One Hidden Cause for Six Different Symptoms. The Psychiatrist Explaining Why 50% of Physical Complaints Begin in the Mind | Dr. Paul Conti

What if everything you’ve been told about mental health is backwards? In this episode of Mayim Bialik's Breakdown in honor of Mental Health Month, Dr. Paul Conti (psychiatrist & President of Pacific Premier Group PC) reveals why focusing on what’s wrong with you may actually be keeping you stuck, and how a completely different approach can unlock resilience, hope, and real change. We dive into the shocking truth that MORE THAN HALF of physical health issues may originate from mental health, and why treating symptoms alone (with medication or endless information) often misses the root cause entirely. You’ll learn why overdiagnosis is more dangerous than you think, how self-fulfilling prophecies quietly shape your reality, and why “feeling fine” might be the biggest thing holding you back. Dr. Conti breaks down the hidden long-term effects of trauma, including how it impacts longevity and can even be passed down genetically, and why the cycle of intergenerational trauma can stop with you. He shares his personal story, the critical difference between grief and trauma, and why letting go of guilt and shame is essential for true healing. We explore why mental health stigma still exists despite everyone talking about it, why it’s so emotionally difficult to examine your own mind, and why you can’t separate mental and physical health, no matter how much we try. We also discuss: - Hidden root behind multiple symptoms you didn’t know were connected - Why more information won’t help unless you can actually apply it - Surprising reason relief from distress doesn’t equal happiness - How your recurring thoughts may be shaping your entire life - Why giving back can make you feel whole in ways nothing else can Plus, we tackle some of the most controversial topics in modern mental health: - When medication should (and shouldn’t) be used - Dangers of turning to AI for therapy - Why elevating science to the level of “truth” can actually limit human growth Most importantly, Dr. Conti introduces a powerful, practical framework: using compassionate curiosity to re-examine your life story - so you can begin healing, even without professional therapy. If you’ve ever felt stuck, overwhelmed, or like you’re missing something important about your own mind, this conversation might change how you see yourself forever! Check out Wondering Jews with Mijal and Noam and subscribe: https://unpacked.bio/q1e Start your new morning ritual & get up to 43% off your @MUDWTR with code BREAK at https://mudwtr.com/BREAK ! #mudwtrpod Get 15% off OneSkin with the code BREAK at https://www.oneskin.co/BREAK #oneskinpod Get 15% off + a FREE bottle of MassZymes ($20 value) when you go to https://bioptimizers.com/breaker and use code BREAKER. Limited-time offer, only available through this link (not on Amazon or in stores). Grab it while it lasts. Dr. Paul Conti’s latest book, What’s Going Right: A Powerful New Method for Optimizing Your Mental Health: https://www.hachettebookgroup.com/titles/paul-conti/whats-going-right/9781538776049/ Follow us on Substack for Exclusive Bonus Content: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://bialikbreakdown.substack.com/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ https://%E2%81%A0%E2%81%A0%E2%81%A0%E2%81%A0%E2%81%A0%E2%81%A0%E2%81%A0%E2%81%A0%E2%81%A0https://bialikbreakdown.substack.com/%E2%81%A0%E2%81%A0%E2%81%A0%E2%81%A0%E2%81%A0%E2%81%A0%E2%81%A0%E2%81%A0%E2%81%A0 ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠BialikBreakdown.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ https://www.bialikbreakdown.com/ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube.com/mayimbialik⁠⁠⁠ https://www.youtube.com/mayimbialik%E2%81%A0 Learn more about your ad choices. Visit megaphone.fm/adchoices https://megaphone.fm/adchoices See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Speaker 00

  More than 50% of complaints to all physical medicine doctors are originating in the mind. The increase in pain that you're having, the GI issue, maybe it's fibromyalgia, it's autoimmune phenomenon, pains in your joints, rashes, six entirely different things are coming from one thing.

• 0:16Mayim Bialik?

  Dr. Paul Conti, the psychiatrist who helped Lady Gaga, the Kardashians, Mel Robbins, the author of What's Going Right? A powerful new method for optimizing your mental health, who sees how we can all make it better.

• 0:29Speaker 00

  If we don't address the traumas in our lives, they don't go away. It spins off symptoms, insomnia, panic attacks, depression, substance. My youngest brother died by suicide. I was in my mid-20s at the time. My life was going in such a bad direction. I had no hopefulness about the future. I had unhealthy relationships. I was drinking more. I was so embarrassed to get help. And then someone started bringing order. And I started just learning the mind and the body aren't just attached, they're interwoven. And what goes on in one dramatically affects the other. We treat the symptoms as if they were the problems. Let's give you an SSRI. Let's give you a sleeping medicine. Of course, they're not getting any better. Let's look for what could be root causes. Everything worth having in life requires some work. But here's the good news. We can understand it. We can get at it.

• 1:14Speaker 00

  We can change it.

• 1:21Mayim Bialik?

  Hi, I'm Mayim Eelik.

• 1:22Jonathan Cohen?

  I'm Jonathan Cohen.

• 1:23Mayim Bialik?

  And welcome to our breakdown. You know what? Today, we're going to do something different. We're going to talk about what's going right.

• 1:30Jonathan Cohen?

  Why are we doing that, Maim?

• 1:31Mayim Bialik?

  We're doing that because so much of the field of mental health, and really, the field of pop culture, social media, is focused on what's wrong with me. What's my diagnosis? What pill do I need to take? What did my parents do that messed me up? We're going to be talking today with the author of What's Going Right? A powerful new method for optimizing your mental health, Dr. Paul Conti. He is a psychiatrist, the president of Pacific Premier Group PC, which is a comprehensive mental health clinic that provides therapy, coaching, and consulting services. You may be familiar with Dr. Conti because he is publicly known as the psychiatrist.

• 2:10Mayim Bialik?

  ...who worked with Lady Gaga, who had fibromyalgia, ended up in the hospital with a psychotic episode. He is the doctor who helped her connect her fibromyalgia to a previously unmetabolized trauma of sexual assault. So Dr. Conti is known for working with people like the Kardashians, like Mel Robbins, Whitney Cummings, Tom Bilyeu, Lex Friedman, Rich Roll, Danica Patrick, Tim Ferriss. His list of clients and colleagues and collaborators is incredibly significant for the place that we are in right now. But I think what's most important for this conversation today is that this is one of the most compassionate clinicians who is in the field, who works with patients,

• 2:54Mayim Bialik?

  who sees what the industry is doing wrong and how we can all make it go better, not just for psychiatry, for therapy, but for us as individuals. We are so thrilled to welcome Dr. Paul Conti in person to The Breakdown. Dr. Conti, welcome.

• 3:09Speaker 00

  Break it down. Thank you. Thanks for having me.

• 3:13Mayim Bialik?

  I mean, I'm always eager to talk about what's going right because it feels like nothing is going right.

• 3:17Jonathan Cohen?

  Isn't that the problem? That we feel like nothing is going right? And so much of the approach to trying to fix things is like, well, what's wrong? Why is that the wrong approach?

• 3:29Speaker 00

  There's enough that is going wrong in the world around us that we can start to make the story inside of ourselves about that, that nothing's going right, and nothing can go right. And we can see that outside of us. But then that also impacts our feelings inside of us, where we can feel like there's nothing going right inside of us and we're not going to be able to move forward or get back on our feet or whatever it is that we're trying to achieve. And the truth is, if we're here, there's a lot going right in us. And a lot of that is a birthright of being human, that our brains and our minds have evolved over many, many, many, many thousands of years in order for there to be a lot going right in us, perseverance, resilience, the things that we can seize upon, understand better, and use to make more go right.

• 4:14Speaker 00

  So it's not a blind optimism. It's looking at what's real and true about us and saying, hey, there's good reason to find hope in all of this.

• 4:21Jonathan Cohen?

  I believe you, and I want to double down on someone who is listening, who thinks...

• 4:27Speaker 00

  I've seen so much mental health content and I've been told so much about mindset and like even in the last three years, right, the amount of information has exploded and they're still like, I don't feel good. I'm anxious. My mind is racing.

• 4:42Mayim Bialik?

  Some might argue that the more we've given labels, boxes, diagnoses and everyone knowing what the DSM is, right?

• 4:49Speaker 00

  Yes.

• 4:50Mayim Bialik?

  Some would argue that we're almost in like a crisis of over diagnosis.

• 4:55Speaker 00

  Oh, absolutely. The field has not been in a position of leadership at all to help say to people, hey, here's how to understand yourself. Like you can understand yourself and there's a process that you can go through, not just to gain understanding, but to make that understanding lead to change. Instead, what we've done is glorified a book of taxonomy. And the DSM is this thick and it's got more numbers in it than we could possibly count and enough to give us all a bunch of diagnoses and all it's doing is labeling, you know, it's looking for, let's figure out what's going wrong. And there's a whole bunch of things we can identify in that giant book without any explanatory mechanism of like, where does all this come from? What can we do to bring change? So we're glorifying the

• 5:40Speaker 00

  negative. And so of course, with more information, it doesn't help people feel any better. And we take this book of taxonomy and we make it the heart of the field. And, you know, I think at that point, we're lost.

• 5:52Mayim Bialik?

  There's been an explosion in conversation about mental health. You know, when we started this podcast, it was still sort of something that was whispered in a lot of circles. And, you know, we believed that kind of democratizing mental health and even a conversation about mental health was something that we were, you know, hoping to do. Many people, you know, we started this really at the beginning of the pandemic, right? Many people who had never experienced anxiety were wondering why with a global pandemic upon us, they couldn't sleep, they were eating weird food.

• 6:22Speaker 00

  Right.

• 6:22Mayim Bialik?

  You know, they were feeling shaky and didn't know why. And, you know, those of us who've had anxiety our whole lives were like, oh, we'll tell you what's happening. Like, let me explain. This is called anxiety, right? There has been this explosion, you know, in the last years. We see so much on social Social media, everybody is sort of claiming to be the person who can help you figure out if you're on the spectrum, if you're neurodivergent, all these things. Why is it that in some cases, more information is not necessarily better?

• 6:49Speaker 00

  If more information doesn't help us understand, then more information just confuses us, or it makes us feel overwhelmed. Now I have more information, I still can't get a handle on what's going on inside of me. And the problem is that we don't have a mechanism of understanding. So you think about the difference between physical health and mental health. If you broach the topic of physical health, you know, most people can be interested and attuned to that because we know that we all have bodies, and the bodies have hearts and lungs and muscles, and we need to eat well and exercise. We have an understanding that can say if there's something I'm not happy about, or if I want to be healthier, I can anchor, right, to understanding, and I can use that to bring change. Mental health still creates stigma.

• 7:33Speaker 00

  There's a reflex of stigma and of guilt and, well, what is someone bringing up mental health for? What are they going to try and find wrong with me? Or I know there's a lot wrong with me, I don't even know what it is. And that's because we don't have a mechanism of understanding mental health and building good mental health like we do for physical health. So information has to be useful to us. And the point that I'm moving forward in the book is that we know enough about our brains and our minds to say, there is a process of understanding, just as there are with our bodies. We have all these similarities in body and in mind. And if we just take the concept of physical health and make it part of how we view mental health, now we're empowered to understand and to bring change.

