EXPERTS ON EXPERT: Dr. Drew

[0] Hello, everybody.

[1] Welcome to Armchair Experts, Edition of Experts on Expert.

[2] I don't know if I phrase that correctly, but here we are.

[3] Today is a friend of mine.

[4] Dr. Drew Pinsky is on.

[5] He and I have, well, we met doing Loveline some 15 years ago or something.

[6] And then over the years, our paths have crossed many times.

[7] He and I are both spokespersons or spokespeople for the, the Prostate Cancer Foundation, and we're always trying to raise awareness for that and urge people to get screened at their PSA level checked.

[8] He's a fascinating man. He's brilliant.

[9] I love chatting with him, and I think you'll love it too.

[10] Please enjoy our expert today, Dr. Drew.

[11] Wondry Plus subscribers can listen to Armchair expert early and ad free right now.

[12] Join Wondry Plus in the Wondry app or on Apple Podcasts.

[13] or you can listen for free wherever you get your podcasts.

[14] He's an option to.

[15] He's an up to my doctor.

[16] Dr. Drew Pinsky, welcome.

[17] Amen.

[18] This is ultimately, I hope you'll receive this as a compliment.

[19] I did very little research on you.

[20] Oh, I do.

[21] Which is not like me because every time you and I run into each other, there's never enough time for us to talk.

[22] Absolutely.

[23] It's always rapid fire.

[24] Of course, we only get commercial breaks usually.

[25] Yes.

[26] But what I like is it, what you don't know, is that both of us will do these things just so we can spend those commercial breaks together.

[27] Yeah, that's nice.

[28] Drew and I are both, you know, advocates for prostate cancer awareness.

[29] And Drew works a lot with the Prostate Cancer Foundation.

[30] And I, too, was trying to help with that.

[31] So last year we did this media tour, right, where you show up at a place at 5 in the morning.

[32] And you literally talk to 110 news stations around the country.

[33] And it's like every three minutes.

[34] Michelle and Will in Wisconsin.

[35] Now it's a Susie and Jam in Atlanta.

[36] They'll be on in three, two, one.

[37] And then so we're both just regurgitating all this information about prostate cancer and awareness and not what you should do.

[38] And then anytime we have 12 seconds between them patching us through, I'm like, well, did you hear that episode of such and such podcast?

[39] Because I was, I was on iTunes You like consuming.

[40] I consumed everything there was from Yale and Berkeley and a couple of schools.

[41] iTunes You used to be this great repository.

[42] world -class lectures well they started pulling back there was some liability issues or some this some that I think you see still does it but I mean I was consuming this stuff there was nothing left and you advocated some podcast to me and I was like right no no no no I can't get I want lectures I want this and you went no no no no remember this conversation oh yeah what about Sam Harris so I started getting into podcast now I'm deep into podcast yeah yeah when you get that brain candy I always thought podcasting wouldn't be I needed like somebody to have thought out the material and presented to me the way a lecturer with.

[43] Do you know what I mean?

[44] I thought I won't get enough for a podcast.

[45] I was wrong.

[46] Right.

[47] Oh, good, good.

[48] And you're smarter than me and have much more schooling, but I hope.

[49] Maybe, but smart you know.

[50] I hope you have the same experience I have when Sam Harris is talking to say an astrophysicist or somebody like that.

[51] Yeah.

[52] Where I am just like I'm struggling to keep up.

[53] You have to concentrate.

[54] It's my favorite feeling.

[55] Like, oh, I got it.

[56] I got it.

[57] Like in any moment, if I lose like a sentence, I'm going to be gone.

[58] No harm re -listening.

[59] Just peel it back.

[60] Go do it again.

[61] Yeah.

[62] Like the episode that I love so much was the Jonathan Hight episode.

[63] Probably listen to it.

[64] You have to draw my memory a little bit.

[65] These two had had a longstanding war in academic journals and online, I assume.

[66] And then finally they sat down and talked.

[67] And what you quickly found out is they do agree on 99 .9 % of everything.

[68] Of course.

[69] And where they really diverge was Jonathan believes that, being religious is a part of our evolution, right?

[70] That it is a byproduct of evolution.

[71] Right.

[72] That we are actually, we evolved to have religion, right?

[73] We must have.

[74] Yeah, as an anthropology major, we never came across a group that didn't have a creation myth and somebody.

[75] And it benefited us as a society at some point.

[76] Yes.

[77] From some evolutionary perspective.

[78] But, oh, I'm so excited to talk to you.

[79] I have some other things I want to say.

[80] But Sam, you know, I was a neuroscientist.

[81] That was my original, original training.

[82] That's how I, so I went off in neuroscience and back to medical school and then into internal medicine and then ended up sort of back in neuroscience vis -a -vis addiction.

[83] Yeah.

[84] That's sort of why that intrigued me so much because the brain has always been my thing.

[85] So I am mind -blend with Sam as it pertains to most of his science and most of the things he talks about.

[86] Yes.

[87] That stuff I know.

[88] He is a true neuroscientist.

[89] He, you know, he has a PhD neuroscience.

[90] I don't have that.

[91] but it's the domain that field I know deeply.

[92] Yeah, I think it's one of the more exciting places that's happening in medicine, right?

[93] Because it will always will be because it's so complex.

[94] Yes.

[95] Infinite questions to be answered.

[96] But we've been studying psychology, I guess, as a real discipline for what, a hundred years now?

[97] Well, since it split off from philosophy, I mean, Aristotle had a psychology, right?

[98] I mean, philosophers all had psychologies.

[99] It just was considered natural philosophy at that point.

[100] Right.

[101] But so much of this stuff, you were never able to actually view, right?

[102] The functions.

[103] The functions of the brain.

[104] We still really are pretty primitive what we're using.

[105] Even though people declare as though it were the case with great sort of certainty.

[106] This is very vague and very much interpreted.

[107] Yeah, it's in its infancy.

[108] Yeah.

[109] But it all is very, very exciting, right?

[110] Because we, some of the examples I'll give is even in a Malcolm Gladwell book, they talk about pitchers, right?

[111] They would talk to these great, I'm sorry, great batters in Major League Baseball.

[112] And they'd ask these batters, how is it you know when to swing at a pitch, right?

[113] And they all had an answer.

[114] Oh, I can tell when the guy Cox his arm this way that he's going to throw a fastball, whatever it was, they all had some reason after the fact of why they were able to be great batters.

[115] and then as they broke all this down, they realized that from the time the ball leaves the guy's hand until he's making the decision to swing, it would be physically impossible for the brain to do the things they're saying that their brain is doing.

[116] It's their perception of what they're doing.

[117] Yes, and that it actually, the area of their brain as they monitored these guys while they took batting practice, what was that their emotional center of their brain is what was telling them to swing or not swing.

[118] So it's instinct.

[119] Yes.

[120] And that there might actually be some weird communication between the pitcher and the batter on an emotional level.

[121] But let me make it more complex.

[122] I would argue that what's embedded in our right brain, which is those visceral sort of emotional centers, holistic centers, is a shit ton of information coming out of our body.

[123] Oh, uh -huh.

[124] The autonomic nervous system, we don't even know.

[125] To me, that's the final frontier.

[126] How do these gigantic webs of parasympathetic mats that sit over our chest and our stomach, How does that process information?

[127] And 85, somewhere right, I think 80 % of the vagus input, which is what all this feeds into this one trunk, is Afrid.

[128] It goes to the brain.

[129] And we were always trained that it was just the nerve that slowed the heart down and maybe made the stomachs to create some acids.

[130] Turns out most of it is coming back from the body.

[131] So all this information is going in and then it's embedded in the right side of the brain.

[132] And that communicates, and there's body -to -body communication that we just don't understand.

[133] Right, which I believe is happening.

[134] How else do you flirt with a woman, if not some of that?

[135] Go right there.

[136] Yeah, because it's old factory, right?

[137] There's like biochemical things.

[138] Everything is picking up.

[139] All kinds of crazy stuff.

[140] But I, having been in, you know, I did years and years of therapy.

[141] I was in therapy.

[142] And I'm as a patient.

[143] As a patient.

[144] Right.

[145] And I was aware that there was some exchange, some co -created something that was way beyond my ability to consciously process and understand.

[146] Right.

[147] And it's where healing occurred.

[148] It's rhythm.

[149] I think it's where spirituality, a lot of things are.

[150] It's this thing between people that can be achieved if you're really open to it.

[151] Which in physics is kind of string theory.

[152] So there's that applies also to physics.

[153] Interesting.

[154] So when you take, I try not to take it all the way down physics because there's so many intervening processes of sort of a physiological wiring nature that, yes, ultimately, of course, if we knew everything, it could explain everything through quantum or theory, we'd be able to drive it back up.

[155] Right.

[156] I don't think we can do that.

[157] I think things change.

[158] things change actually qualitatively at certain levels of expansion or growth.

[159] Yeah.

[160] Now, but you were just mentioning doesn't the, I remember someone telling me that your stomach has as much, as many neurons or as many something, the circuitry in there is as complex as your brain.

[161] That's right.

[162] And they're usually talking about the gut generally when they say that or they say that, you know, there's all the serotonin to your guts.

[163] Yeah, yeah, there is.

[164] But it has to be able to integrate that and process it in some way.

[165] We have no idea what that is.

[166] So when you say I have a gut instinct, that's what you have.

[167] But exactly what's coming to you and how you develop, how your gut knew something, which it did.

[168] Yeah.

[169] Come on now.

[170] It's awesome.

[171] It's very exciting.

[172] And I want to go back to, we were talking about evolutionary biology of religion.

[173] Yeah.

[174] There's one strange, really strange thing about the human being is that we repeat trauma, particularly from childhood.

[175] We repeat it, repeat it, repeat it.

[176] We repeat it through the mechanism.

[177] of attraction.

[178] In other words, if I have an abuse of alcoholic father, I'm magically attracted to abuse of alcohol.

[179] If I'm, you know, I get attracted to that kind of person.

[180] Yes.

[181] And that's repeating the trauma.

[182] Now the psychologist will go, well, they're trying to solve the past.

[183] That's not my theory, by the way.

[184] My theory is we have a wiring that makes us repeat the past because there's no rational reason we do it.

[185] It's irrational, except, let me propose my theory because it has an anthropological basis to it.

[186] I think I've sketched it for you during a commercial break when we were sitting there.

[187] And it sort of goes to the religious thing.

[188] We could expand it out from there, which is that explicit memory only serves us so far.

[189] And certainly as a population, we really cannot have much than I have explicit memory.

[190] Even when we write it down, we distort it and mythologize it and alter it unless we ritualize it and repeat the behavior every year.

