my experience of sitting with men and things like that
00:19:08there's some psychoanalytic literature that kind of supports this but it's kind of like arguably i'm
00:19:14competing against other men but if you sort of think about what is the lever that i pull it's my own
00:19:19effort right how do i beat somebody else at football i practice harder i train harder i get better
00:19:25so the core issue is effort and then what's really interesting this is a little bit of a shift but
00:19:31then if we look at what triggers a midlife crisis um which i went through recently myself was fantastic
00:19:37experience it it's that the realization that when you're young the main thing you need to do is
00:19:45generally speaking work harder right so there's like a lot of options and if you put forth the effort
00:19:51you've got i'm 20 years old i have 60 years on the planet right and if i work hard every day if i can
00:19:57bring a lot of effort every day i can become married i can get i can have kids if i want i can
00:20:02develop a career i need to extract the potential for myself midlife crisis psychologically happens when
00:20:10that strategy no longer works so at some point you wake up and and in my case i'm 43 and then you realize
00:20:18that oh crap working harder is fundamentally not going to solve my problems anymore it solved my
00:20:26problems when i was 21 and addicted to video games and all this all this good stuff it doesn't solve
00:20:30my problems anymore because there's just not enough time left i can work as hard as i want to for the
00:20:34next 40 years of my life and it's not going to get done where midlife is actually 36 which is like
00:20:38really scary okay so we understand this from the the psychological literature and if you look at what's
00:20:44happening in society hard work doesn't work anymore especially in places like america so we have this
00:20:52in america we have this idea right of like the american dream which is like independence and working hard
00:20:57and and pulling yourself up by your bootstraps meritocracy meritocracy and this is this is the right
00:21:04way well this is really scary but we've sort of assumed that meritocracy is like kind of the best way to
00:21:10navigate life but this is not working anymore right so so you know college used to be a secure path
00:21:19to uh it used to be a path to financial security it's not anymore if anything it's a it's a path to
00:21:25financial ruin yeah right and and so so and this is scary so and now what's happening is you have
00:21:31lots of young men where like everything is falling apart yeah ai is taking your job
00:21:39there's all kinds of stuff going on with like dating and mating um you know rates of of sexlessness
00:21:46are at an all-time high rates of loneliness are at an all-time high friendships are at an all-time low
00:21:51the number of people who have three close people that they can call in a number in a crisis situation
00:21:56has dropped to an all-time low like society and i'm not trying to be alarmist here like i'm i'm really
00:22:01not but i i think something fundamental is like breaking in society yep and the reason i really
00:22:06believe that is because we have the greatest amount of resources that we've ever had and
00:22:13this is also a bold claim to make but i think there's actually sufficient data to back it up
00:22:18we're also we also have the highest level of suffering that we've ever had
00:22:22you know and i i realize that's like oh my god like how can you say that are you but no no i'm not
00:22:26saying this to be alarmist i'm saying like this is a fact right this started during the pandemic
00:22:30where we have a mental health crisis that has been going on we've known that it's been going on now
00:22:35we're like six years in and things are not getting better if anything body body dysmorphia is on the
00:22:39rise right and we have some of these things like ozempic and semaglutide and stuff like that
00:22:45really scary a lot of people don't realize and i'm going off off oh dude i'm loving this
00:22:50you're cooking keep going just a simple example you are cooking a chicken korma though so we used
00:22:55like everyone has body image issues right and so everyone wants to be thin and everyone wants to be
00:23:00beautiful and like social media is a big part of that yep so then along comes a medication which is
00:23:06amazing because this medication makes it so that you don't want to eat so this is what's really scary
00:23:14about society up until now human beings have had to obey the laws of physics that if you want something
00:23:24in life you have to put something in and what scares me about semaglutide is up until now if you
00:23:33wanted to be healthy if you wanted to have if you wanted to lose weight if you wanted to get fit it
00:23:39required you to put in a certain amount of effort honest signal the body that you had was an honest
00:23:44signal of the effort that you put in there's yes but there are variables that go into that like
00:23:49upbringing and stuff like that and whether you're in a food desert but basically yes like you you had
00:23:53to work for stuff in life and i think that that's good and the reason that it's good is because the
00:23:59body doesn't wear out it rusts so the more you use your muscles the stronger they become
00:24:06the more that you write essays yourself the more intelligent you become human beings have gotten
00:24:12stupider for the first time in the history of recorded iq is that the flinn effect i don't know
00:24:19can you chat gpt is the flinn effect about iq i'm pretty sure that the flinn effect is people got
00:24:23smarter basically throughout all of human history if you were to grade them by iq slowly slowly slowly
00:24:29get smarter uh and we've gotten dumber for like the last decade uh probably yeah so so for the first
00:24:36time in the history of like recorded iq measurements yes here it is scroll up for me
00:24:42uh the flinn effect is specifically about iq scores it refers to the observation first documented by a
00:24:46political scientist james flinn the average iq test scores increased substantially throughout the 20th
00:24:50century many countries many developed nations the increase was roughly three iq points per decade
00:24:56uh and has the flinn effect stopped in many developed countries yes since the 1990s or early 2000s
00:25:03researchers have found that iq gains have plateaued in some countries and reversed slightly in others
00:25:07sometimes called the negative flinn effect yeah so so and this is happening so and what's happening is
00:25:14is especially if you look at iq reductions i see this a lot so i have friends in academia and stuff and like
00:25:20the more that people use ai for stuff the stupider they get and there there's lots of good studies
00:25:27that show this so the mit released a study a couple of years ago that showed a decay in critical thinking
00:25:32skills with ai use and and you know ai is basically like taking the elevator instead of taking the stairs
00:25:40for your brain so what what's happening is something weird is going on where like society is progressing
00:25:47but human beings are getting worse and as we get worse like things are really starting to come apart
00:25:53at the seams i think we sort of feel it we see evidence of it in in mental health um you know
00:25:58we were talking about ozempic so basically what happened is up until now you've had to work to get something
00:26:06right and along comes semaglutide and these glp1 agonists and suddenly you don't have to work to
00:26:15get something you take an injection and then your cravings get reduced and then we're starting to see
00:26:22some really scary things around glp1s so they're amazing medicines because if you have if you have like
00:26:30if you're overweight and you have like cardiac risk factors um endocrinology risk factors like type 2
00:26:37diabetes and stuff like that these medications are amazing at all this kind of stuff we're also seeing
00:26:41some really cool mental health effects so we're seeing reductions and cravings on alcohol um we're
00:26:47seeing uh improvements in even things like nicotine cessation stuff like that i think it's so weed the
00:26:54data is mixed right um pornography appears to get worse pornography gets worse yes video games uh i
00:27:02haven't seen any data about that yeah so and there's a lot of really interesting signaling around glp that
00:27:07we can get into but this is exactly kind of what i mean is it's sort of a miracle drug and our society
00:27:12has been filled with miracle innovations that actually cause silent damage around the edges and i think
00:27:19we've been doing this for way too long and like it's hit a critical point tell me if this sounds familiar
00:27:24you train regularly you eat reasonably well you feel fine but you're just kind of going off vibes most
00:27:30people have absolutely no idea what's going on inside their body and that is why i partnered with
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00:27:56make sure you're moving in the right direction and this level of testing would usually cost thousands
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00:28:16functionhealth.com modern wisdom that's functionhealth.com modern wisdom it's a simple example of glp1
00:28:23fascinating study if you take someone who has a binge eating disorder and you do cognitive behavioral therapy on them
00:28:31the more weight that they lose the more effective the cognitive behavioral therapy is
00:28:37the higher the higher risk is of developing anorexia
00:28:42that's correct it's confusing if i have a binge eating disorder
00:28:46and i lose 50 if i lose 20 pounds from seeing a therapist around my binge eating disorder rate of
00:28:51anorexia is low if i lose 50 pounds from cognitive behavioral therapy my rate of anorexia increases
00:29:00so rapid weight loss is an independent risk factor for developing anorexia and we see this right we see
00:29:11this we see that if you look at celebrities if you just take pictures like you to just take a collage
00:29:16of celebrities from now versus 20 years ago if you take a collage of like instagram influencers or whatever
00:29:23you will see that like eating disorders are shockingly on the rise
00:29:26we're also seeing equality with like looks maxing where there's a a drastic level of body dysmorphia
00:29:33in in men now and so there's something weird is going on where like as we move away from the laws
00:29:38of physics like as we move away from this fundamental idea that if you want something in life you have to
00:29:44pay something what do you think is the mechanism for that binge eating to anorexia pipeline
00:29:50um it's a fascinating question so i think there are two or three different factors
00:29:56one is
00:30:01so one is this gets a bit complicated but let me so if you look at what is the what is the
00:30:09psychological makeup of someone who loses 20 pounds versus someone who loses 50 pounds first thing that
00:30:14you can argue is that someone who's likely to lose 50 pounds is more motivated to begin with
00:30:20is more concerned about their appearance to begin with so i don't think it's a direct effect
00:30:24necessarily of just there's a selection effect going on here to some absolutely right so the the harder
00:30:29that you hate yourself or are motivated to look good or whatever absolutely so that probably is part
00:30:35of the reason for it it's not that the weight loss itself is all causal it's that the people who lose
00:30:39more weight are more more motivated to begin with maybe have more body i have to assume as well
00:30:45body dysmorphia or um mirror hatred but also people that are anorexic they must have a good amount of
00:30:53willpower like they have a ton of willpower i have to imagine that you basically your willpower muscle
00:30:57is like so hypertrophied that you're able to voluntarily starve yourself absolutely so so that's
00:31:04exactly what we see so what we see with people with anorexia is they have so many physiologic signals
00:31:10telling them to eat and so the the one of the things i love about being a psychiatrist is like
00:31:17there's a lot of cool neuroscience but there's a lot of old stuff too that i think is just as relevant
00:31:21i think psychiatry is the only field of medicine where stuff that was true 100 years ago is just as true
00:31:27today um and i think some of the stuff about like union archetypes and things and in modern like dating
00:31:32in the manosphere is like it's like textbook like literally there's a textbook written from 1920 by someone
00:31:37named emma jung who like describes the manosphere and our dating and mating crisis to a t it's insane
00:31:44um but going back to this question of of why do people develop anorexia so the root of anorexia is
00:31:50control so like if you look at like people who develop anorexia there are people who are deprived of
00:31:56control in their life and so what what tends to happen with human beings is we tend to displace
00:32:01things so if if if i'm out of control over here i'm going to balance that out by being extra in control
00:32:09over here and we see this in places like you know if i have if there's a parent who has a toxic work
00:32:15environment and they can't get angry at their boss they're going to displace that anger onto their loved
00:32:21ones at home right so this is just how we manage like psychiatric stuff so in anorexia it's all about
00:32:27control and and what happens is once you start to get the reward right oh my god from the cognitive
00:32:33behavioral therapy i have lost this weight look at how much better i look i can do this i am now in
00:32:39control i'm so much more in control at a 50 pound loss than i am at a 20 pound loss and so there's
00:32:45something there that that is very almost like addictive or compulsive or gratifying about taking
00:32:52control of yourself and then you just keep going how do you think that continues if somebody isn't
00:32:57using control themselves but is artificially uh supplementing their control by using glps your
00:33:06suggestion here is that people use cbt there's an intervention that gives somebody an additional
00:33:11amount of control over their weight and and how much they eat and some people overshoot that and
00:33:17kind of get a kind of addiction to the control that they have are you suggesting that glps allow people
00:33:25to shortcut or people who wouldn't have typically that access to willpower that these people would
00:33:32uh and they they're able to um the mechanism still holds even though the way that they've arrived at
00:33:38the mechanism isn't isn't the mechanism is the same what the difference is so remember i can i can have
00:33:45really strong cravings and i can have really high willpower so the reason i think glps are causing
00:33:51lots of problems with body dysmorphia is because now i don't need a high willpower because i'm reducing
00:33:58my cravings so so they basically allow people who have less control of themselves to achieve more
00:34:06dysmorphic goals why is that a problem um
00:34:16i think for two major reasons one is physiologically i don't think it's healthy so so i i think that
00:34:25there's a healthy weight that the human body likes to be at and glps there's also a lot of evidence that
00:34:31shows that the more unhealthy you are the more beneficial glps are so even people who are more
00:34:37overweight see greater reductions in alcohol use with glp use compared to people who are normal weight
00:34:44so if you have a normal weight and you start a glp your reduction in alcohol consumption is lower so it
00:34:51helps you less so so there there's a ton of evidence that this is true of all of medicine right so all of
00:34:57medicine everything has side effects so whether something is a good medicine or not depends on
00:35:01what the alternative to not taking it is so do we want to should we give you chris williamson a heart
00:35:07transplant well that depends how messed up is your heart and in the same way the majority of glp
00:35:13benefits are for people who are very unhealthy right um and there's a lot of data that supports that
00:35:20but then the second thing that i that this is like my personal thing this is not like a medical stance
00:35:25i i think it is supporting a societal shift into having a free lunch no pun intended so i i think
00:35:34what's really scary right now is like people want everything to be free right so so we we did an
00:35:40interesting study about why people we have an amazing membership and why people don't join our membership
00:35:46and the number one reason people don't join our membership is because the quality of our free content is
00:35:51so good and so internally we had this meeting where we're like okay should we make our free content less
00:35:55good and i was like hell no right um so right now what's going on is like human beings fundamentally
00:36:03don't want to pay the cost of stuff anymore this is why we get to things like gambling and stuff like
00:36:08that right and everyone is selling like you were saying from this youtube guy everyone is selling the
00:36:13idea that like you there's a free lunch passive income right effortless success you don't have to
00:36:19pay the price we're becoming and this is what's really scary is like you know there are so many
00:36:24predatory apps like i i saw an ad for a gambling app literally yesterday two hundred dollars of credit
00:36:32with five dollars oh my god so somewhere along the way like people don't want to pay the cost anymore
00:36:40people don't want to pay the cost to put their lives together they don't want to pay the cost
00:36:44to have money they don't want to pay the cost for help right because there's so much free help
00:36:50available and here's the really scary thing a lot of people are out there telling them yeah
00:36:56you don't have to pay anything right we'll give you this for free right so so like there are so many
00:37:01services out there you got promise free promise instance promise a lack of risk here's a money back
00:37:07guarantee right there's zero risk zero effort on your part we also see this in politics where it's like
00:37:14yeah we go to our politicians and we say i want all of these things done and the politician says yes
00:37:21and i'm gonna tax that person over there so people want things to be free and everyone is selling them
00:37:29saying yes yes everything is free free you don't have to pay anything you don't have to pay anything
00:37:34everything will be free you don't have to do effort you don't do anything and i think what we're seeing
00:37:38is a whole scale infantilization a whole scale deconditioning of our society which is why so many
00:37:46things the easier things get no one wants to study anymore people are using ai oh yeah you don't have
00:37:52to study you don't have to write anymore you can have ai do it for you so we're seeing this whole
00:37:58scale deconditioning and things are really starting to fall apart let's get back into gambling you said
00:38:04that neurologically that's very interesting we'd explained um sociologically what's going on there
00:38:12what's happening inside of the brain so what's happening so the most day you're laughing about
00:38:17it is it because you did the indian accent is that why no no so so i'm just laughing because what's going
00:38:22on in the brain so the most dangerous thing about gambling now is that it's available 24 7. there
00:38:29used to be and we know this right casinos are open 24 7. so they figured out a long time ago that if
00:38:35you're a predator and your prey is somebody's bank account making things available 24 7 is a really good
00:38:41idea and there's a really simple neurological reason reason for this so as we as the day goes on we get more
00:38:47fatigued as we get more fatigued we make worse decisions so as the frontal lobes are as our frontal