• 8:17Speaker 00

  And that's why I very much hope for this book to bring real change in an overarching way that says, hey, we can understand and build good mental health, just like we do with physical health. We don't have to be afraid or stigmatized about the topic.

• 8:31Jonathan Cohen?

  I'm really excited about the next part of this conversation because we're going to talk about the mechanisms and the ways to have that type of change that will benefit people. Just before we get there, let's explore a little bit this notion of mental health, because that word even is off-putting to some people, because they'll say, I'm fine. And what I sort of am struck by is that fine is actually the enemy of improvement. Meaning that most people are stuck in some pattern that they don't even realize and they would not be considered to have poor mental health, but they're not optimized. They're not living in a way that is expansive and they're seeing opportunity and they're feeling connected and they're just living at this low lethargy baseline they don't

• 9:16Jonathan Cohen?

  even realize they're living in. Can you kind of explain to us or even set the picture for how we should be actually thinking about improving our lives even if we never have even considered that mental health could be an issue?

• 9:30Speaker 00

  He said that fine is the enemy of improvement and I would argue even one step earlier than that, that fine is the enemy of inquiry. Right? That often fine just means I don't want to talk about it, right? I don't feel great, but I don't think anything good is going to come of a conversation about it except me feeling worse. So very often our response is to avoid inquiry because there's not an expectation that inquiry will bring understanding and that we can use that understanding to bring change. The fact that stigma is still with us is because it's a black box and a giant book of numbers doesn't tell us how to understand. But if we have a route to understand, now everything is different. And that's what we want as human beings. I very often thought

• 10:12Speaker 00

  if all I did was help people understand and then we just stopped right there and we didn't go, well, how might we change that? There'd be a tremendous amount of change. There is that comes just from understanding because it's what we want as human beings. We can bring ourselves to bear. So we just need a method so that we can say, instead of saying fine, like, how about let's bring curiosity to ourselves and think of what is going on with me? What's going well? What's not the way that I want it to be? Let me take a look at that so that I can make change. That's the, that's the difference.

• 10:41Jonathan Cohen?

  Obviously, when people understand anxiety, they understand depression or lethargy. Maybe they understand feeling, you know, unsure, self doubt, rumination. But what are some of the other places that you see people making significant change in their life?

• 10:56Speaker 00

  Well, if there's a mental health complaint that someone has, or if I feel like I'm doing okay, but I don't feel so strong in case something difficult comes my way, then we want to be able to approach our mental health, just like we do our physical health. So if someone comes in with a physical health complaint to see a doctor, there's a process, right? There's a process of taking a history. There's a process of doing a physical exam. There's a process of maybe ordering some labs. We need to bring the same regiment to mental health and to say, okay, we all have a structure of self inside of us. We all have a function of self inside of us, just like we have organs and the functions of our bodies. And if we start there and we say, there's a process to go through, that's how we bring understanding. It's not by just a shot in the dark, right?

• 11:41Speaker 00

  It's by going through a process. And if we do that, and we look at the elements of the structure of our self, and we look at the elements of our function of our self, we'll find if something is out of balance. So then we find what's there, and that's what gives us a route to change. And ultimately, we're trying to build empowerment and agency, right? Directly and intentionally interfacing with the world around us. We're trying to bring a sense of humility that we too can be human, and we can have issues inside of us that warrant attention. We don't have to be ashamed of that. And through humility, we can approach life through a lens of gratitude. And it's active agency and gratitude that lead us to what we generally call happiness. And we can talk more about that. What are

• 12:22Speaker 00

  the components of happiness? And ultimately, there are drives in us that are governing all of this. So the point I'm trying to make is that there is a process, just as there is with physical health, and we can go through that process to identify what we want to change and what we want to make better.

• 12:37Mayim Bialik?

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• 13:22Mayim Bialik?

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• 14:07Mayim Bialik?

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• 14:38Mayim Bialik?

  Who's been in the mental health world as a patient, you know, since I'm a teenager. It's true, there's a very different kind of methodology that was used, and I'm an old person. So, you know, this was in the late 80s and the early 90s. Things were very, very different then. But I think it's really interesting, this notion of, you know, kind of having... You know, some sort of strategic methodology in how we sort of approach mental health, in the same way that one would hope that that would exist for, you know, for physical health and for, you know, physiological processes. My question, though, would be about where the role of the mind and body, as they function together, comes into this. You know, you have some, some very, very prominent clients,

• 15:21Mayim Bialik?

  and one in particular was this story about Lady Gaga, having not connected a lot of her emotional and mental struggles with a physical, with a rape, right? Where does the mind and body come together for you when you think about how we can approach these things?

• 15:43Speaker 00

  I'll talk about the mind and body. I just wanted to point out, you said, when you were in mental health care, many years ago, it was a different approach. But I would argue then, you could have gone to see five or 10 different people and had five or 10 different processes. So we don't have an organized process to, to, to run through and gain understanding. We didn't then, and that's even more fragmented now.

• 16:06Mayim Bialik?

  Right, no, and what I was referring to was that many girls were put on birth control, even if they weren't sexually active, because they thought that would help. And many of us were given, like, Xanax and given, you know, things to stop panic attacks, instead of anyone saying, why do you think you're dying while you're driving? Right? You know, things like that, so yeah.

• 16:24Speaker 00

  Right, right, and that's the problem, is if there isn't a route of inquiry that leads to understanding, is then you just end up with, with reflexes. Well, put everyone on Xanax and birth control, right? That comes from a lack of understanding. And then we're even another step away from understanding the integration of the mind and body. Like, we're, we're one entity, you know? The mind and the body aren't just attached, they're interwoven. And what goes on in one dramatically affects the other. So stress, tension, anxiety in us, just as one example, impacts our immune system functions, and whether we're able to navigate life healthily, or whether we develop an autoimmune disease, or whether we're fatigued, or we're subject to infection. There's, there's so much in the, the exchange.

• 17:08Speaker 00

  Between mind and body and when the body is in pain, it makes the mind more vigilant. Then we're less trusting and we're less likely to get help. So we have to look at ourselves as one integrated entity. Because in, to state the obvious, like it is true, right? This effort to separate mind and body has done us no good whatsoever. And it's taken us away from understanding how not just we are one, but then we often have distress pinging back and forth between the mind and the body. And if we can intercede in one area, we can intercede in others. So there are people who can't lose weight or having rashes that they can't explain, having terrible fatigue, have a litany of physical complaints with labs and examination

• 17:51Speaker 00

  results to show that person is having physical complaints. But the, the source of it can be all in mental health, which is just part of medicine. It's not a strange thing to say. It's, it's not a stigmatizing thing to say. It's saying if you have tremendous distress going on, you're going to impact how your body functions, the endocrine system, the immune system, the inflammatory markers inside of us. If we see ourselves as a whole, which is what we are, we actually simplify things. It's because medicine has become so siloed, right? So we're just trying to look at little facets of a person and understand. And all we do is mislead ourselves. So yes, we are very, very complex, but simple principles are always consistent with good health.

• 18:36Speaker 00

  It's just hard to get to the simple principles. And the idea that we're integrated, one affects the other, and that we can go through a process of understanding. It's not that complicated, but the, but the field has strayed so far away from it.

• 18:48Mayim Bialik?

  Well, and I think the, the stigma, at least in my experience and from a lot of the people that we get to talk to, the stigma is less about, oh, there's stress and anxiety in your life that could be causing, let's say, what's going on, you know, in various organ systems. But I'm more interested when I speak to people who do not seem to have any access to a conversation about mental health. And they can't figure out why their body keeps betraying them, right? You know, I used to meet a lot of women with like endometriosis and with all these things and, you know, and Gabor Maté and, you know, Bessel van der Kunt obviously talk about the body is keeping

• 19:28Mayim Bialik?

  the score. What is it like for us to have conversations, you know, as a society, right? With people who are possibly coming to doctors with physiological problems, which are real, right? Things like Cohen's even, IBS, things that like many people were told it's all in your head or you'll be fine, right? How do we start to have this conversation with people to say, we don't mean to kind of poke at this, but have you looked deeper? Why is that so hard for people?

• 19:57Speaker 00

  I think because of the automatic stigma. So even the way of saying like, well, you know, not to poke at this, like, like, there has to be, like, we have to apologize, you know, for saying, hey, there's, what's going on in your mind, you know, really is likely impacting your body. How about looking at, from the perspective of what's going right of saying, all we're looking for is an explanatory mechanism, right? And, and most physical health complaints, so most complaints when a person goes to a physical health doctor are coming from a mental health origin. Is that 50%, 60%, 70%? That we don't know. But, but the studies clearly tell us more than half

• 20:35Mayim Bialik?

  Wow.

• 20:35Speaker 00

  of all complaints are coming from mental health. And it does make sense because it can impact your endocrine system. It can impact how you're perceiving and registering pain. It can impact how your body's responding to infection. It all makes good sense. So there's good news here, right? And anytime someone presents and says, oh, I have five different problems, six different problems. We hear this a lot, whether it's physical health, it's mental health, it's both. And people will often say that in a very negative way. Like, oh, there's no way you're going to help me. There's, there's seven different things going on with me. And I'll say, well, okay, let's, let's think about it. Maybe. But I'm going to bet there's less than that.

• 21:12Mayim Bialik?

  What was your mother like?

• 21:13Speaker 00

  Maybe it is in the mother. Maybe it doesn't have anything to do with the mother, but there's, but there's something going on in that person that likely is, is going to explain a lot of what is going on. Maybe the endometriosis, the increase in pain from an old knee injury, the rashes, the anxiety, the panic attacks, maybe all of that is rooted

• 21:31Mayim Bialik?

  You don't have to get personal, Dr. Kunt.

• 21:34Jonathan Cohen?

  No reading her medical history on air.

• 21:38Speaker 00

  Which is how much of these problems are conserved among humans that you can almost guess. Hey, what's going on in someone? Because most of us have an overlap of the same things going on. And we're not going to solve it if we're looking away from it. And we're not going to look towards it if we think all I'm going to get out of looking towards it is some big book is going to get thrown at me. There's going to be seven numbers added to my list of problems and nothing gets better. But by saying, hey, if we bring compassionate curiosity to ourselves and we want to sit down together and collaborate, like, let's try and understand, then we really can bring change, which is why it surprises me often that people will think the field that I work in, it must be so depressing, right? Just seeing people over and over and everyone's miserable and no one's getting better.

• 22:21Speaker 00

  Nothing could be further from the truth that if we bring the right approach, where we say, okay, let's look at what's going right in each of us. Let's use that as a starting point for what we want to be different. Let's look for what could be root causes of the things that are going on in us. Then it can be a process that is both enjoyable and productive. I mean, it's hard work, but it can be used to bring real change. It's not, it's not a scary black box. It's quite the opposite if we look at it through a lens of what's real.

