UnShrink Me, Ep. 75

[00:00:01]Okie dokie. Let's Let's take a look. Let's see how we're doing.

[00:00:18]Okay.

[00:00:21]Okay. Sounds like we're doing good.

[00:00:25]Just going to move some things around, then we'll get going.

[00:00:31]All right, let's find the stream and share it on YouTube and we'll get started.

[00:00:40]Okay.

[00:00:44]Okay, I'm going to get rid of that. Go over here.

[00:00:49]And there we go.

[00:00:51]I think that's it. I think we are uh I think we are shared. So, good afternoon, good morning, whoever you are, wherever you are. I am Dr. Patrick Lockwood and I am back with another episode of Unshrink Me. But for the purpose of this podcast, I'm just Patrick. So, please do not sue me, but feel free to cancel me. This is a weekly podcast on everything related to mental health. And for those of you who are brand new, this is my YouTube channel, The Psychology Checkup, and my weekly podcast is called Unshrink Me. Thank you for being here. Thank you for watching.

[00:01:29]Um, looks like I have some fans of the new jacket today, which is great. I hope that uh hope that you enjoy the jacket, Jeff. Glad to have you here in the chat as well. So, uh, without further delay, we have a lot of important things to talk about on today's podcast. And a couple of things that showed up on Twitter this week that we'll be discussing as always. And so, if you are brand new to the podcast, please understand that this is just me giving my opinions. I happen to have experience as a clinical psychologist and a professor. However, this podcast is just my personal opinion. So, so please feel free to [ __ ] off if you believe that I'm doing something wrong because this is definitely not for you. I'm just here to chat it up and share what I believe is true. So, without further delay, today we are going to be talking about what are hallucinations exactly and what does it mean to be quote unquote mentally ill? because there's been a lot of debate this past week on therapy Twitter, which is a cesspool of various kinds of people, myself included. And we're going to talk also about what exactly does it mean to depathize people who experience what we can call symptoms. And finally, third, we're going to talk about what does it mean to quote unquote be mentally healthy in the first place. Now, I'll be talking about some posts on Twitter, and I always start with a softball, and I'm I'm a softball post. I'm glad you're loving the jacket, Jeff. But as always, before we get going, just know that this podcast is not Not, not sponsored by Celsius. However, I love this stuff. It makes everything more fun. Occasionally gives me some energy and some pep in my step.

[00:03:10]Ah so again this is a weekly podcast for you the consumers of mental health services.

[00:03:20]So my goal here just so everyone understands is to be very clear about what we can know and what we cannot know from the point of view of science from the point of view of professional experience. And so I want everyone who is out there who is seeking therapy, counseling, coaching, anything like that to get a better understanding of what perhaps is going on inside of them and that they can get the most out of the services they're they're receiving because it has been my experience as a professional that most people get less than they pay for. And so I'd like for everyone who's watching and listening to hear something that would potentially help them.

[00:03:59]Jonathan Cogburn's here in the chat.

[00:04:00]Good to have you here, Jonathan. He says, "I sometimes hallucinate that there's money in my bank account, usually on payday, but then I go look like the next day there's nothing there." Yeah, of course. I have the same problem as well, especially if there are new guns to buy. Anyways, so we have uh some fun topics today. And if you are brand new, please follow this YouTube channel, The Psychology Checkup. And I pull a lot of my content from Twitter and you will find me on Twitter retweeting things that I discuss live so you can fact check me and follow the thread so you know that I'm telling the truth or not. And so please follow me on Twitter and join in on the conversation or harass me if you like. My handle on Twitter is alobeha al ha p a t r i c k. And so, as always, I talk about topics from Twitter. We're going to start with a couple of softball posts just to make sure we get nice and warmed up, and then we're going to get into the main topics. Dour.

[00:05:03]So, first and foremost, and I will circle back around to talk about this more, but let me discuss this real quick to get us started here today. So, Jonathan Shedler, for those of you who don't know, um, okay, Jonathan Shedler, his handle on Twitter is at J O N A T H A N S H E D L E R, that's his name. Um, is a psychologist here in California who is fairly popular on Twitter and talks about therapy kinds of things. has a Substack that's very popular, does a lot of podcasts, seems like a good dude, and Jonathan uh put out a post a couple of weeks ago that became pretty popular on Twitter and had lots of comments. And so, we should talk about what his post means and why it matters for this podcast and for people more broadly seeking therapy. Uh Ryan's here in the chat. Good to see you, Ryan. He says, "I like the jacket. Looking snazzy." I'm trying to be more snazzy. get more uh get more street cred, more aura, as the kids say. So, here's what Jonathan Shedler said about two weeks ago, and the post he's criticizing said, "I don't believe in therapy." And Jonathan said, "I do not understand people who make general statements about therapy or therapists." There is no definition of what it means to be a therapist. There is no such thing as therapy to believe in or not believe in. There is only the knowledge and skill of the individual clinician, the psychology and circumstances of the patient and what happens between them.

[00:06:43]Peak schnaz that exactly so let's talk about what he said because I think what he said is a really good primer on what it means to do this work correctly.

[00:06:55]So, and I quote, "There is no definition of what it means to be a therapist.

[00:07:02]There is no such thing as therapy to believe in or not believe in. That's a direct quote from Jonathan Shedler. And so as a professor in graduate psychology who teaches future M's level and doctorate level clinicians, I have a few things to say about this statement.

[00:07:18]So on the one hand, Jonathan is correct.

[00:07:21]He is 100% correct that there is no universally accepted definition of what therapy is, psychotherapy is.

[00:07:29]Secondarily, there is no universal definition of what it means to be a psychotherapist. For instance, people with all sorts of degrees can practice psychotherapy. People with different types of master's degrees, and there are different types of them. There's people with counseling degrees. Hey, Phil. Good to see you here. There are people with MFT degrees. There are people with um doctor degrees, psychiatric uh physicians who practice, you know, therapy. So, psychotherapy is not degree specific.

[00:08:03]Likewise, there's no particular one thing that is therapy.

[00:08:09]And so because there is no universally accepted definition of therapy and there's no universally accepted set of credentials, we have a bit of a sticky pickle. Sticky pickle. Is that a thing?

[00:08:22]I'm just going to make it a thing.

[00:08:24]Sticky pickle. And so the problem we face is, by the way, sticky pickle was the name of my allgay uh male band back in high school. We were uh emo sca band. So the the challenge we face is if there is no universally accepted definition of therapy and there is no perfect consistent credential across the country across the world for therapy that means that it is not a perfectly obviously objectively defined thing. So what Jonathan said is, and I quote, there is only the knowledge and skill of the individual clinician, the psychology and circumstances of the patient and what happens between them.

[00:09:05]And so therapy is an interaction between a professional with certain skills per se, excuse me, and a patient, an individual who has their unique circumstances. So therapy is a professional relationship.

[00:09:23]It's a specific professional relationship designed to help change whatever the person wants to change essentially. Phil says, "When I grow, I'm going to be a psych." Good for you.

