GUEST SERIES | Dr. Paul Conti: How to Improve Your Mental Health | Huberman Lab

Welcome to the Huberman Lab guest series, where I and an expert guest discuss science and science-based tools for everyday life.

I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine.

Today's episode marks the second episode in our four episode series with Dr. Paul Conti about mental health.

The first episode in the series dealt with how to understand and assess your level of mental health.

Today's episode is about how to improve your mental health.

I do want to emphasize that you do not need to have heard or seen the first episode. in order to understand or glean important information from today's episode about how to improve your mental health.

But I do encourage you to go and listen to the first episode at some point if you have not already.

Today's episode deals with several topics important to all of us, as well as protocols to improve one's mental health.

For instance, You will learn how to guide yourself through a process of self-inquiry in which you address certain key questions about your drives, your level of aggressive drive, pleasure drive, and the so-called generative drive.

These are essential things to understand about oneself if you want to guide yourself toward your aspirations and, If you want to understand how your subconscious processing is influencing your thoughts and your behaviors and your feelings in ways that sometimes serve your aspirations and in other ways that can hinder your aspirations.

Dr. Conti shares with us a way of assessing our internal narratives, as well as a way of creating a constructive self-awareness and an understanding of where those narratives and that self-awareness stem from in our childhood so that we can navigate forward with the greatest sense of agency.

We also talk about how to move past common hindrances to improving one's mental health, such as overcoming intrusive thoughts.

And perhaps most importantly, today's episode provides information and protocols that anyone can use to cultivate their generative drive, which is a hallmark of mental health.

Just a reminder that Dr. Paul Conti has generously provided a few diagrams that we include as PDFs in the show note captions.

They are completely zero cost to access and they can help you understand some of the material that was discussed in the first episode of this series, as well as the current episode about how to improve your mental health.

And while those simple PDF diagrams are certainly not necessary in order to understand the material in today's discussion or in the other discussions of this series. many people find them useful.

So I encourage you to check out those links in the show note captions.

Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford.

It is, however, part of my desire and effort to bring zero cost to consumer information about science and science-related tools to the general public.

In keeping with that theme, I'd like to thank the sponsors of today's podcast.

Our first sponsor is BetterHelp. BetterHelp offers professional therapy with a licensed therapist carried out online.

I personally have been doing weekly therapy for more than 30 years.

And while that weekly therapy was initiated not by my own request, it was in fact a requirement for me to remain in high school.

Over time, I really came to appreciate just how valuable doing quality therapy is.

In fact, I look at doing quality therapy much in the same way that I look at going to the gym or doing cardiovascular training, such as running as ways to enhance my physical health.

I see therapy as a vital way to enhance one's mental health.

The beauty of BetterHelp is that they make it very easy to find an excellent therapist.

An excellent therapist can be defined as somebody who is going to be very supportive of you in an objective way, with whom you have excellent rapport with and who can help you arrive at key insights that you wouldn't have otherwise been able to find.

And because BetterHelp therapy is conducted entirely online, it's extremely convenient and easy to incorporate into the rest of your life.

So if you're interested in BetterHelp, go to betterhelp.com slash Huberman to get 10% off your first month.

That's BetterHelp spelled H-E-L-P dot com slash Huberman.

Today's episode is also brought to us by Waking Up.

Waking Up is a meditation app that offers dozens of guided meditation sessions, mindfulness trainings, yoga nidra sessions, and more.

By now there's an abundance of data showing that even short daily meditations can greatly improve our mood, reduce anxiety, improve our ability to focus, and can improve our memory.

And while there are many different forms of meditation, Most people find it difficult to find and stick to a meditation practice in a way that is most beneficial for them.

The Waking Up app makes it extremely easy to learn how to meditate and to carry out your daily meditation practice in a way that's going to be most effective and efficient for you.

It includes a variety of different types of meditations of different duration, as well as things like Yoga Nidra, which placed the brain and body into a sort of pseudo sleep that allows you to emerge feeling incredibly mentally refreshed.

In fact, the science around yoga nidra is really impressive, showing that after a yoga nidra session, Levels of dopamine in certain areas of the brain are enhanced by up to 60%, which places the brain and body into a state of enhanced readiness for mental work and for physical work.

Another thing I really like about the Waking Up app is that it provides a 30-day introduction course.

So for those of you that have not meditated before, or getting back to a meditation practice, that's fantastic.

Or if you're somebody who's already a skilled and regular meditator, Waking Up has more advanced meditations and yoga nidra sessions for you as well.

If you'd like to try the Waking Up app, you can go to wakingup.com slash Huberman and access a free 30-day trial.

Again, that's wakingup.com slash Huberman.

And now for my discussion about mental health with Dr. Paul Conti.

Dr. Conti, welcome back. Thank you. In the first episode of this series, you laid out for us in a very structured way what true mental health looks like, essentially what we should all be aspiring to.

And he touched on these themes of agency and gratitude as verb states, really ways of being in the world that allow everybody to have some sense of wellbeing, to have some sense of themselves in a way that is kind to themselves and to others, and really to feel good and do good in their life.

Without question, this is what people want, right?

You also spelled out for us these two pillars, the structure of self and the function of self. that consists of a number of different things that from which geyser up or kind of give rise to these feelings of empowerment, humility, agency, and gratitude. and reminded us several times that when we are challenged, when we're not doing as well as we would like, that we need to look back to the structure of self and the function of self and ask specific questions in order to arrive or re-arrive at the sense of agency and gratitude.

I think it would be wonderful for us if you could just recap the overall model because it has the components that I just mentioned, but There's some subtlety and some really key aspects of these pillars of structure of self and function of self I think if people keep in mind for today's episode, which is about challenges that people commonly face, and even if you will, phenotypes that we see commonly out there.

For people that haven't heard of phenotypes, phenotypes are the typical appearance of something So there is the phenotype of the anxious person, the phenotype of the person who just can't seem to get out of a rut.

There's the phenotype of the traumatized person.

And these things play out differently in different individuals, men and women, boys and girls.

But we're going to visit many of the most common phenotypes out there. and think about how to do better, be better, feel better through the lens of the model that we spelled out in episode one.

And of course, if people have not seen or heard episode one, today's discussion will still be entirely accessible to them.

So in keeping with that, give us an overview of what this structure of the healthy self looks like as a roadmap for where we're all headed today.

Thank you. Thanks very much. Revisiting the pillars is, I think, the best place to start because there really are routes to understanding.

And if we understand, then we can strategize, we can make change, we can make things better.

So the first pillar, the structure of self starts with the unconscious mind, right?

This incredibly complicated biological supercomputer that's firing a mile a minute right underneath the surface in us and is throwing up to the surface all sorts of thoughts and ideas and states that then the conscious mind apprehends and our awareness comes into play.

And then we have defense mechanisms that sort of rise up from the unconscious mind and they and sort of gird themselves around the conscious mind, which they can do in an unhealthy way or in a healthy way or anything in between.

And then the character structure is sort of the nest around all of that.

And it's from the character structure that we are engaging in the world in the ways that we're engaging.

It's our active engagement with the world around us.

And the idea is that the self grows out of that.

It grows out of that nest sitting on top of the unconscious mind to the conscious mind rising above the defense mechanisms and the character structure.

And if we go back to that when we're trying to understand ourselves, trying to understand states of health as well as states of unhappiness or states that aren't healthy, By going back and looking at the structure we can learn a tremendous amount.

And the other side, the other pillar is the function of self.

And it really starts with the self-awareness, right?

The awareness that, hey, there is an I. I am in the world, 24 hours in the day are going to pass today and I'm going to be doing one thing or another.

So I'm to some very significant extent deciding how am I going to engage in the world around me during that time.

So on top of that, are the defense mechanisms in action.

So defense mechanisms, remember, are unconscious.

So there's a lot then going on inside of us that's determining sort of the field set of options, right? there may be a lot of automaticity that narrows down the set of options of what we may entertain, what we may be aware of what we may decide and that could happen for better or for worse, depending upon the health of the defense mechanisms.

But on top of that lies salience. So the idea then we would next visit, okay, what are we paying attention to? what's coming from inside, what's coming from outside, and we have to not pay attention to many, many, many things in order to pay attention to whatever our attention is alighted on at the moment.

So it's a complex process and it's worth looking at very closely if we want to understand ourselves.

So after thinking about the defense mechanisms in action, the unconscious aspects of how we're engaging with the world, Then next to consider is salience, which is sort of where does the mind arrive at at rest, right?

Where does the mind trend forward? Is it something internal?

Is it something external? What are all the things we're not paying attention to in order to pay attention to something?

And is that thing healthy? Is it not healthy?

Is it serving us well? So there's so much to understand about salience.

And then the next step beyond that is understanding behavior, right?

How are we engaging with the world around us?

What are our behavioral choices? What are our automatic And then sitting on top of all of that are our strivings. a sense of wanting something in the world around us.

What is that? And how are we trying to get to it?

And how does it make us feel? So if we look at the 10 elements, the five under the structure of self and the five under the function of self, then what we're really looking at is sort of like looking at 10 cabinets, right?

And if we're trying to understand ourselves, whether we're trying to just generally understand ourselves or we're trying to get at a problem, then looking at all 10 of those cabinets makes sense.

Some of them will be bare, meaning that they may seem to have very little to do with the problem we're bringing.

And we kind of maintain an open mind. We may be led back to that cabinet and there may be something there but what usually happens is if we look in all 10 places we find a couple where there's there's some rich material to explore.

Sort of the X marks the spot and then we go and we dig there to sort of mix metaphors.

We dig in the cabinet where we're going to find something, right?

And then it leads forward a process of understanding.

And if we're bringing those things into line where we have – a healthy structure of self and a healthy function of self.

And we're aware of all of this and we're working on it.

We're self-aware and we're paying attention to everything built on top of that then what we end up with is a sense of humility because one can not be anything but respectful, compassionate, understanding the complexity of all of this and understanding how does it manifest itself in us and And just the very fact that we can wake our ways in the world is so impressive.

In a way I think it brings to us a respect, a respect for being here, navigating the world, And I think of that respect is born humility, the complexity of us, the fact that millions of...

Things are going on underneath the surface.

Millions of neurotransmission and... endocrinological function, all this is going on under the surface, I'm not even aware of it, and then it kicks up to the surface, generates a tremendous amount of respect for the complexity and also the diligence and perseverance it takes us to navigate through the world.

And I think built upon that understanding is a sense of humility and a sense of empowerment. and the humility and empowerment in action, right?

So express, right, become, agency and gratitude.

And agency and gratitude, as you said at the beginning, we're seeing as verbs, right?

That's like how we're living It's through the lens, so to speak, of agency and gratitude that we're actively living.

And again, I would put forth that when we look at measures of human happiness, across disciplines and across time, this is always what we see is some way of describing how agency and gratitude together as verbs manifest and then create happiness.

It's the state that we're seeking to be in.

Because from that state of active agency and active gratitude, we achieve what it is that I think we're really searching for.

There are infinite words throughout human history to describe what that is.

We might choose to use words like peacefulness, a sense of peace, a sense of contentment, being delighted by things, just being amazed and impressed by things in the world around us.

This is a state that we're... striving for and I think when people talk about happiness and what we're really trying to get to, it's this.

But it's not that these things are passive.

These things are coming from the active agency, the act of gratitude and they're then interacting with a generative drive within us.

We have an aggressive drive, we have a pleasure drive.

This has been thought about now for a long, long time. within mental health and validated in a lot of ways, but what hasn't been validated is that they're the only things, right?

We see human beings striving. We see human beings wanting better for themselves and for the world around them.

We see acts of kindness that seem to be rooted to nothing other than the act of kindness.

We have within us a drive. to know, to understand, to learn, to make better.

And that has been described as many, many things across human history But I think the words we might choose are generative drive, a drive to create and to make better, and it's the generative drive as something active within us. that is then allying with agency and gratitude, the active ways in which we express ourselves.

And then that all together brings us the peace, the contentment, the sense of delight.

Sometimes that may exist in us in a state of rest.

But very often it's existing in us in a state of activity.

And that's why... people find the quote unquote happiness, like what people are seeking, not just in meditation.

Sometimes we can find it there, but people also find it in in action, right?

They find it in doing that thing that they love to do or taking care of someone and learning something.

So when we look at all of this, we can then have a route of understanding what is going on inside of us and how... we can make the changes that let us be in this state, which is really the state that we're seeking.

I really appreciate that you highlight that agency and gratitude are verb states. from which peace, contentment, and delight emerge.

And also the way that you explain the generative drive that is distinct from and pleasure drives that exist in all of us.

You know, I'm smiling because a number of examples of peace contentment and delight while in action come to mind.

I mean, for me personally, podcasting and in particular preparing for a podcast trying to mine the literature and figure out where the gems reside and where the confusion could emerge.

And all of that brings about such peace, contentment and delight for me, but it's anything but passive.

Likewise, yesterday I had the experience of running into a puppy.

It's been a while since I've owned a dog.

Dogs are delightful. Puppies are particularly delightful.

I had the experience of seeing you light up when you ran into the puppy.

And you did. And I'm still buzzing from that short interaction with the puppy downstairs, the Weymariner puppy.

I don't know why, but I just delight in animals of most all kinds, not a fan of reptiles, sorry, reptile fans. so much, but it just drives so much energy from it.

And it felt like life energy and the way the animal is sort intentionally scattered is amusing to me as compared to the dog that he will eventually be, which is going to be more linear in his thinking.

Like it encapsulates so much of the other things I love like brain development, et cetera.

Anyway, I highlight those examples because um there's nothing passive about it it's pure delight and joy for me um and it intersects with other delights and joys.

And I think that as you describe agency and gratitude, peace, contentment, and delight in these, generative forces as well as other forces that exist in us.

I think it's really critical that people understand that These are not states that you sit down and place yourself into, although perhaps one could through reflection or meditation or waking up from a really great night's sleep, things of that sort.

But that these are things that we can find ourselves awash in if we are doing the right things.

And those things can oftentimes be very challenging.

So assuming I understand the way the model is spelled out correctly, I'm more and more delighted at the fact that this is not just accessible in one domain, but is accessible in many, many different domains for everybody, right?

This is not something unique to my experience, even though I give examples from my own life, but that we really all do have access to this if we're looking in those cupboards, those 10 cupboards, and asking the right questions.

And to maybe comment even a little further on the experience of you and the dog, right?

So it was an experience of delight. right and and you enjoyed it and brought a sense of peace and contentment like all of that happens right but think about what that's linked to like I believe there's a strong sense of agency in you that you are enacting.

There's a strong gratitude in you that you're enacting.

You're handling your life in a way And also for all of us, good things always come with good fortune, but it comes with our strivings and our achievements that you're in a place to delight in that.

If you are unhappy, like, I don't like what I'm doing, I'm angry, I'm frustrated, then there's no room in you to find the delight.

And the delight that you find is also very much linked to the generative drive.

It makes me think of how you loved and nurtured Costello.

So you have it in you to love and nurture a dog.

And you have... done that in a really wonderful way.

And that generative drive is part and parcel of the delight you feel When you see a dog, because you love dogs and you think about nurturing and it all comes together.

The... the agency and the gratitude expressed as verbs puts you in a position to have that sense of delight, which is so intertwined with your generative feelings drive with a sense of caretaking, a sense of creating the beyond self.

Because although you enjoyed and loved Casello, you enjoyed and loved his happiness.

So it all comes together and I think it's interesting because in some ways it's a simple example, but that's life.

Life has its big moments, So much of our lives are the smaller moments that link together.

And I think that smaller moment becomes a big example.

I appreciate that you mentioned Costello.

For listeners of this podcast that have tuned into early episodes, Costello was the source of the background snoring.

For those of you that haven't, you can go check.

It was a 90 pound English Bulldog Mastiff who had many skills, the best of which was snoring.

So in addition to the generative drive, which is something that we certainly want to talk more about today, you mentioned these Other drives, aggressive drives and pleasure drives.

And much of what we're talking about today is going to be where people can go wrong or where people struggle.

We are also of course going to go deeply into where people succeed. in particular where people can ask questions of themselves, in particular, what is working? for them and why as a route to understanding how to sift through those cupboards and understand what's not working and why, and come up with real actionable answers and then the ability to move forward.

If you would, could you tell us a little bit more about drives generally?

When I hear drives, I can't help as a neuroscientist but default to, okay, the dopamine circuit or the endogenous opioid circuit or the serotonergic circuit.

How do you conceptualize drives within us?

And then perhaps you could tell us what the nature of aggressive drives and pleasure drives and generative drives So the concept of a drive, the definition of a drive is something that's intrinsic to humans.

So we could look at it as a motivation, right?

I mean, we don't just lie on the ground and do nothing until we passively die, right?

So something is going on inside of us that is driving us to do something other than that.

And historically the thinking in the field arising from early psychodynamic principles, The theory in the field that has really dominated the field either directly or indirectly in so many ways has been that there are two drives. within us, that there's aggression and pleasure.

And again, these are just words, right? So we could apply many, many words, which is why, of course, we want to define means right so aggression even though we're using that word for it because the word for it is commonly used right but it means it means sort of forward active engagement, right?

So a good healthy amount of aggression, using that word for the drive, would be a strong sense of agency.

So too little aggression can be a problem, then the person isn't bringing themselves to bear.

So there's too little in the way of self-determination forward movement, empowerment agency.

And in the same way, too much of this drive becomes actual aggression.

So the idea that I want more and if I can't get it in, In certain ways, I'll just take it, right?