[191] So on Passover, to never forget this horrible night, we'd eat and do the same thing every freaking year, and it never changes.

[192] Right.

[193] And it becomes an externalized repetitive trauma, but because it's externalized, it's a memory that's fixed that remains an anthropological fixture that informs the population from an evolutionary perspective.

[194] Yes.

[195] Gives us some advantage to survival -wise.

[196] There's a ton of literature.

[197] I think this overlaps with that, which is it's our storytelling nature, right?

[198] And because the great advantage that human has, right, is that we have culture, and that's our software.

[199] And that's what's able, allowed us to expand and evolve so quickly and dynamically is that we download new software to our children, right?

[200] They're only born with a handful of instincts that would serve them.

[201] And then we got to load everything else in them.

[202] Yes.

[203] So this storytelling was absolutely a prerequisite for passing on culture.

[204] And information.

[205] Before there was any written text.

[206] And again, culture being modes of survival.

[207] Yes.

[208] At that point, particularly.

[209] Yeah.

[210] And that's why we're.

[211] so drawn to story just innately because that's how we were passing on all this acquired knowledge.

[212] That's how we were downloading.

[213] It was over a campfire and we were telling all these myths and that was helping us, right?

[214] But you keep seeing acquired knowledge.

[215] I think of explicitly as survival techniques.

[216] Okay.

[217] Or enhanced mechanisms that enhanced survival.

[218] Uh -huh.

[219] Right?

[220] How to cook, how to eat, where to eat, where to eat, where to eat, don't eat this kind of stuff.

[221] Where do you wash your dishes?

[222] Where do you go to the bathroom?

[223] Yeah, yeah.

[224] And then here's that you survive and here's, you know, if there's a war, here's what you do.

[225] Yeah.

[226] And to counter Sam's position, which I probably am not doing it justice, but did you read Homo sapien or Homo Deyes?

[227] I did not.

[228] What he is suggesting is that what has allowed us to basically amass into these large civilizations where you can get specialized industry, right?

[229] You can have a doctor Drew who doesn't have to grow his own food.

[230] He can just specialize on addiction.

[231] Because that would not be a good survival story.

[232] What was required for us to assemble peacefully was a shared myth.

[233] But he says this ability for humans to share a myth is what allows them to peacefully congregate, right?

[234] Because you're in a group of 100 humans.

[235] You come across in a group of another 100 humans.

[236] There's a high probability that there's going to be bloodshed.

[237] Yes.

[238] What helped facilitate peace is that we can all believe in a myth, right?

[239] So be it the myth, the value of a currency.

[240] or the value of gold.

[241] So now we...

[242] Ooh, I love to you.

[243] Put money in the same category.

[244] That's perfect.

[245] Right.

[246] So you come across this group of another 100, but you, both of you believe in this concept of gold in its value.

[247] So now we have this thing we both believe in.

[248] And that allows us to kind of coexist.

[249] And then, of course, that extends to, if we have the same God, if you meet a group of another 100, and they go, well, we believe in Yahweh.

[250] And we're like, cool, so do we.

[251] Now we can get along.

[252] That it's really that ability to share a myth that allows us.

[253] to assemble in great masses.

[254] And so in this country, we believe in the myth of, A, that this is a country, that that's a thing, that we have the same nationality, that that's a thing, right?

[255] All these things are, they're just myths that we make up.

[256] And it helps us bond to one another.

[257] And we endow them with all sorts of meaning.

[258] And it delineates in -group, out -group, right?

[259] And so it's all very dangerous.

[260] And yet it is the thing that allowed us to create civilizations.

[261] I would argue there's one other thing that sometimes we believe out that I think was probably significant is that we have to have a way to deal with our aggression.

[262] And I think one of the ways we dealt with that collectively was human sacrifice.

[263] We would put all of our aggressions into this one.

[264] And you see human sacrifice in extremely traumatized populations where there's lots of aggression pre -revolutionary France, Aztecs, things like that.

[265] And in our culture, we just sacrificed one guy and he did it for all of us.

[266] Right.

[267] We drink it, we eat him and drink his blood, this one guy.

[268] But he did it for us.

[269] And it's just, we don't have to do any more because this one guy did it.

[270] Now we ritually eat him and drink him and all this stuff, which is one of the problems with Christianity in the Roman eyes.

[271] They thought it was a cannibalism.

[272] That's what they thought it was.

[273] But anyway, but now because we have this ritual around that and we relive the trauma of him being dying for our behalf, we're going to have to do it anymore.

[274] So great.

[275] So you just brought up something that really still fascinates me and I'm boggled by.

[276] I feel like humans just as a species have this.

[277] great propensity towards guilt because I think what you're saying is they would they would sacrifice a person right and they would funnel all of their errors and I think we all walk around with a good deal of shame and guilt yep and so if you can put that on to one person right that that's somehow gratifying and we get a catharsis from it too and then we feel collectively guilty we're relieved to our guilt by him coming back to life yes his guilt's over he's survived but I want to know what it is evolutionarily that has made all of us.

[278] And again, I don't, I'm speaking anecdotally about what I think happens.

[279] Yeah, we're going to, we're going to speculate purely.

[280] Yeah.

[281] Why, what would be the advantage of us feeling this shame are being so easily led towards guilt and shame?

[282] Is it just a product of being a very social animal?

[283] Yes.

[284] We kind of, we, we police each other's morals as a group and shame each other.

[285] If someone wasn't shame, they would probably be sociopathic and then they would be murdered by the group.

[286] Well, sort of yes.

[287] It's probably, probably many, many layers of this, right?

[288] So we're going to just go on the, what occurs to us.

[289] But, you know, I think you're really talking about guilt primarily.

[290] Yeah, Yeah, because shame is different, right?

[291] Shame has all kinds of antecedents in trauma and mistreatment.

[292] you know, it's, I'm bad as opposed to I did something bad.

[293] Right.

[294] And really all the society cares about is that you did something bad.

[295] Uh -huh.

[296] So guilt is a very powerful mechanism.

[297] So really quick, society is saying, you did something bad, but the individual person's feeling like I'm bad.

[298] Shame is I'm bad.

[299] Guilt is I did something bad.

[300] Oh, okay.

[301] Great distinction.

[302] And so guilt is something that, you know, if you never did anything wrong, you never feel guilt.

[303] Right.

[304] But we're humans.

[305] And so we always do.

[306] Good luck not doing something wrong.

[307] Right.

[308] And so then we carry guilt and that can even, you know, that can be shame also associated with that because I must be bad if I did that.

[309] It's not just guilty in the eyes of others.

[310] I've judged myself.

[311] You know, we, we, we, we, we, take on what the culture tells us, right?

[312] Yeah.

[313] Stigma.

[314] It's another thing.

[315] Self stigma is a real thing.

[316] I'm giving a lecture on self stigma in July.

[317] And with stigma is out there, right?

[318] Mental illness sort of what I'm interested in is if it pertains to stigma.

[319] But the people that are mentally ill feel like, yeah, yeah, I should be stigmatized.

[320] There's something wrong with me. Well, and it's kind of crazy.

[321] And you know what's interesting.

[322] This was something that I had a whole course on in anthropology, which is the Western world labels people with mental illness as a permanent condition.

[323] They're a schizophrenic, they're manic depressive, they're this, right?

[324] Whereas like in sub -Saharan Africa, where they believe in witchcraft and, uh, and, um, spirit possession, it is a temporary condition that someone can have either because someone put a spell on them or whatever it is.

[325] And they can be relieved of it.

[326] And they, there is proof of people overcoming illnesses here we think of as permanent.

[327] And it's a language thing.

[328] You're going to bump up against this.

[329] This is where the, The objective and relative.

[330] I wish I could change biology with that.

[331] Right, but it is fascinating that culturally you can label those things as permanent or not.

[332] Well, I would argue that it's probably more that the outlying problematic behaviors may not be perceived the same way.

[333] And if you are more inclusive, like for instance, I noticed in Western Europe, they don't really identify alcoholism.

[334] It's just, that's just Uncle Joe who drinks.

[335] That's the drinking Uncle Joe.

[336] Right.

[337] He's wasted every night.

[338] That's what Uncle Joe is.

[339] It's wasted guy every night.

[340] They, they incorporate it into identity.

[341] Okay.

[342] And so the behaviors aren't pathologized.

[343] They're just sort of recognized as part of, well, that's who that guy is.

[344] Right.

[345] He's that guy that, I'm not like unilateral.

[346] They're specific to Uncle Joe.

[347] They're, I remember, like I was in a restaurant.

[348] I remember this I was in Florence and it was a restaurant and this, my waiter was wasted.

[349] And he was dropping dishes.

[350] Oh, great.

[351] And the other way.

[352] We're just like, dude, that's the alcoholic waiter.

[353] That's that guy.

[354] Of course he's dropping dishes.

[355] He's the alcoholic writer.

[356] What else do you expect?

[357] I thought, wow.

[358] So when he dies, it's like, oh, maybe you should have looked a little bit differently at it.

[359] Yeah.

[360] But they just sort of adopt and adapt and bring in the behavior.

[361] So if you're schizophrenic, Joe, and you're having visual hallucinations, I mean, you might make that person a shaman or might bring them into some other something, the word that those behaviors had utility.

[362] You wouldn't stay sick, move them out.

[363] Well, I'll commit at some point a full two hours to why I do believe what this teacher was saying.

[364] But I want to jump all the way back to repeating trauma.

[365] Yeah.

[366] Because I didn't spit out my theory to you.

[367] I think that we are more than maybe we're trying to win over the approval of the father we never were able to.

[368] Yeah.

[369] I think that we often mistake familiarity with another emotion.

[370] Yep.

[371] So you meet this person who's basically reminding you of your dad, even though you're unaware of that.

[372] And it just feels familiar.

[373] And things that are familiar are less scary than things that are unfamiliar.

[374] So I do think people often confuse feelings of familiarity with love.

[375] That could be.

[376] That would make sense to me. And familiarity is often what sort of talked about is the reason that people are engaged with this repetition.

[377] It feels familiar.

[378] It feels like, but there's really an attraction associated.

[379] with it and when I deal with patients they will say like I was really like lightning bolts like I was really attracted to that guy and he was nothing like all the rest I've had all the rest were the alcoholics this guy's not like that yeah and lo -behold he turns out to be an alcoholic because our attraction mechanisms are perfect oh my god so you just reminded me of my favorite speech you ever gave and it was on an episode of celebrity rehab which I want to talk about a great length because there's there's haters and there's lovers I'm one of the lovers but you were talking with a patient who was describing how they felt about someone they were attracted to and you were saying that's not love right let me tell you what love is right and you had the best description that I remember hearing someone say about love what did I say I don't know I was hoping you would nobody knows I know I would tell people we routinely told people was if you if you have this repetition pattern and you feel lightning bolts it's that again yeah you should feel butterflies not lightning bolts is what we would tell people right and love that we'd say you know more about two complete people of being mutual and attracted and being able to fuse and come apart, but not being overcome by intensity.