[00:09:32]I hope that you do it because we always need more people out there doing it.

[00:09:39]So is it true that there's no such thing as a universal definition of therapy?

[00:09:43]No. There's tons of textbook definitions of therapy. That being said, all of them are pretty flimsy.

[00:09:49]And there are state boards, you know, the state of California has um their own definition in the law of what it means to do therapy. And so every state will have slightly different definitions as well. So because there is no universal definition, the idea that you're supposed to quote unquote believe in therapy is silly.

[00:10:13]Believing in people is silly. What makes the most sense logically to me based upon my experience too is consent.

[00:10:23]We don't walk into therapy with some, you know, unending level of faith in other people.

[00:10:31]And Jeff said, "Do you have a definition?" No, I don't have a definition. I don't have a specific definition. I think it is using the I mean if I were to make a super vague and broad definition of therapy, it'd be something like using the principles and knowledge scientific knowledge of human behavior and emotion and motivation to help change a behavior or pattern for another person. Very broadly, very vague. which includes everything from personal training at the gym to coaching sports to the practice of law to psychotherapy and so and education as well. So I don't think there is a perfect good general or specific definition.

[00:11:15]I don't think it's possible. You know, I think what's possible is genuinely trying to use the principles of human psychology and behavior change, the knowledge that we have of it from the point of view of behaviorism, psychoanalytic thought, neuroscience, everything else in between, evolutionary thought to create a story that makes sense to the other person that they agree with and they buy into that they do something with to change their patterns of behavior.

[00:11:43]You know, but when I start to talk about what mental health is here at the end of the podcast, hopefully I can circle back around and make Jonathan's post make sense. But the general idea that people are supposed to believe in therapy is not true. Just like you don't need to believe in medicine or believe in your mechanic, either you go to your mechanic and they fix your car and your car functions better or it doesn't, right? The same thing's true with therapy. either you go see your therapist and you function better in some obvious way or you don't.

[00:12:17]Now, how quickly you want to function better is completely up to you and is to be negotiated with the therapist.

[00:12:24]Sometimes we feel worse as we start to grow and change. But that doesn't mean we function worse because of therapy. If you're functioning worse, something might be wrong with the therapy you're doing.

[00:12:38]So, for what it's worth, thank you, Jonathan Shedler. You don't believe in therapy. It's absurd. There's no need to believe in therapy.

[00:12:48]Okay, let's uh let's uh let's see. Let's see.

[00:12:54]Let's see. Let's see. Let's see.

[00:12:57]Okay, you know what?

[00:13:01]Let's uh let's dig into the first topic.

[00:13:06]Okay. And so the very first topic for today's podcast, the first formal topic, let's say, comes from something I said earlier. Okay? And earlier I was getting into a bit of a back and forth with someone who I do not know at all. Um, and I believe that there's a gross misunderstanding. Hey, Angie, glad you're here. I there's a gross misunderstanding of what it means to be mentally ill.

[00:13:37]And so what I'd like to do in today's podcast is try to put to rest this idea that there is such a thing as normal.

[00:13:43]Number one. But number two, I want to put to rest the idea that there is no such thing as abnormal or maladaptive.

[00:13:50]So we're going to use the example of hallucinations today to talk about, you know, what could be normal in in a non-technical sense, in a statistical sense, and then what could be a problem.

[00:14:03]And we're going to use the concept of hallucinations as the example. And so just so everyone knows, I'm going to try to explain as thoughtfully and reasonably as I can what a hallucination actually is. And there are lots of misconceptions that people have. And because I'm a professor, I try to stay up on the literature about this. I try to read Carl Friston's work if you've read his work on probabilistic thinking and basian reasoning and predictive inference and things like that. I try in the free energy principle and so on and so forth. I and I tried to read Lisa Feldman Barrett's work, another famous neuroscientist who's written all about how emotions are constructed.

[00:14:46]And so I'm going to pull from those authors. I might not name them going forward, but just know that I'm trying to pull from recent research, not outdated nonsense from the 50s, 60s, and 70s or BS psychoanalytic thought or something. I'm trying to talk about what we can technically actually know. I'm not trying to talk about what I wish to be true, just to be clear for everyone.

[00:15:10]So without further delay, let me repost something that I said uh earlier today in this little discussion in this back and forth.

[00:15:22]Okay? And again, if you're brand new to this podcast, follow me on YouTube, The Psychology Checkup, and follow me on Twitter, al Ha P A T R I C. So, here is what I said a couple hours ago, and I'm going to explain this in full detail.

[00:15:38]So, please forgive me if you didn't sign up for a lecture today. Get some caffeine. We'll make it worth it.

[00:15:45]So, here's what I said. Hallucinations, I was asked to define what hallucinations are. I said, hallucinations are aberrations of the normal sense construction process.

[00:15:59]Follow-up question. What dictates how we construct our senses? It's our needs and our drives and our wants. So when we're sensing something, taste, smell, temperature, whatever it is, that is a construction of what we believe we are experiencing or should be experiencing mixed in with the real data of the external world, the external stimulus, the noise, the the temperature change, so on and so forth.

[00:16:28]Paragraph two. Our brains mostly rely on memory to guide how we construct what we hear and see.

[00:16:38]But sometimes we have unregulated constructions.

[00:16:43]And the metaphor he uses, imagine a builder of a house who ignored the blueprint.

[00:16:50]Imagine how strange that house could look if he were motivated to build it strangely. you know build things a skew and not connecting logically. So what I said in summary is that sensation is a real external event plus lots of memory and motivation and needs.

[00:17:09]So this might seem a little convoluted.

[00:17:11]So let me let me back all the way up.

[00:17:16]So there are a lot of theories of psychosis and what psychosis actually is and can be. And to be clear, there are two different types of symptoms that people can experience while they are psychotic.

[00:17:28]Excuse me. Like the Winchester house.

[00:17:30]Yes, exactly, Jeff. So, the very the simple truth of the matter is for people that are experiencing psychosis, there's sometimes what we call positive symptoms of schizophrenia, those positive symptoms are the things that are present. they're positive on a test like a blood test, but they shouldn't be there like hallucinations and delusions and disorganized behavior and speech.

[00:17:54]On the other hand, there are also these things called negative symptoms of schizophrenia. Negative meaning they're absent when they should be present. So classic examples of negative symptoms of schizophrenia include anhidonia, the inability to experience positive mood.

[00:18:10]Not just sadness, but the inability to experience positive mood in correlation with an outside stimulus that normally produces it like a hug or food or whatever.

[00:18:21]Anhidonia, a motivation, the lack of energy to get up and go, right? Not because you're not internally motivated, but because whatever is motivating you isn't pushing you over the limit anymore to get up and go. So, anhidonia, a motivation, poverty of speech, the literal inability to produce speech, even though you are perfectly smart and capable of speaking and have maybe decades of speaking just fine, fluidly.