So it starts to become what we more map to the word aggression, which would be something... negative in most cases.

Like a desire or a tendency to harm. Sure, as aggressive drives get higher, which you see why they're in us because let's say we're defending ourselves or you're defending a family member. or an entire family, then it makes sense to have high levels of aggression if your family is threatened.

So those drives are in us at potentially those high levels for a reason, but we certainly access very high levels of aggression without the indication of preservation of life or preservation of safety.

So the thought is that's a drive in us, and that gets us up and off the ground. so to speak, right?

And that the other drive then is pleasure, which again doesn't just mean that we all want to be hedonists, right?

So pleasure could be even the pleasure of relief and safety, right?

Like we're all back in the cave together and we rolled the stone in front of the door.

Ah, we're safe. Throughout human development, pleasure comes in a lot of ways.

It can come through the pleasure of food or other people, friendship, romance, sex.

There are a lot of ways we can It can be relief of things that are unpleasant, relief of pain.

But there's a drive towards this in humans, which again really does make sense. sense and and too little of it again can be problematic because the person then isn't motivated to sort of seek things because they're not anticipating or don't receive gratification and too much of a drive for pleasure can also create problems.

So we can kind of see how these two drives, like, okay, they get us up and off the ground, so to speak.

But the question is, do they explain everything?

And it's a very important question because if they explain everything, then... there's not room for behaviors and choices that are beyond the self.

There's not an explanation for the person who... I'll give you an example of... a person I've taken care of who is a very strong swimmer, knows how to swim, has swam throughout his life, who was in a place, I saw video of it, where there had been a hurricane and the waves were so frightening.

You know, they were just this huge surf.

And there were people who had gotten dragged out.

And you just see him, he runs into the water, right?

He runs in and he goes and he was running really at risk.

He needs to be saved himself, but he saved them.

And I do not believe you can explain that. through these drives.

I don't think you can say, well, he was aggressive, he wanted to go and do something that was imposing himself on the world, or he got pleasure in... thinking, I'm strong enough to go do this.

I mean, I think we're really gyrating, you know, we're contorting ourselves, right, in order to explain it that way.

If we think there's a goodness in that man's heart, like I know there's a goodness in that man's heart, I know him, right?

And that goodness sees him in the moment and You know, he knows that maybe he can save them.

Maybe he can't, he's not sure, but maybe he can.

So next thing you know, he's in the water.

And I think things like the love and nurturing of other people, of children, love and nurturing of animals, of plants.

There are things inside of us that we can't explain with those two drives.

And I think they have led to a very... sort of darker way of just conceiving of humans.

I think it's a reason why now you look at us in the modern day and age, we come at humans through the lens of pathology, right?

I mean, there's a very, very thick book if a person is assessing another person, is thinking about like, okay, what numbers in that book apply, right?

Which is like, that's not the way to go about understanding And I think if we just think there are those two drives, we're not doing justice to humans.

One, I think it's not true. I think it's evident that it's not true.

And then if we're framing it in a way that's not true, we are not appropriately respectful of humans.

And if we come from what I believe to be the truth, that there is a generative drive in us, a drive for the beyond... self a drive to make things better whether it has anything really directly to do with me or not and as with the other drives There can be more or less in people, a combination of nature and nurture.

You know, what... genetically is in us a predisposition based upon the genetic lineage that comes down to us and the recombination and now we're a unique person. with a unique set of drives, but they are impacted by the genetics and then they're impacted by life experience. strongly formative life experience.

So the younger the person, the deeper the impact of events, of nurturing versus abuse. on the array, on the relative weighting of drives within people.

But ultimately we get to... these three drives and how they're functioning in a person being a way of understanding and assessing like how how healthy or not healthy the person is.

And then we look back to those 10 cupboards for the answers.

If we're finding things that we don't like, those drives are out of balance.

Here are the problems they're causing. So very, very concrete issues of problems in people's lives, we can look and see where is that out of balance And if it's out of balance, there's something in those pillars that are not in the right place.

We can then go back and look in all those covers for like, where do we dig to find the answer?

We learn things. We bring things more into balance.

So the pillars are in a healthier place.

And then what... sits on top of it, as you use the word geyser, right?

The geyser that then comes up and floats everything on top of it can do that in a healthy way.

And during episode one, we touched on some of the similarities between understanding the self and building towards a healthy lifestyle. or healthiest version of self, where agency and gratitude are these states that are being expressed.

And one of the themes there was this idea, People perhaps want to be healthy so that they live a long time, but presumably they also want to be healthy so that they can walk up flights of stairs. pick up their kids, move objects, not get injured, perhaps even do sport or...

And of course, some people want to be healthy for aesthetic reasons as well.

And if we were having a discussion about physical health, we could... the major pillars there, which were items within the cupboard.

You know, most people want some ability to have endurance or stamina to walk some distance or maybe even run some distance. as I mentioned before, walk up a flight of stairs, have some strength, some degree of flexibility, certainly some mobility, maybe even dynamic mobility, et cetera. in order to address those or improve upon those, they could look in those covers and say, well, how much running, swimming, long form cardiovascular exercise am I doing per week?

How many steps am I taking per day? How many times a week do I lift objects that are, slightly heavier than is comfortable for me to lift, et cetera.

It's very tangible, very concrete. Here you're making the psyche and the self and mental health, very much concrete in some of the same way, saying there are 10 cupboards that one can look in.

And these drives, as you refer to them as generative drive, aggressive drive and pleasure drive, you'll probably tell us in a few minutes, can be expressed to varying degrees in different people and how that shows up and what that looks like and I just want to frame this in people's minds as very similar to addressing whether or not, okay, if somebody can run very long distances, but they're always, you know, it, having aches and pains, or they feel weak, or they are weak.

There are good reasons for that. They're overemphasizing one form of exercise.

The expression is more along the lines of endurance and stamina, not strength. or vice versa, the power lifter who can lift 750 pounds from the floor in a deadlift. walks up two flights of stairs and is belly breathing and has to stop at the top of the stairs.

It's obvious in the physical realm, it's slightly more cryptic or more cryptic in the psychological realm, but here it's becoming concrete for us.

I think it's very interesting and very ironic, right?

So the field that I'm in, the field of psychiatry, has historically wanted to be sort of part of the rest of medicine or like the rest of medicine.

And what I believe it's ended up doing is glorifying a taxonomy. right, glorifying a category mechanism of understanding human beings.

So in the way that, that if I'm practicing general medicine and you come in and you're congested and I determine like, oh, you have... you have bacterial sinusitis, right?

So now I've made a diagnosis and now I know what I'm going to do about that.

So, okay, I'm going to prescribe an antibiotic.

Now the thought comes in of like what antibiotic, right?

But the identify sinusitis, now you need an antibiotic. is like kind of how medicine works, right?

So the thought was psychiatry is gonna categorize everything, right?

So we'd say, okay, I've listened to you like, ah, I know your number or your numbers, right?

And then once I've given you the numbers, Now I know what to do.

I prescribe this medicine, that medicine, these many sessions of a certain kind of psychotherapy.

And like, that doesn't work It doesn't work in mental health.

It's not that it never works, but if you're going to try and understand people like it's different the problem of self like if I have a lack of confidence in one area of life and not in others that's a significant issue.

It is not like bacterial sinusitis where then, you know, okay, arrow goes to prescribe antibiotic.

And I think what is ironic is that this route of approach actually does bring psychiatry or mental health into line with the rest of which is why you can make that parallel and it fits well when you're making the parallel to physical health I want to be healthy.

Okay, what are the components of that? What am I doing to achieve that?

If something's not the way I want, let me go back and look at those components.

I mean, it may be because it's more tangible, is essentially easier to comprehend, right?

Because it's more concrete. But I don't, in a sense, see it as cryptic, just less obvious, right?

But if we go and we look at it and we say, oh, that really makes sense, right?

And in a sense, it makes sense that it makes sense, right?

If there's a mechanism of understanding that applies to lots and lots of things that are more concrete Why would a similar kind of mechanism?

Understand what the components are, understand what's built on top of them.

I believe is how psychiatry actually fits with the rest of medicine not by glorifying a taxonomy but by coming through the lens of understanding.

I couldn't agree more. And I think that what's so reassuring is that both in terms of creating physical health across the various domains of heart health, lung health, endurance, strength, et cetera, cognitive health, as well as mental health is verbs.

It comes back to action items that we, each and all should engage in in order to arrive at the states and you know, ways of being that we all want to be in, right?

We want to feel healthy, look healthy, you know, et cetera.

We want to, be happy. I know very few people who don't want to be happy.

I mean, certainly there are people who give up, but We'll talk about that today and routes out of that.

But at the end of the day, it's all about looking in those bins, asking specific questions, and then moving forward in specific actions to get to the place of empowerment, humility, agency, gratitude, peace, contentment, delight, et cetera. as opposed to simply using words and understanding to arrive at insight and then stopping there and expecting everything to change.

And I think that's where a lot of people are confused about psychology, therapy, and psychiatry.

And as you mentioned, psychiatry has its own shadows, if you will, within it, where the use of drugs, which certainly can be very useful, even lifesaving, oftentimes is seen as a fix-all that somehow could reorder everything within the cupboards and make the recipe just right when in fact,

So we'll talk about today that that is generally not the best route.

But again, with the understanding that drugs can be very powerful tools.

They can play a role. But it's important we understand what role is appropriate for them, and that's where we often go astray.

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As we move forward here in defining and helping people gain, for lack of a better word, agency over their own mental health and self-understanding. finding for them what action items to take.

I'd like to ask you about some of the things that I observe in the world and hear a lot about. in particular from the audience of this podcast.

You know, it's obvious to me that people vary in terms of their level of aggressive drive, pleasure drive and presumably generative drive as well.

One common question is how do I become more motivated?

And of course that opens up a bunch of other questions like, are people afraid of failure?

And that's why they're not motivated Are people afraid of success?

Is that why they're not motivated? Is there some underlying childhood trauma or unconscious process? that's driving that fear and so on.

But if we were to take the psychiatrist perspective, your perspective, if someone comes to you and says, you know, I just don't really feel like trying.

School loans are excessive, which is true by the way.

It's not even clear that with a degree I can do much, or I had a series of failures in the work domain or in the relationship domain, and they're just feeling weighed down as if it's not worth trying.

What does that tell you in terms of where to look?

And what does that tell you in terms of their drives?

I mean, do we conclude something about their innate level of aggressive drive? or their pleasure drive or their generative drive.

I mean, I think there are many such people out there and then we'll consider some other kind of phenotypic examples.

So it's a great example because any good clinician could hear that story and have thoughts about it. could and would hopefully be helpful without necessarily referring to drives.

So I think you can anchor any set of assessments, any evaluation, any attempted understanding to drives, but it doesn't have to be that way.

So for example, you might ask that person more questions about what they're doing, how they spend their time.

Because you're telling me about someone who's not... getting enjoyment or gratification out of anything.

And that then becomes of interest to me.

Is there something this person does enjoy?

Something they'd rather be doing? Did they go to college and take on a bunch of loans because they thought that was better, because they thought they were going to do something that now they actually don't want to do? or that opportunity isn't there and now they're frustrated.

What is inside this person that might seem different?

And again, the answers could be complicated.

It could be maybe that person enjoys what they're doing, but the cost of living where they are is so high that they still feel miserable.

There's a sense of privation. And then that gets back mapped to like, I'm not getting any pleasure out of anything.

So the answer could be as simple as you strategize with the person.

For example, does a person like that move to a different area?

So there's so many ways of looking at this and so many ways of understanding this, but you're describing someone to me who... who is kind of really complaining that nothing is feeling good.

Nothing is providing a sense of enjoyment or of pleasure.

So I would probably be interested in that first and think maybe the pleasure drive is higher than what's being fulfilled, right?

Maybe the pleasure drive is low and that's an issue in and of itself, but we sort of learn those things.

Maybe the aggressive drive is low and if that person just put a little more energy into it, like they could be in a different place.

So you're trying to help the person understand themselves so that you can make change.

And again, that understanding doesn't have to be anchored to the drives, but I do believe the drives are at the root of all understanding.

Because if you sit with that person and you talk to that person, then you're going to be able to understand what is... out of balance, either in the actual array of the drives or in how they're being experienced, because again, if you have a high pleasure drive, for example, and it's not gratified, that represents a problem.

What about people who can experience some pleasure or can keep busy, say for instance, on social media or playing video games, And I should also say, perhaps it's bringing them to a place of peace, contentment, and delight. in some sense it's not really generative, right?

You know, I'm not going to cast judgment and say that video games and social media are all a waste of time.

I'm on social media trying to provide value to people and learnings.

And I derive value and learnings from other people. accounts as well.

But there are these milestones, if you will, in life.

I mean, not that everyone has to go to college and get married and have a family, man, there are a lot of different paths through life that I would consider successful.

But in some sense, there are milestones, like we want to move forward.

There's this phenomenon nowadays of a lot of young people, so-called failure to launch.

Like they're not leaving home or they're not finding a vocation.

They're not feeling as if they're good at anything. or they have the sense that unless you're going to be, you know, like top 1% in something, it's not worth trying, but they can still find, you know, what most people would describe as pleasures.

Like they might enjoy food, maybe a little too much.

They enjoy, Alcohol, maybe a little too much.

They enjoy social media or video games, maybe a little too much.

And I say a little too much because it's providing more or less a sink or a reservoir for their aggressive and pleasure drives that's not moving them forward in the standard milestones of life.

I hear about that a lot. I see that a lot.

So it's a slightly more complex phenotype than described before is just simply. the amotivated or non-motivated person.

But, you know, what does one, you know, what do you think of that, of the phenotype I just described? because we're unique, right?

Each person is unique, although we fit categories, right?

So there are categories a person there could fit that could be different from what I'm saying.

But I think most people to say on balance, right?

What is most prominent, right? And I think what is most prominent in that situation is there's something out of balance in the generative drive.

And what you see a lot of times is the person has a generative drive in them that's higher than their ability to realize that drive.

The generative drive then is frustrated.

I'll give an example, this is a real true story of a person who had worked very, very hard, gone to school for a long time, and it achieved a very high-paying job.

And that was the goal, right? It's a prestigious job, it's a high-paying job.

And the person for a while was doing quite well And you know, things went my way. relatively rapidly in a negative direction, maybe for a little while the person's doing okay, then the person becomes very negligent of themselves and their environment when they're they're not at the job.

So the house is a mess, things are dirty, the person is wasting time with things.

So this is a person who It wasn't exactly video games.

Let's say it could have been. Well, it enjoys them to a certain degree and can really gain pleasure and feel good about the time spent, but start spending too much time.

Now, what was pleasurable starts becoming a distraction mechanism.

And then what that transitioned to was overuse of alcohol.

So now you have either something that is actually destructive and was negative to job performance towards the person.

This wasn't a person who was drinking a lot before, and this is a person who is miserable. when they were drinking, or they were sort of wasting their time.

And we're aware of all of this. It was a very clear problem, which is that that person had no interest in what they were doing.

None whatsoever. It felt like the majority of waking hours were spent in an automaton-like way, but being awake and aware of the tedium of it, the frustration of it the professional side so they essentially had very little uh intrinsic curiosity or desire to do the job that they were successfully doing.

Right, which comes out only after exploration because it seems like, well, what's going on with this person? this person has a good job and their life is going really, really well and they're doing well financially.

Is this person trying to now overly indulge themselves?

Is that why they're drinking? What's going on? is that this person had a strong generative drive and it wasn't met one little bit by what he was doing, which was creating such frustration inside that the person was either taking himself online or doing something that was punitive and self-injurious.

And like, this is a real story. The person exchanged that job for a job that paid a tenth of what the job they had paid.

And the change in the person's life was amazing.

Like I didn't know this guy could smile.

He became happy, he loved what he was doing.

He sold the larger house, bought a smaller house, kept it beautifully, like he was happy.

That's what he needed to be happy because then the generative drive in him, he loved what he was doing, gets enacted. it gets expressed and then other things can come then into line, right?

He's not being over aggressive towards himself and, drinking too much because he's saying, oh, to hell with you, to the world around him and to himself.

He's not taking something that serves a purpose in his life.

Like again, if the example had been video games, it would be like, yeah, great, you enjoy doing that. x amount of time and like go do that and get gratification from it as opposed to then over relying on it and then it's not providing gratification it becomes a distraction so Those things came back into balance in his life, but there had to be the understanding.

And I think there's a lot of that in people who have a generative drive in them that they feel is frustrated by a world around them that isn't cooperating.

Now, do I think we can understand that and change that in the vast majority of people who are in that place?

Yes. But it has to be looked at first, right?

Because it's not always that. It's just that a lot of the time, right?

So it has to be understood, what is it in that person?

And then how do you go back to those pillars and look at, What's going on that the person is in that place?

Because the world can bring us a lot of difficulties.

And that person who now is saddled with a lot more loans than they expect.

I have tremendous... compassion for that and sympathy for that.

Like that's real, right? So people can be up against a lot of things and that's just one of them, right?

But it doesn't mean that life can't be okay.

It doesn't mean that. But the person has to feel that there's some way, they have to understand enough about themselves, okay, this is what this is and I kind of see what this is and why and how I'm here and from there I can start to plot a route to something that is better because yes, we have our difficulties and we can have a lot of them.

But for the vast majority of us, it's not like they're not surmountable.

We have to just understand them. And let's say if that person goes and says, I'm going to get some help.

And they go and someone says, okay, wait, you get 10 sessions of cognitive behavioral therapy.