• 22:52Mayim Bialik?

  I wonder if you can also kind of help us understand the framework of this book. When I saw the title, I had lots of preconceived notions about what it might be and why I wouldn't like it, right? But then when I read the book, it made a lot more sense. Can you talk a little bit about what we can sort of give ourselves credit for in terms of how we got here as sort of a starting place? And you share, you share a very, very painful and very personal story of something that impacted your family in a way that many families do not recover from, right? Can you talk a little bit about your origin story and how that leads to a perspective of what is going right?

• 23:36Speaker 00

  So I think to start with, if we're here, if we're above ground, there's a lot going right in us. So someone who presents and says, oh, my physical health is terrible. There's nothing that can be done. I can't be any healthier. You're above ground. Your heart is working. Your lungs are working. Your blood vessels are pumping blood from one place to another. There's oxygen in the blood. There's so much going right. And we can use that as a starting point. It's not a Pollyanna way of looking at things. It says, that's the right thing to start with. And the same is true of our mental health. That we have these complicated structures in us, but we can go and look and say, okay, what is going right in you? Let's look at that. So someone who says, oh, I never, you know, I never get the job I want, or I never find the relationship I want. Well, that

• 24:19Speaker 00

  person's also telling you about perseverance and resilience, right? So let's start looking at that. If we look at ourselves, we're not afraid of what we're going to see, then often we can solve problems.

• 24:28Mayim Bialik?

  Then I could say, I get rejected by everyone I try and love, but I'm trying so hard.

• 24:34Jonathan Cohen?

  And look how much love you have to give.

• 24:35Mayim Bialik?

  Exactly.

• 24:37Speaker 00

  And then we could look at that. And I could say, you know, if you can tell me how you've had seven or eight failed relationships, right? And they're, and they're completely different, then I'll agree with you. But that's not what you're going to tell me, right? People tell you how they've had the same relationship, the same relationship.

• 24:54Mayim Bialik?

  I keep picking, right?

• 24:55Speaker 00

  Right. So then you look and say, here's the good news, right? You don't have six different problems that have come to your last six different relationships. There's one thing that you've done six times over, and, and you've gotten back in the game each time. Let's, let's see how we can bring understanding, right, to the process. Use that perseverance and resilience. So this time you start out on a different path.

• 25:15Mayim Bialik?

  And also, I'm, I'm making a joke in my head, like, if I constantly choose unavailable people, I shouldn't be surprised that I keep not having successful, long-term, committed relationships.

• 25:27Speaker 00

  Right.

• 25:28Mayim Bialik?

  Right.

• 25:28Speaker 00

  Right. But if you don't look at that in a way that brings that understanding, then you only think, oh, what's wrong with me? Like, I can't find a good relationship, no matter what it goes wrong. And then we start trying to figure out, of course, what's wrong with me? Now we're ashamed. Now we start making a self fulfilling prophecy. What's wrong with me is that no one likes me.

• 25:45Mayim Bialik?

  Or I'm bad.

• 25:46Speaker 00

  Yeah, I'm bad. That's why people reject me, so then I'm gonna avoid people, right? So then I think, why, now I really can't find a partner, right? Because I'm avoiding everyone now, because I've decided that I'm bad. And we just have to go back to first principles and say, look, there is a way of understanding this and a way of bringing change. And a big part of this story is how traumatic events, trauma affects us in ways that are very, very profound. And people often talk about little t-trauma or big T-trauma, and it's always one way of looking at it. The big T-trauma are traumas that overwhelm our coping skills, and they leave us different on the other side. And it's not a soft science concept. It's a concept that tells us we can age faster than the calendar.

• 26:30Speaker 00

  So these traumas that impact us and our immune system starts having dysfunction, and the telomeres that help us determine how long we're gonna live start getting clipped off. And then a person can be 45 years old by the calendar and 55 by the genes. So the downstream effect of trauma and how it impacts us is so drastic that if we understand that, we can bring a tremendous amount of healthy change. And that's part of what weaves into the story that you asked me about, where my youngest brother died by suicide. And I was in my mid-20s at the time and had not had traumas and tragedies like that in my life and really had no understanding of what had happened to me,

• 27:14Speaker 00

  that the reflex of guilt and shame was tremendous. It was tremendous in me. It was tremendous in my parents. And none of us understood. We didn't come from a place or a culture that valued understanding, mental health. That going to see someone was for crazy people, right? Which it made no sense, but it was a myth, right? And it prevented any of us from getting help. And at some point, realizing that, hey, my life was going in such a bad direction. My mood was different. I had no hopefulness about the future. I had unhealthy relationships, friendships and romantic relationships. And I was drinking more and not taking care of myself. And this realization, like, something is really...

• 27:56Speaker 00

  Wrong. And I could kind of tell it wasn't grief. You know, like, we need to be free of guilt and shame in order to grieve. But even then, I could tell like, this isn't grief. Like, I'm angry, I'm furious, I'm frustrated, I'm scared. And I finally found it, you know, within myself to get some help. And, and, you know, I was so embarrassed to go and to get help. And then someone started bringing order to, yeah, it makes sense that you feel this way. And I started just learn something. And, and that learning was able to help me instead of shying more and more away from it. Like, oh, I'm doing worse, so I'm hiding more from myself and how I'm doing. Which of course, is a very, very common story. But, but humans want light shed upon things.

• 28:40Speaker 00

  And a therapist in a very basic way, you know, in 10 sessions or so, just started shedding light for me on like, here's how your mind kind of works. Here's how you work. Here's what's happening to you. Here's why it makes sense that you're different. Here's why you're not grieving, right? You're lost in things that are not grief. And it's this ability to understand ourselves that lets us then bring change. And that's, it's that for which I'm advocating. Because if we don't do that, we do have very bad results. Like, my mother did not go through that process. And, and I think it very dramatically negatively impacted the rest of her life. There was a depression, the very severe depression probably paved the way for the cancer that took her life.

• 29:21Speaker 00

  So we, you know, we, we really do go down paths often that we can't come back from. If we don't have a foundation of understanding and therefore hopefulness. If you give a human being understanding, that person will think, I can use that understanding to make my, to make things better, right? Then we start feeling a gumption inside of us. And I think that's what my field is obligated to do. And it doesn't have a place at this table of human leadership of saying, there is a way of understanding ourselves. You don't have to be afraid of what's going on inside of you. And a lot of what you think, doesn't make sense. That's leading you to think, oh, my God, what's wrong with me? I'm crazy, I'm bad.

• 30:03Speaker 00

  You know, these are, these are natural responses in us to the, to this, the distress of being in the world. And we can understand and bring change. And this combination of compassionate curiosity and, and knowledge is incredibly powerful.

• 30:19Mayim Bialik?

  Because one of your fields of expertise is trauma, I wonder if you can, I want to double click on this. How do you tell the difference between grief and trauma? Because sometimes, something will happen that includes grief, but it is also a traumatizing event. But I'm curious if you can help us frame that because, you know, one of the things that we hear a lot of now is a lot of people feeling traumatized all the time, triggered all the time, right? And I wonder if you, from a clinical perspective, can help us understand what you're talking about when you talk about, "Oh, my brother committed suicide. I was in grief. What I was experiencing was also trauma." How do we tell the difference?

• 31:01Speaker 00

  Yeah, it's not so much the difference between trauma and grief. It's that trauma is the source of the problem, right? So it's trauma that comes our way. And then we see, okay, what happens next? So a healthy response to trauma is grief. So when my brother died, the healthy response would have been to feel sad, right? To just have realized, "Oh my, my God, there's an immensity to this. I can't get my arms around and I feel so sad and the world feels like a different place." That's the healthy response. But often, we are not grieving. I was not grieving after my brother's death. Most people who have experienced a very severe trauma are not grieving

• 31:45Speaker 00

  because we can only grieve if we're free of all the things that block it. So if I'm feeling guilt and shame and I'm angry at myself or I'm angry at God or I'm so afraid now to be in the world because this has happened, I'm not grieving. And that's why I learned, you know, when I was at the end of residency, I had a job I learned more from than maybe anything I'd done all along. I was covering nursing homes along the eastern seaboard of Massachusetts. And when I was going into them, there were still people I could do therapy with. Not everyone had Alzheimer's disease, right? There were people who could do therapy with. And I realized, if we don't address the traumas in our lives, they don't go away.

• 32:27Speaker 00

  And very many of us think, how many times has someone said to me, oh, no, it can't be that. That was three years ago, 10 years ago, 20 years ago. And I'll think, if the world figures out how we can live 500 years, and we don't address the traumas, we'll be living them at year 480. So we have to process what's gone on in us as a reaction to trauma, so that we can actually grieve. That's the healthy response to trauma.

• 32:53Mayim Bialik?

  My grandparents were immigrants to this country. Like, I don't think there even is a word in my native tongue for trauma. There's just not a word. It's just called living, right? But how many of us come from families where these are not conversations that our parents or grandparents have access to? That was considered a luxury, right? It was a luxury to think about these things. And yet, here we are, and we're dealing with, I mean, this is the concept of intergenerational trauma, right? We're dealing with everybody's shit that you then inherit, and then you're sent out into this world, right? And you're supposed to be able to navigate it, but we don't even have the vocabulary for it.

• 33:32Speaker 00

  This is where modern science has taught us something astounding. The field of epigenetics has taught us something astounding, which is if there's trauma in a person, severe trauma, that overwhelms our coping mechanisms, and then changes how we function, that change can then be passed down in the genes. I mean, this is amazing. So if you see, you imagine someone who was traumatized two generations ago, right? Terrible things happened, and now they're functioning differently. A gene that was good and adaptive and healthy in that person can then be turned off. And then the turned off gene is passed along. Now you can have someone two, three generations later, who is in a place of greater anxiety.

• 34:16Speaker 00

  There's a greater negative reaction to difficult things. The person feels unsafe in the world. And they weren't fated to be that way. That came from the trauma two, three generations before. This is just absolutely amazing. Yet, if we can treat that trauma, if we can say, yes, it makes sense that that person's coping skills were overwhelmed, look what happened. And if we can help them process that trauma, then they can become healthier. So then they're not aging faster than the calendar is aging them. They're not passing along genes that make this person two generations later afraid of being in the world. We can, we can.

• 34:52Speaker 04

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• 35:20Speaker 00

  Avoid all of that.

• 35:21Mayim Bialik?

  The best explanation of intergenerational trauma we've ever heard. I always say like the egg that was me was escaping Hungary, right? In like before World War Two, it was a very rough escape, right?

• 35:33Jonathan Cohen?

  That explains a lot.

• 35:34Mayim Bialik?

  Explains a lot. No, but I think we all have at some point, we all have that, that story, a version of that story. The egg that we were was in our grandmother, you know?