[380] Intensity is not love.

[381] That's usually what I'm telling them is intensity is not love.

[382] Yeah.

[383] And they confuse intensity and getting high with love.

[384] Well, absolutely.

[385] As an addict myself, I can fully relate to getting myself very high on attraction.

[386] And I mean, as high as any other drug I've ever been on.

[387] the fantasy takes off and I'm going to be this person when I'm with this person and I will no longer have any of this self -doubt, self -hatred, self -loathing.

[388] Everything will work because I can feel it.

[389] I can see it.

[390] I can see where it's going and it's all my earthly troubles will be behind me as I am inside of this woman.

[391] I love it so much.

[392] It's humanity at its best.

[393] First of all, we're the worst people on the planet.

[394] But let me also say, no, hold on.

[395] I'm going to defend us too.

[396] No, no, no. Don't you feel a little bit bad for us that, that whatever it is we're dealing with, require, that we need relief that bad?

[397] Because you're human beings.

[398] You're like, you're like, you're like, your humanity is writ large.

[399] And it's full of pain and uncertainty and all kinds of horrible feelings that overwhelm you guys.

[400] Yeah.

[401] But it's, but it's that richness that is what I love about addicts.

[402] Yeah.

[403] And smart, too.

[404] They're always smart.

[405] So you've, you clearly were drawn to addicts much, not unlike.

[406] my mother who married many of them, admittedly.

[407] I didn't know I was.

[408] I had no idea.

[409] It was it was an accident how I got involved in.

[410] So you don't have a parent that was an addict?

[411] Not that I can not actively, not they could tell.

[412] I got concerns with my mom may have had the genes or something.

[413] Okay.

[414] So you weren't like repeating.

[415] No, not that I could tell.

[416] Okay.

[417] Not in any kind of classic way anyway.

[418] Let's just really quick say that your father was a doctor.

[419] Yes.

[420] Yeah.

[421] What kind of physician was he?

[422] Family practice.

[423] Family practice.

[424] And your mother was a singer.

[425] Yeah.

[426] an actor.

[427] So you are the perfect cross -pollination of them.

[428] But she had stuff going on.

[429] Oh, okay.

[430] Well, I said she was a singer and an actor.

[431] Well, but for instance, but for instance, when I was about, probably about 10 years ago, she was in a lot of these noir films.

[432] Okay.

[433] And a friend of mine was sort of into that stuff.

[434] And he was visiting me at Love Line.

[435] He was a professor at SC.

[436] And he was looking her up online.

[437] He goes, oh, here's a webpage for her.

[438] I'd never done that.

[439] He goes, oh, here it is.

[440] she was married to the silent film star and I was like really?

[441] Wait.

[442] That's interesting.

[443] No. Like she had an entire life.

[444] An entire life.

[445] Good for her.

[446] Good for her.

[447] I'm so proud of her.

[448] Married to some very famous Western silent film star.

[449] I don't know.

[450] Harlan something.

[451] What if you said Gene Autry?

[452] No. It was no. It was before silent only.

[453] Yeah.

[454] And she was 18 years old.

[455] Wife number five.

[456] Oh boy.

[457] He was my age.

[458] Oh, my God.

[459] Wait, that didn't last?

[460] And even if they had a great relationship, he would have certainly died quickly and it couldn't last at all.

[461] That's right.

[462] And so that, you know, there's all that kind of stuff going on.

[463] But does it humor you at all that you have this weird hybrid of both being a physician and you are an entertainer on some level?

[464] Yes, yes.

[465] But I had not done therapy, parts of me would have been left behind.

[466] link therapy forced me to bring all my parts together oh really yeah I could not have done all this without therapy no way because I was being the perfect doctor at that time you wanted your dad to really be um I guess I just was fully invested in the identity of physician period great and and I'm so glad you just said that because why why were you drawn to that because if I could just say as someone who grew up dyslexic and was uh an idiot first through fifth grade leaving to go to I was going to special ed and I was the dumb dumb.

[467] That's just a fact.

[468] I later overcame that.

[469] They did not have the proper technologies to identify and help you with these barriers that were preventing you from expressing your cognitive skills.

[470] Absolutely.

[471] My point being is that in those formative years.

[472] Self -loathing.

[473] I thought the self -loat goes away in recovery.

[474] I'm beyond it.

[475] I'm beyond it.

[476] But it's something he overcame.

[477] Yeah, I can tell you overcame your body.

[478] You've brought up four times already today.

[479] Well, I'm just saying that because.

[480] of those five years, I have spent the rest of my life trying desperately to be recognized as someone who's smart.

[481] I know why I was drawn to having some kind of credentials that said, you're smart.

[482] So that's my baggage.

[483] That's the only reason I shared that.

[484] So I'm curious to know, do you think you had any kind of baggage that required you were going to have to prove to the world you were a doctor?

[485] If it wasn't your father?

[486] No, a very different experience for me. it was something more about my identity and my doing because I struggled with it in college.

[487] I didn't want to do it.

[488] It's not me. Everyone expects this of me. I was sort of expected to do it.

[489] And I rejected it and I screwed around for a year and a half.

[490] And I got very depressed and very had panic attacks and all kinds of psychiatric symptoms.

[491] And as I was struggling one day I went, but one thing I can't.

[492] I'm not going to go backwards.

[493] I'm not going to take their job.

[494] You know, there were.

[495] And I thought, well, you do like science.

[496] What if you were to do it?

[497] And I started.

[498] started feeling better as I started thinking about doing these things that I'm really good at.

[499] And the more I moved towards it, the better I felt.

[500] And then I got excited.

[501] And then I got invested.

[502] Well, is it because you made it yours?

[503] Exactly.

[504] It's precisely right.

[505] But still, the identity was still some sort of subconscious processing of mom and dad and all that stuff.

[506] Yeah.

[507] But it also was mine now.

[508] It was truly mine.

[509] And I always remember first year medical school I park on the roof of this parking structure and I'd always had I had anatomy lab at the end of the day every day and I'd walk out in the sunset just go I am just I'm so grateful to be here I'm so happy oh that's so much fun I'd love and I loved my training I you know eight years of training and I really dug it and as it went on I got more and more and more more into it and then I became a severe workaholic severe severe uh how's that going it's way better is it way better I still No, it's way better.

[510] Now I don't feel, I mean, I felt it then.

[511] Now I'm busy, but it's busy that doesn't bother me. I like it.

[512] Then I was having dread and I was not sleeping.

[513] I was just, oh, for years and years.

[514] Well, let me ask you this.

[515] As someone who, because you're not an addict, you weren't forced to go, like, be thoroughly humbled and then take advice from other people and do all this stuff.

[516] How does one who doesn't go through that process, how do you have the willingness to confront your identity.

[517] Do you evaluate your own identity and just have a checks and balance like, Drew, this is, this is bullshit.

[518] This is something you think people like about you and do you?

[519] Like, do you do that?

[520] Lots of it.

[521] But I've always done it, but very, very self -critical, but it got more realistic in an interpersonal context, again, and that was therapy.

[522] Right.

[523] Therapy did.

[524] I got so much out of therapy.

[525] You did everything, everything.

[526] How many years were you?

[527] Eleven years.

[528] Really?

[529] I did a three -year closure.

[530] Oh, wow.

[531] That's to say, goodbye?

[532] Yes.

[533] Oh my goodness.

[534] Yes.

[535] You built this person a very nice house probably.

[536] Possibly, but I, it was worth everything.

[537] Oh, my God.

[538] And I, you know, it was deep sort of psychotherapy and stuff and I fell into some trauma.

[539] All kinds of stuff that I didn't know was sitting around.

[540] Right.

[541] And towards the end, like the last couple of years, she started going, why are you here?

[542] You're not doing any work.

[543] I mean, you know, I was like, yes, I got to come.

[544] I need more.

[545] I need more.

[546] And I'm like, I want to keep in it.

[547] And she's like, well, you're not doing anything.

[548] And finally I went, maybe I need to go and started working right again.

[549] So, and I realized that something that I had gotten none of growing up was reproachment.

[550] Do you know what that is?

[551] No, I do not.

[552] It sounds French, though.

[553] It's a French word for coming.

[554] I got horny when you said it.

[555] For coming and going, reproach and reproach and maneuver, you know, away.

[556] Come and report away.

[557] And it's what kids do when they're game.

[558] They go, mommy, mind me, watch me. When you go out and come back for refueling.

[559] And they go, they do some stuff, take more risks, and they come back and get refueling.

[560] Okay.

[561] Well, I had none of that.

[562] Zero.

[563] I mean, zero.

[564] Because you were so closely monitored in helicopter parents.

[565] Yeah.

[566] Well, it was a little more pathological.

[567] You were probably had a ton of anxiety and you were something she could control and it felt great.

[568] Until she couldn't.

[569] And then I had to be rejected.

[570] Oh, sure.

[571] So as soon as I started express autonomy, I can't, no. Yeah.

[572] No. Oh, yeah.

[573] So it's either all in or all out.

[574] I've heard so many little pearls of wisdom from you over the years.

[575] And I don't even know where I heard you talking about this.

[576] But you were saying that what seems to be kind of ubiquitous in our culture is that parents are trying so hard to be such great parents that they're doing every single thing they can to prevent the kid from having any kind of discomfort or upset.

[577] And then you also said that because our children are an extension of our own ego.

[578] Well, they shouldn't really be.

[579] They shouldn't be, but we make them an extension of our ego.

[580] And we, of course, are inclined to prevent discomfort in ourselves.

[581] So naturally extends.

[582] Two things.

[583] One is we don't have a good boundary between us and them.

[584] So their feelings become our feelings.

[585] And from an ego standpoint, they represent us.

[586] Sure.

[587] Two different things.

[588] Two different things.

[589] I find myself all the time.

[590] I'll take my five -year -old somewhere.

[591] And she has this defense mechanism.

[592] We get too much attention when we go out.

[593] And so when too many adults start talking to her as some kind of like conduit to us.

[594] She doesn't like it, understandably.

[595] And her response is to talk and baby talk.

[596] Mind you, it took me many times of watching this before I realized, oh, this is her way of saying, shut the fuck up, stop talking to me. Maybe.

[597] Or she's regressing because she feels scared.

[598] Okay.

[599] Either or.

[600] Either way, I had to recognize that I was embarrassed that the five -year -old was talking baby talk.