[00:18:49]and poverty of thought. The inability to connect internal experiences to one another in order to produce a logical thought.

[00:18:58]So those are four of the common negative symptoms of schizophrenia. So there's positive and negative. Positive hallucinations, delusions, disorganized behavior and speech. Negative things that are absent that should be present.

[00:19:09]Anhidonia, a motivation, things like that. So I want to talk about only and only and only the positive symptoms.

[00:19:17]Okay, so talking just only about one of the types of positive symptoms, hallucinations.

[00:19:25]So almost everyone doesn't understand how they in experience any of their five senses. Touch, taste, smell, all these things. Let's be very clear that we have an intuitive sense in our mind of how we experience sensation.

[00:19:44]But the truth of the matter is is that our sense organs, you know, the tempanic membrane in our ear or the rods and cones in our eye and so on and so forth, these sensors that evolution has gifted us with do not experience reality in some raw way. We are unlike every other animal that exists. We see differently, we hear differently, we smell differently, so on and so forth. Our olfactory bulb that is responsible for integrating sense information with memory around smell sensations is different than any other species on the planet. And so it is literally the case that every species has different abilities to see, hear, smell, taste, and all that stuff.

[00:20:31]Which means that none of us experience reality the same. And even trippier than that is the idea that no human being experiences the world exactly the same as any other human being, believe it or not. So although we all have the same basic anatomy, we all have rods and cones, we all have touch receptors in the top three layers of our skin and stretch receptors and things like that.

[00:20:55]We all have the same basic mechanical makeup, but what we don't all have the same is the densities of these things.

[00:21:02]So, it could be the case for me that if I've spent so much time messing around with cars as I have and using my hands to mess things up, I might have fewer touch receptors on the palm of my hand, but I might have more stretch receptors.

[00:21:17]So, I might have less of those pressure receptors because I know I'm going to beat the crap out of my hands, but the stretch receptors are still useful, right? And so our experience changes the way we are physically built at the level of the body in terms of you know stretch receptors in our skin and things like that but also at the level of the neuron. For those of you who do not know one's brain is exactly like anyone else's brain. Literally everybody on the planet has different densities of serotonin receptors and dopamine receptors and things like that. So quite literally no one is motivated the same way and no one experiences our sensations the same way because we don't have the same numbers of receptors and these different parts of the brain and we also don't have the same minor interconnections between neurons between systems in our brain. All the big major superighways in our brain are exactly the same. We all have a corpus colosum and so on and so forth. But at the level of the micro, at the level of one synapse to another in our brain, we are all built differently, literally, not metaphorically.

[00:22:27]So because of that, we all literally experience reality differently. So score one for the constructivists out there.

[00:22:35]I hope that makes sense to everyone because I'm not even close to done yet.

[00:22:39]So, because we're all built differently at the level of the neuron, we don't experience reality the same as anybody else. We generally know what green is. We generally know what blue is, but it's rather subjective.

[00:22:53]How intense are the colors? What shade of white is my shirt really? Some of you might see it very brightly, and some of you might see it more pale, depending upon how your eyes are constructed.

[00:23:08]So because of that, we literally do not experience reality in this raw vegan way, if that makes sense. We experience reality in a constructed way where we have these sense organs like the top three layers of our skin, the push pressure receptors, temperature receptors, stretch receptors in our skin. And then for our eyes, we all have rods and cones, but we have different densities of rods and cones. And we have different sensitivities of those rods and cones. But then once the information hits that set of rods and cones in your eyes, it goes back to your visual cortex. And depending upon your experience, you will see differently than other people. And your brain uses memory to filter how you make up what you're seeing. So your senses are both top down, like what is coming in, and bottom up, what does your brain believe you should be seeing? If that makes sense. I hope that basic separation makes sense. And I'm going to pause for a second, read some of the comments so you can have time to chat in case I'm losing anybody.

[00:24:15]Tax centric here says, "It occurred to me recently that we don't experience sound through our ears. We just place it there mentally because we know how we are enabled to hear." Correct? So, it's true that sensory information that we call noise is bouncing off of our earlobe and into the ear canal, but also we conduct sound through our skull. You know, it's called So, we have all sorts of ways that we hear. There's a couple different ways that all mammals hear, but our hearing is not just through the ear. And then whatever happens in our temporal cortex right above our ear to construct the sound based upon the incoming vibrations in our skull and in our ear will dictate how we hear.

[00:25:00]Cuz like right now I'm speaking right.

[00:25:03]And so, not only am I putting the sound out into the world and into my headphones, but also the vibrations in my mouth and the way that those vibrations are experienced by my skull near my ear into my temporal cortex is helping me hear.

[00:25:22]So, sensation is not the end is not like only because of the external stimulus. When we experience any of our five senses, we are experiencing something that is literally made up, just so everyone knows. So, I'm not hearing myself as I actually sound. And we've all had this experience if you've ever recorded a podcast or or recorded yourself. You know exactly what it's like to be talking to somebody and you know what you sound like when you're talking, but then when you play the recording back, you're like, "Wow, I sound so differently." Now, some of that is because of the specific recording mechanisms, but the truth of the matter is is how you hear yourself is not how you actually sound out there, which is true for every other sense.

[00:26:10]What the information coming in looks like to you is not actually what the information is like out there in the real world.

[00:26:18]Inspired by reason here says, "I have been hallucinating schizophrenia patients, doctor. How do I resolve the trauma responses?" I couldn't tell you.

[00:26:26]There's so many words in that sentence.

[00:26:27]since I couldn't tell you where to start. But best of luck to you.

[00:26:35]Yeah, answering machines used to do that, too. You know, voicemails, listen to voicemails, right? The person's voice on a voicemail sounds different than what they sound like on the phone versus in person.

[00:26:46]So it's very much the truth I believe based upon the data based upon what we know about how the brain works that our senses our five senses sight touch taste smell hearing these things are not raw experiences. When we're experiencing our five senses we are constructing them in a probabilistic way. We are making a guess, an educated guess about what we are supposed to hear, what it's supposed to sound like or what it's supposed to smell like based upon the actual sensation coming in, the smell, the sight, the temperature intensity, and what our brain remembers it's supposed to sound like. So, I have seen myself do this podcast, you know, 75 times now. And so I have an idea of what I look like, but that idea of what I look like is mostly memory. The fact that my eyes can tell I'm wearing a different shirt and a different jacket, that doesn't really change what I think I look like to myself.

[00:27:49]A lot of what I think I look like is made up in my visual cortex based upon what I think I'm supposed to look like, what my eye color actually I think is, what my hair I think looks like. Right?

[00:28:03]And that's all memory because I did my hair 10 minutes ago in the or whatever in the mirror upstairs. And so I have that visual memory about what my hair is supposed to look like that is also im imposing itself on what my hair looks like right now. If that makes sense. So quite literally speaking, everything that we experience, all of our five senses are made up. It's this bad combination of what's actually happening and also what we remember and wish to be happening. What we're motivated to believe based upon our memory should be happening.