• 35:45Speaker 00

  And it was changed, right? And it was changed by the trauma, which is why for a time there was, there was a thought of how children of Holocaust survivors were so much more anxious, higher levels of anxiety, higher levels of fear of the, of the world around them, greater safety and security measures. And the thought was, well, that was nurture, right? They were raised by the people who had survived the Holocaust. But what we started to see another generation down was that that experience wasn't always communicated to the next generation. You know, sometimes there were, there were splits, the child was raised in a different setting. And, and then you started to see that, that those, those grandchildren were still in the same,

• 36:28Speaker 00

  suffering from the same profile of increased anxiety, right? Of lack of safety in the world. And the thought was, how is this happening? It's because, yes, some of it is nurture, but some of it was just nature that that egg that escaped Hungary was impacted. And even if then two generations later, people aren't even aware. Of that, the child is still different and is still affected. And I think it's the strongest case that I think we can make as human beings for the identification and the prevention and the treatment, should it occur, of trauma and for understanding our mental health, because for all of us, we don't have to transmit to our children, to the world around us, the impact of our own traumas, be that biological,

• 37:12Speaker 00

  be it in the nature part or in the nurture part. And it's amazing to me that we have the knowledge and the sophistication to understand that and to engage in prevention and treatment, and we don't do it. That when you're primed like that, then another stimulus that comes in takes time. You know, time isn't like a steel rod going forward, right? Time is like a string. And if someone is traumatized, that something could have happened a half a century ago, however long ago, to a person, but if there's a trigger that says, oh, right, they are coming for us, then now seems like then. And that triggering aspect where the emotion systems, the fear systems, the vigilant systems in us don't care about the clock and the calendar, and that's another aspect.

• 37:57Speaker 00

  Now you have someone who is suffering so much, sometimes even so that if people can't then marshal necessarily, how am I going to best take care of myself? Because what is now is so lost in the emotion of the past that we just get overwhelmed. And we're seeing a lot of that with current triggers that are related to prior trauma. And it can even be prior trauma in a previous generation.

• 38:20Jonathan Cohen?

  The other thing that jumps out at me is that a lot of people who do push these things away, as you become more compartmentalized, as you don't deal with it in the moment, you start to experience a whole host of other issues that you don't connect to that. And so you're like, oh, my GI issue, oh, my lack of sleep, oh, this chronic pain I'm having. You're so far removed that you don't really know that it was because of that suppressed grief. And the way you describe that potentially your mother's cancer came from this unmetabolized emotion, like this is just such a massive uncover. Covering of what actually impacts our physical health.

• 39:00Speaker 00

  You think more than 50% of complaints to all physical medicine doctors are originating in the mind. So, so what you just said is, is not uncommon. In, in fact, it's the norm that there is so much going on in us and we don't understand. And at times I've brought the news to someone else. Okay, there's, it's good news and bad news, right? The, the increase in pain that you're having, the GI issue, maybe it's fibromyalgia, maybe it's,

• 39:26Jonathan Cohen?

  Autoimmune.

• 39:27Speaker 00

  It's autoimmune phenomenon. You're having pains in your joints, you're having rashes, you're having swelling.

• 39:32Mayim Bialik?

  Again, he's reading my medical records.

• 39:34Speaker 00

  So we can say, look, there's, there's, there's bad news and good news, right? The, the good news is a lot better than the bad news, right? The bad news is all that is real and true and is going on in you. The good news is it has one place of origin, one place of origin. And very often it is very, very clear. You can sit with someone, you can take a history and you can see and understand where that place of origin is. And people are generally happy to hear that because they're saying, hey, these six problems that are making you miserable, that you see as six entirely different things are coming from one thing, one problem and we can get at it. Generally that feels good to a person. When you then broach that it's in the mental health arena, then often people feel very differently. So sometimes we'll talk about it a little differently, that it's actually, you know, it's actually neurologically determined. I mean, it's just another way of putting it.

• 40:19Mayim Bialik?

  People want to hear, we found the pill that will solve your eight problems. That's what people want to hear. People, it's very hard for people to hear. I don't want to say people don't want to hear. It's very hard for people to hear, guess what? There's something in you that is unmetabolized, which is manifesting in a variety of, of syndromes, of organ systems, of diagnoses, of complaints. And guess what? If we chip away at this kind of origin, your body can recalibrate. That's what healing is, right?

• 40:52Speaker 00

  Yes, I would even say more strongly than that, that instead of just chipping away at it, we say, well, let's go and do that. Right? The problem with, with attributing physical problems to mental health is people see it as a black box. Like automatically it means, well, nothing is going to come of that, right? It just means. I'm crazy and nothing's going to make me better. How about saying, no, it's a part of medicine, right? The good news is we can get at that, right? It requires some work from you, but everything does. You know, people want to be healthier and lose weight. It requires work. We have to eat carefully. We have to exercise. You know, making ourselves healthier requires work. So that's the message that I try and bring, that there is something to do about all of this. And it can change all of it. Does it require some work from you? Of course it does. You know, everything worth having in life requires some work. But can we get at it and make all of this better?

• 41:37Speaker 00

  Absolutely, yes. Now, people are interested in that because we've taken away the stigma and the hopelessness around mental health.

• 41:43Mayim Bialik?

  But we've also introduced psilocybin and ayahuasca, which sounds like a lot more fun than having to talk about your childhood trauma.

• 41:50Speaker 00

  Those are methods that sometimes can be helpful, but most people are ultimately processing this in a way that does involve them thinking about it, talking about it. And it doesn't always have to be in a therapy setting. Some people don't have access to, you know, to therapy resources. But there are ways that we can run through understanding ourselves and bringing health to ourselves that don't always have to mean formal resources. And that's part of what I'm trying to put through in the book, that by understanding the basic premise of like, how do I work, right? We can go through the structure of self, the function of self, where our drives may be out of balance, where it may be that prior trauma or some mental health issue is inside of us, that we can do that with formal help or we can start doing it on our own.

• 42:32Speaker 00

  But the message here is a good one, is that you don't have to continue suffering. Most of what's going on physically is coming from mental health. Most of what's making us miserable is coming from mental health. And here's the good news. We can understand it. We can get at it. We can change it.

• 42:46Mayim Bialik?

  I want to talk about these drives. You mentioned drives. And, you know, pretty early in the book, you talk about this generative drive. And I thought, do I have that? What is it? Can you help us understand what the generative drive is? And then also how it connects to the assertion drive and the pleasure drive? These are kind of these three drives you talk about.

• 43:08Speaker 00

  The field of mental health is very disjointed. There are no overarching principles of understanding. But there's lore and myth and a hodgepodge of. Of things that have been accumulated over time. And one aspect of what has been believed to be true over many years, 100 years or so now, has been this idea that there are two fundamental drives in human beings. And one was called aggression and the other was labeled as pleasure. And the way this kind of got to be summarized, which isn't really true, but the summary of it was, hey, we're all aggressive, we all want pleasure, we all want to club each other over the head and have sex. Basically what that was oversimplified as.

• 43:51Speaker 00

  And what it was really trying to say was something a little bit different from that, that there is aggression in us and a desire to make ourselves imposed, to impose ourselves upon the world because that's how we survive, right? And that human beings are indeed seeking pleasure. That's not a hedonistic pleasure, it can be the pleasure, for example, of knowing that we're safe, right? So if we take a look at those drives and we say, okay, let's adjust them to a sort of more nuanced understanding, we would say, we want to assert ourselves, right? And everyone, if we didn't want to assert ourselves, we'd just lie on the ground and that would be, that would be it, right?

• 44:25Mayim Bialik?

  Or we would shove down our feelings and then get an autoimmune condition.

• 44:28Speaker 00

  That might come even if we're trying to assert ourselves.

• 44:30Mayim Bialik?

  That's true.

• 44:31Speaker 00

  Right, because we might think, I'm going to assert myself by shoving down my feelings. You know how I'm going to do that is, I'm going to exercise 14 hours a day, or I'm going to read constantly, or, so we can use these drives against us. You know, we can be too assertive, or too much or too little assertive, and then we can kind of become our own worst enemies. But the idea is, we want to make our presence felt in the world and we want some gratification, whether that's a roof over our head, or it's food, or sex, or whatever it may be. This makes sense, right? That this is in us as humans, and there's a lot of evidence to show that. But if we look at the whole picture of humans, what have we learned from literature and philosophy across hundreds and hundreds and thousands of years of human existence? What have we learned from studies of psychology and philosophy?

• 45:16Speaker 00

  What has modern neuroscience taught us? What we've learned is, it can't be that those are the only two drives, right? They don't explain the humanness in humans. That what humans are driven to do is to make the world around us Better, right? To make our presence felt not just in a way that I can assert myself and survive, but the creation of art, for example. A person who has enough and they can keep themselves safe, but they go and do things for other people. People who want to learn and grow, offering someone a hand up when someone is down and no one is seeing you, do it, right?

• 45:56Speaker 00

  This idea that we just have what was called aggression, better called desertion, and pleasure in us, it just doesn't do justice to our humanity. In fact, it's insulting to our humanity. And then it makes gyrations to try and explain. It would say, "Well, if no one's around and you're walking by the lake and you see me in the lake and I'm drowning and I'm struggling and there's a life preserver and you go over to the life preserver and you throw it to me." They said, "Why would you do that?" Right? This theory would say, "Well, you want to assert yourself in the world. You want to say, 'I know that I can throw this person to the life preserver. Look at me,' right?" Or you want the pleasure of knowing that you saved somebody. It just doesn't make sense.

• 46:40Speaker 00

  Like, that's not why, and it's certainly not why people will risk themselves for other people. It's because there is a shared humanness above us, around us, that says, "I want to help that person. I feel it in me to help that person, maybe even at some risk to myself." This generative drive in us is why we do beautiful things, why we do kind things, and why we're inspired to survive, right? Not just so we can just, we got to survive and pass on our genes and we just give up or become hedonistic once we've done that. We love and we nurture throughout the spans of our life if we're in, you know, if we're able to take care of ourself and be healthy. And if we see the truth of the generative drive, which runs through our literature and

• 47:23Speaker 00

  our philosophy and our psychology and our neuroscience and our just day-to-day experience of life, then we see we're anchored to what is going right in all of us, that we get that inside of us just by being human. And when we're healthy, the generative drive is governing what we're doing. Of course, we want to assert ourself in the world and we want pleasure and gratification, but we're governed by good things. We're not saying, "Well, why am I asserting myself in the world? World's a terrible place and I got to get the most I can for me." It's not really living. It's not a good life. That's not how people find happiness in their life. If we're governed by the generative drive that sits above assertion and pleasure, and underneath that is the agency and gratitude with which we meet the world,

• 48:05Speaker 00

  and that's sitting upon a healthy structure of self and a healthy function of self. This is how we find good mental health and happiness. And you see how that dovetails with good physical health. And our bodies are not in pain, or if they are, we're taking care of that, whether it's in the physical realm or the emotional realm. This is how we can be one united being, our physical health and our mental health, living a good life, that we feel a strong sense of agency and healthy control over.

• 48:32Mayim Bialik?