[601] Yeah, of course.

[602] Which is preposterous.

[603] I'm not talking baby talk And I do the same thing I think we all do the same thing With our parents like Yeah Actors' parents will visit a set And they're just mortified for four hours And they forget that Another actor's parents were just on set the other day And they weren't mortified for that actor They just recognize them as parents that are older And you know But you really take on Yes That shared family identity Yes Right And so I just every time I hear Like she'll start talking baby talking public I can't stand it It's embarrassing But then I just go I'm not going to tell her not to talk baby talk because it's just my embarrassment.

[604] She's not embarrassed and this is somehow helping her get that person away from her, whatever.

[605] It's also societal though that you feel they're representing you because people will say like Dak Shepard's kid or even if you're not famous, that person's kid did this.

[606] So they must be parenting incorrectly.

[607] No, you're right.

[608] They will, the family sort of crest is identified with the bad behavior of one.

[609] member of that family.

[610] Yeah.

[611] But back to what I was, what I would, because it's all, it's all back to the tribes and the groups and the outgroups and everything.

[612] All that stuff represented.

[613] I personally am judgmental of some of my friends' kids, their behavior.

[614] I'm assuming my friends are doing a terrible job.

[615] That's awesome.

[616] Ruling out any biochemical issues that are going.

[617] I don't know what to do with my kids are now 25, I have 25 year old triplets and they're starting to complain now, but stuff like that, that I wasn't around or I was famous or that they were, they were having to subjugate their needs to me and my brand or people's sense of me and I'm like dude don't I said don't do that if you want to go do something or speak ill of me publicly please proceed yeah that's my problem I'll deal with it it's not me telling you how to be you yeah please please but but your overall point which I think is needs to be heard by all parents is that what you sow or rather what you reap when you when you do this oh yeah when you prevent them from ever feeling discomfort or or embarrassment It's a great book out there called The Gift of Failure about parenting.

[618] Okay.

[619] We just had Dr. Wendy Mogul on who wrote a gift of a skin knee.

[620] Yes, same idea.

[621] Blessing of skin.

[622] Same idea.

[623] Yeah, so what you were saying was if your children, if you never allow them to develop some coping mechanisms, you will eventually send them off to college.

[624] They will meet the real world full of tons of disappointment.

[625] And they will have no option but to use drugs virtually.

[626] Potentially.

[627] you know if those feel good to them because you have to have a certain genetic set up for it to feel good right you know right so I guess I should let you say that because it was your statement no no no no I just want to remind you it's good it was just a real light bulb moment for me where I thought oh yeah man if you don't if you don't go through all that stuff yeah and there's there's other stuff that I'm worried about now too which is you know I'll sort of put under the category of grit and insurmountable tasks both are important experiences grit meaning overcoming adversity and dregling and struggling and struggling, struggling, without us intervening and saving it.

[628] Right.

[629] And the other is having some sort of insurmountable task in your life, overcoming some thing that you think you couldn't do.

[630] Uh -huh.

[631] I had a couple experiences like that.

[632] And one of my sons did too, and I was talking about it.

[633] And it was like, yep, I know what that is.

[634] What was yours?

[635] My had two.

[636] One was, I was the crappiest football player in the world.

[637] And I became the captain of a football team.

[638] Oh, really?

[639] I just gritted it out.

[640] Now, at a, you know, at a little private school and stuff.

[641] It wouldn't have been possible, but I did it.

[642] Right.

[643] And then the other was when I was screwing around, hey, you're not the boss of me, man in college, and then decided to go to medical school.

[644] It looked, there's no way I'm going to pull that off.

[645] Right.

[646] I remember I actually had a visual image in my head of a brick wall that went to infinity, like Jack and the Beanstalk, and I had to get over that wall.

[647] And I just thought, one brick at a time, man, just start putting the pegs in the bricks, let's just go.

[648] Yeah.

[649] And pretty soon I was over the wall.

[650] And my son, football, was a not a great football player and ended up anchoring an offensive line and uh same school same problem with a math degree he had to get to and uh he just did this amazing job and this impossible discipline right and both he feels like doesn't that give you such as you can handle anything now you know isn't that the most prideful moments you can have when you watch your kids uh overcome something they're not immediately great at it's yes i think except they will let you know that because i although i thought it was really important it was exactly what i wanted him to experience.

[651] He, of course, blames me for the misery of it.

[652] So they got to let you know.

[653] It's not something you can hold the pride for very long.

[654] Yeah, well, you just can't let them know.

[655] That's right.

[656] But I will say, having had two kids now, I am daily shown how much of this recipe is just nature, right?

[657] So my five -year -old, we have these poles in the patio and they go up to the roof.

[658] And she started trying to climb this pole.

[659] And she just, she spent 90 minutes doing it.

[660] failing, failing, failing, failing, until she finally climbed it and touched the roof.

[661] And I'm just watching the whole thing and I'm like, I have nothing to do with this.

[662] I couldn't have instructed her to do this.

[663] I can't reward her for doing it.

[664] She has it in her to just keep at that thing.

[665] And what a blessing, right?

[666] And I don't know that the three -year -old has that, but we will find out.

[667] Is it two girls or point girls?

[668] So, yeah, you know, there's only so much you can kind of take credit for.

[669] Yeah.

[670] Yeah.

[671] You can screw things up, though.

[672] I think it's mostly what we do as parents.

[673] Yeah, yeah, yeah.

[674] We mostly screw things out.

[675] Yeah.

[676] And so the being recognizable and I don't want to put you in a position where you have to air too much of what your kids are saying to you.

[677] What do they, what do you think you could have done better?

[678] What should I be doing better?

[679] Because I think about it quite often.

[680] Yeah.

[681] Part of it is it is what it is, right?

[682] I can't not be famous.

[683] I can't turn a switch on.

[684] Right.

[685] And I and I was in full survival mode with triplets and I had to make ends meet.

[686] And I couldn't be home.

[687] Right.

[688] Could I?

[689] Could I?

[690] I've been home more?

[691] Yeah.

[692] Could I have been less driven?

[693] Could I have been less anxious because I was super anxious back then for sure?

[694] Could I have interfered with some of the stuff my wife was doing that they're complaining about now?

[695] Yeah.

[696] Yeah, but, you know, that's her.

[697] And she's who I married and she's your mom.

[698] And I can't really change or control her necessarily.

[699] Right.

[700] Because I tell this to new dads.

[701] I'm like, if you want to say in how these kids are going to be raised, you got to change half the fucking diapers and you got to wake up and meet him half the time.

[702] You're only entitled to equivalent levels of advice as you are putting into it.

[703] And I think traditionally in the past, dad's gone so much that he just really isn't entitled to kind of say what he thinks should be being done.

[704] I was active, very active and in there.

[705] But my daughter says not enough.

[706] Right.

[707] And also, and this is what I think of sometimes too is that I don't know where the concept comes from that you're entitled to perfect parents.

[708] and that they should be there with you all the time because I certainly felt that way.

[709] But at the same time, that's not reality.

[710] Someone does it go out and bring food home, right?

[711] It's exactly right.

[712] And so I just keep thinking to myself, they need to have kids, they need to have kids.

[713] Once they have kids, this will all stop.

[714] Because you realize it's just, it's just, you've got to survive.

[715] Especially with trippily.

[716] No, I would have left if I were you.

[717] I would have just own the fact that I was going to be a degenerate dad.

[718] A lot of people do that.

[719] Yeah.

[720] It happens a lot with triplet parenting.

[721] It's a lot.

[722] For you, that's what they sat us down.

[723] They said reduced to two.

[724] because no marriages make it through this.

[725] Right.

[726] It's like having an autistic child, your rate of divorce just goes through the roof.

[727] Although, I don't know, we were fine.

[728] You were fine.

[729] We were partners in it all the way.

[730] We really, when we decided to go for it and do the triplet, but we couldn't imagine reducing it was just something we couldn't bring ourselves ethically morally to do.

[731] Yeah, of course.

[732] But we were being encouraged to do it.

[733] And they can do that.

[734] They can give an abortion to one of the - It's called a selective reduction, yeah.

[735] Oh, my goodness.

[736] I had no idea.

[737] And we spent a weekend at a hotel down in Lagoon.

[738] It's just like, what are we going to do?

[739] What are you going to do?

[740] And I literally had this image in my head finally on like Sunday morning.

[741] I was like, chips are all in.

[742] That's it.

[743] The chips are in.

[744] We're just all in on this.

[745] We're in on parenting.

[746] That's it.

[747] We did it.

[748] Stay tuned for more armchair expert, if you dare.

[749] We've all been there.

[750] Turning to the internet to self -diagnose our inexplicable pains, debilitating body aches, sudden fevers, and strange rashes.

[751] Though our minds tend to spiral to worst -case scenarios, it's usually nothing, but for an unlucky few, these unsuspecting symptoms can start the clock ticking on a terrifying medical mystery.

[752] Like the unexplainable death of a retired firefighter, whose body was found at home by his son, except it looked like he had been cremated, or the time when an entire town started jumping from buildings and seeing tigers on their ceilings.

[753] Hey listeners, it's Mr. Ballin here, and I'm here to tell you about my podcast.

[754] It's called Mr. Ballin's Medical Mysteries.

[755] Each terrifying true story will be sure to keep you up at night.

[756] Follow Mr. Ballin's Medical Mysteries wherever you get your podcasts.

[757] Prime members can listen early and ad -free on Amazon Music.

[758] What's up, guys?

[759] It's your girl Kiki, and my podcast is back with a new season, and let me tell you, it's too good.

[760] And I'm diving into the brains of entertainment's best and brightest, okay?

[761] Every episode, I bring on a friend.

[762] and have a real conversation.

[763] And I don't mean just friends.

[764] I mean the likes of Amy Poehler, Kel Mitchell, Vivica Fox.

[765] The list goes on.

[766] So follow, watch, and listen to Baby.

[767] This is Kiki Palmer on the Wondery app or wherever you get your podcast.

[768] And you said something really interesting to me. We were at a wedding, not too long, go together.

[769] And you said, what shocked me is that you wouldn't want your children to pursue medicine.

[770] No. Does that not blow your mind, Monica?

[771] Only one circumstance, I would.

[772] if it's their calling, if they must.

[773] Like I said, it's part of my identity.

[774] I couldn't imagine having not experienced it.

[775] And, you know, even I've not been as active in my practice last couple years.

[776] And so I've been backing away a little bit.

[777] And it's changing my perspective.

[778] But if you talked to me four years ago, I would have said, I can't imagine not understanding all the things I know.

[779] How do you get through life without this information?

[780] Right.

[781] Now I'm sort of like, you can always go to somebody and talk them about it.