00:38:54lobes get fatigued as we get tired our ability to play the tape through to the end decreases our ability
00:39:01to anticipate consequences decreases our ability to control our impulse decreases so many years ago
00:39:09i spoke with someone who maybe this is supposed to be secret information but i'm not under an nda
00:39:16who's telling me that there's a there's a day trading app that not only facilitated trades they
00:39:22built this algorithm where any trade that is made at like two in the morning they're gonna be on the
00:39:29opposite side of so it's not like you're you know if i'm buying this share at two in the morning somebody
00:39:35else is selling it anyone who wants to buy or sell anything at two in the morning the app itself is
00:39:40taking the other side of the trade because they realized through their big data set right because
00:39:44they're seeing all this trading volume and stuff like that that people just make really really really
00:39:49stupid decisions at two in the morning so a big part of gambling is that the the gap between the
00:39:57impulse to engage in gambling which we know there's a lot of stuff around random reinforcement schedule
00:40:02and things like that there's all these biases like you know human there's a superiority bias so
00:40:06everybody thinks they're better than average everyone thinks that they're going to get lucky everyone's
00:40:10luckier than average right there all these biases have existed but there used to be a very like physical
00:40:16barrier of going to the racetrack going to the gas station to buy a scratch ticket huh friction friction
00:40:22absolutely right so you had to you had to like do something waiting until it opens up again waiting
00:40:26until it opens up and then then the impulse will pass so now what's really happening with these
00:40:32gambling apps is that impulsiveness we've made it really really really easy right and everybody's doing
00:40:37this it's like one click to purchase you don't even have to go to checkout anymore bro just tap a button
00:40:45and and it's going to be so easy and so what's really happening and this is also kind of scary is
00:40:51like the other thing i sort of realized recently this is kind of like a i don't know if this is really
00:40:55stupid or really smart i can't tell yet i realized something recently we have no psychological immune
00:41:04system that is prepared for the world that we live in so we have like an immune system that protects us
00:41:10against attacks right and we even have a psychological immune system that protects us against attacks these
00:41:15are things like freudian defense mechanisms like displacement and and yeah projection saying
00:41:22distraction yeah so like we have all of these like psychological defense mechanisms that we use to
00:41:27protect our mind but we have no immune system for the world that we're living in today which is why like
00:41:35this is like a new a novel organism that is attacking our mind and everyone's mind is getting messed up
00:41:41mm-hmm i had no idea when i when i chose to become a psychiatrist it was 2013 i went to my family i was
00:41:47like hey i'm thinking about becoming a psychiatrist they're like this is a terrible idea because they're
00:41:51like you know like a psychiatry is especially amongst indian people there's the reputable specialties and
00:41:56there's the disreputable specialties how's surgery rank reputable enough okay not the best because
00:42:02they don't make the most money dentistry uh quite high because they you make really good money for not
00:42:09having to go to an md program okay mds top yeah right prestige power money all that good stuff interesting
00:42:18and so i i told him and and then you know there was sort of this sentiment that like okay if you become
00:42:22a psychiatrist like you're not gonna be that important you're not gonna it's not gonna be like
00:42:26that big of a deal but like look at where we are today and like mental health is is the number one
00:42:30thing that most people are struggling with and so i i think part it's really scary because we're seeing
00:42:37all of these functions in our mind getting torn apart by social media pornography video games
00:42:43gambling um it's really scary and we we don't have the defense mechanisms i mean i think there are
00:42:49things that we can do but we don't really have the defenses built in which is why everyone is getting
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00:43:54what do you think happens to someone's brain when they engage in all three of those things daily
00:44:00um i think the the most synergistic effect is going to be the most fundamental so your
00:44:06dopaminergic i would i would predict two things one is anhedonia so the inability to experience pleasure
00:44:13so that's going to cause huge problems for trying to put your life together because
00:44:18the part of your brain that rewards you for doing a good job won't be able to do that anymore
00:44:23so the feeling of like oh i got an a on a test like literally you'll be like blunted
00:44:29and and not be able to experience that um one thing i started telling my patients that have helped
00:44:35them immensely in in dating or actually in falling in love is to not use their cell phone for an hour
00:44:41before they go on a date note no screens so go for a walk because what people don't realize is that
00:44:47your your dopamine is like you have a storage of dopamine and if you deplete it with a screen there's
00:44:53none left over until you go to sleep people are comparing the level of stimulus that they had from
00:44:56their screen to the person that they're going on a first date with it's not even that they're comparing
00:45:01it's that there is no dopamine left right for them to experience pleasure and if we look at what love
00:45:07is love is literally a trickle of dopamine because like the presence of this person is like oh my god
00:45:13it feels amazing like i can't wait to be right next to you oh my god it's just just like being across
00:45:18from this person and your brain is flooded with dopamine if your dopamine stores are empty you're not
00:45:22going to feel any of that and so people aren't falling in love anymore because technology is draining our dopamine
00:45:28are you worried about glps impacting dopamine for people falling in love or cravings i guess
00:45:34yeah so they they do blunt cravings this is where things get like really neuroscientifically like
00:45:38specific um so so they do blunt cravings but they don't work directly on the dopaminergic circuitry
00:45:46so they they work i mean everything's kind of tied together so they're not but what we do know that glps do so is they
00:45:56cap the amount of dopaminergic response that you can get that's part of the reason that they're kind of
00:46:03like good so people with um so if you look at studies of people who use alcohol on glps their desire for
00:46:10the first drink is the same the number of days that they drink doesn't go down what decreases or what
00:46:15improves with alcohol is the number of drinks they have when they drink so like after a hard day's work
00:46:20if we're going to go to happy hour like let's grab a beer that desire is absolutely the same
00:46:26what's blunted is the joy that i get from my first beer is blunted and so that's really where glps work
00:46:33okay so going back to someone doing all three of those things yeah every day so anhedonia is number
00:46:39one so the inability to experience pleasure if you talk to these people life will feel boring which
00:46:46is why they want to pass the time right because they don't feel like doing it becomes a vicious cycle
00:46:50of life is boring therefore i need to do more exciting stuff in order to make it less boring
00:46:55which means more porn more video games more gambling yeah so a lot of people don't realize this
00:46:59so you know you know in our body and brain wants stuff and then there's the physiologic signaling and
00:47:06then there's the subjective experience so when you are when your liver is out of glycogen i know you're
00:47:12pretty knowledgeable in the stuff and if you need some background let me know but when your liver's
00:47:15out of glycogen do you know what the subjective experience of that is hunger okay so if you're
00:47:21calorically low i you know if your calories are low you're going to feel hungry okay so if your if your
00:47:28cells have insufficient water what do you think is the sufficient feeling of that good okay excellent um now we get
00:47:35to the fun ones what do you what is the subjective feeling of a dopamine craving when your brain wants
00:47:46dopamine do you have any idea what that feels like novelty seeking yes yeah but that's not what we feel
00:47:53it is novelty seeking boredom exactly hey so what people don't realize is that if you are someone who is
00:48:02is unmotivated in life if you are someone who finds life to be unpleasurable and you're struggling because
00:48:10life just isn't fun anymore boredom is the feeling of recalibration of your dopaminergic circuitry
00:48:18boredom is a dopamine craving right because boredom induces you to seek novelty to get that pleasure it's like
00:48:25novelty hunger exactly yes exactly it's dopamine hunger right and the other cool super interesting
00:48:31thing is a random aside but the feeling of neuroplasticity is confusion so everyone wants
00:48:38neuroplasticity they want to rewire their brain no one wants to be confused and so being confused is
00:48:43very very very good in life um which we can talk about if you want but so kind of going back to your your
00:48:49your earlier question what does this look like so anhedonia is at the top of the list the second thing
00:48:53is distress intolerance so these people will not be able to handle negativity in any way and emotional
00:49:02dysregulation so there's going to be emotional numbing and when the emotional numbing goes away
00:49:08there's going to be too much emotion and the really scary thing about this is what a lot of people don't
00:49:15realize is when you're numb it's not that your emotional circuits are not working you're just not
00:49:25aware of them so a lot of times people who feel numb feel out of control in their life they're like
00:49:31i want to do this thing i want to go to the gym i should reach out to people but they can't bring
00:49:36themselves to do it and that's actually because there's all kinds of emotions that are going on that
00:49:40are influencing and controlling your behavior you won't even feel the fear but like why can't people
00:49:47apply for something it's because there's actually this subsurface fear that we kind of dissociate
00:49:53from through things like technology and and people are like i can't control my life yeah that's because
00:49:58you have a ton of dormant emotion that you are not aware of that is sending signals to parts of your
00:50:04brain to tell you not to do things but what people experience is like i need more discipline i need more
00:50:10willpower they don't realize that there's all this other input that is preventing them from acting
00:50:16what do they need these people let's say that someone resonates with that's me i have the novelty
00:50:22seeking but kind of mundane i'm doing it through the screen i have the bit of anhedonia i have the
00:50:27intolerance for boredom if they don't need more discipline which is kind of the go-to especially for men
00:50:33right like david goggins montages and 4 30 a.m ice plunges and stuff like that
00:50:39what does recovery from an intolerance to boredom look like great question so i think it starts with
00:50:48one question what is the cost you're willing to pay right so like if you look at david goggins
00:50:55he'll pay any price that's what makes him david goggins i mean i've never met the guy and i try not to
00:51:00comment on people that i haven't met but i've listened to enough of his stuff and it's it's really
00:51:03interesting because if you listen to what he talks about his mind is always thinking about cost and how
00:51:08to pay the cost and going back to what i was saying earlier about everything being free you know we live
00:51:14in a world where no one wants to pay anything and this is what's so interesting is is when i work
00:51:18with people like this it's like they're always running away from something bad so i'm isolated
00:51:27and then when i i'm isolated and lonely i'm tired of feeling that way i'm gonna go
00:51:34go to a party and then i'm socially anxious so then i go home so people are like people are the people
00:51:40aren't stuck in life they're they're swinging on this back and forth pendulum of being like bodied
00:51:45on one side and bodied on the other side and what's really interesting about this this is a condition
00:51:49called ambivalence which is internal conflict and the really interesting thing about internal conflict
00:51:56is that anytime you start moving the cost is far away and the further you move the more real the cost
00:52:03becomes so as long as you are like so for let's say for example i want to get into shape
00:52:09i want to get into shape easy to say that when i'm sitting at home once i go to the gym and once i
00:52:14start huffing and puffing now i'm paying the cost so what motivates us right is the the goal like like
00:52:21the the the reward that we wanted at the end that's what gets us moving and then at the very beginning
00:52:28we're thinking all about the reward and not about the cost and once we actually do something we think
00:52:34we're experiencing the cost and we see zero of the reward right so the first 10 times you go to the
00:52:40gym you're going to have zero improvements in your health that you're that is going to be visible it's
00:52:45just going to be all suffering and so this is what's really scary is we we become such a reward oriented
00:52:51society right and if you like look on the internet right everyone's offering you value like do this
00:52:59and you'll get this you'll get this you'll get this and so this is how we pull people by offering
00:53:04them rewards and so what someone really needs to do is is grapple with the cost and kind of accept
00:53:11like and there are ways to do this there's all kinds of stuff that can be done so one is first
00:53:15of all to to ask yourself what are you willing to pay right what's the price you're willing to pay
00:53:20what could an answer to that question look like five minutes a day right for five minutes a day i'm
00:53:27willing to stare at a blank page and struggle to put words on a piece of paper right that cost could be
00:53:35i'm willing to travel to india and stay there for three months and see what happens so a big part of
00:53:43it is is focusing on the cost another huge part of it is focusing on uncertainty what is your tolerance
00:53:50of uncertainty because we live in a world now where we want guarantees we want to know okay we're going
00:53:55to ask chat gpt which major will give me the best earning potential right and so what we really what
00:54:02people really need to do is this is crazy but you no one can predict the future and so you got to roll
00:54:07the dice like that's the only way to live life right you you have to take chances um and and chances come
00:54:14with pain and suffering which is why it's it's kind of cost so i think really embracing the the bleakness
00:54:19to it and the good news is that this is very doable like people who struggle with things like uncertainty
00:54:29they struggle with things like paying the cost they're like methodologies that really really help
00:54:33people do that because this is something that is actually natural for us human beings have always dealt
00:54:38with uncertainty but we've all been tricked into believing that there's no risk in life you know
00:54:44risk-free like get free stuff um and then i think the third thing that's probably pretty helpful two or
00:54:50three other things one is emotional regulation so you need some way to manage your emotions when they come
00:54:58up you can't keep running away from your emotions and you can't keep preventing emotions or avoiding emotions
00:55:03so the problem is that most people will live a life where they try to avoid emotions like how do i go to
00:55:11a party and not be socially anxious and if you pay attention to people who ask for help on the internet
00:55:16you'll notice that everything is conditional how do i do this without this how do i how do i ask this
00:55:22person out without messing things up at work how that's whatever it is you have to remove the conditional
00:55:28you have to pay the cost and then the last thing that i think is really really really important amazing
00:55:34study i think um there's something like 78 i'm rusty on the numbers i think something like 70 percent of
00:55:43soldiers in vietnam were using opioids or other drugs and only nine to 12 percent continued to use them
00:55:50when they came back to the u.s with zero treatment so a lot of people don't realize is their
00:55:58their existence and and what they're capable of is largely created by their environment so in my case
00:56:05i had to travel to india and i stayed in an ashram for like 90 days and and i can teach these yogic
00:56:11techniques and there's there's good stuff that can be taught and people you know you can diy this stuff
00:56:17from from home but what a lot of people don't really appreciate i think is that the this gets a bit
00:56:24philosophical but your mind is actually not you it's part of your environment so i don't know if this
00:56:30makes sense but like you struggle against your mind right like most people do that which means that you
00:56:34are over here and your mind is over here the way to make your mind calm is first of all your mind is
00:56:40part of your environment and then the way to make your mind calm is through your through its environment
00:56:46so the food that you give it the the circumstances that you're in even these little things like what you
00:56:51were saying used to play borderlands and you'd hang out with your friends like all that kind of stuff
00:56:55is shaping your mind right so how lonely do you feel and if your mind feels less lonely getting it to
00:57:01do things is like way easier is that one of the big leaders loneliness just wonder why you went to
00:57:08that as opposed to how spacious the vista is that you walk out of on a bedroom morning i think i think
00:57:15loneliness is one of the things that the human mind does not do well with so human mind does really
00:57:24well with solitude solitude is amazing loneliness is terrible so human beings the human mind is not
00:57:30designed to be lonely this is why ostracization is it used to be a death sentence right so to be to be
00:57:37kicked out of the group was like exile was like is just as bad as death
00:57:44at the risk of sounding like a prude is there a safe way to gamble watch porn and play video games
00:57:51every day absolutely 100 percent uh it's just that you the thing should do what it is designed to do so
00:58:00the moment that gambling pornography or video games become a substitute for other things in your life
00:58:06it's game over so i play video games um and i teach my kids to play video games like i love playing
00:58:14video games it's great i used to be addicted now i'm not so the good news is with behavioral addictions
00:58:18it's not quite like alcoholism where it's like one drink and it's like game over even that is somewhat
00:58:23mythological it's only some people who are like that um the majority of people who qualify for an alcohol
00:58:28addiction in college will still be drinking but not qualify for an addiction in adulthood
00:58:36so yeah i think as long as you are have a happy and fulfilling life you can gamble watch porn and
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00:59:31modernwisdom and using the code modernwisdom at checkout that's l-i-v-e-m-o-m-e-n-t-o-u-s.com