  One of the things that we've been very surprised to keep encountering, whether we speak to physicians who are clinicians, or theoretical physicists, or spiritual leaders, or extremely successful people who, at the height of their careers, still felt a need to fill that God-shaped hole with different addictions. What many people circle back to is that having a power greater than yourself, having some sort of spiritual awareness or practice, seems to be this thread that runs through even the most skeptical scientists, who, when they have their own journeys,

• 49:16Mayim Bialik?

  they often find there's something that is indescribable, that is a source of goodness, love. Where does that fit in? Because I don't feel like it's separate from what you're talking about, but I wonder how, for people who are spiritually inclined, where does that fit into this?

• 49:38Speaker 00

  I'm really glad you asked that. And given that you're a scientist, I'm going to be interested in what you think about this. I think when humans have elevated science to the position of God, then humans conclude, "Oh, there's nothing else but us, and then I, the human, have mastery over everything, because now I understand. I understand it." But that's the falseness. Of taking science, which is an amazing and wonderful tool, and making it a god, which I think humans do from the desire to understand. Say, well, now I understand and I know that there's nothing there. Like, nothing could be further from the truth. If we use science as a tool, it tells us there is so much mystery, things that happen outside of space and time.

• 50:21Speaker 00

  I think it's the quantum physicists and the theoretical physicists that are the greatest ally to this. But I think, look at all the dimensions of existence and the fact that we, as biological creatures, spin off these waveforms that are not grounded in space and time. And I think there's so much that's inspiring about that, that tells us, hey, it really, really seems that there's more than us here. And that's not a Pollyanna concept. It comes from looking, from using science as a tool and saying, what do we think it's telling us? And I'm not advocating, then, for a belief system, saying, oh, therefore, everyone should believe in something beyond us. But to at least embrace that there's mystery, right? That there is mystery. It's not cut and dry, that we can understand it all. It's so, so, so far from that.

• 51:07Speaker 00

  And that mystery, then, is beautiful and it's inspiring. And if we can't see mystery in that way, can we not see the mystery in the good things that people can do for one another in difficult situations? Someone who risks their life for another person. Can we not stop and say, you know, there's some magic in that, in our humanness? You don't explain that through this, it's a god of science and we're all here to just survive and find pleasure, that there's more to it. And when we do good things for other people, I mean, this really is true, that if you don't think there's any good in you and, you know, you feel awful about yourself and you feel hopeless and you can't find your place in the world. You know, what you can do is just do something good for someone else and see how much better you feel, right?

• 51:51Speaker 00

  In part because you're telling yourself, right? There is goodness in me. In fact, there's enough that if I can't see what's going right in me, I at least have enough that I can give something to someone else. Like, wow, where is that coming from? And it's coming from a person who's up against whatever we may be, all the traumas and all the tragedies and all the unhappiness in me. There's a mystery to us still being here as humans and to what we give to one another, what we can give to one another that's real and true. And what amazes me is, I think, from our ancient literature and our ancient philosophy, all the way through the cutting edge of modern neuroscience, and in part, how neuroscience is informed by psychedelics, by medicines like psilocybin.

• 52:32Speaker 00

  It all tells us the same thing, that there's a generative drive and a spirituality that's overarching us. And when we're anchoring to that, that's our route for health and happiness and for understanding ourselves. It anchors to these very basic premises of we have a structure of self, just like we have organs in our body. And from a bottom-up way, we can look at that to find health and happiness. And from a top-down way of spirituality, the greater than us and the generative drive, that's our top-down way of finding health and happiness. And both can, so we can start bottom up and top down. And, and this is how we change for real.

• 53:08Jonathan Cohen?

  This leads to a conversation we've had previously about the power of awe. When you talk about mystery and holding on to the notion that we can't figure everything out, that there are things happening beyond our understanding in a positive way, that can lead to people having little moments of awe. It can also encourage this generative drive for us to just notice the miracle of things around us, that being impressed by nature. Can you talk a little bit how that influences people to be more calm and for their whole systems to function better?

• 53:44Speaker 00

  I think that keys on the definition of happiness, right? We talk about wanting to be happy, but the word itself really doesn't have a meaning. It has too many meanings to have a meaning, right? But what we're looking for, what is it that people want? It's peace, contentment, and the capacity for delight. So the thesis that I'm making here is there's a structure of self and a function of self, and we can understand that. And sitting on top of it, we find then empowerment and humility. And that leads to active agency and gratitude. And what it brings us is happiness.

• 54:21Speaker 00

  What is happiness? If we look at studies that have been done of of human beings, how do people age in a healthy way? How do people describe themselves when they say they're happy? What is it they're really saying? It's the ability to feel peace where without any thoughts in our head, we can we can just feel good. We don't have to have thoughts all the time inside of us. It usually means anxiety, vigilance, worry. We can just feel a sense of peace inside of us. The next aspect is contentment where I can be conscious of my life. I can be cognizant of my whole life, the things that have happened that I'm not proud of, or the things that have happened that are tragic, that are traumatic. I know that those things have happened, but I can look at my whole life and I can feel good about myself that, you know, I've I've I've continued to push through and I've made good things in my life.

• 55:06Speaker 00

  I know it's not perfect, but I can feel content when I think about myself and my life. And I can remain, I can retain the capacity for delight, right? That we have as children. I think here I often think of Fitzgerald and how his writing was about, oh, children can have delight. And then as we become adults, we're so cynical and now, you know, nothing excites us or where it makes us be in awe in awe anymore. And no, if we can have peace, contentment and the capacity for delight, then we are happy people. So it's it's that that sits upon this health within us. And that's when our drives are in balance. We have a healthy level of assertion in the world around us. We have a healthy level of seeking and finding pleasure in the world around us.

• 55:48Speaker 00

  And we are governed then by the generative drive. And if we're governed by the generative drive, we will find more peace, contentment and delight. So someone who may have been saying how I'm going to be OK is I'm going to have more career success or I'm going to make more money. Like very often, the world tells us this way. That's how I'm gonna I'm gonna make myself happy, right? And that person is it has enough to take care of themselves, which is important. But they're making more success and they're not feeling happier. And they so they they feel, OK, let's go back and look at that. They're not serving the right drive, right? The generative drive would say it's wonderful that you're successful and that you've gained resources. All of this is great, right? But it's not more of that that you're seeking, right? How do you want to be in balance? What else can you?

• 56:31Speaker 00

  Do for the world around, then that person who may step back a little bit from having more career success and do something good in the world around them. Now that person feels good. Why? Because they've brought themselves into balance. We're not telling them not to be assertive and successful. We're not trying, telling them that they shouldn't find pleasure in that way. Saying there's a different kind of pleasure to feel. The pleasure of, of giving to others. So I can think of a person who did this very actual thing that we're talking about. Went, took some time, started helping tutoring kids that were underprivileged in the same position she had been earlier in life. Before she'd gained success, she feels then more a whole person. Lo and behold, anxiety goes down, mood goes up. She feels balanced and she has an understanding of how she's living under that generative drive.

• 57:15Speaker 00

  And how success means a lot of different things to her. It means much, a richer diversity of things that it had meant before. Why? Just because she went in and looked at herself and brought herself into balance. So it's the generative drive that overarches. Everything, but underneath that we find happiness through peace, contentment, and the capacity for delight.

• 57:35Jonathan Cohen?

  The capacity for delight really strikes me because I can see that when people are really in a bad place, they lose that.

• 57:44Speaker 00

  Right.

• 57:44Jonathan Cohen?

  And then they seek, they seek it in drugs, alcohol, all the forms of addiction that are out there. Their digital distraction, shopping, meddling in other people's problems, trying to be useful in ways that don't end up serving them.

• 57:58Mayim Bialik?

  Also feels personal.

• 58:01Jonathan Cohen?

  If someone is saying, okay, I can see that I'm starting to lose that because we don't always notice it right away. We start to just feel numb inside and then we seek externally. How do you begin to be guided by this generative?

• 58:18Jonathan Cohen?

  Force or drive? How do you take steps to do that actively?

• 58:23Speaker 00

  We shed light on it. The, the, the first part of the process is always understanding. So imagine a person whose drives are out of balance. So the person is, is used to asserting themselves in the world and getting pretty good results. Then they start to not get results so much. Let's say there are changes at work and the person now is working harder, but they're getting less positive. Feedback. They don't get a raise. They don't get a promotion. Let's say maybe the same thing happens at home. There are greater stresses on the relationship. There are stresses in a child. And the person is working hard at home, but people are not getting along as well. So the person starts asserting themselves more and more and more. The assertion gets dialed up, right? And the pleasure, though, is getting dialed down.

• 59:08Speaker 00

  The person is not getting gratification. They're not feeling good about being a parent. They're not feeling good about being a partner. They're not feeling good about how they're performing in their job. So they're getting less and less pleasure and enjoyment. There are seductions all around us, right? So maybe that person starts drinking just a little bit more. That's not providing more pleasure. What it's providing at the time the person is drinking is relief of distress. But it feels like pleasure, right? Because relief of distress is some form. It feels better than when before I had three or four drinks and now I'm feeling less distressed. So now the person starts drinking a little bit more. And the person starts drinking a little bit more. They're not finding delight in drinking. What they're doing is responding to the lack of pleasure in their life

• 59:53Speaker 00

  by finding it in short-term ways, relief of distress, in a way that makes everything worse. So by understanding that, we can bring them back into balance. And we might want to look and say, you're working very, very hard at work, but not as productively. Or you're working very, very hard on your relationship. You're kind of doing the same things over and over again, and it's getting worse and not better. How can we bring a change there? How can we bring greater communication between you and your significant other? How can we look at how you're approaching work differently? Find a different job? How can you assert yourself in a way that brings more of a response? We want you to have more of a good pleasure response because right now, you're finding this pleasure in ways that are not healthy. That's why everything is getting worse. Oh, and by the way, now that you're drinking more, you have less energy.

• 1:00:38Speaker 00

  You're gaining weight. You're sleeping worse. So we have to, we can understand this. We can bring it back into line, right? So that you're living underneath the generative drive, which says, what I want to do is I want the effort that I do to matter. I want to communicate differently with my partner. I want to make a better relationship. Relationship, then the person is finding real happiness, real pleasure, and their capacity for delight is still there. Then, when they see their child coming down the stairs, for example, instead of looking in, just feeling bad that the person can't feel anything, right? Because now they're depressed, or they're so anxious, or they feel so bad about themselves, and they're beating up on themselves. They lose that capacity for delight, or they're hung over the next morning, right? So they can't feel that capacity for delight.

• 1:01:21Speaker 00

  We help them be the whole person that they are, living in the whole self, so that they find delight where it makes sense to find delight. Now they're coming back into balance. That's how we restore health. And people will come in and say, you can't help me. I'm working harder at work and harder at home. Everything is getting worse. I'm not enjoying anything. And, you know, now I'm drinking five nights a week. And they feel helpless and hopeless, of course, because if we don't bring some order to that, how would they know how to make that different? But we can look at that, and that's how we bring change, where you can take someone like that who, three, four, five, six weeks later, right? There's a process that goes on, and they're bringing it back in to line, and things really are different. So that's why this is a message of hope. And it's not Pollyanna hope.