[00:28:42]Tacentric just asked, would you say we overly rely on sight above the other four senses? I have no clue.

[00:28:51]I would imagine different people function very differently, but I I couldn't tell you honestly. That's a really good question and I don't know if there's any particular research on that.

[00:29:00]I'm sure some people are more visually oriented in the world. However, I would be shocked if all of us simply ignored what we were hearing. Now, obviously, right now, because I have headphones on, what I'm hearing is rather blunted. I don't really hear, let's say, what the outside world is like comparatively speaking. I can hear the air conditioner running. I can hear my voice, but that's kind of it. Whereas without those headphones on, I can hear probably two or three other distinct things at the same time. And so I might be more engaged audibly than other people, but I think all of these senses work together to some degree for most people. And maybe some people are more visually oriented. I don't know. I don't know. I don't know that there's a good crystal clear consistent scientific answer to that.

[00:29:47]So, so far I've tried to explain how senses basically work. Now, to be completely fair to everybody watching and listening, I'm sure I'm going to get some hell for this, but let's be clear.

[00:29:57]I'm trying to simplify decades and decades of neurology neurology research and sensation research into like a 10-minute explanation.

[00:30:07]So, I'm using euphemisms and shortorthhand as opposed to spending insane amounts of time on a podcast explaining the fine grained realities of how, you know, your old factory bulb is built and what those hairs in your nose do and what kinds of chemicals cause you to smell things and how much taste is involved in smell. Like, I can get into all those layers with you, but I don't think that's going to be a super entertaining podcast to be quite honest with you. But I can. So to again recap everything I've said so far, it is literally the case that what we sense with our five senses is at least 50% made up because of what we are motivated and remember to feel, smell, taste, or touch.

[00:30:54]That's not even going as far as talking about all the complicated reasons why our senses might be dulled in some way.

[00:30:59]if we're intoxicated, if we're tired.

[00:31:03]Jonathan says, "The sensational jacket is helping." Good. I'm glad my sensational jacket could help.

[00:31:12]So, our senses are at least 50% construction at least. Which means that nobody walking around experiences reality raw.

[00:31:24]All of us are interpreting what we're experiencing. I'm going to say that one more time. Every human being with or without mental illness is interpreting reality. We are not experiencing reality raw. Now the follow-up question is, well then what exactly is happening with a hallucination, right? Cuz clearly something must be awfully different about people who are experiencing hallucinations compared to people who are not. Right?

[00:31:55]If we're all making stuff up, what is the difference between the way we construct our senses versus psychotic people are constructing their senses? What is the major difference?

[00:32:08]And that's a perfectly valid question which I hope to answer here. And Jeff says, are we at the mercy of those constructions? Yes, we are. We are at the mercy of what we believe is true essentially. And I I'll explain more about that in just a second when I talk about hallucinations here.

[00:32:23]So again in summary, all human beings, all mammals do not experience reality raw. What we do is we have incoming real sensations that are then modified, shaped, chiseled away at to construct what we think we are experiencing in any of our five senses.

[00:32:45]So our memory and our mood and our motivation is shaping how we smell that, how we see that, if that makes sense.

[00:32:55]So what that means literally is that if you're hallucinating, then all that's really happening and again I am wildly oversimplifying for the sake of a podcast. I do a much more thorough lecture. Feel free to come to my class.

[00:33:11]But the shortest version of this, if you read Carl Fristen's work and Lisa Felbin Barrett's work and so on and so forth, is that when we hallucinate, normally there's a pretty tight correlation between what we're experiencing and how similar what we're experiencing is to our past experiences.

[00:33:33]So, if I'm used to experiencing this shade of light coming in, my ring light here a certain type of way every time it's on and it's kind of like bluish bluish white. If I've always experienced this ring light as bluish white and that correlates and tracks across time, then I have a pretty good memory bank of what this light sensation is like. Now, if I'm visually hallucinating, there's some simple things that can be happening that can cause me to hallucinate that can cause me to, let's say, not correlate what I'm currently experiencing with the past.

[00:34:14]And tax centric, you just put a really good question in. I'll get there in just a second. So, I'm going to use the example of a visual hallucination real quick. Okay. So, again, I'm currently staring at my computer and at a ring light right now. And the the sensation of my ring light, if you could see it, is it's mostly kind of bluish white. And it I've experienced it this way for the majority of my time doing this podcast and using this ring light for all these months and years. And so, it's literally the case that I have a memory trace. I have a memory pattern in my visual cortex that says this is how it's supposed to look. Basically, now if I were having a visual hallucination where I experienced the light as a different shade, for instance, maybe I experience the light as red as opposed to blue, or maybe I experience the light as dull as opposed to bright. If I have either of those changes in how I see it, that could be because there's misfiring electrical activity in parts of visual cortex one and two and three. Or what if I see the light as moving?

[00:35:23]Now, if I start to see the light, cuz it's a static ring light for those of you who don't know. And so, if I start to see the light as moving when in reality it's not moving, something is up.

[00:35:38]Something is wrong. So what could be happening in my brain such that I'm seeing the light move because different for those you don't know you have different layers of your visual cortex I think it's one through five or one through six if I'm not mistaken and each layer of your cortex does slightly different things.

[00:36:12]And so imagine that for instance I see the light moving. What's wrong?

[00:36:20]Well, what could be happening is different parts of your visual cortex are hyperexited. This is that dopamine hypothesis of schizophrenia of of hallucinations.

[00:36:30]So you do have dopamine neurons in different parts of your cortex including your visual cortex. So if that dopamine response, that that hit, that reward, if you're if you're not firing in a logical way, if there's a misfiring, kind of like how a seizure works, if you can imagine the metaphor of a seizure, there's excess electrical activity that's not coordinated. And so if there's too much dopamine misfiring per se in V2 or V5, which are responsible for shape and motion essentially, then it's possible that I could see the light moving when it's actually not moving.

[00:37:08]And so it's just chemical aberrations.

[00:37:10]It's just excess dopamine, like seizure- like activity that forces these sensations to look differently than they actually look.

[00:37:20]And by actually look, all that means is what they used to look like in memory because in memory they weren't moving, right? And so that's all I mean is that real hallucinations, drug induced hallucinations are just the misfiring, the lack of coordination of memory and motivation and incoming sensations.

[00:37:42]That's all it really is.

[00:37:45]Now once you dig into particular types of hallucinations the neuroanatomy is a little more complicated but speaking metaphorically that seems to be an airtight metaphor which is you have a certain rate of dopamine receptor firing which coordinates firing of other neurons to coordinate memory and mood and motivation for what you're experiencing.

[00:38:07]And so if you're not motivated to experience it the correct way, the way that fits the data and the past data and the current data. So the incoming data is the data of the actual sensation. The past data is the data in your memory and your mood maps and your motivation maps.

[00:38:23]So if there's incoming data and past data that do not sync in your brain, that's a hallucination.