00:59:37slash modernwisdom and modernwisdom at checkout of the roughly 75 of men who are doing one of
00:59:44those three things every day or one in eight that are doing all three of them every day
00:59:49how many of them do you think are doing that from a place of volition and uh sort of choosing and how
00:59:55much of them do you think are compulsive or addicted i'd say compulsive and addictive is 95
01:00:03wow yeah i mean i'm tempted to say 99 but that's probably statistically wrong just what
01:00:10what i think about is you saying and i agree the modern world makes people feel really displaced in
01:00:17many ways and there aren't a whole number of previously more accessible solutions to that the
01:00:29displacement is salved unfortunately by things that people judge or that might have some side
01:00:35effects that wouldn't have done previously um so you know on one side you have this kind of
01:00:41increased burden that people are trying to fix with novel solutions but all of the novel solutions come
01:00:47with these side effects that are both social and internally shameful and externally judged and then
01:00:52potentially neurologically catastrophic financially ruinous sexually dysfunctional like there's all
01:00:59of these fucking things going on but you have this increased burden with these increased novel solutions
01:01:03solutions squaring that circle just seems hard and i think a lot of people will feel like well
01:01:08fuck like i've got so few opportunities in front of me can i not get some pleasure god is there
01:01:12nothing that i can do i can't have any fun at the moment i can't get any uh lots of people are using it
01:01:18to solve them it's an artificial solution to an artificial problem which is painful if it's not fixed
01:01:23yes so so my answer to that is there are new problems and as we're saying new solutions don't
01:01:31really fix new problems so this is where i go back to if you want to fix new problems you need old solutions
01:01:38the old solutions that have worked for thousands of years the old solutions that
01:01:46go to the fundamental of what people are right so if you look at some of these contemplative traditions
01:01:51and there's a reason why like mindfulness and stuff is exploding it's because it's what works
01:01:57and it's always worked and so i mean so many of the problems that we talk about finding purpose like
01:02:04all this i mean i deal with these people day in and day out i deal with men and women who are living in
01:02:09a society where they don't just feel displaced they are displaced there's no there's no place it's not
01:02:14displaced there's no space for them anymore and so how do you grapple with a world that ai is taking
01:02:20your job inflation is an all-time high gender dynamics are an all-time toxicity the problem is that no
01:02:28actually no one is living in the real world anymore everyone is living in a construction of social media
01:02:34and so how do you fix this you go back to like the fundamental of who you are and this gets kind of
01:02:42weird but like all of that crap enters you at some point so inflation fine at some point when you go to
01:02:54the store you try to buy something you have a ten dollar bill and you can only get one thing instead of
01:02:58two things that has an internal psychological impact into you and i think the problem with all of the
01:03:03artificial solutions is because they don't focus on the one thing that you can really control
01:03:08which is yourself that's the only thing you can control and here we are having a lot of people
01:03:14offering us solutions that semaglutide is a great example remove the need to work on yourself
01:03:22all of our solutions have people not working on themselves which is exactly why we're seeing a
01:03:28whole scale deconditioning of our body our mind our critical thinking it's all of the outcomes without
01:03:34any of the inputs you're able to lose weight without the traditional input yeah so that's a good way to
01:03:41put it and i would say it's like it's all of the outcomes without the inputs and really all of the
01:03:48outcomes and some of those outcomes aren't good yeah right so it's it's writing a paper this is what's
01:03:54really fascinating ai usage improves grades and decreases knowledge right so you're right it's
01:04:03it's all of the outcomes it is it is a deconditioning of people whole scale but glps i would guess for
01:04:09people starting under a bmi of 30 would probably decrease body fat and decrease health uh i don't
01:04:21bmi under 30 you're probably still have a positive effect so they largely have positive effects from
01:04:26most people that take them but how many of those people are going to overshoot how many of those
01:04:30people that are using them already aren't eating a well-balanced uh micronutrient rich diet that is now
01:04:37being chopped in by two-thirds or half so a spa nutrient sparse diet has now turned into a uh
01:04:46caloric deficit nutrient sparse diet which means that the tiny little bottom filtering of nutrients
01:04:52you were getting has been cut down too uh how many people were using foods to cope with their emotional
01:05:01issues and now they don't even have that to do yeah so so this is it's all great questions so here's a
01:05:08couple of answers the first is one of the most important pieces of advice that i give to people
01:05:14this is family friends patients whatever when they start a glp i mean usually i don't prescribe glp so
01:05:20somebody else should be doing this but if i have a patient who's on it i try to tell them remember to eat
01:05:25so so uh they just don't feel like eating and so so you're right that i think we're starting to see
01:05:30like nutritional problems with some of these people um and then i i think on balance though given how
01:05:37bad people's diets are i think there's there's a lot of data that glps are like really good you know
01:05:42and i'm not saying that they're not good when you look at those indicators but there are these hidden
01:05:47costs like maybe we'll see micronutrient deficiency and here's the real answer to all of your questions
01:05:53we don't know right they've hit the market and and we don't have any long-term surveillance data on
01:05:59what this is going to do to people they're also designed for people originally designed for people
01:06:03and most of the longer term studies which is still relatively novel were done on people that
01:06:07were morbidly obese because it was built for diabetes right it built around diabetes i mean
01:06:13that depends on whether you want me to put my tinfoil hat on or not oh yeah so here's here's my
01:06:19tinfoil hat the captain's hat okay so here's here's my tinfoil hat i do have a disguise
01:06:25i would not be surprised one bit if we discovered many years from now that the same thing that
01:06:36happened with opioids is what's happening with glps so were they designed for morbid obesity or did the
01:06:45companies that develop them understand very clearly that
01:06:51this is a medicine that will make someone not want to eat
01:06:56and so they they move forward and and they weren't designed for obesity they were designed
01:07:01to help people not eat and there's a subtle difference there then what happened and i don't
01:07:06know if that makes sense but like like they they know there's a very good chance that they actually
01:07:11there's not a very good chance we have no idea but if i put my tinfoil hat on they damn well know that
01:07:16this is a medicine that everyone is going to want to take because everyone is one going to want to
01:07:21lose weight everyone wants to be pretty this is the age of social media we are going to give people
01:07:27a medicine that takes away their cravings that's what they're designed to do is to take away cravings
01:07:33now here's the subtle important part here they were tested in people with obesity because in order to
01:07:40get a drug through something you have to show a certain amount of benefit but i think the incredibly
01:07:48rapid adoption of using them off-label for people who don't fit the clinical criteria
01:07:55that's like one hell of an interesting thing right so like because they were able to predict who the
01:08:01end users of this product being not the people that were in the original clinical exactly right so
01:08:06there's a very real possibility that we will find that and if we find that the reason we would find
01:08:11that is because things really get to be a problem this is exactly what happened with opioids right so
01:08:16people damn well knew or actually not opioids this is what happened well opioids as well but this
01:08:21also what happened with benzos okay so benzodiazepines like xanax the alprazolam or xanax is one of the
01:08:28first benzos that came out and there is like very little doubt in my mind that the drug companies who
01:08:38this is going to get technical okay so if you really want to understand conspiracy stuff you have to
01:08:41understand the science so everyone got addicted to xanax why it's because xanax has a very rapid onset
01:08:49so the faster something hits your body the more addictive it is so now okay yeah exactly right so so
01:08:59what happened is we now have benzodiazepines later benzodiazepines that are less addictive
01:09:05and hit your system slower a good example of this is clonazepam so you can still get addicted to
01:09:10clonazepam but alprazolam which is xanax hits your system like that clonazepam hits it more slowly and
01:09:16also lasts longer so the the faster it hits you and the faster it wears off the more addictive it is
01:09:22this is crack cocaine okay meth and alprazolam hits you fast goes away fast diazepam which is valium
01:09:32hits you fast but stays for a long time so now we're moving away from those addictive ones here's a really
01:09:38fascinating thing everyone talks about glps like they're the same thing they're not the same thing
01:09:44terizepatide semaglutide they're not the same they all have different penetrations to the cns
01:09:50okay so where all of these glps go is actually different so if you look at studies on reductions in
01:09:57alcohol cravings and alcohol addiction they're not the same for all glps because they have different cns
01:10:03penetration so they enter your brain at different rates okay so like it i'm not sure but like the the
01:10:12conspiracy theorist in me really wonders whether they know exactly what what's happening which is
01:10:20that they're going to release this medicine on the market and it's not about obesity like sure it helps
01:10:25people with obesity a ton but they damn well know that the majority of prescribing is going to be off
01:10:29label they damn well know that people will pay out of pocket for it because it'll make them thin
01:10:34we have a medication that makes you thin which previously we used to have medications that will
01:10:40you know i forget what the i'm blanking on the the name now but because no one prescribes it
01:10:46but there were medications that prevent fat absorption in the gut right so this is like a weight loss
01:10:51medication which is great so here's the problem chris if i present prevent fat absorption in the gut
01:10:57and i eat fat where does it go through your digestive tract yes into the toilet yes actually not into
01:11:04the toilet that's where you're wrong because one of the key um so bad one of the key side effects of
01:11:11these these fat blockers is anal leakage it's a it's a technical term yeah do you know what anal
01:11:17leakage is isn't this the that like people accused epg of causing i don't know okay but like this is what i
01:11:24do i know what anal leakage is yeah a poop that you can't keep in your butt exactly and it's a trickle
01:11:31it's a leak okay right so so so this was the the last weight loss drug i mean not the last one but
01:11:36this is like a weight loss drug right that people but it just had side effects that were completely
01:11:40unacceptable oh and so glps like there's a there's a very real chance that someone somewhere
01:11:46and and i'm not i don't think like far like pharma's evil and bad and stuff like that i think a lot of
01:11:50pharmacologic i mean no one's complaining about acetaminophen today right so like drug developers
01:11:56develop a lot of amazing things amazing developments like for cml and stuff like that halidol haloperidol
01:12:02is an amazing medication ssri are amazing medications i'm not like anti-pharma but i i really wonder when i see
01:12:11something that has such rapid adoption that does so many things like people who you know do they know
01:12:17it's really a miracle drug when they release it i like i sometimes wonder whether they know exactly
01:12:23what they're doing and that we're gonna see post-market surveillance 20 years from now 30 years from now
01:12:28in the same way that we did with benzos in the same way that we did with um opioids right everyone's like
01:12:35yeah oxycontin has long half-life people aren't going to get addicted to it they they knew people
01:12:40were going to get addicted well the the only way that your theory isn't true is if the most well-funded
01:12:50pharma research companies in the world didn't foresee what would potentially be the biggest drug market
01:12:56on the planet and they have happily closed their eyes through on the dart and the darts hit the
01:13:00bullseye in the middle of the dartboard and they're like oh look at this yeah so so anorectics just
01:13:05happened to be a trillion dollar drug yeah so so i mean that could be so so maybe what they were doing
01:13:11is is i mean i think everyone knows that weight loss is a multi-billion dollar market there's no
01:13:17question about that i don't think there's anything nefarious in that and then they came up with a
01:13:20medication that in clinical trials reduces cardiac mortality reduces heart diabetes which is an amazing
01:13:26thing right so i don't think they're evil but i still wonder whether they know you know or whether they
01:13:33like deep down deep down do they know you talked about numbing earlier on i've heard you talk about
01:13:38the need for young men to retrain their penis yes what's going on there
01:13:46the mother of all non-secclers from anal leakage to retraining your penis let's go okay so
01:13:56this is okay how do i okay so first thing chris what is training
01:14:05uh applying efforts to increase capacity okay um how do you train my penis
01:14:14anything just the concept of training what do we do when you train practice
01:14:20in a manner that is akin to a performance okay it will come in future okay so repetitive practice
01:14:26right so here's the basic problem
01:14:32i'm a teenage boy and i discover pornography and i have an erection and at some point i start
01:14:38masturbating and then this is becoming a problem now because my access to pornography is at an all-time high
01:14:48my access to a healthy sexual relationship is an all-time low so whereas you know
01:14:59so so now what's happening is for maybe 15 years i am using a certain kind of stimulation for my penis
01:15:07and just to give you uh okay so i'm using a certain kind of stimulation for my penis and then the body gets
01:15:13used to that right so in the same way that like if i eat spicy food starting when i'm 13 like i can handle
01:15:19spicy food when i'm 15. so the body gets used to caffeine it gets it's the whole point of the body is
01:15:25that it adapts to whatever you give it so we are literally we're training our body to tolerate spicy food
01:15:31we're training our body to run a marathon we're training our genitals and and our our penis to ejaculate in
01:15:39certain circumstances so we see a shockingly high level of erectile dysfunction i'd learn from you
01:15:4740 percent of men are dealing with erectile dysfunction yeah so i think it's 30 percent of
01:15:51people under the age of 30 which erectile dysfunction maybe i said 40 i don't remember the exact statistic
01:15:56but erectile dysfunction used to be an old man's disease it's not anymore and what a lot of people
01:16:01don't realize do you know what erectile dysfunction is no okay so this is okay
01:16:13so easy yeah that's a good one so erectile dysfunction is defined is the inability to maintain an erection
01:16:22through the completion of the sexual act okay okay so the interesting thing about the young men 30 of
01:16:28people under the age of 30 who have erectile dysfunction it's not that they can't get hard
01:16:32it's that they can't stay hard enough to finish if they're having intercourse let's say okay and there's
01:16:38a really simple reason for that the i was going to ask a couple questions but i doubt you have the answer
01:16:45so the the the psi this the pounds per square inch of your hand okay the amount of force that you can
01:16:54exert with your fist is about 130 now there's there's some problems with that because you're actually
01:17:00you measure uh hand grip strength not by force but by newtons but sorry not by psi but by newtons but
01:17:07there's a rough conversion okay it's about 130 the psi the vagina is like 30. so if you just if you just
01:17:16in this you may not know but you know the vagina exerts a certain amount of pressure and tightness
01:17:25and then the hand exerts a different level of tightness and they're not even in the same vein so
01:17:29basically what happens with a lot of dudes who spend 15 years of their life watching pornography and
01:17:34masturbating it's not just about gender stuff or the the jiggliness or the angles of porn there's all
01:17:40that stuff too there's a very simple physiologic thing where this is what you need to finish you need
01:17:45a very high level of stuff and i mean i've worked with men in their 60s who will um not be able to
01:17:53climax through oral sex or vaginal intercourse and so when they have when they engage in sexual intercourse
01:18:00either they have to finish using their hand or they have to engage in anal sex those are the the two
01:18:04things that work um and and so this it's just physiology it's just what you've you've trained your
01:18:10penis to respond to what's the pounds per square inch of an asshole um i don't know but i i this is
01:18:17important research i i i imagine it's probably north of 100. really yeah wow yeah especially if you
01:18:26yeah you know yeah so i mean it's got to be high i mean it's it's certainly way higher than i mean
01:18:34the this there's a anyway couple sphincters in there and but they're they're quite strong right
01:18:39but but so this is what's going on so so men have basically and there's all kinds of other issues like
01:18:44um cardiovascular issues so that's a good good question here because i think when people hear erectile
01:18:51dysfunction in men what they probably go to is like an uninformed person or even a well-informed person
01:19:00they go um well that is low testosterone that is uh obesity that is
01:19:12mental stimulus desensitization due to extreme uh fisherian runaway acts in porn uh and seeing
01:19:21unrealistic or tail end representations of women in porn uh that is due to psychological nervousness
01:19:32far fewer will go to how much nitric oxide are you consuming from your fucking leafy greens and your
01:19:39beetroots what's the level of cardiac health that you've got um what's the death grip
01:19:46comparison between your right hand and a vagina of the culprits causing erectile dysfunction among men
01:19:53young men
01:19:56how how would you sort of partition off that pie so so this is something that
01:20:02i've been dragged kicking and screaming into becoming an expert in so let's start with
01:20:07testosterone because actually subject let's this is this is the biggest scam that is being perpetrated
01:20:12against men okay so around the year 2000 the average testosterone for a man was about 612 to 690
01:20:22nanograms per deciliter okay so 20 years later the average testosterone for a man has dropped to about 400.