[782] I understand how people can get through now.

[783] But by the same token, if you want to be a physician, it's the real doctor part of it is so painful now.

[784] It's so difficult and so uncomfortable.

[785] Well, you can't, you want to get to do it.

[786] Unless you're outside the system, like a plastic surgeon or something.

[787] In the system, it's, you know, it's ridiculous.

[788] The system being like Medicare or no insurance companies.

[789] You don't get to do your job.

[790] All you're doing is, you mean an example of that.

[791] All you're doing is administering paperwork and taking liability.

[792] It's essentially all you do.

[793] I mean, you can make judgments and you can do things, but what you can do for your patients is second -guessed by everybody.

[794] So Medicare.

[795] Medicare gives you $36 every 15 minutes for a patient.

[796] And for that 15 minutes, you have to, there's a requirement of all the things you have to document, there's pages of stuff you have to document to get that $36 for that 15 minutes.

[797] And then if you don't dot some eye or cross some T, you'll hear from the office of Inspector General that they're going to federally charge you for having not put the right code in or something crazy like that.

[798] If you, God forbid, there's a bad outcome.

[799] Well, now you've got a lawsuit and everything you wrote down is now gospel and whatever you did and what your judgment was.

[800] It's like a police report all of a sudden.

[801] Absolutely, all the time.

[802] Every interaction.

[803] Right.

[804] And that's just Medicare.

[805] I have noticed now that you say that I've noticed that my appointments have become really computer driven.

[806] So the guy comes in and he rolls in a computer right away and he's going through.

[807] Well, that's the great electronic medical record, which has been a catastrophe for most people, most doctoring.

[808] And because you're spoken, you're doing all your work on the computer, not with the patient.

[809] They are staring at the computer 99 % of the time.

[810] Yeah, you're not doing any care because you have to do that.

[811] And is there a better way or?

[812] Yes.

[813] Like, let the market determine the relationship between the doctor and the patient.

[814] Let the doctor document reasonably well.

[815] Let the doctor's defense in a tort situation be that he or she's decision was a, a Based on my judgment, here's why I made that decision, and that should be a defense.

[816] Right.

[817] As opposed to I was negligent.

[818] I didn't pay any attention.

[819] Well, that's a problem.

[820] But if you have your reasoning there and this is why I did it, that should be good enough.

[821] Yeah.

[822] Nothing's good enough.

[823] Then with insurance companies, they literally determine the care you can deliver.

[824] Like how long you can see the patient.

[825] I mean, I cannot tell you how many, this was most of my life in addiction medicine was spent trying to get resources for patients, not taking care of the patient.

[826] And then dealing with legalities and administrators and meaning trying to get insurance providers to pay for treatment or aftercare and it never, and they never did it.

[827] Patients that needed six months of treatment, the maximum I'd ever get would be like seven days.

[828] Really, seven days.

[829] And then when you discharge, then when you go to the patient, you go, I don't want to bore you.

[830] This is my, the burden of the physician these days.

[831] But you go to the patient, you go, listen, if you stay the extra day, the hospital, we can make a deal with the hospital, but they're going to charge you.

[832] and this is going to be, you know, a lot of money.

[833] So I don't feel comfortable burdening you with that.

[834] But I think you need another three weeks or two weeks in the hospital, whatever it is.

[835] And you were suicidal yesterday.

[836] You're still having heroin withdrawal, whatever it is.

[837] And I'm going to call my insurance company.

[838] They call the insurance company.

[839] Insurance company says, oh, well, if the doctor would just give us the information, of course we would extend your stay.

[840] But they don't tell the patient is the insurance company sets the criteria of that information.

[841] And you don't meet that criteria.

[842] Their criteria, their criteria, not my criteria.

[843] random insurance company criteria.

[844] So then the patient gets angry.

[845] And as with me, they split now the patient and the doctor.

[846] They, again, they do what's called a doctor to doctor review with me. So more time spent on the phone trying to make my case to another doctor who says, get the patient out tomorrow.

[847] So I discharge the patient tomorrow.

[848] And let's say the patient goes and kills himself.

[849] They go, we don't practice medicine.

[850] That's Dr. Pinsky's name on the chart there.

[851] We don't practice medicine.

[852] That's his name.

[853] We have nothing to do with this.

[854] He discharged the patient.

[855] then you make a complaint to the insurance company and they go oh you're a troublemaker Dr. Penske will talk to your hospital administration about this then they complain to the hospital administrators if you continue to if you continue to make trouble they'll go oh really you don't like our business practices we'll decertify you and the entire hospital wow that's the that's the game that does not sound very it's not fun and all you're trying to do is take care of patients it's all you want to do it's all you're trying to do right it's terrible and what what drew you out of school to do addiction.

[856] Accident.

[857] It was a pure accident.

[858] Because you did your residency somewhere?

[859] Internal medicine.

[860] I was doing a residency internal medicine.

[861] I was to be a cardiologist.

[862] Okay.

[863] And I was doing, ended up moonlighting in a psychiatric hospital down the street and all these addicts were there getting detox.

[864] I was like, you can make a discipline out of detox?

[865] How weird.

[866] I've treated lots of heroin addicts and alcoholics.

[867] I didn't know there was some sort of process to this.

[868] Right.

[869] So I became an expert in detox and started having to see lots of alcoholics and addicts.

[870] What's the most dangerous detox?

[871] Alcohol.

[872] Yeah, right.

[873] You can...

[874] Hero can have complications, but the straight detox alcohol is the one.

[875] Benzos is number two probably.

[876] Yeah.

[877] Benzos is a very rough, rough detox.

[878] Very rough.

[879] You and I were talking when we were doing that weird satellite tour is that the thing no one talks about, right, everyone's talking about opiates and it's certainly a huge epidemic, pandemic.

[880] But benzos, there's so many benzo addicts and it's one of the hardest things to quit, right?

[881] It's a very rough.

[882] So Benzos, Xanax, Ativan.

[883] Valium.

[884] Lerazepan.

[885] Hidden epidemic right now.

[886] 96 % of oxycontin deaths included a benzodiazepine or other substance.

[887] Right, because those two combined to really suppress your breathing.

[888] Yes, like Prince was on enough fentanyl to knock him off his feet, but it's the Xanax that made him stop breathing.

[889] Right.

[890] It's a very lethal combination.

[891] Yes, and yet prescribe all the time.

[892] In conjunction.

[893] Yeah.

[894] And so, you know, so physicians learn that the way to end an appointment is open your prescription pad.

[895] That's the quickest way to open an appointment.

[896] And for drug addicts and alcoholics, that's the worst thing you can do.

[897] That's not what they need.

[898] And so, you know, there's this horrible problem going on now.

[899] I don't blame my peers.

[900] I blame them, but I understand why they do what they do.

[901] They aren't trained properly in it.

[902] They don't have time.

[903] They're being pushed by insurance carriers.

[904] Well, in a two -second history of this issue.

[905] It's essentially that a couple of doctors with very spurious information declared that opioids were not addictive.

[906] Right.

[907] And that we were under -treating pain.

[908] Yes.

[909] And they developed a alliance of patient advocacy groups and attorneys and then pain specialty groups that we were in the dark ages in pain.

[910] And a religious fervor emerged to treat pain aggressively to the point where 90 % of the opiates prescribed on earth were prescribed in this country.

[911] Pain became the fifth vital sign that was done by joint commission of hospital accreditation.

[912] What does that mean the fifth vital sign?

[913] pulse temperature blood pressure respirations pain level oh okay as important as your pulse that's how insane we got right and if you didn't have and if you didn't have a happy face you were not only were you practicing poor medicine you were not just a guilty potentially malpractice but they started putting doctors in jail for inadequate treatment of pain oh wow and finding them outside of their malpractice for reckless negligence oh wow for inadequate treatment of pain it sends shockwaves It really incentivized them prescribing people.

[914] It got crazy.

[915] And people like me who were the whole while screaming about it, we were marginalized, we were told we were old -fashioned, we were dinosaurs, we preferred people to suffer.

[916] I mean, it was just really a horrible time.

[917] And still I hear some of that stuff.

[918] Yeah.

[919] Well, there certainly is a time for, right?

[920] So my stepfather just died of prostate cancer.

[921] I was up there and I was in charge of administration.

[922] I mean, he had everything, he had methadone, he had liquid oxycote cotton.

[923] But that's what it's designed for.

[924] Yes.

[925] And I will say, so in that situation, I was saying to my mom and everyone there, man, thank God we weren't doing this in the 1800s.

[926] I just read the Ulysses -S.

[927] Grant biography.

[928] It was life -changing.

[929] Oh, yes.

[930] Was that not life -changing that biography?

[931] Yes.

[932] Unbelievable.

[933] I can't I recommend that biography strongly.

[934] Absolutely.

[935] It's shown a whole new light to me on race relations, why black folks are where they're at, this notion that, you know, they had full access to everything.

[936] in 1868 is horseshit.

[937] No, absolutely.

[938] It's a fantasy.

[939] For five minutes, they had it.

[940] And then completely upended.

[941] But anyways, he died a throat cancer.

[942] And when you read the description of dying of throat cancer in the late 1800s, I can't imagine anything worse.

[943] He couldn't even drink water.

[944] It was like battery acid in his neck.

[945] And they were pulling, when they described pulling out the big clumps.

[946] Oh my God, yes.

[947] The clumps, they would come excavate.

[948] So he could breathe.

[949] So having just read that is sad and it's painful is, the experience of my stepfather, I was incredibly grateful that we live in an era where you can, for the most part, avoid the ugliness.

[950] That's right.

[951] But so you and I also share a view that is kind of a little bit controversial.

[952] We both are pretty critical of Suboxone.

[953] Yes.

[954] But before we get critical about it.

[955] Here's the way I frame my criticism.

[956] I'm criticism of the excessive enthusiasm for it.

[957] Yeah, like it's a cure.

[958] Oh, my God.

[959] Yeah.

[960] That's really dangerous.

[961] So before I even err my grievances with it, let's just say that I want to make their case for them, the proponents of it.

[962] And that is, there's this huge opiate epidemic.

[963] There are a ton of young people dying.

[964] Yep.

[965] You know, tens of thousands are dying a year.

[966] And those people aren't going to go get sober.

[967] And so what you really, we don't know.

[968] We don't know.

[969] We don't know.

[970] But their argument would be that the relapses are so chronic.

[971] and so many kids are dying.

[972] It's unrealistic to say that they're going to get sober.

[973] And so what you're really determining is do you want to save this person's life?

[974] Is our goal to save lives or is our goal to restore to a flourishing existence?

[975] Right.

[976] Those are two different goals.

[977] They're two different goals.