[00:38:30]And what's responsible for making that data sync? Well, it's your frontal cortex. It's parts of your memory cortex, your amygdala. All these things have to coordinate correctly to help you experience reality. The same visual hallucinations are not because something's wrong with your eyes. Visual hallucinations are because something is wrong with your cortex. There's a misfiring of memory cortex and V1 2 3 4 and 5 in in addition to your frontal cortex. Your brain cannot correctly coordinate incoming stimuli with historical memory and motivation.

[00:39:05]That's what a hallucination is.

[00:39:08]But the thing is that means that when we're sane, so to speak, and we're not experiencing a hallucination, we're just more coordinated with the prior data.

[00:39:23]Jeff said, "I thought you said on a previous podcast not to use the brain and explanations." I'm trying not to Jeff, but this particular example has to do with the brain.

[00:39:34]So a hallucination is a discordination, a an a not syncing of the incoming data, the actual external world data like the brightness of the light and other visual sensations with the actual data that exists already in your brain in your memory maps and your mood maps and your motivation.

[00:40:00]So hallucinations are very complicated because they're not just one part of the brain misfiring.

[00:40:07]It is a complete lack of coordination across particular senses which we do have some confirmation of in fMRI data and PET data. It's not perfectly the same across all people.

[00:40:20]Not all visual hallucinations are alike just like not all auditory hallucinations are alike.

[00:40:27]So I hope that makes sense. One simple way of looking at hallucinations is the discordination, the lack of coordination between incoming sense data with prior historical memory of that particular sensation and that's it. And there's all sorts of layers of cortex and when it comes to visual cortex like V1 through 5 that can be misfiring per se when you're experiencing that visual hallucination.

[00:40:57]So, let me get back to the the questions in the chat here because there's a lot going on here.

[00:41:03]Tacentric says, "Why aren't emotions a sense?" I would actually argue that in some way emotions are kind of like a story about what we're sensing. Is it more accurate? Tax Ccentric says that they are stimulus that activate the senses to some degree. They emotions can be a sense, excuse me, they can be a thought or they can be a a representation of what you're experiencing.

[00:41:27]And Jeff Club exile here made a very excellent point that I don't want to let go of which is he said and I quote the experience of emotion is filtered through and mediated by stories. You and I Jeff are saying the exact same thing.

[00:41:43]I'm using the word memory but stories and memory are basically the same thing. Basically the same thing.

[00:41:51]And so the problem we face is that our stories can be wrong and they are wrong most of the time. They're not perfectly accurate.

[00:42:01]But our senses are also let's say shaped by the stories we have in our brain essentially.

[00:42:10]Megan Sheay says is there any chance people call forth the hallucinations they want to see even subconsciously? So this is one of those hotly debated things.

[00:42:22]You know, how much of a hallucination is something that people are motivated to experience? So if they're experiencing like auditory hallucinations, like the devil is torturing them and screaming at them in their in their head, but they can't, you know, um turn the voice off, and that's an auditory hallucination.

[00:42:43]There's a lot of research out there currently for the last 10 years or so that basically says that our brain for like auditory hallucinations in particular, even if you're hearing it out there, it is most likely your inner voice to some degree that is causing that. And it is that inner voice that is being filtered. Remember what I said about your brain kind of matching external data with internal data. So it is, you know, whatever your beliefs are about the devil and how the devil would sound that is making you hear what sounds like the devil out there, right?

[00:43:18]So you're you're actively constructing what the devil sounds like out there and that's all filtered through literally your memory of watching scary movies or stories you heard in church or whatever it is. And so the idea that you subconsciously want to hallucinate something is actually valid. However, we don't want to over state its importance because I think our motivations to remember and hear and smell and see things is only one factor. It's also built on the database of what you have in your head.

[00:43:56]If you have a database, if you have a memory bank, so to speak, that has no data for dark colors, for instance, you're probably not going to experience a lot of visual hallucinations with dark colors, or you'll experience something that's an approximation of a dark color, for instance.

[00:44:14]So, that's just my take.

[00:44:20]Jeff says, "Great example." Yes, I know.

[00:44:23]So I want all this to be super clear and simple for people.

[00:44:28]When people have hallucinations, there is a disconnection between the incoming sensory stimuli and then the internal memory and mood and motivation maps to cause you to feel, smell whatever it is that you're feeling and smelling.

[00:44:46]Because all day long, all day and all night, we are sensing things through our five senses. And what happens is when we hallucinate, there's essentially something akin to like a seizure. There is a discoordination and hyperactivity of parts of the brain responsible for coordinating and correlating internal and external experiences.

[00:45:10]Which is really tough. Which is why, by the way, my dear friends, mental illness is real.

[00:45:17]Because people can't control these experiences. You can't force yourself to hallucinate. You cannot force yourself to have a flashback. You cannot force yourself to be hopeless. Now, certain things can happen to you and it's easier for your brain to fall into the trap of hopelessness or have a flashback or hallucinate.

[00:45:40]But it is absurd to say that there is nothing quote unquote wrong with people when they have a hallucination.

[00:45:47]Which brings me to topic two. this idea that we should quote unquote depathize things. This is about as absurd as I can imagine it being. And so, let me retweet something real quick.

[00:46:03]This is probably not going to be long enough, but it's important.

[00:46:10]Okay, so three days ago, Dr. Jessica Taylor at D RJ E S T A Y L O R and she put out this very lengthy post about everyone and nothing and all she used a bunch of all or nothing language which is a sign of a problem obviously but she basically goes so far to say is that literally speaking literally there's no such thing as mental illness she wants to depathize things like there is no such problem people don't have problems people aren't sick or broken or something. And so, let me be very clear and here's what I said two days ago. As an actual CL because she's not a clinical psychologist, she's a forensic psychologist. As an actual clinical psychologist, I said two days ago, I can sympathize with the desire to depathize.

[00:46:58]Here's the issue. Bipolar one, schizophrenia, narcissistic personality disorder, borderline personality disorder for just a few examples, have literally no adaptive utility and a high morbidity mortality rate.

[00:47:11]Yes, we should certainly fix the institutions which screw us up. But let's not pretend that all mental illnesses are just adaptations to a sick society. That's horshit.

[00:47:22]Psychopathology is real. Some people are overdiagnosed. Some people are underdiagnosed or misdiagnosed. That doesn't mean all of them are not real.

[00:47:32]So, let's be very clear that there are some people that are just built differently, right? Those people might have different types of neurode divergences, but maybe not be so different at the third standard deviation out on the spectrum that their life isn't very impaired. So, they're just different and weird. For instance, some people who are autistic are just kind of weird. However, there are entire swads of people in the world that exist across cultures who have such drastic changes in their mental functioning that they cannot live normal life.

[00:48:16]And across cultures, these people often die early because they hallucinate and fall off a cliff kind of a thing or they get into fights and get killed. So, it's not like there is this beautiful picturesque Barney the dinosaur kind of [ __ ] world where if we were just more accepting of people, all mental illness would disappear. That's garbage because that's never existed in any time in society. Yes, it's true that some people we call psychotic were praised as shaman and things like that in other cultures.