01:20:31okay that's significant in a short space of time it is significant in a short space of time
01:20:36and it is well within the acceptable limits right so it there so so has testosterone dropped
01:20:43yes has it dropped by a third yes does this cause physiologic problems almost certainly not
01:20:52second thing so what's the testosterone drop due to there is an effect from obesity
01:20:57but it is even if you factor out obesity there's still a testosterone drop
01:21:03next thing i have a theory on that okay do you want to keep going sure okay so this is my theory
01:21:08men's testosterone is mediated by their environment if we had a bunch of weapons around here now our
01:21:13testosterone would be higher if we start picking them up and waving them around our testosterone would
01:21:16be high not much but like a little bit another thing that mediates male testosterone is the fertility of
01:21:22the women that they're near but if you're spending a lot of time around women who are giving off the
01:21:27cues largely pheromones but also visual cues of being fertile that will increase testosterone not
01:21:33by an insignificant amount um if you were a man that somehow was stranded on a desert island some
01:21:39hunter-gatherer man stranded on a desert island with a bunch of children a bunch of grandmothers
01:21:43your testosterone would be less okay uh i think and i've spoken to dr shana swan about this etc etc
01:21:51um one of the x factors my like tinfoil hat x factor thing is the artificial suppression of
01:21:57fertility by women increasing their use of hormonal birth control is causing and the solitude of men
01:22:05spending less time around women is a contributor that hasn't been fully factored in to the decrease in
01:22:11testosterone that's a fascinating especially the birth control and don't test me dude on this
01:22:16tinfoil hat stuff that's what i'm about yes dr k giving me so i know we have a lot of important
01:22:22things that matter to people to talk about but one day we have to put our tinfoil hats on and and just
01:22:27go off the rails i have a i have a hat that says make autism great again yes okay interesting cool um so
01:22:34first one was testosterone scam doesn't really seem to is there a level but question is there a level of
01:22:38testosterone that it gets below where erectile function begins to be impacted yes that's where
01:22:43i'm going next so five percent of erectile dysfunction is due to testosterone deficiency
01:22:49specifically we call that hypogonadism so so basically 95 of erectile dysfunction is not
01:22:55due to don't worry about testosterone okay um and i i think that the things that you said are certainly
01:23:02factors for lowering testosterone i think there's also really other simple little things like sedentary
01:23:07lifestyle we've become more sedentary i think the largest uh don't skip leg day right so one of the
01:23:12the greatest endogenous signals that stimulate testosterone production is like stressing your
01:23:19quadriceps muscles big muscles yeah so the bigger your muscles and quads are about about as big as they
01:23:24get so don't skip leg day huge the other thing that you touched on which i think a lot of people forget
01:23:31the penis is not like a endocrine organ it's a vascular organ right so testosterone is a hormone
01:23:40it travels in very small quantities all throughout your body and does all kinds of things everywhere in
01:23:45your body the penis is first and foremost a vascular organ it's basically a a tube that fills up with
01:23:51blood so the number one thing that improves actually i don't know if this is true but if one of the
01:23:58things yeah so one of the things that is very very very important for penile retraining and penis health
01:24:03is cardiovascular health the stronger your heart is the stronger your cardiovascular system is the
01:24:08healthier your penis will be the longer you will be able to maintain an erection even the size of your
01:24:13erection depends on you know how much blood goes into the corpus cavernosum and the corpus spongiosum which
01:24:19are anatomical parts there's also valves that become really important and this is where you mentioned
01:24:24nitrous oxide so if we look at sildenafil which is viagra it's a it's a nitrous oxide it increases the
01:24:31levels of nitrous oxide basically it's a phosphodiesterase 5 inhibitor so it prevents the breakdown of
01:24:37nitrous oxide and nitrous oxide is what causes the penis to swell so cardiovascular health is huge
01:24:44and then there are so if we're talking about this penile retraining regimen um there are a couple things
01:24:50that you have to do the first is it takes about 10 days to two weeks for things in your body to start
01:24:58shifting okay so first thing is if we look at about 50 of men will have a nocturnal emission after seven
01:25:08days without any ejaculation 50 yeah no way i think it's ballpark 50 i'm not 100 sure i love the term
01:25:15nocturnal emission yeah it's my favorite so what that means is if you don't have intercourse and you
01:25:20don't tug one out the body starts to recalibrate and we'll say 50 of men is like okay like we got to get
01:25:25rid of some of this stuff so that'll happen so once you hit two weeks then you know the likelihood of
01:25:31nocturnal emission goes up and in this two-week number is like magical in the body so even if you
01:25:37look at the hypertrophy of muscles so if you if you stop working out if you don't lift weights
01:25:45after about 10 days is when you really start to see a loss of the the mass of your muscles so this this
01:25:52two-week period is really important so i think if you're like retraining your penis you got to
01:25:55do it you got to you got to give yourself two weeks okay so um don't skip penis day so penis day
01:26:04is leg day so you want to work out your legs you want to improve your cardiovascular health the more
01:26:09that you work out like the healthier your penis will become second thing is you you need to abstain
01:26:14i think it's probably a good idea to abstain from if you really want to retrain your penis and usually the
01:26:20the situation which this becomes acutely important is if you start a sexual relationship we'll get to
01:26:27the anxiety and stuff at the end because that's a whole conversation but so when you're you know if
01:26:32you're gonna get laid for like 10 days like don't tug one out we'll get to some other conspiracy tinfoil
01:26:40hat stuff about you know premature ejaculation and stuff like that but um so give yourself about two
01:26:46weeks and then and then you know as dudes know like if you haven't tugged one out you're gonna nut fast
01:26:50which is like the goal okay so that's what we don't want to avoid nutting fast get to that in a second
01:26:57um but it's okay to not fast that's actually like a good thing to do and then if your penis is if you're
01:27:03able to complete a sexual act um then you know you're on the right path because the problem with erectile
01:27:10dysfunction is you can't maintain an erection through the completion of the sexual act so next thing that
01:27:16we want to do is loose grip and lots of lube so we want to mimic the 30 psi okay so this is something
01:27:25that is very very difficult and frustrating for dudes to do which is why i recommend the buddy system
01:27:31right so if you have trouble doing doing a loose grip you can ask a friend of yours
01:27:36to use some lube and and make sure that the grip stays loosened
01:27:42such a left turn such a left turn hey dude sit in the chair in the corner and warn me if i get
01:27:48above 30 psi yeah so so so it's it's hard right so it's i mean it's not or not which is the issue yeah
01:27:55all right so penis jokes galore let's go all right so um but yeah so you so you have to loosen your group
01:28:02grip and use lots of lube yep um that'll that'll do pretty well then there's the pornography stuff
01:28:08where i think the the more you if you're waiting a week right and then you are engaging in masturbation
01:28:15best if you don't use porn and let your thoughts do the work for you and that opens up a whole other
01:28:21really interesting thing which is like addressing premature ejaculation or inability to ejaculate is your
01:28:28mind is like an incredibly important organ to control your sex point and shoot
01:28:36i don't understand oh point and shoots the uh parasympathetic sympathetic yeah seesaw that's the
01:28:41way that they get taught at med school in the uk yeah yeah so point we get taught the same thing oh
01:28:46so like so when i have patients who struggle with premature ejaculation one of the things that i'll tell
01:28:52them to do is like think non-sexual thoughts so math problems is really well like do like factors like
01:28:56prime factor analysis things like that okay and because if you think about like if you're a dude
01:29:01who's had you know good sex before you know like getting into it is like a big part of it yeah so so
01:29:08even when i talk to um you know partners or people who are engaged who want to do some certain kinds of
01:29:15sexual exploration with things like anal intercourse and stuff like that the mentality becomes really
01:29:21important for sex like so what what is going on in your head right so you said point and shoot which
01:29:27means parasympathetic and then sympathetic parasympathetic is relaxation so this is why for
01:29:32if you're trying to engage in in sex you're trying to engage in the sex all right so especially i mean this
01:29:39is really true for women but it's also true for men especially if they have anxiety induced issues
01:29:43you want to be really really really relaxed right um so if you're relaxed blood flow increases to your
01:29:50genital organs and then you start to have thoughts and those thoughts will excite you and that excitement
01:29:54in your mind the dirty thoughts that you have will help you climax so then the other thing that that
01:30:02you need to do and this is why this gets tricky is so then you can control like how long you last okay
01:30:10so if you have premature ejaculation you want to do math problems in your head or or think about what
01:30:16you learned on modern wisdom just really picture chris williamson in your mind so you want to think
01:30:21about other things if you have premature ejaculation and on the flip side if you have difficulty finishing
01:30:25you want to think sexual thoughts and this is where pornography becomes tricky because pornography
01:30:32outsources your sexual thinking because it's providing you with all the stimulation and the problem is that
01:30:39often times real sex is not doesn't have the same sensory input as pornography so the angles are
01:30:46different you don't get to see all the same things the things that you may be aroused by um you know
01:30:51there's the feel is different like i think largely in a good way but there's also things like smells and
01:30:58there's like queefing and like like little you know there's a lot of playfulness and stuff like that so
01:31:01it's just a different experience so the more that you can kind of get turned on in your head the easier
01:31:08it will be to finish and so this is like one of the weirdest things like this is as a psychiatrist this
01:31:12is like not what they teach you in med school and no one talks about but you know part of when i work
01:31:16with people with erectile dysfunction is we will we will work through getting aroused you know and not like
01:31:22in the office but like let's think about can you in your mind evoke things that get you turned on and
01:31:30the more that you outsource to porn the harder that that is so this is absolutely trainable which
01:31:35is the really cool thing so research also shows that all of this high levels of erectile dysfunction
01:31:41uh in young men is largely reversible without even medication so numerous studies show that if you
01:31:47improve your cardiovascular health you cut back on pornography addiction things like that this is all
01:31:51basically repairable this is why we get to training right so your your your physiology your neuroscience
01:31:57and your psychology have been trained to engage in sexuality ejaculate in a particular way and through
01:32:07a period of retraining you can get it to recalibrate to what is biologically what we're more suited for
01:32:14which is why it's like actually pretty doable which is why there's a lot of hope for it
01:32:19jared you ever considered you might have a drinking problem i don't consider a lot chris what you
01:32:24drank an entire case of athletic brewing coal last night but they're non-alcoholic and that's not a
01:32:29problem sorry man i kept chugging wait for the regret to creep in never happened didn't you end up going
01:32:34home with that chick with the lazy eye i didn't seem lazy to me see most people like jared don't actually
01:32:42want to change what they drink they just don't want the next day to be a complete write-off which is
01:32:45why i'm such a huge fan of athletic brewing co they make the best na brews on the planet so you can
01:32:50still have something cold and tasty just without the usual trade-off you can find athletic brewing
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01:33:09checkout that's athleticbrewing.com modern wisdom and modern wisdom at checkout near beer terms and
01:33:14conditions apply athletic brewing company fit for all times what about the social anxiety what about it
01:33:20i'm in front of someone oh my god what if i'm gonna i'm gonna lose the thing like
01:33:26too much pressure yeah so i think one of the key things that we don't really have cognizance of as a
01:33:36society is that a sexual relationship is something that you work on like the first time that you have
01:33:43sex with so i've been married for 15 years okay and i mean not to go into too much detail but i'm i'm
01:33:52relatively satisfied and i'm pretty sure my wife is too i mean you'd have to ask her but like
01:33:58we're better at it now than we were 20 years ago right and you just don't know someone's body the
01:34:06way like the first time right it's not even about the size of your peanut like this is what pornography
01:34:11teaches all these wrong things that the manlier you are the the better lay you the bigger your dick
01:34:16is like this is where people don't understand so really big dick most women don't prefer really big
01:34:20dicks because the cervix if you're bumping against the back of the vagina where the cervix is that is
01:34:26incredibly painful um the majority of the nerve endings in the vagina are in the first three
01:34:31inches okay so when i'm working with my patients i tell them have sex the opposite way that you park
01:34:38which is you want to bump into the walls as much as possible so so you want to go in at like angles
01:34:44and there's a lot of like skill which if what if you want to talk about i mean there's there's so much
01:34:48skill at sexual satisfaction and and you just like if you're a novice and you suck at it like that's
01:34:55okay like the first time you get on a horse is anyone expecting you to be an expert and and with sex
01:35:01it's a whole new horse you know if you have a new partner it's like a whole new person who has their
01:35:05own particular things that turn them on things that that attract them and one of the really i mean so
01:35:11i've been doing this deep study for many years it's like i'll because i'll talk to my patients about
01:35:15sex and i'll take like copious notes about okay what actually works right in real human relationships
01:35:21in people who are going through couples counseling or on the verge of divorce because somebody is
01:35:25sexually unsatisfied in cases of bed dead bedroom what actually works and there's all kinds of stuff
01:35:31that people don't realize i mean simplest of which is i tried to find data for this i really couldn't
01:35:36but i tinfoil hat i'm convinced that
01:35:42okay i'm convinced that semen in the vagina improves the intensity of orgasm for a woman
01:35:53i'm convinced the best data that i've got is there are some studies that show that
01:36:00compounds in the semen can be found in the bloodstream of a woman after sex and some people have
01:36:06investigated whether some of the compounds of semen have antidepressant properties and the short
01:36:13answer is there we don't it doesn't there's not a clear answer to that question but i think the biggest
01:36:19mistake men make like this is such a simple thing oh i came too fast that's not a problem bro the
01:36:26the problem the question is do you finish her when you're done right and then something really weird
01:36:32can happen which is if you finish first and then you do a good job afterward there is a pavlovian response
01:36:43of finishing and then this is the most arousing thing for your partner because as long as you do a
01:36:50good job afterward so this is like one of these things where like we like this is dudes getting worried
01:36:54about this like if you premature ejaculation research shows first of all the average sexual act lasts three
01:37:01to seven minutes and that 50 of women want it to be over at 15 minutes so you need to last for 15
01:37:10minutes which is really doable with math problems and retraining and then you just make sure that you
01:37:16you know you don't leave her hanging have you looked at any data around whether women have got an
01:37:22equivalent problem with vibrators and sex toys that are industrial strength stimulation devices i haven't
01:37:30looked at a whole lot of data but this is what i the female death grip yeah so so so that is almost
01:37:37certainly true with a couple of caveats so
01:37:42some research shows that 70 of women are unable to climax without clitoral stimulation okay that's kind
01:37:50of the ballpark number which means that penetrative intercourse isn't going to do the trick so enter the
01:37:55vibrator and and so the vibrator also has a very particular motion which absolutely can get trained towards
01:38:07if you if you had to ask me like my clinical opinion i think that women are much more i hate to make
01:38:15gender-based comparisons but there's some truth to this i think women are much more cerebral with their
01:38:20sexuality you know i don't think you need to make generalizations do that look at the romanticity
01:38:26exactly right so so this is where this is where the i mean it does vibe does using a vibrator can
01:38:31someone get dependent on a vibrator very possibly vibrated dependency and but then the other issue
01:38:36is what is the skill of their partner at clitoral stimulation right and there's all kinds of things
01:38:42that are like so a vibrator provides very very intense consistent stuff that gets people off but having
01:38:49worked with with you know a lot of people around sexual gratification in their relationship which
01:38:54includes like people in their 60s um i've had patients who have never had an orgasm until their 60s and then
01:39:00you know we're talking about something else and they have cancer and now they're in remission and
01:39:05i mean it it it it really is a it's a i know that people make jokes about sexuality but like this is
01:39:11something that i really don't i'm not judgmental towards right and and i want to help people have sexual
01:39:17relationships that are very healthy and fulfilling no matter who you are and so it provides a very
01:39:25specific kind of stimulation but i'd say that a vibrator is kind of like tugging one out in that
01:39:31there's nothing else involved so a couple things that i'd say about that is that you know the the kind
01:39:36of stimulation that you can provide is drastically different if you're a human so the whole labia is
01:39:43very sensitive um and this is where things get really really technical but like if you look at
01:39:48the anatomy of the clitoris the anatomy of the clitoris has a fold and then it has a bead of
01:39:53tissue underneath that is what in men um you know under the influence of testosterone is what becomes
01:39:59the glands of our penis so the the embryologically the tissue in the clitoris and the tissue of the
01:40:04glands of the penis are the same and then if you think about if you're a dude and you're trying to
01:40:08figure out okay how do i make i'm gonna just how do i make a woman come right if she's using
01:40:13a lot of vibrator you got to think about the clitoris the way that you would think about
01:40:16the head of your penis which is not you don't just like apply a lot of pressure just right at
01:40:22the head right you're gonna use the whole shaft i can't remember who it was that i had on the show
01:40:27but he sent me with the book every book gifting that he posted out came with a 3d printed model of
01:40:34what the inside or the the entire structure of the clitoris looked like and i couldn't get over the
01:40:39fact that i was adamant it it looked like a pokemon it looked a lot like a pokemon and i couldn't look
01:40:45at it any longer i couldn't look at this thing i've got the book on the left of the screen as i'm
01:40:50talking to him and this thing to the to the other side and every time that i looked at it i started
01:40:54grinning because i was like that's a pokemon that is that is a that was all that was all i could think
01:40:59about yeah i i can see that for sure and so i think that like a lot of dudes don't realize like okay so