And you're trying to like, how can that person think differently?

Then they'll feel differently. Look, cognitive behavioral therapy has its place.

But it's not going to solve that. That person needs to understand something about themselves, not redirect their thoughts to better places.

So if the person gets a reflex, because that reflex works well for the system, Reflex works well for the system that's treating that person, for the medical system, the insurance system.

That person isn't helped one bit. right and maybe a medicine can help right maybe a medicine helps to just take down the anxiety and the tension in the person then the person can sort of think more about it and And truly medicine did help this person because the idea of leaving the job, I'm leaving the prestige, I'm leaving the money, is that okay to do?

Like it generated a lot of anxiety, and it helped to kind of bring the temperature down a little bit of that so that he could think about it, engage in therapy, ultimately navigate to where he wanted to be, then we get back away from the medicine.

So like medicine has a role, but if he just got medicine, I mean, what are the odds of that helping? because it's not going to make the answers unless somehow the person feels a little bit better and figures it out on their own.

It's not how it works. has its place, but a kind of therapy that recognizes the limitations of medicine in most situations and is designed to really help the person understand That's what we need.

The example you gave is a spectacular one because as you mentioned, medication had its place. perhaps even redirection of thought in some sense had its place because as I recall, under the pillar of function of self, one of the key elements items, salience, what we pay attention to internally or externally, what our internal narratives are.

But in staying with the example of this individual, again, as a as a phenotypic example for everybody to learn something from the, Asking of better questions about oneself is really what leads to the understanding.

So like... better forms of inquiry, right?

To me, these better forms of inquiry, better questions are really the... cardiovascular exercise, the strength training, the flexibility training, the mobility training, coordination training of physical health just translate to mental health.

It's so interesting, right? Because if you think about it, in the example I gave, both the therapy part through the system, right?

The CBT has a place. And the medicine part also had a play.

So both of those things have their role, but if we build the whole story, of like, this is what this is, and this is how you're gonna be helped around those things.

We don't help that person at all. In fact, we ultimately, if you take on balance, you take all comers, we end up doing harm.

Well, in some ways, if we stay with the analogy of physical health, it would be like the person who wants to get in shape and then they get a, I'm not picking on Peloton as a brand, but just a stationary bike.

And they pedal... and they lose weight, their blood pressure goes down, they're doing better.

But then at some point, if we know for certain, that if you just do the same form of exercise over and over again, like sooner or later, you're going to get overuse injuries.

So then there's like the lower back piece and another piece. and you become out of balance.

But I guess this is stealing from the Lance Armstrong book, but it's not about the bike, right?

I mean, you know, it's not about the bike, it's about the elevation of heart rate. whatever other healthy activities go along with exercising first thing in the morning and all the things that you're not doing as a consequence of exercising in the morning.

So it seems to me that these better lines of inquiry as the path to better mental health, a better life that sit under these pillars of structure of self-function of self are really the key.

So in this example, the parallel that you made is even more dramatic.

It wouldn't be the stationary bike, because the stationary bike is achieving a lot of ends.

It would be more like telling the person, you should walk more briskly when you're going upstairs, right?

Like that's a good idea, but that's not gonna make the change.

So the idea that some CBT, some medicine makes sense, it's more like that.

It's not that walking more briskly up the stairs isn't a good thing, It's that we can't build the story around your whole health is gonna change based upon that.

And then that's a problem then if the person thinks, just walk more briskly up the stairs and you'll be healthier.

Because when it doesn't work, now they've failed.

And this gets used a lot in mental health.

That person failed this therapy, failed that medicine.

I think it's also ironic because that's often what the person internalizes.

Well, they failed because we set them up 100% for failure, right?

Because we took things that have their role, at least potentially have their role and we built the whole story around them because that story is convenient for the systems that are providing the care.

It's convenient for the healthcare systems, it's convenient for the insurers.

CBT packages very nicely. And you could see how if you start changing thoughts and how they make you feel like you can get some movement on the surface, even if there's no movement underneath.

And again, I'm not saying CBT is bad, but to see it as the whole answer, guarantees failure in so many situations.

Same thing with the medicine. If you build the whole story just because it's convenient and by and large medicines are cheaper than people, So you can prescribe medicines very reflexively.

Psychiatrists with 15 minutes with a patient that they can't then see back for a couple of months, like how does that go well?

The answer is it only goes well the way a broken clock is right a couple of times, twice a day, right?

I mean, look, sometimes it goes well, or just somehow it works out, that person can do a little bit of therapy in 15 minutes and choose the right medicines.

But by and large, we do those things because they're convenient for the systems, even though that's why People don't get better like we think they would.

That's why they stay in systems. That's why they come in and out of emergency rooms.

That's why they're not able to stop the drugs that end up only being stopped when the person dies.

This happens all the time. And we don't stop it because we're coming from a perspective that is so limited.

That's not saying let's take a step back and look, can we really like help someone?

Can we really help that person understand?

Can we help that person make change? which ultimately would be of course so much better for the person and so much better for society, but is also better if we just look at bottom line dollars and cents, right?

Because the short-term view of It is cheaper today to have a psychiatrist at a 15-minute appointment reflexively prescribe a medicine.

That is cheaper today. Is that cheaper across time? when that person is utilizing more resources or they're in and out of emergency rooms, it's so short-sighted which fits with many ways how our society works, right?

That we want gratification and we want gratification rapidly.

That's why a person would accept that their problems could be changed by medicine, right?

We're kind of conditioned that way. well and then of course there's the cost we don't see which is that person doesn't get the opportunity to express their generative drive and so the And the consequence of that is incalculable.

Right. Yes. And if we take a step back and we look at that, I think that what we will see is that we have, it's not quite like painted ourselves into a corner, But it's like the idea that if there's a beautiful tapestry that's the size of the wall, that you can see that only standing back from it.

I mean, this goes back, I think a couple of thousand years, this sort of thought and idea, but if you come up too close to it, then you can't see what it means anymore.

And we're up so close to it that we're thinking, well, okay, how could one parameter change? can this person get a 15 minute visit sooner rather than later or how about this medicine instead of that and then it's like our noses are right up against the tapestry and we don't see that we're not doing right by individual people a lot of the time, and we're not doing right by society.

Which then if you stop and think about it, we're not doing right by us.

Because any one of us could be in that position and many of us have been in that position being on the other side of things and really needing help and needing to understand so any of us can be there.

So if we're failing a lot of individual people and we're failing the society, it doesn't matter who we are listening to this, like ultimately we're failing I'd like to take a brief break and acknowledge our sponsor, Eight Sleep.

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Again, that's eightsleep.com slash Huberman. let's therefore talk about what does work, you know?

And again, placing on the shelf the fact that medications can help and CBT, cognitive behavioral therapy, can help, but they are just but two components of a much larger picture.

The map that we described briefly at the beginning of today's episode and that is, by the way, available as a downloadable PDF in the show note captions if people want to look at it visually.

And that was described in a lot of detail in episode one, which I hope people will take the time to listen to because it's so rich with depth of understanding.

And I'm certain everyone will learn a ton about themselves and others. simply by listening to your words.

I'm absolutely certain of that. That map provides essentially a description of the bins, the cupboards to look in. to arrive at better answers and even the sorts of questions that one might ask.

If we could just talk about that in the context of the example that you gave of this person who made this really incredible choice to move away from this higher paying job, They were overindulging in certain maladaptive behaviors.

And again, we will use this example, but this example is about one of, an infinite number of examples that we could use of a person who's in a struggle.

They're doing something that's not working for them.

And they're also not doing things that they know they ought to be doing.

This is important for people to understand because there are going to be people out there that are thinking, oh, like this poor guy, like he's making tons of money, poor him, you know, but you know, he was experiencing deep, lack of satisfaction so it could it could have been the reverse example like the person isn't in a job that that brings about enough wealth for them to to because there are financial realities to life.

So it's just one example, right? But it's a good one, I think, because the person left the money.

Right. So what would make you leave that?

Right. And what would make you leave that is if you're miserable in the situation with that and you're happy in the situation without it.

Right, so it's about leaving misery and finding happiness.

So if you'd be willing to share with us a little bit of your mindset during those sessions, meaning the sorts of questions you asked him about the structure of his self or to reveal the structure of his self and the function of his self that allowed the both of you to eventually set him down this far better course.

What's better than moving away from frustration and overindulgence and maladaptive behavior to deep satisfaction, peace, contentment, and delight and to become a generative human being.

Right, so we can look in each of those 10 cabinets, right?

So let's say we look in the unconscious mind cabinet.

There's not much there. When the person was growing up, it was very clear that having more money and having a job that impressed people was an important thing.

He internalizes some of it. So some of it's unconscious, but by and large, he's aware of it.

And that was revealed to you how? You know, you would ask him a question about, you know, like tell me about your upbringing.

And he would say, yeah, like, you know, money was important to my family, but I always felt like we had It wasn't super wealthy, but it had enough.

And so when you say there wasn't a lot there, do you mean that there was no kind of like X marks the spot or like, blinking red light, like, whoa, there's something really in his unconscious mind that's in his way.

Do I have that right? Well, more because it was conscious, right?

So he was aware that it was very much like beat into him.

Like this is the only way to be okay, is to have a prestigious job that makes a lot of money.

But he's aware of it. If he weren't aware of it, we have to bring that to light, right?

But he was aware, he was like, look, it has a big impact.

It makes it hard to step away. Like I know I don't really care that much about the money, but I also kind of do, you know?

I always say money can't buy happiness, but it certainly can buffer certain stressors in life.

I mean, nobody, sometimes you hear people who have a lot of money saying like money can't buy happiness.

Cause you know, there are a lot of miserable rich people, but it's like, you know, It's very different to have two night nurses to take care of a baby than to be the person who has to stay up all night taking care of a kid.

Or a single mother versus a mother that has a partner who's willing to pitch in.

You just can't compare. And while that's absolutely true, in this case, we're just looking at money as money. like as an endpoint, right?

The idea that no matter what, how secure and safe, like is more money better, right?

And he had an intrinsic overvalue of that.

So it made it harder to step away from it because he was overvaluing it.

He knew he was overvaluing it just in and of itself, not even for what it did. gets you, but for the psychological meaning of it.

Then we look at his defensive structures.

If we look in that cupboard, you see that they've really shifted.

They shifted from healthy places. Now they're sort of twisted and distorted and he's doing a lot of denial a lot of avoidance, a lot of rationalization, right?

He's enacting a lot of aggression towards himself and he's doing a lot of projecting.

He's harming himself with the alcohol. He's punishing himself.

So his defensive structure, it can be healthy.

We know that because it was healthier. But then we see that it is so twisted.

So we learn a lot from that. A lot is conscious in this person.

The defensive structure can be healthy because it was healthy.

Eventually, it was healthy. Well, it was healthy before.

It was healthy before, so you know that it can be healthy again, right?

He has it in him to have healthy defenses.

They just started getting away from him as he felt less and less satisfied with his job and more and more angry with himself and more and more miserable.

This is a really key point for me and everyone else to understand.

Throughout the years of high school and college and friends and things of that sort, I would hear this, like, I used to be really good at fitness or I used to... you know, if I had a dollar for every time someone said, you know, you should have seen me in high school, you know, like the person who lets themself go and arguably is very busy. with professional duties and family duties and you can understand why their time is more compressed than it was when they were in high school but Nonetheless, you know, you hear these sorts of things all the time.

Like I used to have this sense of like I could do things or that like things could work out or that, And then it's as if there was a previous version of themself that is completely atrophied And the new version of themselves or the later version of themselves, rather, just simply... like doesn't have access to that anymore.

Right. And that's the impact of trauma. Yeah.

Right. Okay. Whether it's big trauma or it's a big event or it's multiple things like, Oh, the world isn't rewarding me.

I'm trying, the world's not rewarding me.

Then people become dispirited, demoralized.

So it's the trauma of that that takes away the sense of self, the sense of agency.

Like I thought I could do things before, now I don't think I can do things. right?

But, but nothing has really changed in me.

I mean, that's, that's a problem, right?

And it's a problem. The vast majority of times it's born of Does that necessarily mean early childhood trauma or...

I suppose it could be later life trauma.

I mean, one of the things that I like about what you're saying so much is that, you know, you, the psychiatrist hears, I used to be able to do something well or feel well.

And that's like, it sounds like is a, a signal, it's really a beacon of health that still exists in the person, but that they're out of touch with. for most people when they think about themselves are people who talk about how they used to be functional in some domain and they're no longer functional in that domain any longer. it sounds as if things are fundamentally broken.

It's as if a piece of them that was functioning drifted out of their body and left.

But I love the optimism, right? Because I think so much of what we're interested in covering today is not just what's not working and why, but also what's working and why and what used to work and why.

And the idea that, you know, within these cupboards there can be the discovery of problems clearly that's why one goes to the cupboards, right, as we're defining it, but that there are a lot of answers.

The ingredients for success already exist within us.

Right. Especially if we know we've had that ability before, right?

Because we know that we had it before. So think about in this man, He felt that he couldn't make change.

Like now he's stuck, right? Like I got a lot of things done. to get myself into this school and achieve this and you know and then get this job like he could do all those things but now he feels like he can't do anything to make himself happy.

So we know he could do that. He had a strong sense of agency.

He does it now. And like people often do, they feel a sense of loss.

Like naturally, I've had this happen in myself.

Like it feels like something's cut out of you and there's something hollow, I had that thing and now I don't, right?

Hence the I'm broken, I'm hopeless, the things that we hear over and over and over again.

So think about the shift in this person to what's actually going on, which isn't that hard to discern, we just pay attention to it.

So then if we run up the structure of self, we say, Okay, not a lot of it is rooted in the unconscious mind, right?

There are problems of overvaluing certain things, but they're in the conscious mind.

He knows, like in his household over dinner, it was, you know, dad or mom, you know, being proud of some dollar amount that they achieved.

So that narrative... And he's like, yeah, like money was a big deal in my family kind of thing.

By the way, I'm not speaking about my family, rarely were there discussions about money.

There were discussions about other things, of course, but in this hypothetical, not a real patient, sorry.

He knows he overvalues it. He knows it independent of what money buys and what he needs and all that.

He just puts too much importance in money and he knows that.

So, okay, there are conscious mind issues.

He's pretty aware of them and they're pretty kind of set in him.

Like those are the issues and they're there.

Okay, we learned that. Then we go look at his defensive structure.

Boy, that's very, very helpful to talk about, wow, like you had a very healthy defensive structure.

What were you doing before? A lot of sublimation.

Could you explain sublimation? Yeah, take anxiety, tension, or something negative in the self, or there could be negative, and you channel it towards something positive.

He channeled that energy towards learning.

He channeled some of the aggressive drive into a sense of agency that got achievement.

So he looked and he said, right, that network of defense mechanisms that comes up out of it. unconscious mind was like looking pretty good, right?

It was pretty clear, light was coming through it in a way that wasn't distorted.

And now we can look at, wow, things are pretty different. now, right?

As he's saying, no, it's okay. What do you mean?

I spent... 10 hours of my weekend utterly wasting time.

And what's wrong with that, right? Or, you know, he's... rationalizing even that he likes to drink when he doesn't because he so mattered himself.

Like the defensive structure now is twisted, right?

So we can say, okay, that's a big observation, right?

And then the character structure, when we look at that, we find a person who's pretty good at figuring out and understanding things and coming right up to the precipice of change, but has a long history of then difficulty making the change. right I know it and I'm on the verge of it but I don't I can't bring myself to do it like that's in his character structure by the way it's such a common thing I mean, people that know better, know they know better.

Sometimes you almost have to wonder whether or not it's like...

It's like a medication in the pocket. Like they could take it if they wanted to, that might even give them some comfort, but they just don't do it.

They just don't engage in the proper actions to move their life from one place to the next.

And if we look then at the level of strivings, he does know what he wants.

He wants a feeling of contentment. It's really what he wanted was a feeling of contentment. a feeling of like, I'm taking good care of myself.

I'm doing something that's of value. I'm enjoying doing it.

He wanted those things and even when we talked more, he had ideas of what jobs would do that.

In the beginning he said he had no ideas, what he really meant that he said to me, but was also saying to himself, is I have no ideas of jobs that would meet these requirements for me that pay as much as the one I have.

But within him, which we got to, where he knew, that there were jobs that would make him happy.

He just had to get over that they were lower paying.

So think of what we learn about that. There's nothing lost in this man.

There's nothing cut out of him. But he's not damaged.

He's not hopeless. And now he can understand that... that he understands himself actually pretty well, right?

And his conscious mind is apprehending pretty well what's going on and where he wants to go.

But boy, as he hasn't taken good care of himself, the defensive structure gets sort of warped and then it makes it a lot harder to take care of yourself.

It starts making other problems in life.

And he starts like feeling lousy about himself.

Like maybe I can't do much of anything, right?

Why? Because work isn't going as well, because he's drinking too much.

The role performance goes down, right? So we can see that and then what's of most interest there is that there's a character structure that can come right up to the precipice but not pull the trigger, so to speak, on what the thing the person wants to do because now we start getting, okay. an understanding of what's actually going on, right?

And then if we look at function of self, let's look in those cabinets too, right? to help him be more aware of there's an I here, which he was pretty well aware of, but not enough.

Like there's a person here I'm shepherding through 24 hours in the day.

I am an I and I'm aware of what's going on inside of me and it can make me happy or it can make me miserable.

Let's be more aware of that. How did he go about doing that?