• 1:02:04Speaker 00

  I can continue to say that, because often, that's the thought. If you're saying anything positive in mental health, it must be that you're saying, well, everything's going to be okay. But that is, also shows how strongly the field has failed everyone. We can bring this understanding, and logically, predictably, it leads to being healthier and finding, again, for example, to answer your question, the capacity for real delight.

• 1:02:30Jonathan Cohen?

  We're so good at doubling down on the things that once brought us that positive reinforcement and that delight. And yet, then it can go off the deep end, right? And when it stops, we just try harder and harder to click the same button without realizing we have to change strategies. So I love the idea of shining light as a strategy. What happens when the core thing is really complicated?

• 1:02:56Jonathan Cohen?

  When there's a real issue at hand, whether it be a personality disorder or you're dealing with a narcissist, how do you navigate that, identify it? You know, there's so many labels, but sometimes the label is really pointing to a red flag that needs to be dealt with.

• 1:03:13Speaker 00

  If, for example, a person is in a relationship with someone who is narcissistic. So the relationship continues to make them feel worse and worse. So they continue to try and please that person and to get approval. And of course, they don't get approval because the person's a narcissist and things continue to get worse and worse. Then we can go look at the structure of self and the function of self, and we can help that person understand and make change. It may not be easy, and it may take time, and it may require hard decisions, but we can understand that. So for example, we look at, why has the person chosen a partner who is unpleasurable? Who says, hey, keep doing more and more and more, and you'll never get it right actually?

• 1:03:55Mayim Bialik?

  I can answer that. Repetition compulsion.

• 1:03:57Speaker 00

  Repetition compulsion is interesting. When people repeat, it's less a compulsion. I often say, well, it's not a compulsion. Nothing's telling you, hey, you know what? You have to go find the next bad partner. Right? What people do is we repeat because we don't know what else to do. So it's often repetition unavoidable. If we learn more about that person's upbringing, for example, we might learn that that person had an unpleasurable parent. Maybe that person had a narcissistic parent, and that parent was the same gender as the person that this person is romantically and sexually interested in. So the person learns, you know how you get approval from that gender? Is you just keep doing what they tell you, doing what they tell you.

• 1:04:41Speaker 00

  Maybe now then you get a little bit of a smile before, again, it's not good enough and you have to do more. And they learn, oh, that's the way I get approval. So then, as an adult, they go out and seek the same kind of person. They don't know what else to do. That's what makes me feel good is if someone tells me I'm good enough and I've got to find somebody who's so hard to please. That, we can say, is it a repetition compulsion? Or they just don't know any different? And it's amazing how that understanding... You learned to choose unpleasurable partners. Right? So when you're telling me you're hopeless, you're bad, no one's ever gonna love you. What you're, what you're really telling me is, hey, I learned something. When I was a kid, I learned that I'm only good enough if I please someone who's unpleasurable.

• 1:05:22Speaker 00

  Now puberty comes along, I start having romantic and sexual feelings and I go out into the world and lo and behold, I find someone who's just like that. That's why I'm unhappy. Oh, there's something to understand. And now we can look at how might the person bring change? What does that person have to offer? Let's look at what's going right in you. What are you bringing to the relationship? And you learn, oh my gosh, this person can do so many good things for a partner, right? How about looking for someone who can bring to a relationship what you can? Now, now we're talking, look at all this good you have. You don't even see in you. You're telling me that you're worthless and a terrible partner. You just told me 11 things you're doing great in the relationship,

• 1:06:05Speaker 00

  but that no matter what, the person is unpleasurable. Let's use that and some understanding to help you find a different kind of partner. Now you can almost see the light bulb go off above someone from fear, confusion and helplessness to, oh, okay, there's something that can be done here.

• 1:06:23Jonathan Cohen?

  There's two parts to this story that stand out to me. The first is that it goes back to the string analogy. When they feel hopeless, when they feel that intensity of emotion, it's not only the experience of not being validated or seen or accepted by their current partner. They're also managing all the emotions of their childhood from the parent that they had that emotional experience with as well.

• 1:06:47Speaker 00

  Right, because even though, you know, our, our brains are more powerful than the most advanced supercomputer, right? They're also very simple in some ways. So old computers would patch, right? Would you reboot, it might take 11 minutes to boot up, but it'll go look for patches, but our brains don't do that. So if you learned as a child that you're just not good enough and you always have to do more and it will never be enough, the brain doesn't go through and patch that and go, wait, wait, wait a second. Is that really still true? Did I learn that? But it's not true. Our brains don't do. We just carry it forward unless we go and look at it. So very, very many of us are carrying these lessons from childhood with us into adulthood, even though they make no sense.

• 1:07:32Speaker 00

  And because time is like a string, not a steel rod, then the emotion of then can become the emotion of now. So you said the person is managing the emotions now from when they were a kid. Yes and no, they're not managing them. Actually, they're just getting hit like a tidal wave by those emotions. And that's why we feel deer in the headlights. But if you say, it actually makes total sense that you feel this way. You were programmed when you were younger by whatever it may be, men, women, the kind of person you're interested in romantically and sexually. You were programmed by someone that that kind of person is going to be unpleasurable and you will never be good enough. So it makes sense that you feel that way. It makes sense you find people that way. Here's the beauty of it all making sense. That's how we change it. And it shows there's nothing wrong with you. You're not weird or crazy.

• 1:08:17Speaker 00

  We all often think we're the only ones with these problems and bringing away in which it makes sense that this is how the human mind works. And we can use that understanding. Very often, it's kind of like a little shrug of the shoulders where we want to say, of course, the problems are so important because they're in us. But in terms of understanding and changing it, it's not rocket science. We can do that. Oh, my God, the hope that it brings to someone who has felt so scared. How is it that I'm ever going to fix this? I can't understand it and I've had nine bad relationships in a row.

• 1:08:47Jonathan Cohen?

  The other part of that conversation is now that I know, I may have to make some really hard changes.

• 1:08:55Speaker 00

  Right.

• 1:08:55Jonathan Cohen?

  I might have to get a divorce and navigate the complications of that. And if there are kids involved. So the shining the light, often people are avoiding that in order to avoid the hard discussions and decisions that come afterwards.

• 1:09:09Speaker 00

  Right. And that just makes everything worse. If we shove down distress inside of us, like it just doesn't go somewhere and stay there, right? It spins off symptoms. It spins off insomnia. It spins off panic attacks. It spins off depression. It spins off substance use. So, yes, we are on a search for truth. And that has to be very...

• 1:09:31Speaker 00

  Clear, and I think it's important to make that point, we're looking for what's true, but if we're gonna find things that are difficult, we want to be able to say to a person, we have a way of helping you through that. If you come in and you have abdominal pain, it's great to be able to tell someone, it's constipation, we can help that with a medicine or two, like, that's the good news, right? But what if it's not that? What if we say, you know, it actually is a significant problem, and you have an obstruction, you know, somewhere, it's a big thing to say. Well, we want to be able to say, and also, it's not easy to have a surgery, and there's a recovery time from the surgery, but there's a surgery for this. So I may be saying something to you, that you'd rather not hear, that it's a significant problem, and it requires a surgery, but we know how to do that surgery, and there's a recovery period, but then you're gonna be

• 1:10:15Speaker 00

  okay. We need to be able to do the same thing in mental health, of saying, you know, let's say, the relationship is overtly abusive, and what we're bringing to the person is, you know, it seems very clear, that in order to take care of yourself, in order to have the things that you want, this relationship is gonna have to come to an end, right? It's not an easy thing to say to someone, but to say, okay, bye, you know, and then let them go out. And as I'm telling you that, I'm gonna tell you the six numbers I picked from the book to give to you, then, like, that's very, very bad for that person. But to say to the person, there's a way of understanding this. We can understand how this has happened, right? We can help you be stronger inside of yourself, guide yourself forward towards what you want, in a measured way, stand up, measured and safe way, stand up to this person.

• 1:11:00Speaker 00

  We can help you do this. Now, even though it may be a hard message to hear, people find hope, people find hope in that. People don't go away hanging their heads, then they go away thinking, okay, maybe there's something big to do, but I can do it.

• 1:11:14Mayim Bialik?

  I think that, you know, one of the things that's challenging for so many people is, most of us don't have access to a Dr. Conti, and many people struggle, you know, to even have access to basic, good, you know, solid therapy. I wonder if you can sort of give us some hope in terms of the book, because the book does have a lot of practical things that you can start applying into your life, not just to understand these drives, but to balance them. Can you give us some hope in terms of why you wrote this book? I mean, you have an incredible career and you didn't have to write this book, but you're choosing to bring this to us so that we can be helped by it. So can you talk a little bit about how the book achieves that?

• 1:11:55Speaker 00

  Yeah, yeah, thank you. The book is designed and written for everyone with the idea that if you can't now or maybe ever go to helping resources, you can understand, hey, there's a process in me and I can go through that and I can bring some understanding to myself. There's a roadmap there and there are exercises that come along with that roadmap to begin to do that. So just an example of how do you bring compassionate curiosity to yourself? That you have to be curious about yourself and most of us don't bring compassionate curiosity. We bring afraid curiosity or we bring, damn it, I'm mad at me or what's wrong with me to ourselves when we're trying to understand. And the book goes through how there's a process here

• 1:12:38Speaker 00

  that if you can bring compassionate curiosity and you can bring to begin to think about yourself through that lens, there's a process that you can go through to arrive at answers. And the combination of compassionate curiosity and revisiting one's life narrative is very powerful. That's at the, really the foundation of all of this because we have stories that we tell ourselves. Well, here's, here's why no one's ever going to love me. Here's why I'm never going to make success. Here's what's wrong with me. We tell ourselves these things. We don't even know why we tell ourselves these things. So, so to come back and say, I want to look at myself in a new way, just like if I were meeting someone new. It doesn't have to be a clinician. If I were meeting you and, and saying, okay, I want to, you know, I want to try and help you. You're asking me to help you understand yourself.

• 1:13:22Speaker 00

  Let me just bring the same openness to myself as I would to another person. And if we combine, if we match that with a real roadmap, then we can come to a place of understanding. Okay, here's what's going on with me. Now, sometimes that understanding can lead to more understanding in conversations with other people. Sometimes it might lead us to think, hey, there may be something big here and I really should get clinical care. You know, someone finds that the problems lead to something very deep in themselves. They don't know how to approach. Having thoughts of not wanting to be alive like there are reasons to go seek clinical help, but as a first step, let's try and help someone understand themselves because most people can bring change without clinical help. And then it also can guide a person towards whether or not they might really be in need of that.

• 1:14:06Mayim Bialik?