[00:48:54]But it's not like everybody who was mentally ill by modern terms was just exalted as some brilliant deep person in history. There have been tons of people in history who are really psychopathic who have gotten out of control and were killed by society because they were too aggressive and violent and antisocial.

[00:49:16]Those people have existed and they were killed quickly. You know, kids, a lot of kids were killed for being unruly all the time. Look at the Bible. Killed all the time for being antisocial. And so it's very quite literally the case that it's not like there's some brilliant perfect world where if you just let people be, they would never become mentally ill. There have always been people who are mentally ill. Literally, there have always been people who are mentally ill. There have always been people at the second and third standard deviation of pick a trait, personality trait, temperament, whatever it is, and their lives have been impaired because they are so radically different. Just like imagine the people that are super tall and super short.

[00:50:05]Those people have lived radically different lives across history.

[00:50:11]And it's not like there is a world that exists where every difference is perfectly the same.

[00:50:16]No, life sucks. Actually, life is great, but there is no perfect society where you can be all sorts of different and everything is fine and you're never outcast, hurt, or at a disadvantage.

[00:50:31]So, I am 100% on board with calling out all the crappy providers who overdiagnose. They should all feel ashamed and probably lose their license. In my opinion, I am all about getting rid of the the psychiatrists and psychiatric nurse practitioners that overmedicate people. Shame on them and disgusting.

[00:50:54]There's tons of people on anti-depressants who don't need to be on them. There's tons of people on mood stabilizers who don't need to be on them. I don't know how many. It could be a hundred. It could be a thousand. It could be 10,000. I don't know. But there's too many of them.

[00:51:07]So I am all about depathizing and dstigmatizing things that should not be pathized. However, what I will say is illnesses like bipolar one and you know more severe versions of schizophrenia, they concern me because those people have never existed perfectly in harmony with society in history. They have always struggled and needed support.

[00:51:36]And sometimes they have been harmed because people didn't understand how sick they were. There were plenty of decades in the past where they were badly mistreated, tortured. Nowadays, the worst torture they get often is psych meds that suck and have metabolic consequences and can harm them. But it's not like the hundred years ago when people were being physically beaten and shoved into cold baths and electrocuted all day. Things have gotten a little better. Okay. So, it is my belief that yes, we should depatholize things, but some things are seriously a problem. No matter what time in history you come from, what culture you come from, what language you speak, narcissistic personality disorder is a problem no matter where you are in history, and no matter what niche you find yourself in the world.

[00:52:29]Jeff said, "I consider that take on ner divergence deep pathology." Yeah, I think there's a spectrum of differences that people can have that aren't necessarily pathological. So, I'm all about expanding that and talking about that.

[00:52:48]But, let's get to Angie's point because Angie, I think, has some problems with what I'm saying. And fair enough.

[00:52:55]Angie says, and I quote, Psychiatry is the arm of the state to control the people who we don't understand and they are hurting these people. And so let me just agree with you Angie that in many cases people are using psychiatry to control people and make them more socially adaptable. And I am not for that. So the problem that you and I face Angie is what do we do with the sickest of the sick? Because some people are extremely ill. Some people have such a severe case of bipolar one that they do things like buy five cars and bankrupt themselves and go on, you know, speeding sprees and get super drunk and assault police officers. I've had a patient like that before. It's not because he was traumatized or something. It's because he had a very severe case of bipolar one and his manic episodes were lifethreatening.

[00:53:50]And there was no talking nice to him when he was manic. He either needed to be medicated or restrained so he would not literally punch somebody.

[00:53:59]Okay, now that's not most people with bipolar one. Thank God. However, we have to make sure we take care of the people as best as we can who are very ill.

[00:54:12]And until there are better models, we are stuck with the system that we currently have. So, I'm all about building different models.

[00:54:21]And if anyone wants to pay me, you know, $100 million to build alternative models, I will do it. I will quit everything I'm doing right now except for teaching. And I will go do it. If Elon Musk or Jeff Bezos or somebody wants to fund my, you know, master plan to create alternative communities for psychiatric healing, I'm all about it.

[00:54:39]I'm all about it. I'd love to do that.

[00:54:41]However, in the world where we practically literally have to exist, there are realities around what we do with moderate to severe illness. Mild illness is much more manageable in so many ways, but severe illness, there's no way you're just going to talk nicely to people and destigmatize their experience.

[00:55:05]Angie's just said, "You can't say what exactly is ill, though." Oh, yes, I can.

[00:55:09]As both a professor and a clinical psychologist, I certainly can. I can easily easily say what is ill. If you are so impaired by your hallucinations that you cannot remember to eat or bathe yourself, that's not merely weird.

[00:55:28]That's life-threatening. And I've dealt with those people in psych hospitals before. If you are so psychotic, if you have such intense visual hallucinations that you literally put yourselves in harm's way by walking into traffic because you are fighting something that does not exist, that is illness.

[00:55:48]And so there's always a simple practical definition which is are your symptoms so intense that you cannot function in your environment? Simple enough.

[00:56:01]You can always have a consequentialist argument. And it's not because I want these people to be treated badly. What I want is I want them to be safe enough to function.

[00:56:16]Angie said, "When you make these arguments, you're leaving out their history in any psychiatric harm or abuse or trauma." And no, I'm not I'm not doing that at all. I'm trying to give you a simple definition. It doesn't matter if you were traumatized. It doesn't matter if you were molested. If you're visually hallucinating and in the middle of your visual hallucination, you cannot track your other senses and you walk in the traffic, that is dangerous for you, the individual. So even if you were molested as a kid and and that's why the content of your visual hallucination is what it is, it's great that that's the content and we can talk about it in therapy and I'd love to do that to help the person.

[00:56:54]The problem is is that while these hallucinations are happening and you can't not stay out of traffic, that's a problem. That's a huge problem. I don't want you to die and I'm sorry. I don't want people to die. And so for many people, a short course of medication to stabilize the hallucinations at least is lifesaving. And I've dealt with so many people who are so acutely ill that I cannot imagine them not die.

[00:57:23]And I've had so many patients in life-threatening situations. One of my favorite people I ever worked with who had a pretty gnarly case of bipolar one literally got the crap beat out of him because he was visually hallucinating.

[00:57:35]He had mania with psychotic features. He was literally hallucinating outside of a bar and masturbating in public and he got the crap beat out of him by a bunch of drunk [ __ ] at the bar. And masturbating in public is certainly weird. You could say that's a weird behavior, but like there is no society where people are just going to be okay with you jerking off outside the bar.

[00:57:56]There's just no way.

[00:58:00]Angie says, "These examples you're given are the rarest of the rare." I know these are rare, and I'm telling you that I have to deal with everybody. I have to deal with everybody under the sun. I don't get to just choose the people that are less ill.