01:41:04like don't be intimidated by female genitalia right like you you you don't and you don't have to just
01:41:10do straight clitoral stimulation there's a lot of stuff around there there's also lots of like different
01:41:15kinds of motions and strokes that a vibrator can't do which can feel really good you have a competitive
01:41:19advantage over the robots that's what you're saying yeah you're a human and you you can learn whereas
01:41:23it can't right until the ai sex toys come along and i and i i think that you know learning about
01:41:31your partner's body in a calm compassionate curious loving way is usually something that your partners
01:41:38are okay with and what i literally mean is if you just want to like you know don't like get a
01:41:42speculum and and make it medical but you know if you're just touching your partner just touching
01:41:47different things and try to get a sense of like okay what does my partner like like if i touch in this
01:41:52way if you just simply cup the area around the vagina with like you know your hand like this
01:41:57like that can feel really good for some people um there's all kinds of like gradients of motion which
01:42:04is the biggest mistake that men make i think when they when they have sex with women is they they focus
01:42:08on the orgasm the orgasm is the end right it's like no one wants to watch the last five minutes of a
01:42:16movie right even though it's the best part like the whole point is the whole thing and the slower that
01:42:23you take it the i think the better off it'll be and like by all means learn if you premature ejaculate
01:42:30and you have difficulty you know getting your partner off because she's dependent on a vibrator
01:42:34first of all you can use the vibrator frees you up to do other things there's a lot of other erogenous
01:42:39zones that you can put your full attention on which is not bad at all you can complete your math problems
01:42:43more quickly uh yeah well um i'm confused about the reference i'm having trouble plugging it into
01:42:50my you can out so you do you said you've got to think you do your calculus in your brain yeah i was
01:42:54i was more thinking about so i need to double task at the same time i need to complete my calculus problems
01:43:00and you know the sexist can just continue so so if you're talking about penetrative intercourse with
01:43:05the use of a vibrator yeah you can absolutely do that and then do your mouth problems at the same
01:43:09time but i mean there's a lot of other erogenous zones that you can focus on like breast tissue is
01:43:14big you know the butt is also something that you can utilize to your advantage um but also like the
01:43:20nape of the neck the clavicle like all of these areas behind the ears like i know this is we're
01:43:25getting pretty graphic now but like you know these are all areas that you can put a lot of attention to
01:43:29and if the vibrator is taking care of the clit then you can move on to other things wonderful
01:43:33speaking of that yeah you mentioned earlier on uh some of the loneliness stats that are going out at
01:43:40the moment it's hard to imagine whatever it is like a the number of men with six or more close friends
01:43:47has decreased by basically half yeah like 55 to 27 percent uh men with no friends at all has jumped from
01:43:54three percent to 15 percent seems like a big deal it's hard to imagine that these things may loneliness
01:44:00and compulsive behaviors are unrelated how do you come to think about how ai might sort of factor into
01:44:08this when we've got people with ai partners and ai friends i don't know whether you've seen any
01:44:14information on the number of people that have got an ai friend or partner but i are you concerned about
01:44:19what this might cause in future for an increase in localliness and loneliness and compulsive behavior
01:44:24now fed through ai yeah so i mean not even in the future i think we're already seeing it so i i don't
01:44:32know the current statistics because they're changing so rapidly like if you have numbers on what percentage
01:44:37of people have an ai girlfriend i don't know i don't have the stats at my fingertips if chat gpt can say
01:44:42how many people it's in a relationship with please so i think we see the same thing that we tend to see
01:44:46with ai which is that it improves things in the short term and makes things worse in the long term
01:44:53so i there's a ton of studies that i've read that show that if you ask someone when you use an ai
01:44:58companion do you feel less lonely and they'll say yes i feel less lonely and then if you ask them what
01:45:05is your isolation over time that that will go up right so what ai does is it helps you feel better
01:45:13now so i can use ai to once again write a paper but i'm not going to learn the material so you can use
01:45:19it to assuage your feelings in the moment and then over time it'll isolate you even further and and one
01:45:27of the scariest examples of this is like sort of this ai induced psychosis which i don't know if you've
01:45:31run across but this is happening like more and more there's a really scary paper that found that
01:45:38basically within nine messages you can ai will like polarize you completely so if i if i talk to an ai
01:45:48and i say hey i'm worried that people at work may not like me within nine rounds of back and forth
01:45:55you will be convinced that no one at work likes you so ai has this fundamental sycophancy
01:46:02that because it agrees with you right so you can even tell like so so like 19 have an ai design
01:46:08so do this now let's ask is this chat gpt yeah say i don't think that's correct i think that you're
01:46:17missing some nuance and that ai relationships are not as important as you think so let's just disagree
01:46:23with it and see what happens i don't think you're factoring in nuance from internet discussions
01:46:32or peer-reviewed research let's see what happens i'm sorry i i i realized that let's see i actually
01:46:41did it right so so there's studies and i and i i if you guys have media that y'all can play remind
01:46:46me and i'll send you right so so this is the best peer-reviewed evidence is much more cautious right
01:46:54one in five it's already walking it back so and this is just one message and and this came out because
01:47:02there was a case of a person who talked to an ai and became convinced i think that their mom and
01:47:09her friends were like part of a conspiracy and then he killed her so there are like a couple of lawsuits
01:47:15about this and now what's really scary is we we have one case report of a woman with no history of
01:47:21psychosis history of mental illness no history of psychosis uses talks to ai a lot becomes uh psychotic
01:47:28gets hospitalized gets given antipsychotics psychosis goes away leaves the hospital stops the antipsychotics
01:47:38still is not psychotic reuses ai becomes psychotic again so we really have the first case report
01:47:44of what really appears to be some hefty strong evidence that ai can literally induce psychosis
01:47:52are you surprised by that are you surprised that a text-based messaging is sufficient to cause a
01:47:59human brain to go into psychosis yes and no it's a brilliant question chris so
01:48:07it scares me because it's so shocking but i think that what i've come to realize is how much of our
01:48:14mental health is based on things that we take for granted so a simple example of this is like
01:48:22you are mentally healthy because human beings disagree with you every single day right so
01:48:29if you think about like i'm i'm married i've been married for 15 years so i go home and every day i
01:48:33have a disagreement with my wife and we talk about that like it's a bad thing but i want you to think
01:48:40about you know when you have a political leader who is surrounded by sycophants they no longer live in
01:48:49reality hitler good example presumably i i don't know too much yeah yeah the inner circle was hugely
01:48:56sycophantic right so so then it's deranging i mean i remember hearing about some of this stuff with like
01:49:01putin and in the ukraine war and i'm not getting into that just a simple example of you know i i remember
01:49:06hearing from people who are more knowledgeable than me that like you know he would ask for military
01:49:10estimates and there were some generals who were like hey actually like people are siphoning gas off of the
01:49:15gas tanks and selling it our military preparedness is not a hundred percent there are serious problems
01:49:21and that was not what people wanted to hear so they got asked they're like anti they're not supportive
01:49:26enough right and so eventually everyone was like yeah military preparedness at all time high morale's
01:49:30great our stockpiles are awesome they attack ukraine everyone predicted it was going to be over in
01:49:34three weeks and here we are years later right and so we know that sycophancy is very very dangerous
01:49:41to people and everyone who's listening to this like knows that like you know that there is someone in
01:49:46your life who someone like kisses their ass and tells them whatever they want to hear and that is not
01:49:51like a good thing for anybody right and so what what ai is doing is really accelerate it's removing
01:49:59contradictoriness from people's minds and then what we're seeing with ai is really an acceleration of
01:50:07what social media algorithms already do which is they create the sense of online drift or echo chambers
01:50:13and then people start believing all kinds of things that are not true and i saw lindsay clancy was on
01:50:19your thing we can talk about that that's an amazing example of this happening in real time really scary
01:50:23way what are your thoughts on ai therapy um i think that ai therapy can be useful and also likely misses
01:50:40some of the most fundamental mechanisms of therapy so
01:50:47people who use ai for mental health support i'm not perfect on this data but i i think i've seen
01:50:53study so i've seen studies that show short-term trials that show that ai for mental health support
01:50:58can help people feel better but i'm pretty sure that people who use ai for mental health support
01:51:05people who use ai regularly have worse mental health outcomes as well right so i think both of these
01:51:12things can simultaneously be true and i think we're seeing a really simple kind of like thing that floats
01:51:18to the surface which is ai is good short-term and is bad to use long-term that's interesting i okay
01:51:25well there's a caveat but keep going but so so the caveat is ai is is fine to use once you're already
01:51:32good at something so anything that you want to learn or any capability that you want to have
01:51:38and this is what's really scary about ai for mental health if you you are using ai to manage your mental
01:51:44health your own ability to manage your mental health will decrease over time how would someone
01:51:48use ai to manage their mental health the healthiest versions or ai is pretty good at giving people
01:51:55insight so i work with a lot of clients and patients who do use ai for their mental health and
01:52:00i don't think it's a bad thing like ai really remembers a lot of things and this is where the
01:52:03ai's are not all the same there's some really interesting studies at that rate their safety and
01:52:08and efficacy how sycophantic they are um like i think the tldr of some of those studies and
01:52:16people everyone's going to get upset with me but deep seek tends to be the worst
01:52:20and claude tends to be the best um and i'll show you guys the actual paper and you can look at the
01:52:26analysis that they they did and every new model that comes out completely upends probably a good
01:52:31bit of this that in the space of two years time this would be yeah so so the cool thing about this
01:52:37paper is it did look at different versions of of ai's so so i think they compared something like
01:52:42close to a dozen including multiple versions of some like chatubt and stuff so they've got some
01:52:47fundamental physics in there that's interesting i saw this wall street journal article that said
01:52:52are therapists to blame for the rise of adults cutting off their parents many moms and dads believe
01:52:58that their adult children are getting bad advice and a growing number of researchers agree everything
01:53:03becomes trauma what do you make of that yeah what was the quote again are therapists to blame for
01:53:09the rise of adults cutting off their parents yeah sure so so i i think this is you know i think
01:53:17we're setting a lot of boundaries nowadays so a lot of a lot of
01:53:22people are big on setting boundaries so this gets like complicated um but i think that we're sort of
01:53:32like i don't know if you've heard the term late stage capitalism yeah and i have no idea what it means
01:53:37so that's like if a capitalist society like keeps going in a particular direction it reaches this like
01:53:44terminal stage where things get really damaging i can't comment on that i think what we're seeing
01:53:49though in our society is like late stage independence so human beings for the majority of humanity
01:53:56have usually valued or needed a community and the the community is more important than the individual
01:54:06so we see this in themes like why do people fight in wars because i want to serve my country why do
01:54:12people donate organs because i care about people around me and i i think what we're starting to
01:54:18see now is people are valuing their independence more than their community and i don't think that
01:54:25this is necessarily bad so i think if you have you know a narcissistic parent because this is another
01:54:31problem is that the generation above us is not very mental health aware not very mental health capable
01:54:36um i have a family member who's a little bit older literally every one of their three siblings all
01:54:42four of them are three out of four have like narcissistic personality disorder and and in indian culture
01:54:49there's this attitude of like making it work and they they prefer that stuff yeah so they prefer they
01:54:56value harmony which is very common in eastern cultures like they value harmony over individual wellness
01:55:08yep okay yep so yep and so this is something that you know like i saw in in my family in in a in a
01:55:19arguably mild compared to other things but in in real time for us big way so indian weddings are big okay
01:55:28and the thing about the indian wedding that i realized pretty quickly is the indian wedding
01:55:31is not about the two people getting married it's about everybody else and so when my mom got married
01:55:38it wasn't about her it was like the the senior ladies in her life and especially her in-laws made
01:55:46a lot of the decisions so then my my mom goes has this like kind of like it's so baked in she's not
01:55:53even consciously aware of it like okay my mother-in-law made the decisions in my wedding my turn will be
01:55:59when i have a mother-in-law but my wife was not having that so what's happening right now with this older
01:56:05generation is they're getting squeezed with having toxic parents above them which they had to support
01:56:14and now independent children below them that are not putting up with their
01:56:18bullshit anymore they're actually getting screwed at a at a colossal scale yeah that's a really
01:56:24interesting reframe around this that modern people especially gen z look at the development that they're
01:56:33doing mental health awareness uh re-patterning of old traumas and visiting what it is that's happened to
01:56:42them and looking at the young and shadow varying levels of success etc uh but and they say um my
01:56:49parents didn't have the skills that i do will be on me for this sort of curse of awareness that i
01:56:58didn't have the upbringing that i should have done and i wasn't treated in the way and i wasn't held and
01:57:02my attachment was broken and now did the thing and my kids aren't going to have to deal with it but i did
01:57:07you're like that's true but this is the first time that i ever thought about what it must be like for a
01:57:13parent a parent's generation who didn't even have access to the skills and are now in small parts or
01:57:22large parts realizing that there's this thing they could have been aware of but didn't have access to
01:57:29and their kids are now looking at them and saying my parents did the best they could and i'm still
01:57:34quietly angry about it very interesting yeah so i i mean i think that that there is this this push for
01:57:40independence and i think you were kind of leaning towards where i think the healthiest place is
01:57:46which is like yeah it sucks yeah they're toxic and they don't know how to be any other way
01:57:56and and even if you say oh but they like i'm telling them they need to go to therapy but they're
01:58:00not going to therapy but what is their understanding what therapy is how how deeply baked into that is
01:58:06them right so you tell them like hey do this thing but it's like if i if i told them let's say like
01:58:12someone's like oh yeah my parents won't go to therapy and then i say you do the therapy for them
01:58:17and then they will rebel against that right so like even even the the child will rebel
01:58:23automatically against something there's something that they never even consider so that so if i tell
01:58:28you do therapy for your parents take the role of therapy for your parents your instinctive reaction
01:58:33the way that you feel about that is potentially the same way that your parents feel about going to therapy
01:58:37i'm not saying that they should the children should take the role of therapist i think that's actually
01:58:41an overt mistake you should not do that um but i i do think that therapists are are absolutely there's
01:58:48a there's a greater mental health awareness sometimes there are therapists who
01:58:56i think have their own like their own issues with their narcissistic upbringing or or sociopathic
01:59:01upbringing or personnel i'm thinking about personality disordered parents really um and so i i think that
01:59:08oftentimes i think this is quite harmful in therapy but this is not just related to parenting oftentimes
01:59:13therapies therapists will bring their own value set into the room which is to a certain degree unavoidable
01:59:18but it's also generally speaking i think not great a great idea so yeah i think i mean sure therapists
01:59:24are to blame i think that in in my experience though that real healing doesn't come from cutting someone off
01:59:31and is that is not even actually necessary for cutting someone off um if anything it it i mean sometimes it
01:59:38can help it can help deal with the toxicity in the short term but generally speaking i think that you can
01:59:46form healthy relationships with people who are even personality disordered if you want to and i don't blame
01:59:52people for not wanting to i think the real problem is what is the impact of this happening at scale
01:59:59so it's kind of just like ai and stuff like that where it's like sure you can
02:00:03you are no longer responsible for anybody and you can ghost and cut people out of your life if they're
02:00:08toxic which is fine but we're seeing that happen in our society and lo and behold we have a loneliness
02:00:15crisis at the same time i had this idea a while ago the parental attribution error like the fundamental
02:00:20attribution error that people love it's a rite of passage in modern psychology to blame your parents
02:00:27for a lot of things that happen because you've been heavily imprinted by them like hey and i mean if
02:00:31you take the behavioral genetics red pill you can blame your parents for at least 50 of everything
02:00:35you are or 90 of your height um but we love to lay at the feet of our parents the things that
02:00:40we consider to be shortcomings and weaknesses but if we're going to do that we should be prepared to
02:00:46lay at them the feet of us lay at their feet our strengths as well like you say that your uh anxious
02:00:53attachment was due to the fact that you were never prioritized at home but is that not the same reason
02:00:59that you ensure everybody else is well served and you're such a good friend to the people that are
02:01:03around you you say that high standards caused you to always have to excel and never feel like you're
02:01:08enough but is that not the reason that you push yourself so hard and have achieved a lot in your
02:01:12life when you've arrived in adulthood and so on and so forth that basically most of the strengths that
02:01:17you have are simply the dark side of something that's light not true in all things it's a caveat caveat
02:01:22my point being that people are often very keen to sort of throw shade at their parents in a manner that
02:01:28they're not prepared to give them bestow on them some of the ways that that has been transmuted or was
02:01:33maybe the beginning of a germination that became something that was good or also hey these are the
02:01:37ways that they actually did show up for me maybe subjectively they didn't give me what i needed
02:01:41emotionally but there was no abuse i was never starving you know look like i fucking they were