[978] I am not interested in the former.

[979] I just want to say, though, I want to acknowledge that I 100 % I appreciate that point of view.

[980] If I was the parent of a 19 year old, I would say, fuck it.

[981] I'd rather have them a little zoned out in a lie.

[982] We'll deal with it later, whatever.

[983] So, yeah, I'm very sympathetic to it.

[984] Me too.

[985] With that said, I'm not interested in participating in that.

[986] That's not a form of treatment that turns me on.

[987] I'm interested in what got me into addiction treatment is while I was moonly at the hospital.

[988] When I was doing all those detoxes, I watched these people go from dying, young people with rich lives ahead of them dying to amazing.

[989] And I was like, nowhere in medicine does that happen.

[990] What is that?

[991] People are basically beating terminal cancer in front of you.

[992] I had no idea.

[993] And not just being tournament, but like, and then becoming like Olympic athletes.

[994] Right.

[995] At the other side of it, I was stunned.

[996] I was stunned.

[997] I couldn't figure out what was happening.

[998] Yeah.

[999] But I wanted to know.

[1000] And that's what I got me in.

[1001] And that's what I'm interested in helping with.

[1002] Yeah.

[1003] So it begs the point, though, how do you select the right patient for the right treatment?

[1004] And we don't really know that yet.

[1005] Yeah.

[1006] We have instincts.

[1007] What would help us?

[1008] because it is such that stakes could not be high.

[1009] If you're trying to evaluate whether someone will be able to use a 12 -set program and maintain sobriety and have all the wonderful discoveries I've had through that or will they just never get that and they just need to be on suboxone?

[1010] Or some intermediate something.

[1011] They get motivational enhancement and CBT therapy while they're tapering on suboxone.

[1012] But at least tell people what are the effects of suboxone.

[1013] You get very high.

[1014] You're on a drug.

[1015] You're on opiates.

[1016] If you took it now, you would have trouble working.

[1017] Right.

[1018] Should I take some just to treat this conversation?

[1019] I have plenty of patients that used to abuse Suboxone.

[1020] Lots of them.

[1021] Right.

[1022] It's a common.

[1023] It is not dissimilar to the methadone response.

[1024] It's the same.

[1025] It's a different thing, but it's the same idea.

[1026] And it's the same thing that physicians have done since 1890, which, how do we treat alcoholism in 1890 with morphine sulfate?

[1027] How do we treat morphine addiction with amphetamine and electric shock therapy?

[1028] And it's all kinds of crazy stuff.

[1029] We always go to the replacement.

[1030] We all, because that's a, we do?

[1031] We use pharmacology as doctors.

[1032] What else do we do?

[1033] We don't do a lot else.

[1034] That's your toolkit.

[1035] Yeah.

[1036] And we there with knife.

[1037] We can't go home with these people and police them.

[1038] Right.

[1039] Which is my point about 12 step.

[1040] That's the only way that can happen.

[1041] And they do need that.

[1042] Yeah.

[1043] And but anyway, um, sidebar.

[1044] Have you read any of this stuff about, um, psilocybin's being used for addiction recently?

[1045] Um, it's kind of compelling.

[1046] Even though I'm never going to try it.

[1047] I'm trying to work on some documentaries on this topic.

[1048] I'm mostly, Cilocybin's LSD, I think mostly are going to be end of life.

[1049] They're going to be interesting end of life.

[1050] Like micro -dosing people?

[1051] No, that's a mood intervention, like to try to deal with your existential problem.

[1052] Right.

[1053] But I'm not surprised people are trying psilocybin.

[1054] I don't see how it possibly works.

[1055] I listened to a really good podcast on it.

[1056] It was on Tim Ferriss's and he had a guy on, he was saying, what's interesting about psilocybin is your neocortex, right, is where your identity lives.

[1057] that's the that's not true that's not true we don't we don't know that oh because uh like demasio down at usc thinks it's it's this entire big section sort of parietal in deep in and by the way we're embedded in a body that's part of who we are too okay yeah there's much much more complicated than that okay well for the sake of this argument let's say that it exists in your uh you know the the last area of your brain to evolve maybe your self concept yeah your your identity your sense of self.

[1058] Okay.

[1059] And that what happens when you take psilocybin or LSD is it actually shuts that area of your brain off.

[1060] That is true.

[1061] To a degree.

[1062] Yes.

[1063] That you can actually start experiencing the connectiveness of you and the rest of everything on this planet, which is really hard to do while your sense of self is fully engaged.

[1064] And if by the way, you're facing end of life, which is the end of self and you fear that experience, you can have that experience and turn out and feel okay about it.

[1065] Oh, right.

[1066] There, that's probably why it's, useful.

[1067] One of the reasons it's useful.

[1068] That's that sense of identity and self.

[1069] Yeah.

[1070] And again, go through it and go, hey, you can be okay without the self and you can connect to something.

[1071] There is something besides the self out there.

[1072] Right.

[1073] And that makes perfect sense for end of life.

[1074] Doesn't make great sense for addiction.

[1075] Mid 30s.

[1076] Okay.

[1077] So suboxone, what are some of the side effects?

[1078] So you are altered.

[1079] You're on an opiate.

[1080] You're on an opiate.

[1081] It's just a different pharmacology, a different binding structure, different intensity.

[1082] You know, just different pharmacology.

[1083] Yeah.

[1084] And it's definitely better.

[1085] But it's not a lot different than just saying, hey, let's just give you heroin.

[1086] Right.

[1087] And here's where.

[1088] And control it.

[1089] We'll control it.

[1090] And it's important that you get this out here because it would be very easy from the outside to just start looking at statistics.

[1091] And there are a lot of compelling statistics to support Suboxone use, right?

[1092] So one of them is what?

[1093] Survival.

[1094] A year after using it.

[1095] That's where most of the data is collected.

[1096] And the problem, again, but you're zeroing in a bigger problem, which is really to have meaningful data on addiction.

[1097] You need five -year data.

[1098] because this is what I get to see next is all the fallout after the first year.

[1099] Yeah, they kind of stabilize and then they start using other drugs and then they start messing around the suboxin.

[1100] They're still a using addict.

[1101] Right.

[1102] And that thing progresses.

[1103] That thing comes back.

[1104] And you were saying, yeah, a good chunk of those people that even on it for a year, they're peeing other stuff too, right?

[1105] And they're never tested for it.

[1106] Oh, okay.

[1107] None of that data includes testing for opiates.

[1108] So they're not looking for benzos.

[1109] And that makes it very problematic.

[1110] And that's, we just.

[1111] And there's a big black market.

[1112] They sell it amongst.

[1113] They sell it to get heroin.

[1114] The young ones all do that.

[1115] They all do that.

[1116] And so one of the issues is just the data is not long term enough, right?

[1117] Which is generally the problem with addiction medicine.

[1118] Yes.

[1119] And then another great point you brought up was that the statistics for 12 -set programs aren't great.

[1120] Wrong.

[1121] Well, I'm going to let you say that.

[1122] But before you correct me, if you just look at the data and it says, let's say, Hazleton is the most successful treatment facility.

[1123] Oh, treatment is different than 12 -step.

[1124] Oh, okay.

[1125] Right.

[1126] Well, let's just go through it then.

[1127] So one would be the highest percentage of recovering addicts out of one treatment center is like in the 30s, right?

[1128] It's like 36%.

[1129] Yeah, it depends on how many treatments, though, right?

[1130] The Durylo's secret is for a severe alcoholic, it takes an average of four treatments in five years to get one year of sobriety.

[1131] Right.

[1132] That's just the way it is.

[1133] It's a bummer, yeah.

[1134] It's the way it is.

[1135] Yeah, yeah.

[1136] Takes a while.

[1137] But from the outside, if you're just a lay person who's never dealt with addiction and on any level, and you go, wait a minute.

[1138] The best treatment facility in the country is only getting a third of the people sober.

[1139] That's a little disheartening.

[1140] I could see where they would be critical of that.

[1141] But here's the point I want you to make.

[1142] Because we talked about it is, unlike other diseases, where we can monitor the effect of the treatment by going, okay, this person had cancer.

[1143] We gave them this level of chemotherapy, and they had this result.

[1144] A .A. is not a pill.

[1145] Right.

[1146] So there are so many elements of A .A. There is, you go to meetings, that's one of them.

[1147] The other one is you recommend to get a sponsor.

[1148] You start talking to this person.

[1149] Another one is you work the 12 steps.

[1150] There's always things you have to do.

[1151] Right.

[1152] Another element is you provide service and you help other people get so.

[1153] And nobody ever measures that in their studies.

[1154] Exactly.

[1155] So because there are these five pillars or whatever, however many there are, to just say some guy walked into an AA meeting, that's a good judge of whether or not that whole program works.

[1156] When the whole program's taken holistically, the number is probably much more significant When people do it, it works.

[1157] Right.

[1158] And you know that and I know that.

[1159] And it's hard for people on the outside to recognize that.

[1160] There's about to be a Cochran analysis, which is the state of the art. Johnny Cochran?

[1161] No, state of the art meta -analys.

[1162] Okay.

[1163] This is a compilation of all the data that's available being published by a guy named John Kelly out of Harvard, the guy named Keith Humphreys in Stanford that's behind this.

[1164] And the data for abstinence as good or better than any treatment out there.

[1165] For mutual aid societies generally, whether it's smart recovery, 12 -step, whatever it is.

[1166] Their outcomes for abstinence are extraordinary.

[1167] What's the alternative to absence, Suboxone and other?

[1168] Which be some other, is cognitive behavioral therapy, motivational enhancement therapy, replacement therapies, some combinations of these things.

[1169] And these things are helpful.

[1170] But I don't think that, you know, without 12 step, if your goal is restore that person's life, it's just there aren't enough manpower in the world to do what's necessary to get that attic where they need to go.

[1171] Right.

[1172] And it's there and works.

[1173] and now we have the meta -analysis about to be published showing you that it works.

[1174] Yes.

[1175] And the other thing is getting people engaged.

[1176] This is another piece that's really off problematic.

[1177] Keith Humphreys has a study where he showed that, you know, if you go to an emergency room as an alcoholic, they did this study where they, it was, I think it was a veteran study.

[1178] And they somebody came in in the emergency room, then withdrawal, whatever.

[1179] They had one group where the doctor sat with the patient, gave them pamphlets about 12 -step, education about 12 -step, meeting schedule, and said, go do it.

[1180] And that was that.

[1181] In the other population, they did the same thing, a little less education, but said, and I'd like to introduce you to Dax here, who's going to take you to a meeting tonight.

[1182] Dax meets Joe.

[1183] And you say, tonight, I'll see you at six o 'clock.

[1184] We'll go to the meeting.