[00:58:16]It's like the difference between a mild fever and a severe fever. A mild fever can be adaptive, right? A mild fever can keep you from getting extra sick and start to kill off bacteria. A severe fever can kill you and stop your heart.

[00:58:30]So, my my belief is that illness is real as evidenced by all the people that almost die or do die because of their symptoms.

[00:58:41]Case closed. Now, does that mean that every illness is exactly the same or that every illness is severe? No. Thank God. Most people who have something that we could call a mental illness are on the mild or moderate. I can tell you exactly where they are in the brain. I just explained Angie where visual hallucinations happen in the brain. They happen in V2 and V5. If I see the light moving around, that is visual cortex 2 and visual cortex 5 where those aberrations are happening. I can point to it. It's not super it's not super complicated to me. Like certain symptoms have crystal clear correlations in the brain and some symptoms don't. Now, what I've also made very clear in my time here is that I think society sucks. And it's very much the case, 100% the case that society sucks. People suck. People hurt people. The profession hurts people. So I have never denied at all at all that the profession doesn't hurt people. I have talked I created this weekly podcast to talk about all the problems with the profession. So, I think it's fascinating that I get hell from people when I'm trying to do the right thing, which is talk about facts accurately, not with the bias that serves me. Like, I don't make any more money by people getting ill or getting better at all.

[01:00:08]I have no financial investment in people being sick. I would love to leave the profession altogether. Let me become the psychologist version of Tim Dylan and get the [ __ ] out. I would love that.

[01:00:21]Make me famous, people. Cancel me. Get me out of this [ __ ] profession. I would love it. Let's go. Let's [ __ ] go. And all I'm saying is is that unfortunately certain things are real.

[01:00:33]Some things are [ __ ] I think many things in the DSM are not illness 100%.

[01:00:38]But some people are very seriously ill as evidenced by all the ways it impairs their life regardless of trauma, regardless of culture, and so on and so forth. If you're slamming three grams of meth a day, you are [ __ ] There's no culture where that's okay. There's no culture in history where shooting up three grams of meth is going to make your life better. And if you can find me that culture where slamming three grams of meth is good, point it out on the map to me. I'd love to see it. But that's wholly maladaptive. There is no world in which snorting fentanyl is good for you.

[01:01:14]There's no world. That's not just being weird and different. That is self-destructive behavior which has to be addressed. If you don't want to die now, some people want to die.

[01:01:26]That's not my choice. I don't want people to die, you know.

[01:01:31]Oh, Angie just said define real. Boy, I'm at the end of my time, Angie. So, I can't do it. I can't do it. Someone quote me. Someone quote me and get me cancelled. Please, for the love of God, I just It's I'm wearing the right jacket for it. Let's [ __ ] go. Let's go. Um, I miss a lot of comments and I'm very sorry. So, let me see if I can get back to some of them. Uh, Megan Sheay agreeing with me I think said the past doesn't matter when the hallucinating neighbor thinks your house is the devil's house and they are getting ready to burn it down. Example.

[01:02:04]Yes, exactly. Um, illness does exist.

[01:02:07]Yes, Jeeoff, it does. It exists. Now, how much is it real and how much is it made up and how much is it society sucks and society has stupid norms? I'm always open to the conversation. I'm always open to the conversation that if we just had better norms as a society that people would be less ill. If people had better parents, they'd turn out better.

[01:02:32]If people had better friends, if people had a better relationship with a higher power of some kind. I can think of dozens and dozens and dozens of reasons why so many things that we call mental illness would not happen and I'm all about that project and I would love to be able to create alternative communities where people were less [ __ ] up by society and life and all these things. I'm all about it. In fact, one of the reasons why I'm optimistic as a person, just just full transparency, is I think all this AI [ __ ] is probably going to help us not have to do a bunch of stupid jobs. And maybe we're going to have to figure out more of what our purpose is as people away from like being a plumber or in my case being a psychologist or something. I would love that. I think that'd be awesome. I think this evolution is going to be good for us. I'm not a doomer. I'm very optimistic. However, even if we create better societal structures and we get more people off of meds they don't need to be on, I still think there is a there's a there's a subset of people and I don't know what percentage of people it is, but there is a subset of people who are mentally ill and they always have been in history. There is no volume of history that says everyone got along.

[01:03:45]Everyone basically functioned in society that's never ever existed that's ever existed. And so I do not like the fairy tale that there is no such thing as mental illness and that if we just had better social norms people wouldn't be mentally ill. That's such horshit. What is true is that a lot of people are overdiagnosed and overmedicated. Many people are diagnosed that should not be diagnosed. Many people simply have shitty family and shitty friends. Many people have terrible diet habits and terrible sleep habits which always eat better, sleep better, exercise more.

[01:04:22]But those groups of people are not the same as that that 1% 5% I don't know what it is. I can't know. There's no way to know what it is. But there have always been people in history who are so out on the third or even fourth standard deviation of things that they couldn't function well in society. It's no different than IQ. Imagine all the people in history who were born who had an IQ of like 50 or below. Their lives were [ __ ] There's no world where they were going to be okay with the exception of people bending over backwards and destroying their own personal lives to keep them well.

[01:05:05]And that is okay. It is okay that sometimes we have to accommodate a society to the very sick and I think we should and thank God for many professions that try to do that.

[01:05:15]However, those same professions that tried to accommodate and help the people who are very sick and different also hurt them. And so I created a weekly podcast called Unshrink Me, by the way, welcome to the podcast to talk about all the problems with this with the profession. And so I think I have hot take. I think I am the most reasonable mental health influencer that has ever [ __ ] spoken on a camera. I believe that's what I believe. Maybe I'm wrong.

[01:05:44]Maybe I'm delusional. But I believe I'm the only one who is willing to tell the truth about everything.

[01:05:51]And so what I would tell all of you watching and listening because this has been extra spicy and I've cursed a lot.

[01:05:57]I'm sure I've lost all sorts of street cred from people who are fragile and sensitive. But what I will tell everyone is that there are genuinely sick people.

[01:06:07]Even if they're mistreated, they're still sick. Even if they had childhood trauma, they're still sick. They still need extra help. And there's just no way, no way, no way that they're going to be okay. It's true. Some people some people get better by themselves and don't need meds. Some people have hallucinations and they go away on their own and thank God. Some people are severely ill and by, you know, good luck they're taken care of by someone who's understanding and patient and can deal with it. A lot of people don't have those resources and family and friends. It's very hard to deal with a severely ill folks.

[01:06:49]inspired reason says, "Thanks for having fun today." Yeah, you're welcome. It's probably going to get fired and that's a-ok. Okay, you know, um, and yes, Andrew, you're correct. There are some third world countries, some I would call them pre-industrialized countries where the rates of mental illness are lower and the outcomes are lower. But also, what you have to remember, Angie, is in many of those countries, people die at 20 and 30 on a regular basis. They die before things become a serious problem or they die younger than that. Some of them have different ways of handling it.

[01:07:24]Some people are beaten to death and some people are given drugs in those societies.