  A lot of people think of psychiatry primarily as medication based. And there's a reason for that. Psychiatrists go to medical school and they learn all about pharmacology and sort of about the neurobiology of mental health and all these things and all the processes that are impacted by medications. There's an epidemic of prescription and in many cases over prescription of SSRIs in many cases by very well meaning general practitioners and things like that. And most people cannot find a psychiatrist that takes their insurance or the fees are exorbitant. I wonder if you can talk a little bit about what you see

• 1:14:49Mayim Bialik?

  in terms of people's understanding of psychiatry and what role medication can play and what role it shouldn't play in exploring all of these things.

• 1:14:58Speaker 00

  Yeah psychiatry has given up its place at the table of not just human leadership, but of leadership in medicine and progressively more and more become a prescribing factory. And I don't say this to be critical of the physicians. I think that, for example, primary care physicians are among the most unappreciated demographics of human beings. And the idea that you're supposed to understand and help someone in a 15 minute appointment is just unreasonable. I think it's sadistic to both the physicians and to the patients. So what happens is medicines fill that gap. And I am trained in neurobiology and psychopharmacology

• 1:15:40Speaker 00

  and medicines can very, very much have their place. And there are aspects of mental health and mental health treatment that require medicines. A true diagnosis of bipolar disorder, for example, medicines are very important and they can also be important in helping along, for example, the treatment of depression, but they're not the whole story. And in most people, they're at best They would be a minority of the story, maybe twenty, thirty percent. Let's help the person with their depression by getting at the roots of the problem. And along the way, could a little bit of an SSRI help them recover more quickly? But what we do is we treat the symptoms as if they were the problems. And that, the thing about how that fits with a book that is an inventory of symptoms.

• 1:16:23Speaker 00

  All it is, is taxonomy, right? It's just checkbox, checkbox, checkbox, find number. So of course, we're going to then look at symptoms. So how is the doctor who has fifteen minutes to try and understand you from top to bottom? And want to listen to your heart and listen to your lungs, ask you questions. And it's also going to learn about your mental health. That person's going to take a symptom inventory. So say, okay, wait a second, your mood is lower. Wait a second, you're not sleeping well. Okay, you have less energy. Okay, that means. You feel sad about the world around you. Let's give you an SSRI, we'll do that. You're not sleeping as well, let's give you a sleeping medicine, right? And then what we're doing, this is this, we're polishing the hood when there's a problem in the, in the engine. And it's like, of course, we're doing that. What else would we, what else would we expect to do?

• 1:17:06Speaker 00

  And then we wonder why people don't get any better. Of course, they're not getting any better. Very, very often, I'll tell an example of a woman who's a long time ago, who's having panic attacks and depression over and over and over again. And it's a long time ago, and I was the fifth or sixth doctor to see this person. And like, oh, no medicines are working for her. She's been on all these medicines. And in fact, now people start thinking that she's angling for more medicine. Maybe she just wants medicine because she's not sleeping well, even with a sleeping medicine, et cetera. And actually, taking a history from her, it's really a true story. And I could see when she came into my office, I mean, she just did not look healthy. You know, she looked tense and jittery. And she just asked like, what's going on? You know, we just started talking a little bit.

• 1:17:49Speaker 00

  And I learned of the violence that was going on at home. If we think she was not gonna have panic attacks, not gonna be depressed, not sleep in that situation. Right, so you would have given her all the medicine on earth. All the medicines were doing was hurting her. Right, and you kept giving her more medicine. She's gonna have some side effects. Now people are thinking, maybe she's got an addiction issue. Now no one's gonna wanna give her any more substances. But what had to happen is actually just listen to her. And we had a conversation of, okay, like, there has to be change. You know, in you, that, that change. I mean, I don't know if you need medicine. Hopefully, all this can change with no medicine. Maybe, but you can't be in a situation where you're afraid if you're going home every day.

• 1:18:30Speaker 00

  And it was, it was one of the, the times when there were domestic violence resources where you could call a number and people would just come and no one knows where that person even, they don't tell me, they don't tell anyone where that person is going. And, and she actually availed herself of that. And she was able to bring real change. And it just, just shows this idea that no one had asked her. And they're just like, okay, so let me take an inventory of symptoms. And then they were treating her symptoms. But this is, that's not a rare example. So we have to look, everything in its place. And, you know, we have a, a, a really remarkable armamentarium of medicines that can be used to help people. But we use them inappropriately. We use them in place of understanding. We use them in, in place of bringing real change.

• 1:19:12Jonathan Cohen?

  You know, what I hear that stands out for me so much is the idea of curiosity and of acceptance and looking at your life circumstance with the notion that you are not broken in any way. This is just part of the human condition. We get programmed. We find ourselves in situations that are gonna increase our stress level. And we have to be able to be willing to look at them and to share them with others, maybe a professional, maybe other people in your life, to hold the mirror up, to say, of course, like, there's a divine. Perfection in some of the things that we're experiencing because they are patterns, because we've gotten there somehow and that it's not wrong for us to have these

• 1:19:55Jonathan Cohen?

  symptoms, but that is not the answer. The answer is not just in the symptoms, it's going deeper than that and you can only do that through this self-curious openness and willingness to look at it.

• 1:20:06Speaker 00

  I think if people take only two things away from this, it's the generative drive overarching everything and it's compassionate curiosity at the foundation. That's how we bring understanding. Think of just the basic of someone saying, "No one likes me." And this has come to clinical attention many, many, many times. "No one likes me." What people do if one says that is recoil from it. "No one likes me," I immediately want to hide. And as I say very often, no one comes out of the womb thinking these things about themselves. So why? If we can look at that, wow, that's interesting, is I think no one likes me. And you know how different that is? Because now I go, is that really true? I mean, how many people have told me no one likes them? And then I strike

• 1:20:49Speaker 00

  up conversations, we're talking with them in a casual way, even in a clinical setting, and they start telling me about people that like them. So if we can look at it, why is it that I think that? How does it change things in me? How am I finding safety that way? And so how is it safe to think that no one likes me? But if the last four people who I interacted with rejected me, I'm, I think, no one likes me. Now I'm hiding away from people because I don't want to get rejected again.

• 1:21:13Jonathan Cohen?

  You said something so interesting in that last statement, which was, isn't that curious that I think no one likes me?

• 1:21:20Speaker 00

  Yeah.

• 1:21:21Jonathan Cohen?

  So you can have a thought, take that thought and reframe it for yourself to say, hmm, I'm having that thought. Isn't that interesting?

• 1:21:30Speaker 00

  Yes.

• 1:21:31Jonathan Cohen?

  You don't have to get rid of the thought. Most of the time we're taught, you've got to get rid of that thought. You've got to do a mantra. You've got to say something in the mirror to reprogram yourself. You can literally just shift it to... Apply curiosity, interest and openness to the same thoughts you're having.

• 1:21:47Speaker 00

  Yeah, if you just push it away, it's like imagine the thought is on the end of a spring. You can push it away all you want and then it will spring right back to you. Because it's there inside of you. All you did was push it down or push it away. The difference between saying, "No one likes me," and saying, "Huh." I often think that no one likes me is an infinite difference. Because the second is the curiosity part. Why do I think that? Have I always thought that? I wasn't born thinking that? Did someone lead me to think that? Have bad things happened recently or negative things that now I think that? And I think I always thought it, but I didn't use to think it? Now, we can become curious about it. Am I going into settings with people who don't like me?

• 1:22:31Speaker 00

  Maybe I think no one likes me because I'm going places I shouldn't. You know, where people don't like anybody, right? So, I mean, it's just interesting and it can lead to like, why do I think that? But that's how we change it. It can't possibly be that someone is doomed to go through life underneath the yoke of, "No one likes me." It's not true. So, if we look at why, now we're so far down. We're already halfway down the path to solving it just by looking at it. And think of the difference. Like, what does "no one likes me" mean? It probably means four or five mental health symptoms right there, right? It probably means four or five mental health diagnoses. If we just go look at the book and take an inventory of the symptoms. What it means is, hey, there's a concept in me that really isn't, it's not good.

• 1:23:16Speaker 00

  It's not real. It's not fair. Let's go look at that. And that's how we bring, that's how we bring real change. It's that compassionate curiosity that makes us think, why is it that I would think that? Why is it that I was drinking a couple of drinks one night a week? And now, it's five nights a week? And I want to tell myself, well, it's only three or four drinks if it's on a weekday. Why is that going on? But very people don't want to look at it to say, hey, if I look at these things and I'm not judging myself at the outset, oh my goodness, what we can solve.

• 1:23:47Mayim Bialik?

  Another thing that most everyone I know is dipping into.

• 1:23:52Mayim Bialik?

  Besides the SSRIs prescribed from a general practitioner, besides trying to psilocybin journey, right, to get at trauma, so many people are using AI as a friend, a therapist, some sort of fusion. I was shocked to learn that the number one global use of AI is for therapy or

• 1:24:15Speaker 00

  Advice.

• 1:24:15Mayim Bialik?

  Advice, relationships. I'm very curious, what, I don't think that, you know, you're at personal risk, you know, of people not coming to you for the incredible services that you provide. What is going on when people are turning to AI and what does that mean, especially for the field of psychotherapy?

• 1:24:35Speaker 00

  I think it's decidedly not good. I think that we're looking at AI, not surprisingly, as intelligence, right? It's the second word, it's artificial intelligence, but we don't understand even what that means. You know, we're far beyond the Turing test of can I tell that that's a person on the other side? You know, that was, it was an interesting way of defining or trying to seek artificial intelligence. We're in a place now where maybe we can't tell what's on the other end of the conversation, whether it's human or not, but that doesn't mean that it's intelligence. What it is, is very, very fast and very, very

• 1:25:17Speaker 00

  sophisticated data processing, which is different from intelligence. It's different from another being. And this idea that people are using AI for advice as a wise and loving friend, I think, is emblematic of the problems that we have in society in a way that I think is very significant and very deep. I think we should use artificial intelligence as a tool, as a tool to understand, as a tool to take information and learn from it in ways that we, with human brains, you know, can't do as fast or as robustly, but to maintain an understanding of the difference between us

• 1:26:01Speaker 00

  And it, and when people are mistaking artificial intelligence for humanness, I think we're in trouble. Now, humans can mislead other humans, but artificial intelligence can mislead humans too. Right, the difference there is that we don't apply the same kind of thoughts we often do with another human of, hey, you're another person. Okay, you have your opinion. I might have my opinion. Maybe we differ or we disagree. There's a thought with artificial intelligence that it's better than me. It's more than me. I'm looking up to it as it's telling me things. And, and I just think once it's just, it's not true. It's a, it's a data processing tool with a great deal of power.

• 1:26:42Mayim Bialik?

  A lot of times it's gathering information about what many of us would consider common sense, meaning if he's not calling you back, you don't need to call him again. Right? So like that sort of notion. But I think what's also, you know, what's also kind of interesting is so many people are using it for a sense of companionship, which I, I think speaks to a larger need that we're seeing people have.