Because I find this first step within addressing the function of self, you know, self-awareness and really understanding that there's a There's an I, there's a me, and I'm moving myself through life.

I find this to be, so interesting and on the one hand kind of obvious, like, okay, there's a mean like tangible thing.

You look in the mirror, you see yourself.

At the same time, it's a bit abstract, I think, to me and to many people out there.

How does one go about building up a sense of self in a way that provides positive agency in the world?

Is it to tell, you know, we hear all the time about these like affirmations and I'm sure there are people who look at themselves in the mirror and say, you are enough.

And these, and I'm not making fun of these people, right?

I actually have my own internal list that I tell myself on waking every morning. which has nothing to do with positive affirmation.

It's just actually defining the different roles that I play.

I don't know why this is useful to me, but I find it incredibly useful to me.

It reminds me who I am. It also reminds or at least reassures me that I don't have any dementia yet.

So we'll see going forward. hopefully not, but yeah, let's talk about this line of inquiry within the category of self-awareness that people can do, regardless of whatever challenges they might be having or not having.

What does that look like? And what do you think that accomplishes at the level of self-understanding and agency in the world?

So one way of looking at that is, and this is not the words I would use, but like what's pervading a person and sort of setting the stage, right? which you can discern by inquiry.

So for example, in this case, The person, so there's a person who would really not think this is okay.

This person taking a job at 10% of the previous pay and the job has less prestige.

There's a person who would be very unhappy about that and very faulting of that. and talk to this person, my patient, through the lens of that he should feel shame for that.

That person's not alive. The person is not alive.

So one way of looking at it is what master are you serving?

And a lot of the like the givens, the automaticity in him, was as if like that person was alive inside of him really telling him like how this wasn't okay like he was fighting that he wasn't aware that hey that's some other person's voice it was like he's like no i'm very very conflicted about this Actually, he wasn't very conflicted about this.

When he starts focusing on the I, like, what do I actually think?

What do I actually think? I don't care if I make 90% less.

I don't care. My needs are met. I put some money away.

I want to be happy. I'm not conflicted.

But in order to get there, we have to look at the I. How much is the I?

I don't mean in some way like paying too much attention to the self, but like we're all acting through the lens of the eye, no matter what we're choosing.

So to be aware of that and do I want to be impacted by the opinions of this other person?

Because I can let... someone else's opinions very much.

I mean, we all do, right? Very much impact my thoughts, but I want to kind of decide that.

Do I really value that person's opinions?

I don't want them automatically inside my head telling me how I feel about myself.

I can't tell you how many people I know come to me in a place of struggle, even though I'm not a clinician. as I listen to what they're struggling with, it's so clear that they know the best answer and route forward. but that they're dealing with some internal oppressive voice about whether or not they are a good person or a bad person. whether or not the choice they want to make is really a good choice at all.

Sometimes those voices are the voices of parents, you know, in these particular examples, or the voices of peers.

And so I think If I understand correctly, what you're talking about is getting really firmly rooted in who who a person is for themselves and what they really value.

And what they really know to be true for themselves and really trying to not necessarily quiet those voices, but see those voices truly as other, even though they come from within their head.

Is that right? Yes. Yes. To stop and think, what voices do I want inside?

So maybe I want the voice of a kind mentor who still held me to account for a very high standard.

It's a good voice to have inside of me. A few of those.

But what might not be a good voice is like say a not so kind mentor for whom you could never do anything good enough.

That's not so good. Or maybe you take part of that and you leave part of that.

But the earlier and more formative the voices are, the more they're in our head automatically.

Like think about that man thought that he was deep Absolutely.

100%. And he was. His experience was to be deeply conflicted.

But when you go in and dig... If you just dig and you get to like, okay, the eye is going to assess this.

He's not conflicted at all. Which is why then if you're coming up the function of self ladder, and you look at defense mechanisms in action, and what's on top of that salience, Now is when it creates an immediacy, right?

So defense mechanisms in action sort of inform the process and say, hey, the defenses are shifting to denial, acting out, right?

And that's what sort of gives us a time horizon.

Like this thing, this is not going to be okay. that if he kept down this path, what was very clearly gonna happen, you don't have to roll the tape forward that much to see that he's gonna lose his job,

He's going to feel very ashamed of that.

A bunch of negative things are going to happen.

So it helps the person apprehend that there's something going on here.

I'm changing. Because like in some way I'm thinking now that it's okay that I'm wasting 10 hours on something that I could really enjoy if I spent 90 minutes on it.

Like, whoa, I'm kind of losing a little bit perspective there, right?

So it adds a sense, like it frames a situation, right?

And the salience of it. Could you elaborate a little bit on this defense mechanism and action of acting out I think we covered in episode one, and I'm sure it will come up several times more during today's discussion, about things like denial, projection, displacement, et cetera.

Those defense mechanisms seem to have their own intrinsic definition.

But acting out is something that we hear more and more about these days, like they're acting out.

What is acting out? Is it acting out of some conflict?

Is it trying to, you know, demolish a struggle by going and doing something else?

We can think of it as by and large an unhealthy manifestation of a lot of aggression. which could be a very high aggressive drive or an aggressive drive that's not too high, but is then furthered, its powers furthered by a negative situation, right?

Say like this one, right? Because the acting out, what was going on here inside of this person is he was very, very mad.

And this isn't a person who expressed a lot of anger or had outlets for it.

He wasn't going and running 10 miles. This was all inside of him.

He wasn't getting it out in one way or another.

So what he starts doing is, he starts acting out the anger.

Now he's angry at the world around him because he's unhappy in it and it's not giving him more choices.

This is about him and not the world around him, right?

But he's feeling an anger towards the world that won't cooperate, right?

And he's angry towards himself. Right. Because like he can't make himself happy.

Like, look at all of this. Look at all that he did and look how miserable he is.

Right. So a way of acting out then is the drinking.

Because the drinking is to hell with the world.

You think I shouldn't be drinking at night and come into work, can't go over, I'll do it anyway, right?

To hell with the world. It's a way of snubbing his nose at the world, right?

He's also snubbing his nose at him. To hell with me.

The guy who now doesn't come across the way he did before, because I'm showing up at work, not in the responsible way I showed up before, but in a way that's a little disheveled, function is lower, to hell with me.

It's a form of self-denigration, like let people think worse of me.

Why? Because I'm so mad at myself that I think it's justified.

And then there's also the inviting of, If I really have an addiction problem here, I lose my job.

Fine, I deserve that too. There's an acting out against the self if the person doesn't stop and look at that, that can become true, right?

Because that person didn't really, wasn't built to say to hell with the world and with me. or to not even understand what's to hell with the world mean.

It also means to hell with me, and it's not good for the world or me, right?

But he was able to understand that because we would look at like, wow, what shifted in you?

This is a person who did a lot of sublimation before who now all of that's going into acting out.

So they're not taking negative energy and doing something good with it.

They're taking negative energy and doing things that are bad with it.

Why? Because there's too much, there's a lot of negative energy.

It's overwhelming. everything else and then it's going down these pathways where the unhealthy defenses are always beckoning us.

Send the energy down here. It's easier to avoid than it is to face something and figure it out.

It's easier to just act out than it is to hold what's inside of us and then think about why. it's there, so the unhealthy defenses are beckoning us and for him to see you have had a healthy defensive structure, like you can be healthy again, you're not broken, right?

But to also see the way these defenses are going, is bringing real risk to your ability to even be happy.

You get further down the shame and loss path, it can be hard sometimes impossible for the person to get back.

So it sets the stage like this is very, very important what these people defenses are, how they're being enacted, and for him to be able to see that like, oh, this could be healthy, but It's not now.

Yeah, these slow... you know, degrading forms of acting out and self-sabotage and sabotage of others, I think are, particularly dangerous ones because they're slow and sometimes the change is imperceptibly slow and then one day somebody arrives at a place where, as you said, they unfortunately can't get back or it requires going into residential treatment or things that really were big departures. in order to get back into life.

And I would never wish for somebody to choose to act out by driving off a cliff instead, but there are other forms of acting out immediately wake people up.

But it seems like people don't often select those.

They select these more subtle forms of acting out where, they don't get caught or no one's calling them out on it because, you know, Plenty of people have five or six drinks at happy hour, right?

As opposed to 50, right? So it's slow self-sabotage as opposed to immediate self-destruction.

And again, we're talking about alcohol, but we- talking about food, video games, social media, arguing with spouse.

I mean, all of these kinds of things that build up over time to eventually deliver people to a place of real, I'm curious for this particular individual you worked with, sounds like that's not what happened.

They started this process of, of self-inquiry around self-awareness.

And did you see that the salience that is what they paid attention to internally and externally and the defense mechanism of acting out immediately dissolved?

I mean, what was the kind of contour and time course of this?

There was less, so if we're looking in the cabinets, there's a lot in the defense mechanisms and action cabinet. there's not as much in the salience cabinet, because this is the major thing on his mind.

Above all else, he was having intrusive thoughts about it and his self-talk was about it, but we kind of already knew that. just like we knew it was in the conscious mind.

So you think, where's the money at? It's not as much in that realm because he's aware of it.

If he thought, oh, I'm not... this isn't bothering me very much.

And then he said, well, all his internal dialogue is about it, right?

Then like, okay, there's a lot to achieve there.

But just as he brought a lot that was unconscious into the conscious mind, was aware of it, it was salient.

There's less to do there, right? Because...

The things to understand and change are not residing so much there.

For people that are... no doubt everyone is thinking about their own internal processes and where they could ask better questions. and arrive at better answers to help themselves along.

Perhaps you could elaborate a little bit more on this. salience covered under function of self.

You know, to me, salience is what's most apparent and, and, as you talked about yesterday and again today, you know, there's this internal narrative, like what's on my mind often or what kind of jumps to mind I've started doing this recently based on our discussions here.

And I've noticed that under different states of arousal, and here I'm talking specifically about sleepiness versus alertness type arousal. when I wake up in the morning or when I'm tired in the evening, where my mind is at, where it defaults to. and what I'm paying attention to throughout the day is that just asking myself to notice, and I've certainly noticed some patterns.

For instance, I've noticed that any time my overall state is elevated, more alertness or in the middle of exercise, my mind goes to some not so pleasant thoughts. and it's interesting to me it's like wow this is strongly correlated with states of internal arousal that are healthy exercise you know within a limited frame is, or exercises in general, if done in a healthy way is healthy.

And when I'm sleepy, those thoughts never come about.

When I wake up, certain thoughts tend to leap to mind, other thoughts no.

So sort of categorization of different types of thoughts, depending on my internal state.

Is that the sort of line of inquiry that you're, that you're suggesting or describing here?

Yes, I think it's about half the picture, because half the picture would be what's going on in your mind when your mind is sort of at rest.

What then starts playing itself right in your mind?

The other side of it is, what comes to the fore when there's a lot of competition for attention, right?

So I'm making this up, but the idea that like, if he stubbed his toe really badly, he'd still be thinking about this. because it has so much power.

Now, again, maybe if, God forbid, he has a badly broken bone, there's a lot of pain, he's gonna think of that first, but it takes a lot of other stimulus to be more salient than this.

So you can look at what's coming in your mind when your mind is sort of free and open.

That's very, very important and relevant.

And then what's winning out when there's maybe a high arousal state and a lot of competition for attention?

That's very helpful. Again, I think along with this self-awareness piece, the asking of oneself, you know, what... is happening in my mind when I'm in different states or throughout the day.

And as you're describing now, I, also including when there are other things available to think about.

Like, does that include how often I'm distracted by a particular thought?

Like how many times throughout the day my mind goes from the conversation I might be in to something else?

Yes. Does it hijack your attention? You know, there's one way of putting that.

A lot of people mentioned to me challenges with intrusive thoughts. what can be done about those intrusive thoughts?

Or is it simply a matter of paying attention to the fact that they're there and then thinking about the origins of those thoughts.

Right, absolutely. I mean, one example, you could have intrusive thoughts because there's trauma in your background may be very clear trauma that you're not facing and addressing, and then you have intrusive thoughts and say, I'm not safe.

Okay, go look for what's still in the unconscious mind or when it comes out a little bit, you push back into the unconscious mind.

That's a very different scenario than like in this case, this man was having intrusive thoughts about his job situation, his overall situation.

And it made sense that he was having those intrusions.

They were markers of the acuity of it. of like you have to do something about this or like something very bad is gonna happen.

So the intrusive thoughts there, and this has made sense, Like this is not going well and your mind is forcing you to pay attention to this because time really kind of is of the essence, you're a real risk.

So intrusive thoughts can be anything from, as they often are, they can be markers of something that is traumatic, something that's underneath the surface, really bothering us that we shove down, that's making guilt, shame, distress, vulnerability.

That's very often the case, but sometimes intrusive thoughts are a marker of like, Oh, right, that's the thing to pay attention to.

And once we identify the intrusive thought, I mean, how do we eradicate it?

I mean, how do we work with it? we're talking about trauma now, you know, of course it might map back to a childhood experience, some internal narrative, but is there some roadmap for moving intrusive thoughts from a place of... intrusive and disturbing to simply there and kind of meh um i mean it'd be wonderful to hit a delete switch but obviously we don't work like that Let's take a look at this example, which is a little bit different.

If we run through this example of the person in the job, because then we should talk about trauma driven intrusive thoughts, which is I think in many ways the biggest topic about intrusive thoughts.

Think of this person here, if we go up from salience, we look at behaviors.

And behavior actually now is very, very important.

This person is drinking. They're still going to that job they don't want.

They haven't gone and interviewed for the jobs they want.

So we start looking at the behaviors that are making problems, the changes in behaviors that could make things better.

And then on top of that, we arrive at strivings.

And I think When I was talking about structure of self, I think at least one time I misspoke and said striving instead of self.

At the top of these pyramids, Self and striving have a lot of overlap, right?

Because if you're growing a healthy self out of the sort of top of the structure of self pyramid, then that self is going to be aware of strivings and it's going to be better able to enact them.

You know, his sense of self was shaken here, but he was aware of the strivings for a better life, right?

So now let's see the roadmap. It's interesting, right? is his roadmap, right?

If we look in those 10 cupboards, we come up with a roadmap and a roadmap doesn't have a spending very much time in unconscious land, right?

Because he doesn't really need that, right?

If we look at what makes the difference for him, What did we do?

We really cultivated the self-awareness, the I that is making decisions for him.

We looked at how his defensive structure had changed and the things he didn't want to be there now and the good things that were there before.

And how could he get back some of that? How could he trend back towards what was working before?

So we start to really look at that. And then we go from there really to changing behaviors.

Like it requires a behavioral change, which is not to walk up to the precipice of doing this each day, but to actually do it, right?

Because it was very clear, all the vectors, so to speak, inside of them were pointing towards doing it, and that that was consistent with the self being healthier, that garden growing on top of the structure, and the strivings then being realized.

So for him, that was the roadmap and the salience, it wasn't really part of it because the intrusiveness, the salience bias inside of him made sense.

And then like, of course it went away once he made the decisions, right?

Because the intrusive thoughts of like, you have to figure this out, you have to figure this out, weren't there anymore, along with the intrusive thoughts of, You'll never figure this out, right?

Like it goes away because he made the change, but he made the change because we... looked at self-awareness, we strengthened self-awareness, we looked at defense mechanisms, how they could be versus how they are.

We looked at the behavioral change which was really necessary And then also referencing a character structure that has difficulty, right?

Coming across the precipice, right? So we say, okay, that's a baseline characteristic of him.

We kind of understand that. But how do we help him change the behaviors anyway?

When he does that, the self is in a better, happier, healthier place.

The strivings are realized. This person stops. drinking in the way they were.

They start doing the enjoyment aspects of their life, they start doing them within reasonable bounds again.

They're taking care of themselves. The person's smiling.

And now think the generative drive is much more fulfilled.

So what comes on top of those pillars, right?

That person has a sense of humility, enough humility to say, I'm going to walk away from this. job I don't it's okay that the people in the job will think I'm crazy how could you leave that and and like it triggers something in me in some way but like it's okay right like I don't I don't have to I'm not out there for that.

I'm not out there for the big thing that everybody is guiding.

I can have the humility to go to the job that I know makes a difference and feels good to me.

He's empowered to make change. He's moving away from the disempowerment of the alcohol and the avoidance.

So there's empowerment and humility. And absolutely, if you talk to that person on the other like shortly as he was enacting it, getting just to the other side of it, there was so much empowerment and so much humility, which were then brought to bear through a sense of agency that made the changes, that changed the job, that stopped drinking, that dealt with the people who thought negatively of it, through a sense of gratitude of,

It's not awful that I'm going to go make less money.

A lot of people said that to him, like, how could you do it?

It was so terrible. It's not terrible. I'm grateful, you know what I'm going to do?

I'm going to go make an amount of money that's all that I need.

So it was like that's what helps a person do that thing and that's actually true.

That's what mattered to him. So an activated, an active, a verb sense of agency and gratitude then leads him to the place where there was a peace, contentment, delight, he was delighting in the job that he chose, and his generative drive was in accord Then we stopped at some point working together, he didn't need me anymore, he could always come back, but he didn't need me anymore.

Then you look at how were those last sessions.

A lot of the last sessions were him like in an excited way, telling me what he was doing.

Like, oh, and then we did this. And like, I did this, I figured this out.

Like he was so happy about it. And you can see that man's generative drive, which naturally, naturally is quite high in him, but was being squelched, right?

That brings him out of balance. Now the generative drive was in quite a good place and he had enough aggression or assertion to go and do that job and to do that well, and even enough to counter anybody who would still kind of rise up and say that wasn't a good idea.