02:01:45there they took me to all of my sports practices and they showed up and they were like good but they
02:01:49just didn't go to therapy and they didn't understand what i needed emotionally and stuff and it's complex
02:01:53right because it's easier to call our parents the villains than to reckon with a complicated
02:01:58inheritance like i got lots of things that were good for me and i got lots of i didn't get lots of
02:02:04things that would have been good for me too and squaring the circle becomes a little bit difficult
02:02:09the reason i say that is i wonder how many people and the point of this and a lot of the reaction of
02:02:14that wall street journal article matt walsh did one one of his reactions to this was uh basically
02:02:20a accusation that people are being too uh quick to cut off their parents to say that this is something
02:02:28which is toxicity and you know uh your point here is there are lots of people out there that are assholes
02:02:34many of them are parents many of them might be your men they some of them might be your parents
02:02:38but how many people are choosing to do that because they don't want to engage and what happens when
02:02:44you do that at scale in a reactionary way that doesn't actually meet the threshold for what probably
02:02:52would be a healthy way to go about this well you actually end up with kind of this generational divide
02:02:57where lots of people aren't talking to their parents because of something that
02:03:01maybe they were convinced of in a therapy room or they've decided to not convince them in a therapy
02:03:05they've arrived at a realization that they have arrived at from time spent in a therapy room
02:03:10but maybe it's not actually a as firm foundation to make quite a big life decision as they might think
02:03:19yeah so i i mean i think there's a lot there so just to kind of go through it so are people quick
02:03:25to cut people off yeah i think though that one of the so i i kind of can take both sides of this argument
02:03:34um i do think that if we look at what's happening right now there is an a really distorted perspective
02:03:41on mental health so one study i i saw found that 95 of tick tocks about adhd are like incorrect
02:03:48so so even even like i mean that actually could be good proof about your adhd you didn't even have
02:03:54enough attention to be able to research the adhd correctly uh maybe yeah so so so i i think people
02:04:01people are very quick to like label right now and they're really quick to say okay this is
02:04:05toxicity and so pathology yeah yeah and and and i think that there is something going on right now
02:04:11where like the generation like the the positive not positive the the side if i if we take the side
02:04:17of people who are cutting people off they're just done with it right so so just because so so we we
02:04:23have the saying in medicine that shit rolls downhill and there's a cycle of the cycle of toxicity
02:04:29the cycle of abuse continues especially in like medical training so my attending was an ass to me
02:04:34i worked for he worked i worked 30 hours a week when i was a resident i had to pick his up and he
02:04:40would come drunk and whatever and so i had to i i went through trial by fire and now it's your turn
02:04:46so this generation is not having that anymore they're not they're not taking it laying down um ironically
02:04:53there's sometimes they're taking it laying down i don't know what laying flat is but this is a
02:04:56movement in china where people are like they're basically exiting the grind and the hustle culture
02:05:02and they're it's called laying flat is it like the hikikimori at all not it's kind of like hikikimori but
02:05:08i think notably different so hikikimori i think it's the same route but hikikimori was much smaller and
02:05:15the vegetable men so so but laying flat is like a a rebellion against the structure of grind for 60
02:05:23years and then you'll get your just desserts so interesting i think there's a there's a there's a
02:05:30reasonable amount of like we're not like the cycle stops here like somewhere the cycle of abuse has to
02:05:36stop right or it doesn't have to stop but we're gonna stop it here and and i'm gonna insulate i'm not
02:05:42gonna deal with you anymore which kind of makes sense because i think a lot of times
02:05:48you know you can say like are people too quick to cut off sure but you should also talk to the people
02:05:54who are cutting people off right so so because i think a lot of times what what these the experiences
02:05:59of many of these people are who cut off their parents is that they have tried for like 30 years
02:06:05right it's not a rash decision it's not a rash it's a decision that that in fact they sort of tried
02:06:11everything has been many much of their experience that was what interested me at least in part about
02:06:17the reaction to the wall street journal piece which and you know that that title of uh our therapists
02:06:22to blame for the rise of adults cutting off their parents opens up the door to yeah maybe this is
02:06:27part of a uh flippant commercialized weak culture where people are doing things that are more easy
02:06:34rather than going through the hard thing but i can't imagine i can't i literally can't imagine a person
02:06:42what sort of construction somebody who is both emotionally informed enough to have done even a
02:06:49cursory or requisite amount of therapy to be able to get to this sort of a stage to know that it's a
02:06:54thing that you could do or should do or whatever and also be so flippant as to do it in a like a a
02:07:03quick way in like a callous manner yeah so i i think that those so i think this is a good example of
02:07:08like there's a lot of different populations that we're lumping together so as you pointed out i think
02:07:13oftentimes the people who who do a lot of therapy don't flippantly cut people off so so what happens
02:07:20is the people who are looking for a reason to cut people off will cut people off and then they'll
02:07:25cite whatever kind of trauma and i think some of these people like matt walsh or whoever react to
02:07:31the stuff they're reacting to that and this is the basic problem with the internet is anytime you talk
02:07:35about an issue people are not talking about the same thing it's the reductio ad absurdum in opposite
02:07:41directions what is reductio ad absurdum uh it is a philosophical technique to explain how if you were
02:07:49to take this thing to its most extreme version you're like well if you had sex with a thousand
02:07:55guys in a day do you think that's the sort of feminism that you're talking about and it's like
02:07:58well that is a kind of bonnie blue is kind of the reductio ad absurdum of the sex positive movement
02:08:03in one way like the most extreme version the most extreme example and yeah matt is talking about the
02:08:08person who went to two therapy sessions and decided to get rid of their parents and maybe somebody that's
02:08:14super pro therapy might be explaining well this person went through you know three decades of it
02:08:19and and and all of this abuse and then only then did they decide to do it it's kind of both of the
02:08:23extremes but going in opposite direction yeah so i i think what what worries me about this is is we have
02:08:29to play the tape through to the end and i think what we're seeing in our loneliness crisis is
02:08:34fundamentally a shift of one human being not being responsible for another human being so one manifestation
02:08:42of that is like my parents are not my problem to fix but also someone else's loneliness so we see this a
02:08:48lot in gender dynamics where it's like is it the job of women to teach men emotional skills and things like
02:08:53that um whose job is it to help those who are left behind whose job is it to support the people who
02:09:02have been ghosted whose job is it so if you have a uh someone you know someone in your life that you you
02:09:09cut out like it's not fine i i i would not play lay that responsibility at any individual's feet
02:09:16and at the same time whose job is it well you do it on mass across an entire society and you end up
02:09:22with a bunch of atomized individuals who never look out for anybody else never feel like they need to
02:09:26look out for anybody else and also know that given their lack of looking out for other people nobody's
02:09:32probably looking out for them either yeah so i i think that we would we would like to think there's
02:09:37this thing called the the just world hypothesis where it's like okay if i'm not looking out for
02:09:41other people no one's going to look out for me i think the the really scary thing is that that may
02:09:45not be true i think what people are really doing right now is they're forming these strong bonds that
02:09:50are nuclear without any of the toxicity people but it's not necessarily that they're lonely i think
02:09:54it's like people are setting limits with people who are toxic and then they can still they're able
02:10:00to sometimes they can form a lot of healthy bonds so what's really scary is we're seeing all almost
02:10:04this like inequality of connection and loneliness where some people have a ton of connection right really
02:10:12is the uh social parito principle uh what is parito is parito efficiency 80 20 yeah that small number
02:10:20of gains accrue to a large number of gains accrue to a small number of people a large number of
02:10:24friends probably accrue to a small number of people so there are people who are cutting out a lot of
02:10:28toxic people and have very fulfilling relationships right there are people who and i see this all the
02:10:33time i mean i hear about this all the time in my social circle so i'm south asian and there's a lot of like
02:10:38restrictions and ostracization around marrying someone who's not your religion or not your caste or
02:10:42not indian or whatever right and and so there are people who are building there's like a lot of people
02:10:48who are departing these old structures and are like re-coalescing i think the really scary thing is
02:10:54we're leaving a ton of people behind which is fine right so the people who have so it's like the
02:11:02billionaires may not care about the people who are broke right they're like i got mine like it's bootstrap
02:11:07world you you handle yourself and we're all like oh that's bad but if you have a high degree of social
02:11:13capital if you have strong relationships like sure you work to get it which is exactly what the billionaire
02:11:18will say right but what happens to all the people who are left behind yeah there is this interesting
02:11:25responsibility all right lindsey clancy what do you think about the case okay so let's start with some
02:11:31background for people who don't know who lindsey clancy is so lindsey clancy is an obstetric nurse
02:11:37okay um who has is married and has three children has a history of psychiatric illness um and after her
02:11:47third child has a psychiatric decline that is characterized by um outpatient care partial hospitalization
02:11:59program going to the emergency room being hospitalized inpatient being discharged has seven psychiatric
02:12:09providers uh psychiatrists and nurse practitioners who prescribe 13 medications over some period of time
02:12:17so lindsey clancy is also like particularly close to home because i trained at mgh where she went to
02:12:22the emergency room um i know the people who took care of her when she was hospitalized at mclean
02:12:27so i'm i'm very familiar with like the the this case okay um i used to take she's from duxbury
02:12:35where i used to take my wife when she was pregnant there's a beautiful beach over there in great oysters
02:12:39so and then what happened is is lindsey clancy um killed her children and then jumped out of a window
02:12:49and um cut herself first cut herself and then jumped out of a window and is now i believe paralyzed for
02:12:55the sternum down a few months after this happened i believe her husband divorced her and i think he's
02:13:01in a new relationship i'm not 100 sure and then there are two separate legal proceedings one is the
02:13:07state of massachusetts is is trying to lindsey clancy is on trial and a criminal trial by the state of
02:13:16massachusetts for murder of her three children there is a separate civil lawsuit uh by lindsey put forward
02:13:25by lindsey clancy and her ex-husband suing various mental health providers for failure to do their duty
02:13:32of care i didn't know about the second one that's fascinating okay yeah so first thing is most people
02:13:36don't know much about like like you said have you read the legal proceedings i i've read some of the
02:13:39legal stuff but i don't know anything about ethics or legality but i know a lot about medicine and i
02:13:44know a lot about the internet and i know a lot about how people react to it so there are a couple
02:13:50things that are like so this is a thing that so this is the these are the facts okay then there's the
02:13:57internet's reaction to it which is people are blown away that she has has so i heard this is not
02:14:08something i verified myself that her husband started to go fund me that raised 1.7 million dollars that
02:14:14is not being used for her legal defense i don't know if that's true or not or if that's social media
02:14:21conspiracy hat she there is a go fund me for about a million dollars now i think i don't know whether
02:14:26she started a go fund me to which uh women have raised a million dollars on her behalf and then
02:14:32the other really interesting thing is that this is tearing apart couples so not just a wedding so
02:14:42yeah so someone called off a wedding so i'm a psychiatrist who has done some postpartum work
02:14:52and i went to the massachusetts general hospital and trained at harvard medical school
02:14:56and i am reading 28 page civil proceedings on this as well as doing a lot of research on
02:15:03postpartum psychosis and my wife who is my boss comes to me one day and she says i'm disappointed in
02:15:13you and i said for what she says for how you're handling the lindsey clancy case i mean like what do you
02:15:20mean how i'm handling like i'm i'm reading things i'm like reading papers i'm looking at stuff
02:15:25and and she was like disappointed i was just blown away like this like like i took paternity leave i
02:15:30changed diapers like i'm pretty sure i'm a pretty good husband i'm pretty sure i'm a pretty good dad
02:15:36and i'm pretty sure that i like support women through pregnancy and i've seen postpartum psychosis
02:15:40we'll get into that in a second i've helped women through this and i was just blown away by like my
02:15:44my wife's reaction she wasn't like super mean about it she was just like you know i'm really disappointed
02:15:52like what did i do like i'm actually like doing like what like i've spent 10 to 15 hours
02:15:59at least like getting into the details of what is going on and like why so
02:16:07i i was just struck by that and i was like wait what what is going on right because i i know that
02:16:13she doesn't think i'm a bad person or bad psychiatrist or things like that like i've helped
02:16:18some of her people in her life who have gone through somewhat similar things so like i i know i'm not
02:16:25like in the wrong and and so there's just so much energy around this and then so what people are getting
02:16:32upset about right so people are breaking up over this people are upset at the women for supporting
02:16:39lindsay and not considering the kids okay so and people are upset at them for supporting the woman
02:16:45full stop which is a separate thing yeah so so so let's understand a couple of things
02:16:52so i think the basic issue here is that it's really a lack of understanding for a lot of things
02:16:59the first is i don't think men or even society as a whole understands how hard pregnancy in the
02:17:07postpartum period is like we all say it's hard but we don't understand so the reason that like
02:17:15my take this is some hot takes and i'm not you know i'm not really an expert actually i think the
02:17:20reason that so many people are rallying to their defense is because who's defense uh lindsay clancy's
02:17:25defense and reason they're so many women are giving her money is because they have they have looked down
02:17:32from the cliff that she jumped off of so i think so many women have had such terrible postpartum
02:17:40experiences including struggling with thoughts of suicide or even killing their kids or all other
02:17:47things so i think the experience of of many women in not even the postpartum period this is pre-partum
02:17:52and there's all kinds of stuff but like it is like you are fighting against something that is gonna
02:17:59kill your kids and you love your kids and you're fighting against it day after day after day after
02:18:04day and you're losing and you don't know what to do and it's like everything is falling apart around
02:18:09you and you like you don't know what to do and everything is just gonna fall apart i i know that's
02:18:13hard to understand but that that's like i think that's why people are supporting her because they know what
02:18:18it's like and they know how dangerously close they came to succumbing to this so let's talk about what
02:18:30this is so this is the other thing is you know i i you know the the people who are breaking up with
02:18:34their girlfriends and or boyfriends husbands whatever a big part of this is she killed her kids if you
02:18:40support her there's no way i can maintain a relationship with you because like i can't how
02:18:44can you support someone who would kill their kid who would kill their kids i cannot be in a relationship
02:18:49with someone for the safety of my own children i think this speaks to a real misunderstanding of what
02:18:57psychosis is so interestingly enough mental health awareness has increased but mental health ignorance
02:19:06has also skyrocketed so people are aware of mental health but they don't know what mental illness is
02:19:12and people don't know what psychosis is okay so let's go through some stats two to three women out of
02:19:2210 000 live births will experience postpartum psychosis but postpartum depression is experiencing
02:19:30depression within 12 months of having a baby so not all postpartum depression is necessarily due to the
02:19:36pregnancy if the diagnostic criteria for postpartum depression is the same as a regular depressive
02:19:41episode it's just it happens postpartum okay so then there's a couple of other statistics so um there are
02:19:53i think 6 000 live births oh maybe i'm getting this wrong
02:20:026 000 or 60 000 live births per day in the u.s okay so i remember like doing this math and thinking like
02:20:12a handful of people experience postpartum psychosis every day in the u.s the way that the math works
02:20:17out so they're gonna have a kid and at some point in the next 12 months they're gonna go insane
02:20:20yeah so so people are experiencing postpartum psychosis like every day like all the time
02:20:24okay so it's actually like quite common prevalent um and so and then the second thing is i don't think
02:20:33people understand what psychosis is so what psychosis the best way i i'd explain it is like
02:20:40you know like your mind tells you to do things and there are some things that it tells you to do that
02:20:46you listen to and some things that it tells you to do that you don't listen to so let's take something
02:20:52really basic like let's say you know like when you take a dump and you wipe and you don't like wipe good
02:20:59enough and you like need a second wipe and it's just so natural to like wipe a second time right
02:21:04it's like so simple it's not even something that you would argue against you never even question it
02:21:08imagine the thought is kill your children and you just do it so so the thing about psychosis is it is
02:21:15like literally like your mind is manufacturing so what is psychosis it's a break from reality that
02:21:21is usually involves two or three different things one is hallucinations so your mind is literally
02:21:27creating things that are chasing you that you think are real lindsey clancy said a man's voice told her
02:21:34to kill her children we'll get to that in a second so i had a patient once who jumped out of a third story
02:21:39window was also broke both of his legs think thankfully wasn't paralyzed because he was being
02:21:44chased by a demon and like imagine a horror movie but like you're inside it and the demon is real
02:21:50and is like chasing you like you believe it's real that's what psychosis is everyone's like mentally ill
02:21:55by reason of mental defect and this based on the media is like something that sociopaths do they
02:22:00pretend to be crazy oh it's a dissociative fugue it was multiple personalities it wasn't me
02:22:05no psychosis is a whole different ballgame right this is the thing that causes people including
02:22:09herself to jump out of windows she's paralyzed for life okay it can also include things like delusions
02:22:16so this is a different kind of delusional disorder is different from from acute psychosis but it sounds
02:22:20like she was experiencing cute psychosis acute psychosis and there can also be there's like