[1185] Okay.

[1186] In the educational group, the meeting attendance was, what would you predict?

[1187] I'm so low.

[1188] Zero.

[1189] Okay.

[1190] I wasn't going to predict that.

[1191] In the warm handoff, the meeting attendance was 100%.

[1192] No way.

[1193] 100%.

[1194] And the recovery rate amongst that group, I'd forget how far out they took it, was quite good.

[1195] Yeah.

[1196] So part of it is education.

[1197] We don't stand behind it.

[1198] It's free.

[1199] This is what the thing I can't understand.

[1200] We have these freaking free services out there that stand up to scientific scrutiny free.

[1201] And we don't advocate for it.

[1202] Well, by the way, that's a clue for you.

[1203] Oh, yeah.

[1204] It was hugely profitable.

[1205] I'd see billboards everywhere.

[1206] I'd see ads on TV.

[1207] But we should, the government.

[1208] should be getting behind it.

[1209] And of course, you have to be careful because there's 11, there's traditions that, you know, suggests we shouldn't be.

[1210] But I'm saying at least from an educational perspective, we should be advocating on behalf of it.

[1211] Yeah.

[1212] So let's just talk the 11th tradition, right?

[1213] Is that we're going to stay anonymous at the level of press and.

[1214] Right.

[1215] So Bob and I. And I break this.

[1216] Well, I think Bob and I studied a very, that's the fourth one was I don't know what number of it is.

[1217] Well, Bob and I went at that hard before we decided to celebrity rehab.

[1218] Right.

[1219] And it turned out.

[1220] that was mostly Bill Wilson's wife's idea and that late in her life she completely converted and said, no, you have to get out in the media.

[1221] People need to learn about this.

[1222] Well, yeah, I have a friend who's a bit of an A historian and he said what he had read was that that was mostly so that they wouldn't be inundated with the trillion drunks that were rampant in society.

[1223] The level of it was just they couldn't have every drunk showing up at their door.

[1224] And to be fair, it has worked that way, right?

[1225] It's been good.

[1226] But I think there's been a paradigm shift.

[1227] If you were an alcoholic quote in the 50s, that was a very shameful thing.

[1228] And I just don't think it has this stakes anymore.

[1229] True.

[1230] And my stance has always been, I'm happy to piss off a handful of people in AA if it means 25 dudes that listen to me find their way to AA.

[1231] You can put me on a crossover.

[1232] And what they meant by media was totally different than what we have in media today.

[1233] They didn't envision all this.

[1234] That we all are a media outlet.

[1235] Yeah, there was no concept of all this.

[1236] and the idea of a reality show.

[1237] What the hell?

[1238] They were thinking, really, they were thinking advertising.

[1239] Right.

[1240] They were thinking Madison Avenue, promotion.

[1241] Yeah, because we want to appeal to people through attraction, not promotion.

[1242] That's right.

[1243] So your show, which I've had many debates with people over the years about.

[1244] First of all, I loved it.

[1245] Did you watch it, Monica?

[1246] I did not.

[1247] Oh, it was so good.

[1248] And I will say it works on a lot of levels.

[1249] The criticism of it, of course, was that you were kind of voyeuristically, profiting or something on people's pain and addiction.

[1250] So let's go to that.

[1251] So let's go.

[1252] It's just break it on each one.

[1253] So one was the traditions.

[1254] So Bob and I really thought a lot about that.

[1255] And it was actually Bob's idea to go ahead with this.

[1256] And I thought, dude, if this is your instinct.

[1257] Okay, let's go do it.

[1258] Bob's just an awesome, awesome, awesome.

[1259] You should interview sometimes.

[1260] It's a great interview.

[1261] And but I'm fully engaged.

[1262] And so this issue of, let me let me I can take you through all the criticisms because I have I think about it very carefully yeah they're too sick to make a decision to agree to be in a situation oh yeah that's a pretty good okay it's a good one yeah and to me that means that an alcoholic addict in their disease is in too sick of a position to consent to anything they can't consent to treatment they can't consent to what I mean they are they so impaired they can't consent to things right in the eyes of the law that's not true they consent to all kinds of things all day long or they wouldn't be held accountable for either they can't go into treatment without consenting to treatment.

[1263] So that's sort of an issue that's been kind of squared.

[1264] And by the way, if I had heard from any of the patients that, hey, man, I didn't really know what I was getting into, never heard that once.

[1265] Uh -huh.

[1266] In fact, we heard quite the opposite, which was, we didn't know this was going to happen.

[1267] Something happened that we didn't know.

[1268] People all came in because they wanted to make money.

[1269] They maybe wanted a little treatment and they wanted to screw with us.

[1270] They wanted to make hell for us.

[1271] Sure, sure.

[1272] And did a great job.

[1273] And because we wanted, we took the treatment so.

[1274] seriously, halfway through the treatment, every one of them had the same thing.

[1275] They went from being resistive and whatever and just there for the money to being, oh my God, I'm getting something out of this to, I want to share this with other people.

[1276] And I want this to be a good outcome.

[1277] So I can make a difference for the people.

[1278] Every single patient had that transition did not expect that.

[1279] I'm thankful to God for that.

[1280] That was an amazing transition everybody had.

[1281] Yes.

[1282] And also, by the way, I look at it this way.

[1283] It's the spoonful of sugar with the medicine.

[1284] It's like, sure, I initially tuned into that.

[1285] A .O. So I'm an interest in it.

[1286] So I'm tuning into the fucking train wreck, right?

[1287] That is my initial, you know, attraction to it.

[1288] And then I'm very judgmental of the people on there.

[1289] And I'm like, oh, look at this dirtbag.

[1290] And he's a liar and blah, blah, blah.

[1291] And 100 % of the time, there would be a breakthrough where I would go, holy fuck, this is someone's child.

[1292] This is a human being.

[1293] This is a human being.

[1294] And all that stuff aside, we got to help each other.

[1295] Man, look how much.

[1296] that was the goal.

[1297] That was perfect.

[1298] Everything I do media, I do, I try to sort of bait and switch.

[1299] I try to bring you in because it's media, but I want to give you something you need.

[1300] That's, that's always the way I try to do it.

[1301] Absolutely.

[1302] And, you know, some of the other, you know, the only fair critique of it was is that you were a little handcuffed.

[1303] Well, so I would hate for people to think, go ahead.

[1304] Yeah.

[1305] So, so the, so then people go, oh, you're exploiting these people.

[1306] I go, please ask them if they felt exploited or if they had any perception of exploitation.

[1307] Right.

[1308] You would think if somebody was exploited, the exploited individual, one of them would have a feeling of exploitation?

[1309] Yeah.

[1310] Not one.

[1311] Right.

[1312] So good.

[1313] I believe that.

[1314] And I, here's where I was, continue, good doctor.

[1315] Here's where it was different than, then, and I didn't know the cameras, cameras seemed to help treatment.

[1316] The payment definitely helped treatment.

[1317] Because I could motivate them to stay in.

[1318] Hey, you want to leave?

[1319] Get out of here.

[1320] I'm going to dock your check.

[1321] Yeah.

[1322] So that was very helpful.

[1323] Sure.

[1324] And, but I couldn't fire people.

[1325] I couldn't kick them out.

[1326] That was different than normal.

[1327] Yeah, so that's the part that is dangerous because I think some people on the outside were like, oh, these fucking acts, they get away with murder and there's no consequences.

[1328] And that's why they're this way to begin with.

[1329] Correct.

[1330] That was a adjustment.

[1331] That's the thing you just got to swallow.

[1332] Well, I had to think of it as a tool that I did not have.

[1333] And I was going to have to use other things, which was the carrots and the other ticks.

[1334] And it, of course, it ever worked.

[1335] I was surprised.

[1336] The only other thing that's different is bringing 10 people in on the same day.

[1337] You know, everybody comes in all at once.

[1338] And that's like, whoa, that is very stressful for me. Yes.

[1339] Because they're sick.

[1340] And they're sick for a week or so.

[1341] And that's, that is heavy, heavy lifting.

[1342] Yeah.

[1343] Usually it's one or two a day and the newcomers, you know, helped by the old, the guys that have been there.

[1344] Is everybody all the ones.

[1345] I would also imagine, too, it breaks apart this societal dynamic that's helpful, which is you enter a treatment facility.

[1346] There's some people 28 days.

[1347] Yes.

[1348] There's some people that are already working at.

[1349] And your inclination as a, is a multi -member group primate is to kind of blend in and go with the flow.

[1350] It's just fucking everyone leaves the gates at the same time.

[1351] Right.

[1352] And so that's, then it all falls to us, right?

[1353] Then we've got to get them in.

[1354] We got to get them in.

[1355] And that worked too.

[1356] That went, that went okay.

[1357] And what?

[1358] That's, but, but I loved it.

[1359] And my, you know, my, my defense of it was always this.

[1360] Like, you are, whether you tuned in for this, that, or the other thing, you're getting exposed to really great principles.

[1361] And you're watching them work.

[1362] Yeah.

[1363] You know.

[1364] And we treated them for a long time afterwards, too.

[1365] We offer them.

[1366] treatment for a long while afterwards in every case.

[1367] Some of them took it.

[1368] Some of them didn't.

[1369] Some of them were doing amazing, like amazing.

[1370] And some of them not.

[1371] That's the way the deal goes.

[1372] What's interesting is even though I've got like now, you know, 15 years of experience of being in meetings and everything and commingling with a bunch of other addicts, I couldn't do the job you do because I have a, I don't think it's unique to me in AA, which is a fuck you get with the program or go try your thing.

[1373] So there's this weird hang.

[1374] But I need you guys.

[1375] Right.

[1376] I need you.

[1377] I have lots of people glad to hear you that way because I will refer you people to sponsor then you're going to judge and what my my the people that are just or at least to enroll you know the way I look at that is like those people that I refer that way for enrollment will go to the mat for people if they're motivated if they're not they'll have nothing to do with it that's right totally appropriate like when I when I what you have to do is someone who's running a treatment facility is just much different than when I have to do it's a very different role and When a new guy comes in, I just personally believe there is a level of humility required for this thing to work.

[1378] I've seen tens of thousands of people try to get this.

[1379] And to me, the ingredient that is absolutely required is humility and an acknowledgement that you need some help and guidance.

[1380] So I always tell them, you know, shut up, with the cotton in your mouth, take it out of your ears, sit down, sit your ass down a seat a couple times a day, and just shut up.

[1381] now the real art that recovering people sometimes do is I've seen some amazing full -scale attacks on newbies but that scare the crap out of me I think the guy's going to go kill themselves that gets them in either out of resentment or out of waking them up or something people that apply that when they do it yeah well we can also say and you probably can't bullshit motherfucker I know exactly how it works you were just doing this I dude I did it I did it what are you talking about Like, you really think you're telling me that that's what happened?