He could counter all that. He was getting pleasure from it.

He didn't need to seek pleasure by what?

Not even pleasure because alcohol was pleasurable.

No, pleasure because harming himself and saying to hell with you, to the world and to him was pleasurable, right?

He's not getting pleasure that way. He's getting pleasure in... healthier ways, taking care of himself, doing the job he loves, doing his leisure activities.

Like the man comes into balance and then like life is good.

When you say, yeah, okay, come back in a couple months, like comes back in a couple months, maybe in six months comes back one more time, I don't see him again.

That's great. He totally doesn't need me again.

And I atrophied. right, from his life, great.

That's the success state of it. He eventually arrived at being truly wealthy. with all the components of mental health. peace, contentment, delight.

As you describe his story, which is a remarkable one, it occurs to me that the narratives that we hear as children end up being so powerful.

And I'm sure there are people out there that receive such, direct messages from their mother and or father, like, you have to do this, you cannot do that.

But often we get messages through observing and overhearing, right?

The way that... our mother talks about our father when he's out of the room, the way that our father talks about our mother when she's out of the room.

And some of this could be nonverbal, like a rolling of the eyes somebody saying, yes, yes, agreeing.

And then they walk out and they just, you know, and kind of blowing them off, right?

I mean, kids are, We are all so aware and integrating all of that all the time.

And I do think those messages get woven into us at a very deep level.

And then of course, there are the conscious narratives that we build up as we go through in particular, I think elementary and middle school and high school.

I mean, I can still remember a negative comment somebody made about a jacket that I was wearing in like the third or the fourth grade.

I forget everything else that happened that year.

Yeah. And I'm not, you know, I'm not insecure about the clothing that I pick, you know, I mean, obviously it's a black button down shirt.

I've had similar shirts since the first grade, just kidding.

But the fact that that's embedded in my memory systems, It's like just speaks to the salience of negative, of insults, basically.

It was an insult. And I'm sure I've insulted plenty of kids coming up, you know, as a teenager and back and forth.

And... And so, but these narratives get so deeply embedded and the idea that one could pick a different path of vocation or like you miss the opportunity to be truly happy at a deep level based on these narratives.

I mean, on the one hand it's obvious, on the other hand, you just go like, whoa, this is not good.

This is a flaw in the design. And yet you're giving us a roadmap to understanding and to overcoming it.

Let's say we take your examples. They're great examples and we look at them, right?

The person making fun of the code in third grade, right?

We're assuming it hasn't harmed you, it hasn't changed the course of your life.

What does it tell us? It shows that negative stimuli are very salient.

I'm sure you got a lot of compliments in third grade too.

But it's the negative that stands out, which just shows that there's a salience bias in us towards the negative.

And that's probably about survival and threat sensing.

Like in some ways it makes sense around human survival, but it doesn't make sense around human trauma, right?

So you had given the example of, what gets communicated to the child when, say, mother says something negative about father when father's out of the room, father says something negative about mother when mother's out of the room, just to give an example.

So children, because the complex cognitive mechanisms haven't been formed yet, the natural way that the brain functions is in a self-referential way, right?

So the child, doesn't have the capacity to say like, mom and dad aren't really getting along well in this certain way.

So when dad's not here, mom vents a little bit about something about him by saying, the child isn't thinking about that, right?

Then what the child will often internalize is, Okay, there's me and there's mom and dad and mom says dad is bad and dad says mom is bad. and I must be bad too, right?

Because in general, if your parents are bad, then the child takes that on themselves.

Now, again, I'm giving a simple example, but I'm very much extrapolating it.

I mean, imagine if that were very, very aggressive, The mother, when this happens, just tells the child how awful the father is, and the father does the same.

Someone's not gonna come out the other side of that being like, you know what?

Maybe they're both awful, but I'm not. That's not how that goes, right?

So the lessons, the traumatic lessons of childhood get internalized And they don't even always have a solution state.

So you think about the man who knew like, okay, you have to go get this job and like all those things he internalized, you might say, well, I mean, he got to a good place for him, right?

So for better or for worse, at least it was a place to go.

To go work hard, go succeed, go check this box you've been told you're supposed to check, But oftentimes there is no solution state.

So how many children... I mean, it's terrible that this is such a high percentage of the work adult practitioners do is... is helping people who as children were told one way or another that they were worthless, incapable, bad, right?

That gets put into the child, unfortunately, far, far, I mean, one time, on the planet is too frequent, let alone how often this happens.

That example makes really good sense. Could we...

And this is a question, could we add to that the example whereby the child overhears examples of what, say, men should be like, or women should be like, like the, these things, it's not so much like you did wrong, Andrew, or, you know, you did wrong, Paul, like, or, or telling, um, that are like you screwed up, but it's more, again, narratives that we overhear or even a parent showing, delight or excitement about a certain phenotype in the world.

Like, oh wow, look at that person or look at them.

Like, isn't she beautiful, right? That the young child thinks like, okay, well then that's the epitome of beauty through the lens of the parent.

Or gosh, like this person, like, ugh. Then that child internalizes that this is the epitome of disgust with another human being.

And I think children are so savvy without realizing it.

It's like, okay, well then I guess you move toward that and you aspire to that and you deflect from that.

And you can see how these trajectories can be set very early on.

I mean, these are the four-lane highways that we were talking about at in episode one, where just routes of neural processing that can bring us to choices in life and places in life that oftentimes you're like, I don't want to go down this path anymore.

And so the exploration of early narratives, both direct and indirect, first person and third person, seems so critical.

How does one go about that? I mean, clearly with a trained clinician like you, you would guide somebody through the process.

But if somebody were to try and do this in some sort of structured way for themselves, what are those lines of inquiry look like?

Because we have, vast number of experiences from childhood, but some messages are gonna be more salient than others.

The idea that reflective self-scrutiny can help us, I think, is a great idea.

It's a great concept. We do a lot of different things sort of inside and we're guided to do a lot of things inside.

But this, I think... it should overshadow many if not most of all those other things, like what's really going on inside of me?

Because if you think about it, a lot of people will come through that and they'll learn, right?

So the person is told like, this is what beautiful is, this is what successful is, this is what good enough looks like, right?

And that person may through all sorts of experiences, maybe other people in their lives who are more balanced, be able to arrive on the other side of that even still sometimes going through the midst of it, depending upon age and situation.

And they're like, okay, like that's what, you know, my father and mother thinks like, this is what beauty is, this is what success is, but it's one set of opinions.

And it's not a set of opinions that are gonna define Like sometimes people get to that place, but a lot of times they don't and they carry that lesson forward and they're not aware of it.

So they think that they're very unattractive even though other people are giving them different signals.

They think that they're very dumb, even though other people are giving them different signals and their own grades and their own success. maybe giving them different signals, right?

But they're not putting the two things together and that's going to generate tension, right?

That might be why that person doesn't follow up on potential relationships, right?

They just don't think they're good enough.

And the person's eventually going to reject them because of what they look like, right?

They're taking that with them in this example from childhood, right? or they're not satisfied with the job that in other ways is like really great, right?

They enjoy the work, they enjoy everything but it doesn't pay enough.

Right? Why? Because they have some false idea inside of what it's supposed to pay, right?

Because it's what the parents said. So by self-scrutiny, like what are the givens?

I always think it goes back to the math minor, right?

If you can't solve the problem, go back and look at the givens.

What are you taking for granted? Like, oh, I know that every time I see an X, that X equals four.

Really, maybe you wrote down four somehow because you were thinking of four at the time and X actually is a three, right?

So just go back and look at what you're taking. for granted, right?

And a lot of times this is what we're doing in the therapy process.

And then that's when the person can realize, so I'm simplifying, but for the person to realize like, oh, There's a voice in my head, so to speak.

It's a natural voice that is the voice of this person. who may not even be around anymore, whose opinion doesn't mean to me what it did before, but that voice is saying, you're unattractive, you're not making enough money, you're not good enough, right?

And you know what? I don't believe that.

They can identify that and then you can, it doesn't happen all at once, but you can get it out of you.

Generally, you don't get it out of you unless you realize that it's there.

What is the process of getting it out? Because I think that... we all have the capacity to remember certain things and to arrive at a place where we can, okay, I'm taking for granted the fact that there's a voice in my head that says blank.

Actually, I have a brief anecdote to say about this.

And this isn't the quote unquote, I have a friend thing.

I literally have a female friend who the other day called me laughing and crying. because she was being evicted from her apartment.

And she told her mother about this over the phone.

And her mother's response was, well, at least you're thin.

And she was laughing and crying about it because it reflected so much of her childhood.

That like no other accomplishment of having a job, having an apartment, et cetera, like, you know, It was about one thing.

It was about a certain form of aesthetic beauty that I'm not even sure even though she happens to be thin, right?

So the fact that her mother would lift that the conversation, there's such a deprivation of so many things in that interaction.

But it really wasn't about that interaction.

She was calling me because it was really about her entire childhood.

And obviously I'm not equipped to solve the problem and it wasn't a request for money or anything of that sort.

It was almost like the hilarity and the... and the sadness of the whole picture, right?

But again, it's, speaks to these narratives that we internalize and that sometimes show up in very glaring ways in the real world.

It's like to hear that I think was shocking to her.

I think she needed to tell me to like, Like, is this real?

But then it was clear that that message had existed in her head for a long time anyway. um that could be very pivotal if she realizes that right and even the power of the humor of it this is absurd right that could be very powerful in in creating change.

Because if there's some vestige of that inside of her, right, where like she's still Like, I'm not good enough because I achieved A, B and C, but I don't look like X or whatever.

It can have very much help because there's a lot of power behind realizing that absurdity of like, oh my God, that's bizarre.

But wait, is any of that inside of me? Am I carrying some of that with me?

I mean, there's an incentive for self-scrutiny through what you're describing.

Because what's the ideal amount of that to still be in her?

Zero. So as one comes to realize the messages they've heard, or perhaps like in this case that they're still hearing, is the process of overcoming those messages and really arriving at the self.

It sounds to me like it's a, two-part process, at least two-part process.

It's to look in the bin of what are the givens?

What am I taking for granted about the internal narratives?

And thinking about their origins, in childhood or elsewhere, but then also cultivating the self-awareness piece that's under the function of self.

Like wait, what's really true for me at the level of me, that isn't the voice.

And this is really, I think about separating out the voices in one's head, these internalized narratives from the person that we really truly are.

Because the idea is that those two pillars encompass everything we need to look at, right?

Those 10 cupboards encompass everything.

So it's all that. The person who's going and looking at the givens, they're trying to understand what might be in my unconscious mind that I'm not aware of.

And wow, the last time I got this big award at work, I had this reflexive thought of like, but you're not thin enough.

Wow, whoa, right? Like there could be a process like that's going on inside of me.

I don't want that going on inside of me, right?

So the process of trauma, what is unconscious in us that may be causing us harm, which is often where the trauma goes, right?

It's where the childhood trauma seats itself. which brings us back around to the intrusive thoughts.

Intrusive negative thoughts and negative self-dialogue usually does not mean what it meant to the man who need to change jobs, right?

Because they were there for a good reason, right?

Then he needed to make change. More often, the vestiges, the hangover, the lingering badness of some prior trauma.

So oftentimes when you think, we talked a little bit yesterday about the person who was, driving in the car and just telling themselves over and over that they're a loser, right?

And then they can't achieve the things that they achieved when they stopped doing that.

I'm simplifying a little, but that's the basics.

Because the intrusive thoughts, the self-narrative, all the negativity in us is often coming from places that are in the unconscious mind.

Not always, but this idea that I don't think I'm good enough.

I'm saying to myself over and over again, Well, let's go back and look at why, because the answer to that, again, lies in a different place.

It's just a different roadmap. The man who needed to change jobs had a roadmap that spent a little bit of time in the I, self-awareness, and then it went through self-defense mechanisms in action land.

And it spent a lot of time with behavior and then it got up to the strivings.

That's his roadmap. Whereas for someone who's laboring under the intrusive thoughts, the negative self-talk, the automaticity, the givens of childhood trauma, then needs to go to a different place where now we're spending time in the unconscious mind, thinking about what's there. figuring out what's there, bringing things to consciousness.

That person, say, realizing maybe, Your friend, you had this realization of like, oh my goodness.

We say, wow, did that bring something to the conscious mind in her?

If so, great, let's look at that and let's look a lot at it and let's look, are there other things there too?

Are there other givens? Let's bring them to conscious. to consciousness so that we can talk about them.

We can identify them and then look at how does that relate to defense mechanisms and character structure?

And like, now what are we doing? a process of interested inquiry, like this is really interesting.

I mean, it should be interesting to the person doing it, it's them.

And it should be interesting to the person doing it with them.

Because if you're a therapist and it's not interesting to you, you need another job.

So you're talking to a friend, like if it's a friend is going to be interested.

So there's an interested, honest, open inquiry with the idea of, let's learn things together. so that we can make change for the better.

And even though, as we talked about yesterday, the intrusive thoughts and the self-dialogue that's going on over and over and over again, it doesn't go away easily.

But that doesn't mean it doesn't atrophy over time and go away, or that the person can have that reflexive thought like, there's the thought again that I'm a loser or that I should cut myself or I should drink or whatever it is.

I know that thought appears in me automatically, at times because it was in my head for so long, but it is not telling me anything.

It's just an automatic thought. It doesn't tell me I should drink.

It doesn't tell me anything other than the fact that, oh, that's what happens in human beings.

That's how the self-understanding – brings change in us and gets us over the barriers of why I've been trying this for, you know, what modern mental health would often have us think.

I took the Celexa and I did the 10 sessions of CBT like, I'm a failure, nothing will ever get better.

A different framing that says, this can get better over time.

And my understanding and my efforts and my thought redirection, my behavioral changes, all makes it better.

And then those things I don't want in my head, they're going away.

It's taking time, but they're going away.

I'm relieved to hear you say that one can have intrusive thoughts And that one approach to dealing with those is to acknowledge them and look at them and not try and push them back deeper. not trying to eradicate them.

I'm familiar with having intrusive thoughts, not all the time, but at various periods throughout my life.

The idea that one can just like extinguish them is, but that's simply not the way it's worked, at least not for me.

But I have found that if I, you know, say, okay, this is spontaneously coming up through the neural circuits of my subconscious and they're intrusive and I don't like them.

I eventually arrive at exactly the place that you described, which is that it's like, there's nothing actionable here.

They go from being intrusive and troubling to intrusive and just kind of mildly irritating to intrusive and like, And yes, I go through some redirect, like trying to redirect my attention from time to time when they're happening.

But I eventually just get to a place where it's like, okay, it's just a boring story or boring imagery.

There's nothing there. Like there's nothing there.

And then they eventually break up like clouds.

And that process could take a while. Right, because you took the energy out of them.

You made them go away, which happened over time.

And then the energy that was so powerful becomes less and less and less.

And what happens? They dissipate, they atrophy.

That's how they go away because there's no more power.

There's no more power in them. And that really is the way that we make change.

And I think your emphasis upon The fact that it takes time, the fact that it takes effort, the fact that it only goes away slowly Over 20 years of at times being a therapist, what I've seen the most daunting, the thing that makes people just give up and go away and go back to the things that are bad, give up on themselves, that it takes time.

And if you think it's supposed to take two weeks, And the world around you is kind of leading you to think that.

And then you go for help. And the help kind of leads you to think that.

Whether it's two weeks or it's ten weeks.

If it's going to take two years, you're going to go away or maybe more angry at yourself or maybe demoralized.

So we have to look at the truth A parallel to your story, in my own life, for years and years and years, I carried a negative voice inside There's always waiting for me to do something wrong.

So if I say something that's a little bit off or not exactly what I want to say, Now it would say like, that wasn't good.

Like it says something negative inside to me or it's waiting for me to drop something and say that I'm stupid and clumsy, right? with me all the time, but over time through self-reflection, through therapy, like through a lot of hard work, but a desire for things to be better and a desire to understand it, it's not there anymore.

Every now and then it'll raise its head, right?

I'll do something really. I dropped a cup of coffee.

I haven't done it in 10 years and it made a mess.

And now people are coming to clean it up.

And man, the voice came back. But I could recognize it.

I really feel bad about this. And now it gives that voice a chance to come out, but it doesn't come out. much anymore, whereas I lived with it for years.

It doesn't come out much anymore. And when it came out not that long ago, like I could recognize, like I'm not happy I did this and let me help clean it up.

It doesn't mean I'm an idiot, right? So the voice in my head can just go away as I've been helping it to do for a bunch of years now.

Yeah, I think also important for people to understand is that it takes time, but that we can all potentially engage in action right actions you know moving towards strivings and hopefulness as we cope with those and try and diminish those internal narratives, those intrusive thoughts.

It's not as if during the entire process, you can't function.

I mean, I think that it's cognitively and sometimes even physically demanding to do, we can still engage in healthy ways in the world and we can still try and avoid acting out and avoid forms of denial.

And as I say this, I'm realizing that, you know, that the wish for or the impulse to really just suppress intrusive thought born of trauma or whatever else is really futile.

Like that's not going to work. It's not going to work.

We have to embrace these narratives and not expect them to disappear in a finger snap. but embrace them and like see them and look at them and be unafraid to look at them and discount where they are absolutely not true.

I would say unafraid to understand, right?

Because we must understand understand, means we must look at what's going on inside of us.

When I didn't like that voice, but was afraid of it, like what is going on inside me?

What does this say about me? And I'm directing away from it.