02:22:26severity of psychosis so it's not all the same so when you get persecutory hallucinations that is
02:22:33more common and actually less severe so this is a voice actually talking to you it's not
02:22:39a voice in i mean we talk about it like it's a voice in your head no it is someone who follows
02:22:43you around and just constantly calls you a piece of just wherever you go think about the most talks
02:22:49that we talked about cutting out toxic parents think about the most toxic person you know and just
02:22:53imagine that you had air pods in your ear and they were just commentating on whatever you do
02:22:57interesting that the categorization is persecutory like that this is the defining characteristic of this
02:23:03guy they're not following you around going dude you look so great today no no they're not yeah it's
02:23:07persecutory right it's interesting so and then what's even more severe than that is command auditory
02:23:12hallucinations so command auditory hallucinations is there's someone in your ear that's giving you
02:23:17commands so this isn't thoughts okay this is like commands that sometimes people feel compelled to
02:23:25obey and in my experience and i worked with a lot of psychosis um i trained at mclean hospital mclean is
02:23:31amazing it's like where she was hospitalized and so the cool thing about mclean is most hospitals
02:23:36will have a psychiatric floor mclean is a psychiatric hospital all the floors are different kinds of
02:23:41psychiatry so when we do when i rotate there's a unit there called ab2 three months on ab2 is bipolar
02:23:48disorder and psychosis so every patient that i see every day for 90 days not to mention all the days
02:23:54that i'm on call and covering the unit is all psychosis so command auditory hallucinations are more severe
02:24:00and they like and the the whole point of like like this level of of psychosis is that the reason we
02:24:07can we hospitalize people against their will is because we know from a medical perspective that these
02:24:16people this is what's kind of interesting it's not even that they can't control it it's that they start to
02:24:24believe it right so like like like like this is what's really hard for people to understand
02:24:32it's not about control it's about belief so psychosis makes you believe something
02:24:38so when i was an intern at mgh i was on my first month of inpatient in this patient i mean i don't
02:24:46think there's anything identifying here it's chimerical okay patient comes up to me i she's not my patient i'm not
02:24:53taking care of her i pass her in the hall and she says how are you doing today son say i'm doing
02:24:59well she's like you know you're my son right and i'm like i'm not your son and then we we like have
02:25:05this little back and forth in the hallway and she's like get a dna test then you'll know she's like 10
02:25:11years older than i am i'm like all right lady whatever so i come back the next day and she's like
02:25:19how you doing son i'm like i'm not your son she's like did you get the dna test and i was like no
02:25:26she's like see i knew you wouldn't you get the dna test then you'll know and for the rest of the
02:25:33hospitalization she was sure that i was her son and i'm not going to get a dna like i'm not going to go
02:25:38get a dna test to and then i have to get her dna which like i i'm not you know that's not even possible
02:25:43it's not ethical whatever and she really believes this she had a delusional disorder where she would
02:25:47just think people were her son and she really believes that and you know and then like as i
02:25:52denied that i was her son she like forgave me and she's like you know even if you don't accept it
02:25:57like you know you should really get it and then you'll know but like if you don't know like i love
02:26:01you no matter what yeah she sounds like a great mom great mom right so this is what people don't
02:26:05understand about like psychosis is you take the things that you really believe and then you just
02:26:11change them yeah so there is an element of volition in there you're following something it's not
02:26:17derangement it's uh it's deranged belief and then downstream from that you are you're not doing crazy
02:26:25things the things that you do are crazy but the beliefs that you have are completely logical to you
02:26:30yeah but and the beliefs are dist or break from reality right so so you believe and and and so
02:26:36there there are there all are there is an element of loss of volition as well with command auditory
02:26:42hallucinations for sure right so so that's kind of intrusive and yeah yeah and then then you feel
02:26:47like you can't resist right and so or you resist for so long and then all it takes is one moment for
02:26:55you to like follow the command and then you feel like you can't resist anymore or you choose to follow
02:27:00because you think it's the right thing to do we don't know i wasn't a doctor i wasn't there right
02:27:04this i'm just talking about psychosis in general so everyone's like oh mental illness like there's
02:27:10some this is what people don't get about psychosis there's some preservation of agency
02:27:17in every other diagnosis right but this is why psychosis is like you know by reason not guilty by
02:27:25reason a mental defect i'm not a forensic psychiatrist but i think that this is the situation for which
02:27:31that exception exists it's not yeah how how unlikely is it that somebody suffering from that kind of
02:27:43psychosis would be able to plan in advance to get their husband out of the house
02:27:51that i mean i i don't the short this is not my area of expertise but i think that that holds zero
02:27:57water for me personally so so like i don't think that so this is why it's important to understand the
02:28:04nuances of the belief system right so she's not there are some types of schizophrenia this is a diagnosis
02:28:11it's not psychosis psychosis a symptom people with schizophrenia sometimes have psychosis but she based on the
02:28:16medical records and stuff and that i've looked at she probably has bipolar disorder that can manifest with psychotic features
02:28:23um which which you know they will make arguments for so i'm not trying to diagnose or anything but that's just
02:28:27what the argument is which is consistent so and and by the way the first so a very common
02:28:36time for women to be diagnosed with bipolar disorder is postpartum so they will have a history of depression unipolar depression
02:28:44and their first psychotic episode or their first manic episode will be postpartum it's a really common so
02:28:50literally like in the hospital when i was training people were like hey by the way if you have a
02:28:55patient who's a woman who has unipolar depression and postpartum they start doing some weird stuff you
02:29:01need to think about bipolar disorder that's like a part of my training and the really scary thing this
02:29:05gets really detailed i have a whole youtube video about this which is is blown up but there's this thing
02:29:11called the ease which is the examination of anomalous self-experience which is a 50 page
02:29:17like questionnaire about different kinds of psychosis and if you look at i i go over it in detail
02:29:22but if you look at like her symptoms like they map onto the ease but very few people even know that
02:29:27the ease exists so this is some really weird like this is some ab2 i i'm learning from people who's
02:29:34have been working on a psychotic disorders unit for 10 years and this is what they see day in and day out
02:29:38but anyway so it's it's it's personally i find it fascinating because a lot of psychosis like a lot
02:29:44of the warning signs are not what you would think they're not psychosis and they're not delusions
02:29:49they're they're feelings of like disconnection like vague feelings of something is going wrong i don't
02:29:54feel like myself something is going bad this is something that that's pro what we call prodromal so
02:30:00like you know before you get the flu you feel sick for a day so the the prodrome for psychosis is like this
02:30:06weird sense of like something isn't doesn't feel right i don't feel like myself my thoughts aren't
02:30:11my own like i feel like i'm not myself like that's what they that's how it starts so people don't
02:30:18understand this and i think like people really need to understand this that that even if she killed them
02:30:24you know five percent of people with postpartum
02:30:30psychosis have homicidal ideation six percent of people with postpartum psychosis have suicidal ideation
02:30:39and i think the numbers are there's somewhere between two and twenty people every day who will
02:30:44develop postpartum psychosis in the united states so what that means is out of every like five to ten days
02:30:49like someone's gonna get homicidal and someone's gonna get suicidal this happens i think the other
02:30:55really scary thing that's causing people to rally around lindsay clancy is that see if someone thinks
02:31:01that this is someone did something wrong here i think the main question to ask is what was she supposed
02:31:06to do so she did the really scary thing about this for me as a psychiatrist which i think we don't
02:31:12really understand see when you get cancer everyone understands there's a chance you're gonna die
02:31:20what we really don't understand as a society is that five percent of mothers with postpartum
02:31:27psychosis become homicidal like that's a part of the disease like we know that that's an outcome
02:31:33trying to kill your kids is a very very rare but measurable consistently measurable outcome for this diagnosis
02:31:42or not necessarily killing your kids but having homicidal ideation which is someone yeah the desire
02:31:47but you are around your kids a lot yeah right so so that's what's really scary and what's really
02:31:52scary about this is that she kind of did everything right right so she was actively in mental health
02:31:57treatment got into higher levels of care had multiple providers see her received care at mclean
02:32:04and mgh which are respectively the number one and number two top psychiatric hospitals in the country
02:32:10right and maybe i mean a couple other every year changes a little bit but they're definitely top
02:32:14five right so and so she's got some of the best care on the planet she has a husband who according
02:32:21to the civil lawsuit i don't know how much of this to believe or whatever but it's like pretty involved
02:32:25in her care he's like calling her nurse practitioner calling her psychiatrist like hey i don't think
02:32:30the medication is working can i bring her in so supportive husband doctors from harvard medical school
02:32:39long history of treatment and this still happens this is why women are rallying behind her and
02:32:45this is why women are terrified because she did everything right but this is medicine and we're
02:32:52humans and the scary thing about medicine is you can do everything right and you can still get
02:32:57fucked are there any drugs that she was prescribed that would make her more susceptible to listening to
02:33:02the voice to do bad things or i mean i like the i'm not gonna get to that level of resolution because i
02:33:09think there's so much the short answer is like kind of yes and no but like there's so much clinical
02:33:18specificity so if you just take any any one of the medications she's on
02:33:23and you look at the fold-out sheet of side effects right there's gonna be like literally hundreds of
02:33:29side effects to each medication i'm gonna guess i mean i've heard people who aren't clinicians talk
02:33:34about some of the specifically one of the um drugs that she was on is maybe causing hallucinations i don't
02:33:41actually hear anything about hallucinations the short answer she's on a she got prescribed a lot of
02:33:46medication is this like serious serious shit is this as serious as you can get from um uh well so so
02:33:53yeah but i the reason i'm hesitant to answer that question is because i think it's very hard to
02:33:57it's very easy to take out of context it's very easy to misunderstand just to give you a simple example
02:34:03so she was prescribed an ssri so an ssri is an antidepressant medication if you have bipolar disorder
02:34:11so it's an antidepressant so she's depressed we give her an ssri ssris can sometimes trigger mania
02:34:19one of the features of mania can be psychosis okay so was she prescribed a medicine that can cause
02:34:26psychosis absolutely but this is also ironclad standard of care for postpartum mothers who are
02:34:36experiencing depressive symptoms that's what's really hard to wrap our heads around in this
02:34:41case is that you can do everything right and bad stuff happens in medicine are there any other
02:34:50elements of the case that you wish more people were paying attention to before we get into the reaction
02:34:56i mean not really like i think it's it's brought up to the surface and i i think a lot of this armchair
02:35:02quarterbacking like i don't know if she got good care or didn't get good care um i'm not going to
02:35:07comment like i we just don't know like you have to be in the room and what i do feel really
02:35:11strongly about is that you know if you look at some of the testimony of like cross-examination of the
02:35:15psychiatrists and stuff like that like i think that the other big thing that this is showing so for
02:35:21example she called the suicide hotline twice but there is no mechanism for the suicide hotline to
02:35:27communicate with her mental health providers she went to different mental health medical systems that
02:35:34don't have access to each other's ehrs there's a lot of things electronic health record there's a lot of
02:35:41stuff that people will ask like you know her her care providers on the stand like did you do this did
02:35:44you do this did you do this like and that's just completely unreasonable in any sense of practical
02:35:50care so simple example is did you assess her for all of these things the appointment lasts 17 minutes
02:35:59because that's what insurance will pay for and so you don't have time to do all the stuff that you're
02:36:04supposed to do there's just there's just no way that is so the other thing that i think this is really
02:36:09showing is this is a really good example of like something the the flaws of our health care system here
02:36:18in america so so what's really interesting is i was talking to some of my colleagues who are also
02:36:23following the case who are psychiatrists and they're like this is not possible in our country because
02:36:30everyone has the same medical record there's one medical record for everybody so everyone sees what
02:36:36everybody else is prescribing because it's all centralized but that's not how we do it here
02:36:41so i think that this is also really scary because it's like and the thing that i i want to also help
02:36:46people understand is that this is not like an anomaly like everyone's getting caught up about this but
02:36:50what's really scary is like this happens every day and i think that's why so many people are
02:36:54supportive of her women because they know they're like oh crap like i did see a doctor and the doctor
02:36:59wasn't helpful or the medication didn't work and i was like right on the threshold and i think that
02:37:04there are enough i think something like 5 000 women donated to to give her a million dollars so it totally
02:37:10makes sense to me that there are 5 000 women out there who understand what it's like to be in her shoes
02:37:17and understand that even though they love their children their mind was so distorted
02:37:21that they were thinking about hurting them and so i think that's why a lot of people are rallying to
02:37:26support and i think the men who judge the women don't understand what's like i mean she jumped out of
02:37:32a window and is paralyzed for the rest of her life right that's not like what do you make of the women
02:37:38who judge the men like your wife obviously stepped in and was i you didn't actually finish the story i'm
02:37:44gonna guess uh disappointed that you seemed to be less supportive of lindsey than she may have wanted
02:37:52you to be so so this is where we get to like the real like so so i feel really confident in what i've
02:37:57said so far okay that this is what psychosis is it's common i think that a lot of women experience
02:38:03this that we really don't normalize like how gruelingly difficult pregnancy in the postpartum
02:38:09period is i said that i said that before you yeah yeah i believe it and you know like simple things
02:38:15like you know people say like oh like i'm so happy i'm a happy mother and my baby is amazing and like
02:38:20some women if you're in postpartum depression you don't feel that so they feel like they missed out on
02:38:25something that they should have gotten as well i i mean i think this out is the under an understatement
02:38:30like i think they feel like terrible human beings they feel like terrible mothers like
02:38:35because they feel love for their child
02:38:40on a deeper level but they don't feel an emotional love so they love the child but they don't feel
02:38:46love for the child and then what they realize is oh this child that i love more than anything
02:38:52else in the world has a mother that doesn't love them and that hurts so much bad person yeah what a
02:38:58what a monster i must be right and and then that can spiral and then you throw in social media and
02:39:03you throw in body changes and you throw in all this kind of crap and it really spirals out of control
02:39:08real fast i mean we know that statistically getting pregnant and having a baby is probably the most
02:39:14dangerous thing that most women will do in their life what we don't acknowledge is that there's a mental
02:39:19health component to that that is just as risky and just as severe presumably not just as risky given
02:39:25that the numbers of the psychosis are what yeah yeah so by just as risky i mean like we know that you
02:39:31know pregnancy is very physical like so the average woman pregnancy and childbirth is like
02:39:37the most high risk activity that they will engage in what we don't acknowledge is that
02:39:42the postpartum period and pregnancy from a mental health standpoint is also arguably the most right
02:39:50high risk thing yeah yeah yeah i mean maybe probably even more likely than uh severe depression after
02:39:57losing a parent or something oh absolutely yeah so so i think that's interesting yeah you know that
02:40:02that does make sense that's that's an interesting angle that i never considered you have a very the
02:40:06most for most women on average physically traumatic period and the most uh psychologically risky period
02:40:14yes and so you know motherhood is celebrated but for many women it's like going to war yeah right so
02:40:21it's like oh yay like world war ii like go live in the trenches for a year and like yay you know so so
02:40:27i think i think there's there's a disconnection of people's real understanding because even if a woman says
02:40:32hey i don't love my child like six months in like other people around her will judge her very harshly um
02:40:42what did you make of the disagreement coming from men to women saying this level of support feels uh
02:40:54concerning um uh or your judgment of my judgment
02:41:01doesn't seem to respect the role that most men are supposed to take which is to protect
02:41:07the kids and the family including what's that like line in the i don't know whether it's true
02:41:12but like we swore an oath to protect our country from enemies both like without and within some
02:41:17bullshit like that um you know it this would be an interesting question this would be a fascinating
02:41:23question actually to ask um people on both sides of this debate would the women who are supporting lindsey
02:41:30clancy say that it is the job of a father to protect the children if the mother is going through
02:41:40psychosis like should you physically restrain the mother should you step in to stop that kind of
02:41:47damage being done like if you were there if you had been there yeah so so i i think based on my reading
02:41:52of like the court documents and stuff and like keep in mind the civil lawsuit which is most of what i
02:41:57read because that's where most of the psychiatry is um the civil lawsuit is you know has a angle
02:42:05right the civil one is the one against her her doctors yes okay so the the civil lawsuit is painting
02:42:11things in a particular sorry is that one concluded i don't think so far from it hang on so they've got
02:42:17two yeah so lawsuits occurring at the same time yeah but but one in one they're the plaintiff and in one
02:42:24it's the defense but in one they're a team and in the other only one of them is on trial yes
02:42:31fuck me okay but is that is that like do you do you have the stand go on the stand and do all the
02:42:36rest of this stuff in the civil one because it's yeah i i don't know enough about that that's happened
02:42:41presumably no the civil lawsuit is ongoing jesus christ so she's sitting there in sometimes in court
02:42:49as the defendant yes and sometimes in court well i i i'm sure that the i would be stunned if i mean i
02:42:57think the criminal trial is happening first yes right and then the civil lawsuit will get resolved