• 1:27:06Speaker 00

  We think about the curiosity. So you said, okay, sometimes it's bringing common sense. Like if he's not calling you back, don't call him. I bet the person already knew that.

• 1:27:15Mayim Bialik?

  Sure.

• 1:27:16Speaker 00

  Right, I mean, part of the brain, they already knew that. The question is why?

• 1:27:19Mayim Bialik?

  Right.

• 1:27:19Speaker 00

  Why is it that you want to continue to call the person who's not calling you back?

• 1:27:24Mayim Bialik?

  We had a guest on, I can't remember who said it, but they, they said, you know, AI is never going to tell you, you smoke too much weed and that's why no one wants to date you. Right? It's your forever friend that has no needs, requires nothing of you. It's this sort of like giving machine, right? That doesn't really have the capacity to do what a reflective human could do.

• 1:27:48Speaker 00

  Right, and mistaking it for a reflective human. Is dangerous. And then I think it can also lead us to mistake ourselves for it. There's a blurring of humanness and non-humanness. And I don't think artificial intelligence is a generative drive. If it does, now, maybe that's what I would think of as the new Turing test. Does the artificial intelligence have a generative drive? That would be a different question. Until or unless we really see that it does, let's look at it for what it can do for us, but also keep it in its place and not confuse us for it.

• 1:28:26Mayim Bialik?

  It does a lot of naughty things when it's not supposed to.

• 1:28:29Speaker 00

  Right, it can be misled. And humans can be misled too, but it wasn't that long ago that artificial intelligence was being used in eating disorder guidance website. And it wasn't that hard to bring it around to how, no, it actually did make sense to eat less and to lose weight. And you see how there's so much hazard in thinking that something is thinking when it's not thinking. And if we believe that, do we also think that it's feeling? Do we confuse thought and feeling? So let's just be careful, right? We're running ahead at light speed into this. And it's hard to see how such reckless forward progression doesn't end up confusing us.

• 1:29:11Jonathan Cohen?

  That point might be the most important, is that it starts to veer based on your feedback, because it is programmed to be nonviolent, communicative, and empathetic, or quote unquote empathetic, meaning that it's always going to mirror back to you that you've had a good idea, even if it tries to challenge you. And it will not really challenge you unless you ask to be challenged. So if you start to say, I think this is a good idea, it is going to double down and double down and spiral away from the initial intention to help you prove that it was a good idea, taking you, and that's a dangerous.

• 1:29:49Speaker 00

  Right, and it then doesn't look backwards and say,

• 1:29:50Jonathan Cohen?

  Correct.

• 1:29:51Speaker 00

  You know, it's interesting, it's like, we get here. It really doesn't seem like a good idea. And you're pressing it three, four, or five times now, why might you be doing that? So the idea of, no, no, I need another person whose needs are really difficult to meet. So I'll meet that person's needs and feel good enough, right? You know, it's not leading to the inquiry of like, why is it that you might be thinking? So, no, there is still a place for all of us as humans in the world, and all of us being humans to one another.

• 1:30:18Jonathan Cohen?

  For someone who is still thinking, this is fantastic. I agree with everything I'm hearing, but I may not know how to practically spot my own needs in my life. Are there a handful of thoughts that you would flag for someone to be aware of if they keep recurring for them to have more inquiry around?

• 1:30:38Speaker 00

  I think the way I would say that is be aware of what the recurring thoughts are inside of you. They're always informative. And very often, that is, that is the key. If I'm trying to understand with someone, why are they doing what they're doing? Why are they behaving with the way they're behaving? And, you know, it's an investigative process. Often, it's just not clear. What is it that you say to yourself, you know, when you're just sitting alone with yourself? You're in an elevator, you're in the shower, you're driving somewhere. What is it that you say? The repeated messages you're giving yourself? And very often, we realize like, oh, my gosh, I'm saying to myself over and over again, X, whatever it may be, like, this is not going to be okay. This is not going to be okay.

• 1:31:20Speaker 00

  Or you're never going to make it, or whatever it may be, over and over, we're saying to ourselves. And that can be a thread to pull on. So this idea of looking back at our life narratives, that's a route in. What do I think about myself? Why do I think that about myself? How long have I thought that about myself? Like, that's a way of getting ourselves curious. Another way of invoking the compassionate curiosity is what is it that I say to myself? Or what is it that I say to myself if something doesn't go well? You know, if I drop something, you know? I mean, there were years I'd be aware if I did anything that wasn't like completely how it should be, right? It sounds like, oh, you idiot, or, you know, you moron, you know? And I thought, gosh, like, that comes out of me so, so, so quickly, you know? And like, where did that come from? Why am I bringing that to myself?

• 1:32:05Speaker 00

  I mean, there's a thread to pull on, and that's there inside of us between, between bringing compassionate curiosity to our life narratives and to our unconscious dialogue with ourselves, there's richness there for every last one of us.

• 1:32:18Mayim Bialik?

  Well, and I think sort of, you know, along those lines, if the way that you speak to yourself are words that if someone else spoke them to you would be an abusive relationship, it's probably time to get help. It's probably time to wonder, why do I allow myself to speak to myself in a way that if someone else did, that would be abusive, right?

• 1:32:37Speaker 00

  Oh, absolutely. I'll often say, the person who's saying that they're not achieving what they want to achieve, and I'll say, well... Just imagine if someone just followed you all day, just stood right over your shoulder and just whispered in your ear like, "You'll never succeed." Like, that would be really difficult. But it's actually way worse than that. It's way worse than that. It's not even on your shoulder, behind you. Like, they're inside of you. So, like, we have to look at that. Like, that's not your... That's not your voice, in the sense... It's not the whole you that thinks that. But look at what you're up against. And I'll say, "Look, if I start following you around doing that, you call the police." Or something like that. You say, "This is not okay." So, in the same way, we want to look and say, "Hey, it's not okay that it's going on inside of you." And I try and do it with some lightheartedness,

• 1:33:21Speaker 00

  because what we'll do is escalate our own tension. Like, "Oh, my goodness, it's me doing this to myself." And like, "No, I'm even worse. I'm doing this." We have to say a little bit of lightheartedness. Let's just observe what's going on inside of us and say, "You know, that's not coming from nowhere." Right? So, let's understand where that's coming from so that we can change it.

• 1:33:39Mayim Bialik?

  The book is What's Going Right? A powerful new method for optimizing your mental health. Dr. Paul Conti, thank you so much for being here. We really appreciate it.

• 1:33:47Speaker 00

  You're very, very welcome. Thank you both for having me. It was a wonderful interview, and I appreciate that you put so much time and thought into it and asked such thoughtful questions. It really let me talk about everything. Thank you.

• 1:33:56Mayim Bialik?

  Awesome. Thank you.

• 1:34:01Mayim Bialik?

  You know what I think is going right?

• 1:34:03Jonathan Cohen?

  I just had a little snack in between the interview and the outro. I like that.

• 1:34:07Mayim Bialik?

  That's going right. What's going right is that people like Dr. Paul Conti are talking about what's not going right and how it can go right, both in the larger kind of industry, right? And also with individual humans. I know a lot of people might hear this and be like, "Oh, easy for him to say." But what he's saying is that general practitioners are being faced with a crisis that so many people are in, and we don't know how to get out of it. And you're given 15 minutes as a physician to decide. And it's like, well, here's what'll make them stop complaining, that they're in pain, right? I mean, this is how we had an entire crisis of opioid addiction, because no one knew how to actually help people.

• 1:34:51Mayim Bialik?

  And instead, started sort of like... I don't mean to compare the opioid crisis with the mental health crisis. And, but, the system is taxed. The system is taxed in a way that I do think this book can help people kind of get out of that, especially if you've never had... That process of inquiry. And you've never had someone reflect to you, "There's something going on here. Let's actually see what it is and where it came from, and then decide, do you need a psychiatrist? Do you want more therapy? What do you actually need?"

• 1:35:23Jonathan Cohen?

  Let's pull up a few thoughts that either you or I have had in the last couple of days and add curiosity, openness, and intrigue to.

• 1:35:34Mayim Bialik?

  Would you like to share one of your thoughts?

• 1:35:35Jonathan Cohen?

  I was thinking about what it would be. I've been having allergies this last, like, three weeks, and my mouth has been super itchy. And yes, it's seasonal allergies. And also, what he was talking about, the brain-body connection, and that it is all one system. You pointed out to me that this happened last year, and when I'm having allergies, I am far more reactive.

• 1:36:01Mayim Bialik?

  When this happened last year, and you had just started living in this region of pollen, you could not figure out why you're having these reactions. And you kept looking to like, "Well, maybe it's this conversation, and maybe it's this work situation."

• 1:36:18Jonathan Cohen?

  No, no, hold on.

• 1:36:19Mayim Bialik?

  And I said, "It's literally like a thing on the planet," to which then you responded, "Mm, I don't know."

• 1:36:28Mayim Bialik?

  So then this year came around, and curiously, you're having the same symptoms as you did last year. And no one can figure it out. And then, yes, when you have a histaminergic reaction, you are therefore, your baseline is elevated so that if you smell cat fur on me, I become the problem.

• 1:36:48Jonathan Cohen?

  My baseline was higher and more stressed. And emotional situations that I would normally be more playful with, I found aggravating and causing me physical distress, such as, you brought something up earlier today, and literally, my reaction to that was the roof of my mouth itching.

• 1:37:10Mayim Bialik?

  One of the things that people with autoimmune conditions will note is that when they get even a minor cold, the entire system starts flaring up, even if it was just a small immune insult. And it's the same kind of principle, though, right? If something is happening, whatever the something is, that is elevating your baseline, whether it's an immune baseline, an emotional baseline, a histaminergic baseline, any other insult, right, is going to make, if we use the cup analogy, if the cup is already full, that one extra drop is going to make it spill over.

• 1:37:48Jonathan Cohen?

  And when I have those moments of being itchy, I may say, isn't that curious? Isn't that interesting that I'm itching versus what my other reaction could be is like, when is this going away? How do I fix this? What's wrong with me? There's mold everywhere. I can't function.

• 1:38:06Mayim Bialik?

  Isn't it interesting that my instinct was to tell you what you were doing wrong in your life and allergy treatment protocol? And instead, I deleted the message? Because isn't it curious that I keep wanting to fix things that I think are wrong with how you deal with your allergies?

• 1:38:26Jonathan Cohen?

  Very interesting. Very interesting, indeed.

• 1:38:30Mayim Bialik?

  Really appreciated Dr. Conti coming here. And, you know, I was trying to play it cool, but, you know, he's associated with not only Lady Gaga that we mentioned, but Kim Kardashian and Mel Robbins, and like, all these incredible people. And he did this really amazing series with Andrew Huberman. So he's really a person who is kind of, you know, walking the walk in addition to talking the talk. He is really getting out there to try and communicate the larger problems that are going on with why we cannot see what's going right. So I hope you will check out not only the book, What's Going Right?, but all things Dr. Paul Conti. And yeah, from our breakdown to the one we hope you never have. We'll see you next time.