Well, that's why it was with me for like several decades.

But when I start to go look at it, I can find an answer to it.

And you have to look at what's going on in that person.

Because one might presume and maybe people listening are presuming this or maybe not, A reasonable presumption that might just reflexively happen in a person would be to think that, oh, when I was younger, the messaging I was getting was that you're not good enough.

You're not good enough, right? That's why I carry with me that you're not good enough, right?

But it's not that. Sometimes it's the opposite.

I was rewarded a lot when I was younger for doing things in a way everyone thought was great.

Like getting great grades and being well-behaved and doing all sorts of things that brought a lot of positive reinforcement to me. but I never handled well things that fell even a little bit short of that, and then it would evoke a lot of shame.

So the oppression inside... is not coming from denigration, it's coming from something different.

Which is also why this is not a search to blame someone.

Because sometimes the people who are giving the message, they're doing the best they can.

Someone who's saying to a child, you're a loser, that's not okay.

No matter what, that's not okay. But that's often not how it happens.

The parent is communicating, they don't realize that that every time they're admiring a certain level of wealth or a certain kind of beauty, they're giving that message that the child that doesn't meet that or ends up not meeting that isn't good enough. but they don't know that.

Or my parents tried to nurture me and they did a good job of it in many ways and teachers did a good job. realizing, hey, this person's going to end up a bunch of years from now not thinking anything's good enough.

I mean, they don't know that. So it's not a search. for blame and I think that's very, very important, very important because often people don't wanna look inside because they think either I'm gonna find something dramatically wrong with me And the answer I would give is there's almost surely not something dramatically wrong with you if you're having that thought.

And if somehow there is, you're better off looking at it now than later, right?

And so that's part of it. The other part is, that people become worried that they're going to ruin something.

I like my parents, and if I go look at this, I'm going to hate them.

People say things or think things like that.

And the idea that we may get down to something that really involves someone being responsible for something bad.

Now, if that's the truth, the person already knows that inside the vast majority of times.

They know that, they're just not facing But most of the time also, it's not that.

It's just like, okay, that's how life evolved.

And what's the predisposition? I was smart enough to get good grades and I have a low threshold for shame and people reinforced me. and like, oh, I can kind of understand that, so then I can get control over it.

It's not a search for anger, frustration, blame of self or others.

Yeah, and oftentimes I hear that people are afraid of dealing with these deeper issues or addressing these deeper issues for fear that they'll lose say their drive, right?

The thing that makes them successful in the first place and that allows them perhaps even to afford therapy or afford the time to think about these sorts of questions.

It seems to me that the drives that you referred to earlier, the generative drive, the aggressive drive, and the pleasure drive, are such critical nodes or areas to look for all of us in terms of figuring out whether or not we're doing well or less well, according to some features that are pretty much universal in people.

Essentially what I'm saying is, at least by my understanding, we all have drives to some extent or another.

And to the extent that our aggressive drive is very high and pleasure drive is very high and whether or not it's pointed in the right direction, it can be generative.

If it's not, perhaps it can undermine our generative drive.

I'm very curious to know, how you've observed the different ranges of these drives in people and how that predicts whether or not people will do more or less well in different areas of life, essentially how the different drives play out.

I think the first thing to say is where the drives are at, so to speak, in any of us is a combination of nature and nurture.

So the nature part tells us the range that the drive is going to be.

But because nurture means so much... to humans, as we understand it from epigenetics, from the advancement of science, we see more and more and more how much nurture matters.

So the range that's denoted by nature is probably pretty broad.

We see the manifestation of that and then the nurture lets us then move that drive.

Now, sometimes nurture that's not gone in the right place can move the drive in the wrong direction, right?

But as adults, as people who can take care of ourselves, who can learn about ourselves, change where the drives are seated.

It's not an easy thing to do because it requires a lot of changes of self, of self-knowledge and hard work, but we can do it.

We can change the sort of array of how those drives are manifesting themselves within us and we see that, that's part of the hopefulness of mental health treatment, that we see not just surface changes but we can see changes on a deeper level.

So I think it's important that these things are not fixed although there are some natural elements.

Someone who may have a natural sort of low aggression or low self-assertion is going to be in the lower range but it doesn't mean that it's locked in at any one particular point.

And that the place that we want to be, what is the place that's consistent with the things that we want, the agency and gratitude as verbs and the sense of well-being and all of that.

So the idea is the state of health has the generative drive as prominent.

It's the dominant drive. and then aggression and pleasure which are still active in us, but they're subserving the generative drive.

And that's the state that we wish to be in.

So when we're assessing, okay, why is there something that doesn't feel okay or something that's not going okay? then one way to start is to look at what's going on in the person, what may be off in the drives that gives us a very strong idea of what's going on, a way of understanding what's going on as we then go and look in the ten cupboards to figure out the specifics.

Okay, what is actually going on here that we can then change But the framing of what's going on can come through the lens of looking at the drives and how they're manifest in us.

What does it look like when the aggressive drive is very high and the pleasure drive is also very high?

So if these drives are running too high, where we end up at is in a place of envy.

And envy, I'm always on the soapbox about envy because I think envy is just so wildly destructive.

And if the aggressive drive is very high, so the person, say, in one...

One way this can manifest itself, just wants more and more and more.

They're not getting satisfaction from anything, but they want more. that may be because of a strong vulnerability inside of them.

So something that might map to narcissism, for example, there could be a strong aggressive drive to get more and that leads to something that's very unhealthy.

So the idea that I want more, I need more, I don't have enough, I can't get enough, then fosters envy, which is not the desire to be better or to have more, but it's just the desire to feel better about the self, whether that involves raising the self up or bringing someone else down.

That's why envy is destructive. So very high levels of aggression that are not tempered, for example, by a generative drive that would also be high, then create a circumstance of envy and the envy is destructive.

And the same happens if the pleasure drive is very, very strong.

So if one continues to want more pleasure, so I can't find any satisfaction, I don't feel good about myself anymore, I feel bereft inside and I see that pleasure can make me feel better, but just for a little bit, right?

Then it fades away and I want more of it and I want more of it. that also can lead to the place of envy.

Like that's the outcome. So if the aggressive drive is running very high or... the pleasure drive is running very high, or if both are running very high, but it only takes one in order to end up in a place of envy.

So if the generative drive is not high enough to overcome how high the aggressive drive is, which would mean then the aggressive drive would be sublimated towards good performance, productive thing.

So take the energy and put it towards something that is goodness.

But if the aggressive drive was way out there ahead, of the generative drive, that ends up in a place of envy, as does the pleasure drive.

If I want more and more and more, but I never get satisfaction from anything.

It never brings me any sense of goodness that where it ends is in a place of of vulnerability and resentment because envy involves wanting more.

And envy, if we look at what's really going on, envy under the surface involves wanting everything.

If a person is at the outer limits of envy, which is why envy is so destructive.

Because if I can't get enough pleasure and there's so much aggression in me, then I'm not going to make myself feel good.

But what I can do is make other people feel worse.

I want to ask you more about envy, but first I want to ask, is one way to characterize the generative drive and to distinguish it from the other drives is to say that generative drives are pro-social, meaning they tend to bring about benevolent interactions between people.

In the sense that pro-social as constructive, right?

As in a sense, building goodness, then...

Yes, because it's the drive in us that makes us want to love and nurture things, that makes us want to learn and sometimes learn to make better in the world or learn for learning's sake. that the drive is a drive of goodness.

So if the drive is then going to enact itself in the world around us, it's gonna be pro-social because we exist as social units, right?

I mean, if we decide, oh, I wanna be an island off somewhere, like that's not healthy, right?

We exist in... social units from small like a nuclear family to a neighborhood, all the way up to nations and to the planet.

So if we perceive the truth of that, that there's an interdependence between me and others and I see that, then the drive will lead to choices and behaviors that are socially constructive.

Earlier you talked about aggression and you were clear to make sure that we all understood that aggression does not necessarily mean violent aggression. that there are different forms of aggression.

I'm curious if you could give us some examples of how you've observed people with high levels of aggression and high levels of pleasure drive as well, both male and female.

And here without defaulting to stereotypes, I think a lot of people just, despite the fact that you've clarified what aggression is and isn't in the context of this conversation, we hear the word aggression and we think, verbal attack, physical attack.

However, the way you're describing aggression and the aggressive drive, I have a feeling that you're referring to other expressions of aggression as well.

So if the aggressive drive is running too high, and that could have factors of nature, factors of nurture, factors of the situation the person is in, factors of their whole life, but it ends up at the moment in a place that is too high, then what that person is doing in one way or another is to try and exert an unhealthy level of control.

And that can be done in so many different ways.

It can be done in that overt way of just intimidating people, of using harsh language, It can be done by manipulating people.

It can be done through passive aggression.

There are all sorts of ways that the person can try and exert unhealthy control, but that's where we end up if there's too much expression of the aggressive drive in us.

That makes sense, and it reminds me of an example from my own life where, first off, I should say I've had almost exclusively positive collaborations among my colleagues at Stanford and elsewhere. every one of those collaborations has ended in a paper that we were all happy with, but more importantly, the relationships grew and, uh, we're not diminished.

Right. Um, But I had one collaboration with someone not to be named where it was going very well, but I had the need to reschedule an appointment.

So I sent ahead a note about the fact that my car needed dealing with.

I had some other things. I explained why I need to reschedule the appointment. and didn't receive a reply, which was a little unusual, but then eventually received a reply that said, Well, it's clear that you don't want to pursue this collaboration, which is like the furthest thing from the truth, right?

And so I... And so I expressed that and then the collaboration was reinstated.

But it brought to mind some concern for me. because it was sort of an extreme reaction to, you know, something that happens among academics. or anyone, we get busy when things come up.

It was important to tend to the car, that is.

And then at some point later, They were late to a number of meetings.

Okay, no big deal. We're academics, we tend to run late.

That's typical of many academics. But then I was late once to a meeting and they essentially left and wrote an email that said something of the sort like, I've got my own great ideas, so I'm no longer interested in pursuing the collaboration.

And I was pretty shocked, right? Because...

There was nothing really outside the ordinary in terms of... busyness and professorial schedules.

And there were other people involved, postdocs and things like that.

And there was a great project to be worked out.

So I remember being disappointed, but also really kind of surprised.

But then when I mapped it back to the earlier example of the car incident, I thought, well, like there's a real... sort of lack of ability of this person to handle disappointment.

And yet they're exerting or demonstrating rather some of the same behavior of, occasionally running tardy and these kinds of things.

And I remember feeling like it was pretty aggressive.

Like it's a pretty aggressive reaction to something that, you know, it could have been handled with a conversation.

Now I must say, I'm very grateful that the collaboration didn't proceed and it went elsewhere. and worked out great and they're doing great and we're doing great.

And so no hard feelings, but it stands out to me as a, as a, pretty salient example of aggression, but not played out at the level of yelling or anything.

There's a passivity in there, but then there's also kind of a, kind of entitlement.

And here, of course, I'm only looking at the other person's behavior.

And I should acknowledge, I realize, Canceling, not good.

Being late, not good. But listen, I'm a human being and I- But you canceled once, you were late once.

This isn't habitual. This is human stuff, right?

Right. And a lot of good work had gone into the project.

And there was a cost where, you know, most importantly, the postdoc suffered. because they weren't involved in these interactions at all, and yet the project halted at that point.

So to me, that seems like an example of somebody who has a, well, strong, aggressive drive.

And that's clear from that they are incredibly successful in the academic domain.

And when disappointed, you know, lashes back or is passive, one or the other.

Is that what we're getting at here? Right.

Not surprisingly, perhaps the person rarely publishes with other people.

Right. Probably that doesn't make a very good collaborative partner.

Right. And it totally makes sense. I mean, if you think about what you... describing here, which is some vulnerability in the person.

There's some way in which the person doesn't feel good enough, no matter what this person has achieved.

So then there's a sense of the need and the right to over-control.

So when you agree to work together, you didn't agree that...

I'll never have to cancel anything, right?

But the thought was different. The framing is different. on the other end, that now we're going to work together.

So I'm exerting significant control over you.

And again, you're not aware of it. Right?

And maybe that he's not aware of it. In this case, it was a she.

Okay, okay. So I was thinking of someone different, but she... has to have some deficit of self that results then in the reflexive need to over control.

And think about the first response is a non-response, right?

Which is, that's aggression, but it's just passive aggression.

The thought would be, well, you're worried something doesn't feel good in you because I didn't respond, which was true.

You're expecting a response, maybe you don't know, did you get the email?

You know, what's happening? Is she mad? So it's sort of effective.

It creates some consternation and some dissonance. in you, then on top of that, the person is willing to potentially at that point sacrifice the relationship.

So you think about aggression now is not good.

This excess aggression is not good for you. it also is clearly eclipsing the generative drive, right?

Because it's not good for this person and their research.

It's not good for this person and the postdocs. in their lab, but the person is willing to accept that in the service, of gratifying the excess in aggression.

Now, so then you said something that then sort of made it okay. right, for the short term.

Okay, then the person feels gratified. Like whether you apologize or not, they took it as, You know, you've to some degree bowed down before me now, like it'll be okay, at least for the short term, right?

But then the next thing that happens actually does end the collaboration.

So that's not good. And even from a self-serving perspective, that person was collaborating with you for a reason.

She saw a benefit to the science that she's very, very interested in through the collaboration with you, but then let that all go.

In the service of what? In the service of the ego, right?

I don't feel good enough about myself. The response to that then is a response of envy, that I don't like that you have the freedom to behave differently then I want you to, right?

I don't like any of it. I don't like that I don't control you as much as I would like to.

And ultimately... It's that envy that becomes destructive.

So it's a setback for that person. It's destructive of the science that person was doing.

It's destructive of the science that you were doing.

So envy is destructive and here the high, level of aggression, the aggressive drive is at a very high place, it's exceeding the generative drive.

The pleasure drive isn't high enough either because there's not enough pleasure coming from the great science that's being done, right?

So then the person is approaching the world through the lens of envy right they don't feel good enough they want to exert that aggression through over control and what they end up doing is destructive And it's very clearly destructive.

It's a great example because it's destructive of the science, which is ostensibly the reason that you're there.

It's the reason you were there. who needs to exert over control is there not just for that reason, and then the other reasons can trump the generative reason. that they're there.

And that's how envy, when... It is the product of aggression or pleasure-seeking being too high always, unfailingly. creates destruction.

And how different is that from agency and gratitude as active action?

There's a sense of agency, but the agency isn't being exactly enacted, because if the agency is being enacted in the service of science or career or whatever it may be, that's not going so well, right?

And the gratitude part isn't active. Like, my goodness, I'm here.

Like I have this great career. I'm discovering things.

I get to spend my life in science. I get to collaborate with you.

There's so many things to feel good about.

I have postdocs in my lab. I get to nurture them because I know more and I can guide.

That's not leading, right? Envy is not those things, which is why people who are doing that, at least in this realm of life, although this often, no, this bleeds into other realms of life.

What you, the vast majority of times, you see is someone who does not have happiness.

In the way that we're the happiness with the quotes, right?

That happiness is the sense of peace, right?

The sense of, well-being, being able to delight in things, contentment.

The person doesn't have that. Right, and here it's interesting, right?

This person gets to the highest levels of academia and they're very successful and they have a lab of their own and they're collaborating, you think that's all great, right?

But not inside of them, it's not bringing them those things is evidenced by how this person is behaving.

And I would bet almost 100% if you say, what's that person like in other aspects of life, at least in the professional world, probably in others too.

No one's going to describe a happy person. so much of what you just said captures this individual extremely well.

And it also reminds me that so much of the way that you're describing this aggressive drive, can also be observed perhaps in the way that people show up to social interactions. not necessarily big interactions, maybe even just interactions between two people.

What I'm thinking of here is the person, male or female, who shows up and just kind of takes over, like talks the whole time and tells stories.

I went to a meal when I graduated university and someone showed up for the first time at this meal, meaning we had never met them before and just like sat down and just started telling stories for like an hour.

And it was interesting, portions of it were captivating.

And then at some point I realized like this is either total pathology, like this person is crazy, but they weren't crazy or they have no recognition that, They're absorbing all the oxygen in the room, as it's sometimes described.

But it seemed like... they had this need to just control the whole environment by way of speech, just like, you know, fire hose stories.

And I've seen this definitely in the academic realm.

I've seen this in the non-academic realm and social settings.

And what's interesting is perhaps why this person does this or these people do this.

But what's also interesting is how people react to it.

On the one hand, I think most people find that kind of obnoxious, but there also seem to be people who see this as like, oh, that person... has a lot of agency, like they're a leader, like they actually grab a lot of the attention that they're seeking.

And we tend to view those people as kind of empowered.

I don't actually think that they're necessarily empowered, but perhaps it stems from the feeling that the rest of us I like to think have, which is some sense of social etiquette, where there's some give and take.

You walk into a room, you kind of assess, what's the context here? there's some listening as well as some speaking and so on.

And so when someone shows up and kind of violates all those rules, On the one hand, it can be obnoxious and overtake everything.

But as I said before, you know, there's also this sense of like, oh, like – that must be nice to just be able to like be as one feels.

And so I think, I'm describing this not because I think people should mimic this type of behavior either way, you know, be really meek and not say anything that's on their mind or just overtake, but because...

I feel like it might be an exploration of this aggressive drive.

And if someone's doing that, are they trying to mask something else?

And why do people react to these seemingly powerful people in this way?

These things happen in the world around us.