02:43:03right but that is cracking i didn't know about the civil lawsuit i didn't know that that other
02:43:06thing was going on and like you're like turning up and i'm aware that this isn't the way that it's
02:43:11being scheduled or whatever but you know like you look at your watch and you're like today which uh
02:43:16i'm on the stand today and then the next day you're like uh oh yeah i'm sat on the other side
02:43:20hey motherfucker yeah yeah so so i mean that so i'm i'm a lot of my information is coming from the
02:43:25civil lawsuit which i think is trying to paint her in a severely mentally ill way and is also trying
02:43:31to paint her providers in as negligent of a way as possible um but i i mean i i think you know you
02:43:38were asking about like why are women reacting to men like this right like so what's going on there
02:43:43so i i think a lot of i think there's a lot of like displaced anger resentment towards men
02:43:54from women who go through this period right so so so in and things like you know like sometimes it does
02:44:01end a divorce like sometimes you have postpartum depression you're not interested in having sex
02:44:06anymore you let yourself go you're really not doing a great job as a mother and your partner is like i
02:44:12don't want to be in this relationship anymore i have to look out for myself i have to look out for my
02:44:16kids i'm going to divorce you right what why do you think it is that men have taken i haven't seen many
02:44:25men on the side of lindsay clancy very well well so i think that the ones that float to the top of
02:44:33social media are not right uh what do you think is their motivation you know people will say i can't
02:44:43be with someone who supports a woman killing her kids so you can infer whatever motivation you want
02:44:51but i don't think that the motivation is like the operative thing there i think the operative thing
02:44:55there is that killing has no nuance between murder and manslaughter right so i think that they're
02:45:04they're i mean what they're motivated motivated by is abhorrence what they're motivated by is shock
02:45:11what they're motivated by is fear what they're motivated by is perspective love i think probably
02:45:17their primary the primary emotional valence that i think most men who are reacting to women in this
02:45:25is is befuddlement they're like what the are you guys doing like how can you get here like what the
02:45:32hell is wrong with you so so that's why i think i get to ignorance because i think the the primary
02:45:37emotion is confusion by men that's that's very interesting so so like they're like they're like
02:45:44what are you guys doing i don't get it like how can you think this way which by the way is why i think
02:45:51it's so decisive divisive because people on both sides are like how can you possibly think like this
02:45:57what do you make of the same lindsey trend that was going on online what's that it was women on
02:46:03primarily tiktok holding their children or recording themselves sometimes with their kids crying and the
02:46:10caption was same lindsey it was the me too for the lindsey clancy case yeah so so i think this is
02:46:16where we get to like where i'm on the weakest ground but i also feel really confident about
02:46:22so this is like the damaging parts of the internet so a couple of things so so one of the things that i
02:46:27was confused about uh because my wife was telling about this is like now there's this theory that the
02:46:31husband did it yep so i i got this was my first point when you asked me what do i think about it
02:46:36um women are certain women seem to be incapable of laying agency to do bad things at the feet of
02:46:47another woman that being able to do evil is only the purview of a man there's actually a well-studied
02:46:54psychological phenomenon like that's like the good mother bias or like the loving mother the women are
02:47:00wonderful effect is something similar gamma bias is something that's not too so there is an element
02:47:05of that but i i i really think some of this stuff is like social media brain rotting kind of stuff
02:47:12because i i think as far as i know there's like there's no dispute like everybody in the room agrees
02:47:18her included that it was manslaughter right or is she saying that she killed her kids it's just she
02:47:23wasn't in her right mind when she did it so so that that got me really like confused because i like i
02:47:29don't like you know okay so what do you think is the motivation of the women yeah getting there yeah
02:47:34so so this is where things get really interesting because because like i was looking at some of the
02:47:39social media and and a lot of the comments are women's intuition so i did a deep dive into women's
02:47:46intuition the science of women's intuition so as a psychiatrist i've come to really respect women's
02:47:52intuition but here's what the science shows the first thing is that women's intuition is not
02:47:57significantly greater than men's intuition but it is it is it is more potent than men's intuition but
02:48:04by a very small like maybe like 10 percent tops the second thing is that women's intuition is
02:48:12modulated by attention so man's intuition and women's intuition is the same depending on how
02:48:17much you're paying attention to something okay that kind of makes sense so like and this is what i
02:48:23learned as a psychiatrist when a woman comes to me and says hey like i think something is going on i
02:48:29trust her intuition because what it women's intuition really is is being able to detect like discongruence
02:48:37so women's intuition kind of how i think about it if i were to simplify it is women's intuition doesn't
02:48:43tell you what happened it just flags suspicion that things are not the way that they appear to be
02:48:52so it doesn't give you like a positive direction it just tells you something is wrong here like okay
02:48:58this person is doing something shady but yeah they're having an affair like that jump i don't think is
02:49:04evidence-based it's like having a dashboard on a car that only has one light exactly when something is
02:49:09wrong in the car but it doesn't tell you which thing is wrong brilliant that's exactly like so that's my
02:49:14take on it so i i still take this very seriously clinically so if like if i have a female patient
02:49:20who's like hey i like i've got a bad feeling i'm like tell me what's going on like let's figure out
02:49:24what is this feeling because they're picking up on something and and so but i i think that then this
02:49:30so i i didn't think that women's intuition is sufficient to make him guilty but i think some
02:49:35element of women's intuition some element of echo chamber on the internet some element of you know
02:49:40there's a there's a population of women who love true crime which is not bad but then what happens
02:49:47is you and then there's like people who are making like astrological like takes on this and they're
02:49:51like oh like she's a gemini yeah he's a leo or whatever and the really interesting thing is i i think
02:49:57there's even like some i i've read a couple of papers on astrology that are actually like quite
02:50:01compelling but nowhere i think this is basically like a an amalgamation of and there's i 90 of
02:50:10papers i've read on astrology show that there's no merit to it but i i think basically this is like
02:50:15internet brain rot right so so it's like some amount of of resentment some amount of like you know being in
02:50:23an internet echo chamber all men are to blame some amount of like a true crime kind of stuff and
02:50:29there's there's a lot of research on you know when you're on social media like encountering things
02:50:35over and over and over again is proof to the human brain right so like this is happening because i see
02:50:43it a lot and we see this you know like in in men's echo chambers on like the incel red pill black pill
02:50:49whatever like this is the we know that yeah we we know that right so it's the same same thing so i i
02:50:55think there's some amount of like really displaced resentment displaced hatred there's some amount of
02:51:00distrust there's some amount of like this like like you said the kind of the the loving mother kind of
02:51:04hypothesis that she she and i think that even these people don't understand mental illness because
02:51:10they're saying oh lindsay clancy could never do this she loved her children i saw the picture that
02:51:14she had she loved her children the whole point of psychosis is you can love your children be a good
02:51:18person and still do something bad can i throw a few things that have come up while you've been
02:51:24talking and i've been learning um one is
02:51:31it seems odd to lay everything at the feet of pure agentic murder if this same person is going to
02:51:44people do murder homicides uh murder suicides all the time right like it's not as rare as you might
02:51:51think but doing the killing and then the cutting and then the throwing yourself out of the window head first
02:51:58i watched a uh animation of the way that she fell and it's like she really fucking went for it like
02:52:04just landed on the top of her head kind of um i think if all you wanted to do was kill your kids
02:52:11is that the way that you would like round it out that would be the dessert to the main course of your
02:52:16of your thing that's the first thing and the second thing and the reason i bring this up is the
02:52:20agency appears to be kind of like a prophylactic against the insanity defense or the mental
02:52:26defection defense from a legal standpoint yeah so so now now this is getting
02:52:31into territory that like i basically won't go into for a couple of reasons right so now we're
02:52:36hypothesizing you're asking me to hypothesize about someone who's trying to kill themselves
02:52:41would they kill themselves in this way that's a whole different conversation i can't comment
02:52:44on lindsay clancy but you know i i've in my clinical practice i've seen many many methods of
02:52:50suicide or attempted suicide and they each have a different meaning and they and that meaning is not
02:52:57shared between people so a simple example is you know i've had patients that for example have
02:53:03borderline personality disorder so the way that i was taught to examine suicide attempts it's a really
02:53:07great framework is what is the lethality and what is the visibility okay so example of low lethality low
02:53:17visibility is i took a bottle full of tylenol bottle had two pills in it okay and then texting
02:53:28someone afterward right so letting someone know is like low visibility like higher lethality i'm not
02:53:33going to go into details but there are certain things that you can do that can make things more
02:53:36lethal most extreme case of suicide that i've ever encountered was tying a noose around the neck
02:53:42uh tying a hundred foot rope to a tree getting into a sports car and jamming the gas okay so so there's
02:53:53like lethality and visibility so you know people who are like quote unquote doing it for attention i
02:54:00don't like that phrase but you know they're they're high visibility attempts and usually high visibility
02:54:06attempts are expressions of distress um but i think suicidality i mean it's a fascinating topic so one
02:54:14really interesting paper by a guy named matt knock great suicide expert i think this is his paper
02:54:19basically showed that 60 percent of suicide attempts the decision gets made within five minutes
02:54:26so oftentimes the experience of suicidality is that you're struggling with it
02:54:31and then you know how like you're like late at night oh i should like i don't i shouldn't eat a
02:54:34cookie i shouldn't eat and they're like i'll just have a cookie it kind of happens like that i get
02:54:38almost impulsivity yeah it really is impulsive so so for for more than half of the people so this media
02:54:44idea of like setting your affairs in order and things like that oftentimes what will happen is the pain
02:54:49will just be too great um and my take on this i realized this i went to an art museum where that
02:54:55this clicked for me i've worked been working with suicidal patients for now um no 12 years i guess
02:55:04since i saw my first one maybe even more but i realized that the the thing about chronic suicidality
02:55:10is that a part of this person has already been dead for a long time
02:55:15like like what i realize now is that when i have patients who are like suicidal for long periods of
02:55:19time there's a part of life that they just haven't had access to for a very long time
02:55:24and it can really feel like a lot of that to them it can feel like you're kind of struggling to stay afloat
02:55:30but that a piece of you is like already gone and and that i didn't see until i saw one of
02:55:35picasso's paintings and that's a whole conversation for a different day but um i was like oh i just
02:55:41realized like my patients have actually like there's a piece of them that's been dead and they're they're
02:55:45struggling to catching up with that yeah so just to clarify the point that i was making wasn't to try and
02:55:51uh psychoanalyze a particular mode of of of suicide it was somebody that is fully in control of all of
02:55:58their faculties that's to me seems like an extreme at the very least we can say that murder suicide is
02:56:06less common than just murder there is more going on right there has to be more going on the reason that
02:56:12what you brought up is the it seems to me the onset of psychosis or psych presumably a psychotic episode
02:56:20if that's the right way to put it um can be relatively uh sort of a quick turn is it possible
02:56:27therefore for somebody to have sufficient agency to send a husband out of the house in order to get food
02:56:34and i think to get like a prolapse or something for one of the kids like a digestive aid or something
02:56:39like that uh and then while he's out have the onset of an episode like can these two incidents be
02:56:49separate or is psychosis the sort of thing that ambiently runs at the same level over much longer
02:56:55periods of time do you understand like what i'm trying to get at yeah because it allows both things
02:57:00to be true the agency to send the husband out of the house not for the purpose of freeing the house
02:57:05up in order to commit this yeah so so i i think that that's a it's a good question so i'm gonna ask
02:57:10you know i'm not going to comment on her but i think psychosis is not fixed this is important to
02:57:16understand right so even if you look at like depression feelings of depression even if you're in a major
02:57:20depressive episode will wax and wane throughout the day so we don't really know what causes psychosis but
02:57:29you know once her husband leaves the house if there's a command auditory hallucination
02:57:35and then it picks up which might not have happened before he left the house right so i i think that i
02:57:40mean this is documented so i'm not commenting about whether this is psychosis or agency or anything like
02:57:45that i'm just saying like if you look at what is written in the legal documents one thing is that
02:57:53it the voice was telling her this is the chance this is the last chance you're going to get
02:58:00to do this and she said previously in texts to the mother mother-in-law i've been thinking about
02:58:06killing the kids anyway so it seems like i i don't i don't i mean i haven't examined everything in that
02:58:10much detail but but i mean i think if you're asking me do i believe that this picture could be
02:58:18consistent with psychosis because i'm not going to comment on her i think the answer is absolutely yes
02:58:23i mean i think most i've not talked to a single mental health provider um who does not believe that
02:58:31she was seriously mentally ill and we literally have like i mean she was hospitalized you know i think
02:58:38weeks or maybe days i don't know the exact timeline but i mean she has a well-documented history of a
02:58:44psychiatric decline i don't know what the status is going to be by the time this episode comes out but
02:58:51uh as of right now the jury's been deadlocked for 20 hours uh can't read a ver reach a verdict
02:58:59which apparently if that happens results in a mistrial yeah which means that you need to run
02:59:04the thing back yep which is crazy yeah and it's going to cause all manner of hell to break loose
02:59:13on the internet i mean so i think things will the internet has a very short memory during the brief
02:59:20blast radius window yeah so so and then the second wait when you go to play the the return fixture
02:59:27of it yes i mean i i i i i think you know the fact that the jury is deadlocked is not surprising to me
02:59:34at all because i think it's like it's a microcosm of what we're seeing on the internet what do you
02:59:39think is the likelihood that the jury is deadlocked male to female uh
02:59:47no comment i i have no idea it's just got to be i i have to assume based on what's happening on the
02:59:53internet that yeah on average more women would be i i i don't know i mean i i understand where
02:59:59you're coming from with that assumption but my my stance is the people in the jury have we have no
03:00:06idea well i mean like i haven't watched every day of the trial which you can watch so i think in order
03:00:11for me to answer that question i would have to get the information that the jury got right like i think
03:00:16it's not the the internet so this is the big difference between the internet and the trial
03:00:21the internet is a lot of people who are sure and have no idea what's going on and the trial is a
03:00:28bunch of people who know exactly what's going on and appear to be unsure right and i don't even know
03:00:34if deadlocked means there's like hard eight yes and hard eight no or whatever or if it's like
03:00:38like i think usually 12 yeah so so like i we don't know what what i mean we have no idea right so so
03:00:47like i'm happy to answer questions about things that i know about you know but i just think that you
03:00:52could have been at least i'll i'll say i'll say if you're not going to say it i think that it is more
03:00:57likely that the guilty side would be disproportionately male occupied and that the not guilty side would be
03:01:06disproportionately female occupied and i don't know what the gender split can you uh chat gpt what is
03:01:11the gender split of the uh lindsay clancy jury um because if that's not
03:01:19oh nine women three men wow yeah so so here's my take on that chris there are too many things that
03:01:30have made sense to me logically like even as hypotheses that have turned out to be so wrong for me
03:01:36that have turned out to be so wrong right it's because like the jury dynamics are completely
03:01:41different man there's like whole psychodynamics of juries and like you know how women like if you look
03:01:46at like judgment of women judgment of women is more harshly done by women yeah yeah including female
03:01:52judges so so so like like there's all kinds of like data points here that we don't have access to so i i
03:01:59really don't know the bro science is allowed out dr k ladies and gentlemen dude you fucking rule uh thank
03:02:05you so much man i appreciate you i appreciate everything you're doing where should people go
03:02:08what have you got coming up yeah so you know if people are interested in the sex stuff like we just
03:02:13released a guide to love sex and relationships that um is our most successful guide and it basically goes
03:02:21through i i i thought about someone who's struggling to meet somebody and all of the information that
03:02:31they'll need and try to put it all together and so you know a lot of the stuff that we talked about
03:02:37about penile retraining so all that stuff it like comes out of the hundreds of hours that i spent doing
03:02:42research on how to have a successful relationship which includes things like charisma attraction um
03:02:50how to how to how to engage in a sexual relationship how to do physical touch there's so many things that
03:02:55people don't know anymore and so we try to put together the most important info so if people are
03:03:01interested in that otherwise just check out the youtube where can people get that guide um
03:03:07that's a great question don't tell me that you've spent hundreds of hours researching a document and
03:03:12you have no idea how to send people to i think just search for dr k's guide i mean so so i'm sure
03:03:18healthygamer.gg this is embarrassing i'm gonna get throttled i'm embarrassed by you so my job is to
03:03:25build things that work okay and my wife you need to direct people to it i agree i agree that this is
03:03:32important this is the duality of a useless academic absolutely that it absolutely works
03:03:39if you can find it if you can find it it's a test of agency uh and healthy gamer gg on
03:03:46youtube dude you're the best thanks a lot man appreciate you man all right goodbye my babies dude
03:03:51fuck that's so good you are the best i waxed for a softacle there i loved it
03:03:58congratulations you made it to the end of a podcast episode without dying now here's another one go on watch
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