[01:07:31]Some people are drugged with poisons and fermented fruits to make them drunk so they don't function in an erratic way.

[01:07:39]So plenty of these so-called third world countries also do things to harm people that are mentally ill using a western definition. And Jeff says sometimes they die inside. That's true.

[01:07:53]You know, suicide happens everywhere in the world.

[01:07:57]People are harmed everywhere in the world, whether it's by the medical profession or by their community.

[01:08:05]And I'm glad that staying away from professionals, for those you don't know, Andy just said the best thing I could do is stay away from the mental health professionals. When I was like, got it, great. I'm glad it worked for you. I don't know that it will work for everyone. You know, what works for one person is not guaranteed to work for other people. You know, case studies are very helpful. However, case studies are not a complete set of solutions because as I said earlier, we are all literally built differently at the level of the neuron. None of us are built the same at the level of the neuron, which means that we don't all have the same sensitivities. We do not have the same memories or life experiences. We don't have the same personality. Some people are very conscientious by temperament which they cannot control. And some people are very, you know, 10th percentile of trade conscientiousness.

[01:08:54]They're a mess. No matter what they do, no matter what drugs they're on, etc. And so, everyone's built differently.

[01:09:02]And the fact that we're all built differently means that we can't have one perfect simple solution for people that are struggling because people are not machines. I have said this over and over again. So, I'm going to say it yet one more time. People are not machines.

[01:09:18]People, their brains are not machines.

[01:09:21]The brain is not a clock. It's not a watch. I call it the broken Rolex fallacy. The brain is an ecosystem.

[01:09:28]Ecosystems are living and dynamic things and different ecosystems have different requirements to be functional and stable. So a desert as a type of ecosystem is different than a tundra. A desert doesn't need much rain, whereas a tundra needs some rain and lakes and rivers. And so it's very very clear that if you treat your brain like a Rolex, like a precious valuable thing to fix, you are [ __ ] because there's no way from a from a technical that's a clinical technical perspective. The brain's not a machine. One of the worst parts about psychiatry is this mechanistic nonsense that you can just fix this thing by stabilizing this system like SSRIs.

[01:10:15]That's not true because brains are not machines. Brains are ecosystems. Ecosystems involve different organisms, different types of birds and bees and bugs, different types of water and climate, fungi and plants, all working together to keep things in homeostasis. Uh, so excuse me. So, generally speaking, literally speaking, your brain is an ecosystem, not a machine. Which means literally you need different types of people inputs into your life to help stabilize the ecosystem that is your mind. Just like you need diet and exercise and light and rest and all these things to stabilize your mind.

[01:10:59]It's an ecosystem.

[01:11:01]If the desert has too much rain, animals die, plants die.

[01:11:07]You know what I mean? Like we have to be perfectly clear that if the brain is not a machine, which it's not, then if we treat people like things, we get thing results, which is stigmatization, dehumanization.

[01:11:21]So to Angie's point, I don't like a lot of psychiatrists because they think of people like things when in reality, people are ecosystems.

[01:11:31]Brains, minds are ecosystems. And the idea that your mind is something that lives in in your skull is not true literally.

[01:11:40]So if the mind is an ecosystem, it's very very important to be clear that we need not just antiscychotics but also therapy, but also social support and case management.

[01:11:53]We need to help fix the relationships the person has. We need to help them fix their diet and their lifestyle. So I'm very hopeful and optimistic about all this keto stuff.

[01:12:03]Is it going to cure anything? No, I don't think so. Is it going to help?

[01:12:07]Probably.

[01:12:09]Probably.

[01:12:11]It's going to deal with one of the dozens of variables as to why people hallucinate.

[01:12:18]So, I think I'm the reasonable one here.

[01:12:20]I think I am not some shill for any particular industry. I think I hate all of the industries. Pretty straightforwardly.

[01:12:27]Pretty open about how disgusted I am by everything. I don't think I'm very like cautious with my disdain for the profession. I created a podcast to criticize the profession in front of professionals every week.

[01:12:43]So again, I think I am the most reasonable critic and mental health influencer that has ever existed because I I see I think most things and I have a pretty well-rounded opinion about all these things.

[01:12:56]And so again, we are well over our time.

[01:13:00]I really appreciate everyone who is coming out to chat. Angie, very grateful for you in the chat today. I know that you and I have gone back and forth here, but I still appreciate you. And I think that we are, I don't know, 80% 90% on the same page, maybe something like that.

[01:13:18]Brian says, "The Tim Dylan of mental health." Yes, dear. Someone clip this out. And I am the Tim Dylan of mental health. someone. I need the sunglasses and the hat and the hoodie though. You know what I mean? This is my my hat and hoodie essentially. Um, yeah. I think keto is going to be great, Angie. So, I'm excited. So, thank you all for being here. Thank you for this chat. Thank you for the opportunity to get in the mix and talk about things because I'm pretty sure I'm 100% sure that everyone's leaving this chat better off.

[01:13:59]So, thank you for being here. Thank you for contributing to the discussion.

[01:14:02]Thank you for making this, you know, like an interaction, not like a um rant kind of thing. Though ranting is fun.

[01:14:17]I would say that this has been one of my favorite conversations in this podcast so far.

[01:14:23]I've had a number of really good ones.

[01:14:24]This is one of my favorites because there's so much back and forth and there's so much important stuff to say and because I believe that people are really complicated and if we really respect people, we see how complicated they are. It's really important to see them for the ecosystem that they are.

[01:14:40]86% yes. Exactly. Like the mind is an ecosystem. You we're not machines. The broken Rolex fallacy is terrible. It's killing us. It's it's making psychiatry useless and counterproductive. So we have to be careful about this idea that we can simply understand people just because there is a misfiring of visual cortex two and five and you're seeing things move that don't move. Like that might be true but it's not the only thing that's happening in that person's brain and it's not the only thing that's happening in that person's life. And so when you really respect people, you try to see the complexity of the person.

[01:15:19]And that is why I created this podcast because so many professionals don't understand the complexity of people.

[01:15:25]They don't see that the mind is an ecosystem. They think the mind is a machine. And so one of my great joys as a professor is talking about the difference with my students and seeing their eyes light up and go, "Oh crap, that's right." you know, and I want people to have a sense of encouragement that actually it can get better. I think it will get better. I think society is changing so that it gets better. There's push back against psychiatry. There's push back against therapy. There's push back about early childhood nonsense from people like Nick Taber, too. All that's great. So, we should be optimistic, not pessimistic. I see the world getting better. So, thank you for being part of the conversation with me today, everyone who came to the chat, and thank you for helping us focus on what matters in today's conversation and not get distracted by the BS of things. Unfortunately, I got to get going and there's no joke for today. But I will catch you all next week, hopefully at the same time and the same channel. And if you need anything, please follow me on Twitter at alobha at a l o b h a p a t r i c k. Feel free to tweet at me, come at me, scream at me, cancel me. Just don't fire me or sue me.