They're independent of the spectrum of gender, the spectrum of intelligence achievement.

They're human beings. problems so a person you're describing whether that person has character structure problems that are present with them across time, or whether they're in a certain place, whether it's in life or today, like we don't know for sure, what the underpinnings but what you're describing is it's a presentation of narcissism.

Right? And narcissism is rooted not in confidence, not in arrogance, right?

It's rooted in vulnerability. It's rooted in I don't feel good enough.

And narcissism then engages with the world through the lens of envy.

So no one else gets to have any time. No one else gets to say anything funny.

No one else maybe gets to say anything at all, right?

There's a dominance of the room, right?

There's a dominance of the room that comes through an inability to tolerate the back and forth of human interactions, human engagement.

So then that person becomes very dominant.

And why is that? Because when they tell a story and they get a or even if it's not that funny and it's a 15 story, but somebody smiles a little bit or nobody smiles, they can perceive inside that like,

I just did that. I said that. And maybe somebody responded positively.

I feel good about that. For a split second, now that's gone.

And then the next thing comes and the next thing comes because people who are coming at the world through the lens of narcissism, whether it's just in that, particular event, right, or it's across life, right, are never satisfied.

And nothing ever brings enough goodness.

Nothing ever brings enough feeling of pleasure.

So the person then wants more and that's how the person dominates the room.

Now that can be very seductive. Narcissistic people, not always, but are often very seductive because of that appearance of mastery. of control.

So that person did have, we could look at it in the short term and say, that person had mastery over the room.

No one said anything for an hour but them.

So they had mastery over the room. They had control over the room.

But what they're doing is exerting over-control.

It's like penny wise and pound foolish, right?

Borrow a dollar today to pay back a hundred tomorrow. because they got to control that room, but a lot of people, not everyone, Some people are seduced by it, but a lot of people will take away from it something that's not a good feeling. something that wasn't mutual, that doesn't make a person want to collaborate with that person, even be in the same space as that person, right?

So it's counterproductive. because the people who might come under the spell, so to speak, they're the people who were brought under the spell.

They're less observant, dynamic, you know, intuitive, introspective.

They're not the people that you want in a sense on your side, right? the people that would be most valuable to collaborate with, even as thought partners, have conversations with, those people are going to be put off because even if they don't know exactly what's Wrong, they know like, that didn't feel good.

And they map, do I want that feeling more in my life?

No. So that's the counterproductive aspects.

That's why narcissism is destructive. Because you might say, well, there's nothing destructive in that in that interaction.

But again, you have to be standing so up close to it that you don't see the bigger picture.

Because when you stand back from that, that's not a person who's...

By and large, you see that's not a person who's interconnected in the world around them, has a group of good supportive friends, has a bunch of colleagues, where they can exchange information.

Because all that social dynamic has to happen in the rest of life.

So you're seeing a situation that is counterproductive, that is destructive.

And you always see that when people are enacting narcissism, whether it's okay, a bunch of bad things have happened and for whatever reason, like I'm in an unhealthy place and I'm enacting it right now.

Or if I'm enacting it every day of my life because it's in my character structure and I have it recognized and and change it, it's always destructive.

The narcissists that I've known and observed almost always seem to have a partner who clearly supports their narcissism or at least doesn't speak up very much against it, at least not publicly and not much else except a professional role.

In fact, there's one scientist who I did not work with who comes to mind and the joke about him was always that, This person would talk about themselves endlessly for the first half hour that you run into them and say, okay, well, enough about me.

Why don't you tell me about me? This person moved to a different country with their partner, comes back every once in a while, has essentially done nothing over the last, decade or so, kind of left the field.

And it's kind of secretly the laughingstock of the field.

There was a... One other anecdote about this person, I'm just, I'm not picking on them.

I'm just trying to explore these dimensions of aggression and low pleasure. drive and envy.

At lab meetings, it was well known that they would host a basketball game But it was well known that you did not want to score like, you know, on this person. because you would be asked to leave the lab.

And indeed, several people were asked to leave the laboratory for having embarrassed the lab head at one of these lab events. in exactly the event that was described in the way it was described and doing something competent.

Right, so the game was essentially a way for the person to build themselves up. and they were a mediocre at best basketball player.

So like, here's this game where everyone's expected to pretend, Right?

And I have to imagine, pretend that the person is actually better at what they do than they are.

And in some ways, it feels like a replica of how how narcissism shows up in so many other areas of life.

Like you said, you know, these people are rarely surrounded by people who are actually very bright, self-effacing, et cetera, they tend to gather people that just support them or no one at all because no reasonably healthy person would choose to be around that person.

Right, because that game is a metaphor for all of life. for that person.

It's sending that message, like see this message and extrapolate it out to everything else.

What's the metaphor? What's it communicating?

It's communicating that you don't do anything better than I do.

You don't rise above me, interestingly. You don't arise above me in any way.

You don't get to know things I don't know.

You don't get to do anything better than than I do, right?

Or I will be destructive towards you. It's fascinating because it's not about the game.

The game is a way of of communicating that message.

The person is not even that good at the game, why not choose something you're really good at?

Because then the message is not communicated as clearly.

And a lot of this is unconscious. Let's choose something I'm kind of fair to middling at, right?

And then make it very clear that no one gets to be better. or I do something destructive to them.

I mean, that's exactly what that is. And imagine like someone is thrown out of the lab, right?

I mean, like this is in many ways, like the biggest thing in their life or one of the biggest things- Yeah, it's anti-generative.

I mean, the cost of that in the larger world is- one less potentially fantastic scientist.

And that's the broader, that's always the broader picture because the narcissist is standing very, very close to the tapestry.

And so the interaction there is you have scored a basket when I have not.

So you don't understand the message that you're not supposed to exceed me.

And now I will get rid of you because you're dangerous to have around, because you don't get the message and you may exceed me in other ways and also I'm gonna feel better because I have the power to be punitive, even though it's wantonly punitive and completely unjustified, but I have the power to do that.

And it'll make me feel good then to push you away.

And I know that's not going to be good for you.

And I'll feel good about that. right but that doesn't last of course that's why the person continues to do it and it also doesn't understand at all that like that's not good for science, right?

Or most importantly, that's not good for me.

There's a graduate student in that lab because you didn't say, make the graduate student leave if the person wasn't good.

No, it's make the graduate student leave no matter what.

So the person is doing things that are injurious to the society around us, obviously to the specific person they're targeting, and also to themselves.

And that's where if you follow envy and you see high levels of it in situations that are unbounded, So like this situation is unbounded in the sense that the person can do that.

There's no higher authority. Right. Well, labs, this is changing.

And by the way, I should back up a second and say that I do believe, and it's been my experience that most scientists and lab heads are not narcissists are quite kind.

I mean, they'd be a little quirky, we're scientists after all, but not narcissists.

At the same time, it is true that for a long time, less so now, laboratories were sort of like little fiefdoms.

There was very little oversight from the universities.

And so the lab you joined became your entire world and landscape.

And there was some exploitation by narcissistic lab heads for sure. yeah, as you said, it was unbounded, right?

Like there was no oversight, whereas this would be much harder to recreate today if someone wanted to.

And I think that's why almost everyone listening to this will resonate with them.

They'll find some familiarity because You can see this in situations where there's a bounded group of people.

There's just a certain group of people in a certain situation and that's who they are. but the authority of the person leading the group is unbounded.

So there's a situation where if... that person has narcissistic tendencies, aggressive drive is too high, pleasure drive is high but not being met.

If all of those things are happening, that's when you see this coming. to light, which is why the destruction varies based upon the destruction that's permissible within the framework, right?

So here this person wasn't going to fire everyone in their lab, right?

So in a sense, they could only damage their labs so much, although maybe if you damage your labs so much, you don't get funding, you inadvertently sink yourself.

So even there that person could bring about their own destruction.

But when you see the other end, where it's truly unbounded, like in the sense of war.

As someone who can control a machine of war, who then has everything, right?

Like, what do they need, right? Well, they need something they don't have and never will get.

So now they start enacting war and war is...

And you think, oh, that person wants something.

I mean, how many times does someone start a war There's clearly an unjustified war.

It's a war because they want something, then they get something and they're satisfied.

That's not how it goes, right? Then they get something and they're not satisfied and they want more.

So in discussions at times about, narcissism and envy and how that can play out on the world stage.

So sometimes huge events in human history will come up and people, for example, will bring up Adolf Hitler. the idea that Hitler wanted things, wanted things.

No, the unbound narcissism, the unbound envy wanted destruction.

This is a person who, if things had continued to go as this person intended, there would have been no one left on earth. but him because the process is nothing but destructive, which is why after the fact, there's... incalculable human carnage, right?

And he himself was among the incalculable human carnage because that's the endpoint of narcissism of narcissism on a broad stage, right?

That's the endpoint of envy at its highest magnitude.

And we see that as examples, whether we see on the smaller stage of the lab a head that you're describing or on the larger stage of unbounded war we end up with destruction, like 100% time.

That's the final common pathway for all of that.

Are there some consistent themes of childhood that lead somebody to become a narcissist?

In addition to that, I'm curious whether or not narcissists ever have insight, whether or not if offered the opportunity to explore the 10 cupboards under the structure of self and function of self, whether or not they, eventually see inside those cupboards and go, oh my goodness, I've got this, a self that's clearly overinflated and I've got these defense mechanisms and I'm so envious and modify their behavior or whether or not the narcissists are immune from constructive self-reflection.

The answer to the first part is, The vast majority of narcissism, maybe all of it, we don't know for sure, is rooted in the childhood trauma of not feeling good enough. which is not an excuse for people doing awful things.

It's not what we're saying. We're trying to have an explanatory mechanism. which goes back to formative life experiences and not feeling good enough whether it was because that person was directly denigrated or that person wasn't denigrated, but could never work hard enough, never could be enough. to get approval, right?

And again, it's not 100% and human beings are complicated, but if you go and look, you see that, that there was never a state of like, oh, I feel good enough about myself, right?

And if there's never a state of, I feel good enough about myself because someone has told me that and given me the pat on the head or, giving me the positive comment, you can see how in a certain sort of natural lay of the land genetically and in concert with other experiences, that person can get to adulthood with a lot of aggression in them and never having experienced I'm good enough, it's still running along inside of them. and then they're enacting that aggression in the world around them.

That's most commonly what we see. And because there's such deep vulnerability and such deep insecurity than people who suffer from full-blown narcissism, narcissistic personality disorder so an action of envy on the highest levels, that is, they're so defended, they're so strongly defended in an unhealthy manner from seeing their own vulnerability, that it is extremely difficult. to get that person to come around and say, okay, let's look in those 10.

Within the field people often talk about treating narcissistic people, they talk about it in a nihilistic way.

And some just see very experienced people say, oh, that's impossible, right?

That never gets better. Now, I'm not a believer in therapeutic nihilism.

I think... that yes, it is the norm that that person just, can't get it together to go look at that thing.

They're so defended against it. They're so afraid of it.

They won't look anywhere near it, so they're looking in the other direction and they're furthering all that unhealth.

It's not the case that it's always that way.

And on a couple of occasions I have worked with, seen, witnessed narcissistic people who can make changes.

Now, it's usually in the context of something very extreme that causes them to do that.

So someone who will no longer have access to family members they want to see or to financial resources that they, need to keep themselves afloat.

It's things that often are that dramatic.

It's not always that, but we can see though in those kind of extenuating situations where the problem is so big, the envy is so high, But the motivation for change is very, very high because in the carrot and stick model, the stick here is very, very strong. that if a person then goes and does that, you can see change inside of them.

So we're never in a place of therapeutic nihilism. but the barriers to that are very, very high because the self is so wounded that the person is protecting that self so strongly.

That's why the narcissism and envy are so full blown.

And it's hard to get that person to go back and look, but not impossible.

Based on what you're telling me, it seems that it's a very low probability that... a non-clinician could change a narcissist.

Like in other words, if one is engaging in the world with a narcissist, because they have to presumably, or they just find themselves in that place. would you say to that person there's very little, if anything, that you can do to change the narcissist's behavior or psychological framework?

Because of course, if the narcissist can't often do it for themselves with the help of a skilled clinician, why would a, Why would anyone else be able to achieve that?

We're coming at what we're doing here from a perspective of truth about human beings, right?

And that truth brings with it hopefulness.

It brings with it hopefulness that people can change and how people can change.

And I... I'm 100% all for that. It's the way to look at ourselves.

But it is also true that there are aspects of pathology that require clinical treatment in order to improve.

So now we're looking from the other side and saying there's a problem here and there's a deep problem here.

And that we have to come at from a different perspective of how can you help that problem And there's a science behind this too of what level of clinical care, for example, is most likely to be helpful to someone like this.

And it's not an individual clinician. It's a team of people who work through different modalities who can sort of wrap around that person.

So it's not just... a level of clinical care is needed, but it's a relatively high level of clinical care.

And that in general is the only way that we get at narcissism.

That's not a hundred percent, but that's the vast majority of time.

So what can then the person do? A person cannot be a team of clinicians.

What that person can do, one choice is to disengage.

But disengagement can come with the promise of re-engagement.

Many, many times I've worked with people and practiced and rehearsed with them.

Like, okay, what might you say to someone along the lines of, I've known you for a long time, or I care about you, or I love you, whatever they may say to lead in, I can't be with you, I can't be around you.

There's something going on that makes it not okay for me, it doesn't feel okay.

A person maybe says things like, you know, you're aggressive or demeaning or whatever it is, or maybe they just say, it just doesn't feel okay, I can't have it.

And then the need to step away from the person.

But look, if you got some help, right? If you took better care of yourself in ways that would... be better for you and for the people around you, then of course I'd want to be in your life."

Something like that, so disengagement can come with that encouragement to the person.

But one way or another you have to set boundaries, which is okay, I have to deal with this person so I'll deal with them a little bit, Or I don't have to deal with this person, so I won't.

Or I can't get away from this person, so I have to take with a grain of salt what they're saying to me.

But ultimately, some form of strong boundaries or disengagement, that's the response that...

That's the self-care response for the person who's with the narcissist.

What are some other ways that the aggressive drive and pleasure drive and generative drive, for that matter, play out?

For instance, we talked about the former patient of yours who eventually switched jobs, clearly had a generative drive within him, but it was being blocked by a number of choices rooted in narratives that originated in childhood, et cetera.

We talked about individuals with high aggressive drive, high degree of pleasure drive, but a very diminished capacity to experience pleasure and therefore a lot of envy and the destruction that comes with envy.

What are some of the other variations on these drives as you observe them in your clinical practice?

Well, our overall framing is we want the generative drive to be the one that's deterministic, right?

It's the one with the strongest, So we want to nurture the generative drive in us and in others, and it makes sense for us to talk about that. but we've looked at how do things get out of balance?

And from the perspective of, well, what if the aggressive drive or the pleasure drive, what if they're too high?

And then it makes sense, that often not always what can be driving them to be so high are things that aren't healthy in us.

Then the higher they get, the harder it is to gratify.

So we end up with that problem of envy. But we can be out of balance in the other direction where the person does not experience an ability to engage with the world around them.

They don't think they can do anything to change anything for the better inside or outside of themselves.

They're not doing much, they don't feel that they can do much. not receiving pleasure from things.

There's no gratification from the things a person is doing.

Like we see situations like this too, with the aggressive drive, the pleasure drive or both, and then we end up not at envy, because envy is the side of excess, but we end up at demoralization on the lower side.

Now demoralization is not a specific psychiatric diagnosis.

It can predispose to psychiatric problems like the biochemical abnormality of depression.

But what we're talking about here is not a psychiatric diagnosis.

Envy is not a psychiatric diagnosis, it's a thing that can be experienced that can lead to diagnosis.

The same thing with demoralization, if you don't feel that you can make a difference to anything, and you're not enjoying anything or feeling gratification, from anything, then that pool is going to win out.

That's going to be a demoralized... The same way of course we know in experiments when you have a rat going for food, if you do it enough when the rat goes for the food and you take the food away, the rat stops trying.

The learned helplessness phenomenon. Right, that exists in us too, and it comes along with all sorts of other things, because being not rats, We have a whole bunch of thoughts about that of, oh my God, I'm not good enough and nothing will ever be okay.

So demoralization then... can be very, very strong in taking a person away from the other things we're trying to seek, either because that person has essentially the learned helplessness, and all the complicated things inside of us that can come along with that, or the person isn't gaining pleasure from anything.

So when we're considering the ways in which we can be out of balance, right? we think, okay, aggression and pleasure drive, if one or the other or both is too high, we end up at envy.

And if one or the other or both are too low, we end up with demoralization.

And you can take almost any scenario. It could be a scenario of something that's just not really not going well for a person. not a clinical scenario, it's a thing in a person's life.

Or we can take clinical scenarios And the vast majority, outside of outliers like a head injury, for example, we can take those scenarios and we can look at it in that way and we can understand what's going on.

At least we can understand enough that when we go back and look 10 cupboards of the two pillars, we can then have some understanding of, okay, what is going on?

We know the basic picture and how things are not in the balance we want them in.

Now we can understand that enough to go back and then look in those 10 cupboards.

And I believe that just about everything except those biological outliers like a head injury fits into that. which is why we can use it to understand.

We can use it to help. We can use it to make change.

What a powerful lens to think about and explore the self and where things are working for us and where things are possibly not working for us.

If I or anyone else out there wanted to get some read on it, assess their level of aggressive drive and their level of pleasure drive and their ability to experience pleasure.

What sorts of questions would one ask? You know, for instance, is it a question of how driven am I?

How much get up and go do I have? How much pleasure do I, experience from an interaction with a puppy, an interaction with food?

Is it too much? Like, does it draw me off course?

Are those the sorts of very simple, but and perhaps also very informative questions that we could start to use to probe our psyche.

Yeah, I think yes, but I would come top down, right?

So if the goal of health is that aggression and pleasure, those drives are subserving the generative drive and start to look there, right?

If a person can take an honest inventory of self, like what kind of force am I being in the world around me?

And that could mean, for example, what kind of force am I being in my family?

Am I denigrating to the people around me?

Are the other people in the home afraid of me?

What kind of force? Am I being a force for good?

Am I bolstering? People can't always see that in themselves and take stock of themselves, but what we're talking about a situation where we think a person can, like they can bring to bear Who am I being in the world?

In other ways, think of the example of the person who needed to leave the job, who could look at that and say, no, I'm not.

I'm not being generative in the world in the way I want to.

I'm certainly not doing my job as well as I would want to.

I'm making my own life worse. So that person could then see that's out of balance.

Or in another way, a person might see a lot of what I'm doing is self-serving or maybe destructive.

People can realize that, right? So you can realize by taking an inventory of self, is the generative drive what's deterministic in me?

And again, not always, but we're talking about a process of exploration.

If the answer to that is yes, if you say, I'm trying to be the best person that I can be, and I think about the people over whom I have any authority.

And I try to be reasonable and I try to be fair and I try to be circumspect.

I try and think in someone else's shoes.

Sometimes I have to set boundaries or expectations or even punishment. but I'm careful about how I'm doing that.

And I'm certainly not perfect and I get things wrong at times, I do think I'm contributing to the world.

I'm doing whatever I take on as well as I can do it.

I'm productive at work. or my kids are doing okay, or my friends are doing all right, whatever it is that if we can come up with that, then we can say, okay, exhale a little bit.

Like you're in a good place, right? It doesn't mean everything is optimal, of course.

So then go look at, the level of the aggressive drive, which might mean how assertive am I?

Am I the kind of person who comes up to the precipice but doesn't make the decision?

Am I the kind of person who's a little too assertive and sometimes I'm sort of walking on people a little bit?

Like a person can go look at the aggressive drive within them Or pleasure seeking, am I doing things that bring me gratification, right?

Am I engaging with the people around me in a way that brings the gratification that one might one might wish for, right?

So if it's in a romantic relationship, is there romance?

Like are we being nice to one another, right?

So you can go and look at that and say, am I getting gratification from the things I'm doing? taking wherever this drive is within me and trying to satisfy it in reasonable, healthy ways that are also good for others.

And we're back to the generative drive. So that's one way of coming at it and it's the way that we would like to because now What do we try to do next?

And what can we make things better? Can we optimize things?

Okay, things are okay, but can we make them better?

But let's say we see that the generative drive is not winning the day, right?

And people can see that, like, look, I'm seeking... pleasure right it's why i got for example i hear over and over that's what that's why i got addicted to this substance and now is not providing any pleasure to me and it's now making me miserable, but I wanted what it was giving me.

Again, this doesn't mean that the person just wants to have the world's best time. it may mean that they're really suffering a lot, right?

And the pleasure that that drug gave them was some relief from pain.

And this is how many, many people tragically ended up becoming addicted to and dying from opiates. because say the opiate after the surgery or the opiate after the injury then is soothing something.

And it's soothing something because the person feels less bad about something inside of them.

You hear this all day. that then fosters addiction.

So that person looking for pleasure, this isn't something where we would say in some light-hearted manner that person took chances with their life.

I mean, sometimes we'll see that, but more and more what people are looking for then is relief from suffering. but we can get to that point where we can ascertain for whatever reason that the pleasure seeking is too much.

And if pleasure seeking and aggression are too much, we become aware of dissatisfaction, right?

If you're relying too much on aggression, I always want my way. it's not always gonna happen, right?

Or I always want that pleasurable thing.

I always wanna feel better. That also doesn't happen, right?

So then that can guide us towards being aware of where are those drives, and if the drives are high, how much...

Dissonance is created by what's actually coming of the drive versus the level the drive is at.

So I guess it's a long way of saying yes to your question, but I would sort of come top down because the generative drive is so important and it does gain form. like kind of where are we at in the spectrum of like how healthy am I

Are there elements of unhealth I want to kind of go after or am I seeing things in myself that really say things that are unhealthy are really dominating are deterministic, like addiction.

Just one example, addiction, things that are self-destructive.

Because then, that's a place to then look at it more through the clinical lens.

And maybe I won't just talk to a trusted other and go get a book, but maybe I should.

And maybe I should have a clinical care.

Yeah, the example of addiction is very potent.

And it also brings to mind the perhaps less – apparently dangerous situation, but one that I think is really common where people have a certain amount of aggressive drive They have a certain amount of pleasure drive, but there's a kind of passivity and draining out of the generative drive.

We're competing out of the generative drive because of social media.

And the reason I bring this up is again, not because I dislike social media, I rely on and use social media for teaching and learning extensively really, But in going back to the pillars that underlie whether or not we achieve and experience agency, gratitude, peace, contentment, and delight. within the pillar of function of self, there's this thing, salience, and what we're paying attention to internal and external.

And social media does seem to me a unique circumstance, never before observed in human evolution. where you have a near infinite number of environments available to you.

And we know that a picture is worth a thousand words and a movie is worth a billion pictures. when it comes to drawing our attention.

I mean, you just look at, you give a young child, even an infant an iPad, I mean, that kid is in the tunnel.

I don't necessarily think that's a bad thing and that computers and computer screens are going to be a part of their lives now and forever, presumably.

But it is the case that there are a lot of people who perhaps have the propensity for a strong generative drive, but because they also have a propensity for a pleasure drive, they wake up, they pick up the phone, they look at the phone, you know, something captivates their attention.

Then they're thinking about that. It might be something that brings them delight.

But more often than not, it's something that brings them either mild irritation or or mild entertainment, maybe even intense entertainment for a short while. very quickly minutes and hours go by in which we are not engaging in the world unless we are posting valuable content.

And so social media is a bit of a drain on these drives.

I mean, it taps into these drives in very strong ways.

All one has to do is observe the behavior of people in public spaces now, in airports, on trains, even in their cars.

I mean, people are essentially watching TV all day long.

And it does concern me. And I raise it because I feel like it can distract from our generative drive in a way that... it doesn't necessarily speak to any kind of like deep character flaw or any kind of subconscious narrative, but just that that salience, is clearly something within that salience cupboard is happening that's unprecedented. and very, very powerful and potentially quite destructive.

I think to understand this, I would cite this belief.

I believe this to be true. Human beings have a long history of under appreciating the power of the discoveries that are then in their own hands.

So we discover gunpowder, how long until we're shooting each other, right?

We discover nuclear fission, Now, are we going to destroy the planet?

So social media, in a sense, it's a discovery.

It's a thing that comes from what we figured out as humans that now is there in front of us and big powerful discoveries deserve to be treated with respect.

Gunpowder is very powerful and if people need to hunt in order to survive, gunpowder can help them hunt without getting hurt and be more successful.

Nuclear fission has provided some good things to humanity, but it can also destroy humanity.

So I think the same is true here that what you're talking about is something of immense power.

And you can see how if it gets out of balance.

So let's use the salient. So let's say the social media is too salient.

That's going to make a problem. If it's too salient in the sense that the person is always looking at things that don't make them feel good enough, well, that's not going to go well and that's going to affect what's in those other areas.

10 cupboards, right? And what is built on top of it.

So then it gets into the unconscious mind.

Oh, I thought I was good enough until like now I'm looking at all the social media and I realize I'm not.

I mean, this is people who treat teens often talk about this that, you see something that you didn't often see before where a person who might've gotten through a lot of formative years thinking like, oh, how I look is okay, for example, then is bombarding themselves with social media that tells them how they look is not okay.

And then that changes. Absolutely. Or perhaps...

Social media is just simply absorbing a ton of time and energy, but mostly time that could be devoted to a generative force.

Right, that's the other side of it. So think about the example of the person who I know it wasn't social media, but we were saying, well, what if it were social media that instead of 90 minutes a day,

It's eight hours because there's an analog there, right?

And we see a lot of this and it's taking something that can be good.

And in a sense, they even should be good.

There's enough out there in terms of learning and bolstering that why should it not be good? but it's not good because the defenses then shift.

Like if you're relying on it 10 hours a day, there has to be some denial, right?

Because there are other things to do There has to be some avoidance, there has to be some rationalization, like something is going on there that's not healthy.

So if you tell me this person is utilizing social media 10 hours a day, they're not looking at things that make them feel bad about themselves.

They're just doing it. Then I think, okay, something is... is out of balance.

Now, it may be that that person's defenses are out of balance.

So think about the example of the person with the job they didn't like, then their defensive structure changes then the thing that was good for them, they rely on too much, and now it becomes something that's not.

Good for them, right? So then you go and look at what else is out of balance here What else is driving this?

Maybe it's being driven by the change in defense mechanisms, et cetera.

Maybe it's the other way around. this person just kind of habituated to doing more and more and more of it.

And then you would come at it in a different way of, okay, can you slowly but surely do less? replace the time with things that were good before because you could then back that person out to where they were before.

But you're not going to back the person out to where they were before if it's being driven by something else.

So we again come to the curiosity. You tell me that person is on social media 14 hours a day, I'm curious.

I want to understand what is the balance of those drives.

You've just told me a very powerful point about salience. that doesn't sound like a good one.

So already you're giving me clues about where the drives are, which means where's that person at, what's going on in all those cabinets, then you give more, Now sit and talk with the person.

Now you're going to understand what is the lay of the land here and how do we go about making it better.

I love the concept of the generative drive, first of all, because it's pro-social.

It brings about great things for us and for the world.

I mean, what is better than peace, contentment and delight, especially when we remind ourselves that those are active or those can be achieved and experienced inside of action.

It's not just sitting, levitating, navel-gazing, that sort of thing. enlightenment, right?

It's peace, contentment, and delight. Very big difference.

Very big difference, yes. One of the other reasons I love this concept of the generative drive so much is also because it is a verb state.

It has to do with creating things in us and in the world, in cultivating, our experience of things and what we do and what we say and how we respond to what others do and say.

And I also like it because It's distinct from the way that we're normally taught to think about psychological wellbeing or being a healthy individual, usually centers around a discussion of goals and values.

And like, what am I trying to focus on? And what sorts of people do I want to engage with in the world?

And certainly all of that is really important, goals and who you engage with.

But I think for many people out there, much of their time is spent thinking about other people, like how healthy or unhealthy are the people they're dating or their friends or what's going on between two family members, which of course is fine to think about.

But a lot of emphasis is placed on like our assessments of others and how those are impacting us.

And in some cases, people default to just thinking about others and their problems and seeing their problems.

And what we're really talking about here is a process of introspection and inquiry that's very structured.

And as it's been laid out by you, you know, these two pillars, structure of self, function of self with these 10 cupboards, that might sound like a lot of cupboards, as we talked about in the first episode, all of that flows up to these very simple, and concepts and action states and ways of being.

And to me, there's nothing more powerful than the statement that what we are all seeking are states of agency and gratitude.

Because again, to go back to the analogy of physical fitness, there are not an infinite number of different physical states or states of fitness that one, can seek, there's endurance, there's strength, there's flexibility, there's dynamic movement, there's explosiveness, there's speed, there are a bunch of subtleties to it.

Here, it really seems that the psyche ourselves and our mental health is really tractable if we turn the lens and we look inward.

Yes, yes. I think that hits upon a very, very important point as we talk about understanding oneself in the process of change.

And I would describe that as rational aspiration.

So let's use the physical health example.

If I think, okay, I want to be healthier.

I want to have more strength, I want to have more endurance, and I might even have ideas I want to be able to run a certain distance in a certain time, lift a certain amount of weight.

I have an idea of what that is. but rational aspiration is rooted in our present.

Or like I'm aware that there's a me now, that isn't in that state.

And I'm aware that there are things that I'm going to do to get to that state.

And I'm not dreading them. Like, okay, they'll be difficult, right?

But that's okay. I can do difficult things.

I can take pride in doing difficult things.

And that's how we all achieve things. So I see myself in the present because of course goals are good and that's true. as long as we're still living our lives in the present, because otherwise goals just become fantasies or things we want to possess.

So if I'm aware of the state of physical health I'm in right now, and I'm aware of the state of physical health I want to be in, And I know there's a bunch of pathways I could take to get there, but I have to think about it, figure it out, do those things.

And then I'm going to navigate myself there.

That's how the whole process is good. I don't feel bad about myself now.

I recognize something I would like to change.

I'm not saying, oh, you're a loser because you don't have those things.

I feel good about myself now. I recognize there's something I want and there's going to be a process, a process across time, across effort, that's going to navigate me there.

Then when I get there, I feel good about being there.

It's very, very different if I think I want that.

I wanna possess in a sense, right? I wanna possess the ability to run a certain distance in a certain time.

I just want the thing, I'm covetous of the thing, right?

That is not... Because the person then often is denigrating to the self, not always, but that's a motivation to go out and get that thing that's better.

And they're really lamenting the process of getting there.

They just want something as an endpoint.

And that doesn't make for happiness. It doesn't make for even the humility and humility in action, the gratitude of the humility is I can't just do that overnight.

I'm going to have to work hard. People have to work hard.

I'm no different than anybody else. I'm not special.

I got to get in there and work and use the elbow grease and then I'll get... like all of that is good that I just want to possess something is, and that's why people in scenarios like this, they might like go through maybe in an unthinking way or they're gutting it out where they go and they get that thing.

But then that thing is not enough, right?

And they want more. Now, there's nothing wrong with wanting more if it's the healthy inaction of self.

I'm going to now map my way. This feels better.

I want to map myself from here to the next level of better physical fitness.

That's different than I just want that thing because then if I get it, it won't be good enough.

It doesn't make me happy. It doesn't satisfy me.

And that's the unhealthy state of just wanting things to possess them.

And then we don't feel good about them, which is the thought of if you give people, if you give a person something, they'll resent you for it, right?

Again, we're painting it in a certain way.

The context of that statement which I used to hear even when I was younger, people would say that.

And what were they trying to get at? What they were getting at is it doesn't feel good if you didn't work for something.

Like if you didn't work very hard and you got a C, but I give you an A or somebody gives me an A.

I know that that's not good. I know that I got the thing.

I got the A and I might feel happy in the moment because I wanted that thing.

But there's no... real pleasure in it. There's no satisfaction, there's no contentment, there's no sense of self, there's nothing generative.

I didn't work hard enough to go from a C to an A.

So it's that and that really brings us back to the self that we're growing on top of you know, of the structure, right?

And how that self is functioning, right?

How it's striving Now we're really talking about strivings.

And if I'm going to strive for something and work hard to get it, well, I get the good feeling on the other side of it.

And now we're living in the generative space.

Well, I love the structure of what you've laid out.

Again, the pillars of structure of self and function of self.

10 cupboards between the two of them that when explored can seem a little bit complex, but they're really some very straightforward types of inquiry that anyone can go about, about self-awareness and address potential defense mechanisms, what we're conscious of, maybe what we're not conscious of, look at our behaviors and our strivings and how that flows up to these simple ideals again of empowerment, humility, agency, and gratitude as verbs.

And then from that peace, contentment and delight and the generative drive, which gosh, if there ever was a more powerful concept and something to strive for, I don't think it exists because the generative drive is, extraordinary in the number of different ways it plays out and it seems always positively And of course the aggressive drive, the pleasure drive exists to varying extents in all of us, but cannot be allowed to overcome the generative drive if we're going to really thrive.

So thank you again so much for this framework.

And again, to remind people listening and watching that this framework mapped out in a downloadable PDF if people want to see it visually, even though we've touched on it several times before.

I really appreciate how logical clear and actionable this framework is.

And also that in providing a framework for us, it gives us something to hold our mind to.

I think I and so many people out there are familiar with being in a struggle and not being able to orient.

Like, where am I in the struggle not knowing what to do?

And you've provided some incredible points of reference for us to really like focus on, start asking questions about, and how I see myself, what am I paying attention to?

And so on and so forth to really first anchor and orient and then be able to move forward in this process as many times as is required to get where we each and all want to go.

Thank you so much for this. I know in our next discussion, we're going to touch on the relational aspects of human existence, you know, not just selves, but interactions between selves, including some of the let's call it a darker and unfortunate aspects of human existence, like narcissists and some of the challenges of different, you know, full blown personality disorders, but also just in terms of and building healthy relationships between friends, romantic partners, parents and children and siblings and coworkers and all the rest.

So thank you again for this incredibly rich knowledge that you provided us and a map forward.

You're very welcome. And thank you. I appreciate the opportunity to talk about it with you.

Great. Well, to be continued. Thank you for joining me for today's discussion about how to improve your mental health with Dr. Paul Conti.

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[A Structural Roadmap to Mental Health: Understanding Drives, Agency, and the Generative Self]-[GUEST SERIES | Dr. Paul Conti: How to Improve Your Mental Health]

📋 Summary

The Architecture of Mental Health: A Structural Roadmap

The Ten Cabinets: Mapping the Self

The Three Drives: Aggression, Pleasure, and the Generative Drive

Overcoming Hindrances: From Envy to Agency

Protocols for Growth: Introspection and Action

Conclusion: The Path to Wealthy Living

🎯Key Sentences

📝Key Phrases

📖 Transcript