[1382] I have a version of that because I'm really pretty good at knowing what, you know, what's bullshit.

[1383] And I feel, I just thought, this is about 90 % bullshit.

[1384] I've learned to just trust what it comes out of my mouth.

[1385] And I'll sometimes say something like that or worse.

[1386] I'll say, you're full of shit.

[1387] You never even, and they'll be crying and they'll just, they'll wake up and I think, oh, they're going to punch me. And they go, I know.

[1388] How'd you know?

[1389] I don't even know anymore.

[1390] What's bullshit?

[1391] What is it?

[1392] Because they don't.

[1393] Yeah.

[1394] So you also had, there was, there was a spinoff show about sex addiction.

[1395] Oh, yeah.

[1396] Before you do.

[1397] The other criticisms we got was early on, we intentionally kept the 12 steps out because of the 11th tradition.

[1398] It was the 11th tradition.

[1399] And then what was the big complaint from the 12th step community?

[1400] Where's the 12th steps?

[1401] Right.

[1402] He can't win.

[1403] And so we brought it back in and started calling it classes and assignments and things like that.

[1404] That's the same complaint.

[1405] The compromise I had always been instructed on was that I was always allowed to refer to it as a 12 -step program.

[1406] I'm in a 12 -step program.

[1407] You can't name the program.

[1408] Yeah.

[1409] And then just, you know, I'm doing it.

[1410] hours and hours of this, but there's no fucking way I'm going to keep saying 12 -so program.

[1411] The new nomenclature is going to be mutual aid society.

[1412] What is it?

[1413] The new nomenclature is mutual aid society.

[1414] Mutual aid society.

[1415] Yeah, that's even longer.

[1416] The new euphemism.

[1417] Yeah.

[1418] They're just going to have to deal with me saying A. All right.

[1419] But one of the good criticisms, though, I will say that is more of a current issue and why I do have respect for it is if I'm out here talking about AAAAA, now all of a sudden Dax is the face of AA.

[1420] And I'm just as likely to relapse as anybody else.

[1421] And so if I relapse, it will not be an indictment on A. It'll be that I stopped working the program correctly because when I did work it correctly, it got me 14 years of sobriety.

[1422] So that's probably the thing that people do need to lead with and I try to lead with often.

[1423] Yeah.

[1424] But what seems to be pretty acknowledged now, I'm sure there's pushback, but that disease of addiction is real.

[1425] And then it requires treatment and it is a health issue, right?

[1426] I don't feel like sex addiction has that same kind of respect in our society.

[1427] It for sure doesn't.

[1428] And I did interview with somebody today about love addiction and that definitely is not.

[1429] It sounds goofy to people, right?

[1430] Well, and I get a little concerned about the overapplication of the term addiction too.

[1431] I mean, it really, it's a construct.

[1432] You know, with, how would you define addiction?

[1433] Well, how do I find it?

[1434] I define it as a genetic disorder, a biological disorder with a genetic basis.

[1435] that the hallmark for which is the progressive use and preoccupation in the face of adverse consequence.

[1436] Okay.

[1437] Consequence on work or school, finance, health, legal, or financial status.

[1438] Mm -hmm.

[1439] And then denial.

[1440] That's all I need for debt for addiction.

[1441] Okay.

[1442] Now, you know, the DSM -5 has all kinds of breakdowns of criteria and this and that.

[1443] Right.

[1444] But for me, it's the gene, the progression, the consequences, the denial.

[1445] And I know it's there.

[1446] Okay.

[1447] So, but environmentally, so my mom is a CASA.

[1448] Do you know what Acosta is it's a court -appointed advocate for kids in foster care?

[1449] And to be that, she's a volunteer.

[1450] She has to go to all these workshops every couple months.

[1451] And she left one of the workshops.

[1452] And she called me. She was molested.

[1453] My dad was molested.

[1454] Well, but the trauma puts the rocket fuel on addiction.

[1455] Great.

[1456] So I was going to say you could conceivably not have the biological component and have been traumatized sexually as a kid and be still off to the races now?

[1457] No. Really?

[1458] You think there has to be a biologic component?

[1459] Yeah, a gene.

[1460] Oh, really?

[1461] Oh, yeah.

[1462] but but the trauma I mean they're traumatized kids that don't become drug addicts but if you're a traumatized kid with that gene it's game on it's over for sure yeah she said yeah and I always told people I had said look if it's I was giving a lecture one time and I said look you know 100 all of my patients have trauma that's just it's just if they're bad enough addicts they need to see me they had childhood trauma and this very very bright you know important psychiatrist said to me goes don't don't say always never say always so I gave up and the lecture and I said you know Dr. So -and -so's advised me not to say always, so I'll say it this way.

[1463] 100 % of my patients have a trial with drama.

[1464] And it's always, always, always there.

[1465] If it's bad enough, and I'm not saying all the addiction requires that.

[1466] I'm saying if you get bad enough addiction that you need to see me, you had it for sure.

[1467] Okay.

[1468] So because here's one thing.

[1469] And that's, by the way, that's the piece of addiction that people get all effed up about, which is, well, why'd they use in the first place?

[1470] Why did they use?

[1471] I understand why they got out of control.

[1472] There's a gene.

[1473] The biology drove it.

[1474] Okay.

[1475] Why'd they use in the first place?

[1476] That's the trauma.

[1477] They're trying to regulate emotions that are unmanageable.

[1478] Right.

[1479] You're trying to take something from the outside and fix something on the inside.

[1480] And it works.

[1481] By the way, it works.

[1482] You wouldn't do it if it didn't work.

[1483] It works for, we can work for quite a while.

[1484] And in fact, there was a period.

[1485] It worked better than this.

[1486] Like, you know, it could shut that brain of mine off.

[1487] And that was, there was a lot of peace in that.

[1488] The thing was sex addiction, the time that I saw where people seemed to be so outraged that it was being used was when Tiger Woods came out and said, I'm a sex addict.

[1489] And I think what happened there, in my opinion, is that people were hearing that as an excuse.

[1490] And that was not an excuse for my mind.

[1491] That was an explanation.

[1492] And I get so infuriated at people not being able to make that distinction.

[1493] Well, it came up today in conversation.

[1494] In fact, so let me tell you what I told the, it was my radio partner.

[1495] And I said, look, I go, she goes, why does it only happen when the wife finds out about it?

[1496] then, and I go, why do I only see alcoholics when they get a DUI?

[1497] Yeah.

[1498] And she goes, well, that's different.

[1499] And I go, why is it different?

[1500] She goes, well, what if they didn't get a DUI?

[1501] I said, then I see them with alcoholic liver disease.

[1502] I don't see them before the consequences.

[1503] Right.

[1504] You have to get the consequences before you get through to them.

[1505] Whether it's getting caught by the wife or getting an, and she goes, well, if they're not married, when do you see them?

[1506] I said, when they have medical problems, which they do, all kinds.

[1507] Or financial as a result of pain.

[1508] Or criminal stuff.

[1509] They get into all kinds of crazy shit.

[1510] Absolutely.

[1511] And so you don't see an addict until they have their consequences.

[1512] Yeah.

[1513] It just happens that one of the more common ones for the sex addict is screwing up relationships.

[1514] Yes.

[1515] And this, this concerns me, and I've railed about this before, but I think if you, I'll just use a wife for the sake of this argument, if a wife found out that her husband was an opiate addict and she had missed all the signs, and she found out that that husband of hers was driving.

[1516] her children.

[1517] Couldn't be anything more important in her life, was driving them daily, completely fucked up, endangering their lives.

[1518] I have to imagine a great majority of those women would give their husband a chance to go to treatment and fix that.

[1519] And I think it's such a frowness of all of our own ego that if my wife turned out to have a sex addiction, that I wouldn't extend to her the exact same willingness to get better as I would if she was at gambling at it.

[1520] if your husband was a gambling addict and he he gambled away your home and you now were on the streets and you jeopardize the safety of your children what could be more paramount than that's right yet if your husband got a hand job in Tokyo let's blow this whole fucking thing up or your wife got it you know I don't but let me tell you why that's not that can be a great explanation but of course primary it's that explodes the intimacy right it explodes the intimacy it explodes the trust and the feeling of safety that you need for intimacies, and it's very shattering.

[1521] And the codependent of a sex addict, by their nature, has got a lot of stuff going on.

[1522] Okay.

[1523] Somebody that would be attracted to, back to this attraction conversation.

[1524] Somebody would be attracted to somebody who's prone to sex addiction needs to do some work.

[1525] And they're very fragile on many levels oftentimes.

[1526] I would imagine that's ultimately true.

[1527] I look at it from an AA perspective, which is.

[1528] is the reason that that can't be overlooked is that them being addicted to opiates does not trigger one of our deepest fears.

[1529] No spouse is going, I wasn't enough of a spouse to keep you from being an opiate addict.

[1530] I wasn't enough of a spouse to keep you from being a gambling addict.

[1531] But our biggest fear as humans is that we wouldn't be attractive.

[1532] You know, it's so deep attraction.

[1533] It's mating.

[1534] It's a little more of a man thing.

[1535] It's a male thing that we put sex and attraction in the same category.

[1536] Well, I think, let's just say we all have a deep, deep biological component to mate.

[1537] Yes.

[1538] That's eating, shelter, mate.

[1539] But the main thing is about safety and about, you know, it's all kinds of things that way, way deep.

[1540] When it's shattered, it makes you crazy.

[1541] It does make you crazy, but I do think you can trace back to people's oversized reactions to it triggering fears in them.

[1542] Most partners of sex addicts stay in the relationship.

[1543] Oh, really?

[1544] That's the, of those in treatment.

[1545] The majority of the ones in treatment, like 70%.

[1546] Okay, so, but they got to treatment still in a relationship.

[1547] I feel like a lot of people were probably weeded out before that statistic takes off.

[1548] And a lot of people, you know, blow the relationship out.

[1549] But I asked this really, so we were talking.

[1550] In a weird way, that partner may be healthier.

[1551] That just, I can't stand this.

[1552] Right.

[1553] In a weird way.

[1554] I wouldn't advise it.

[1555] I wouldn't advise it.

[1556] I'd like them to hang in and work it through.

[1557] Yeah.

[1558] But sometimes.

[1559] And I'm not even advising someone stay with a sex addict.

[1560] Yeah.

[1561] But, but this, I'm obsessed with this topic.

[1562] all the time because I just think sex is so triggering for people.

[1563] And I ask this question to a group of people that are at our house.

[1564] At your house?

[1565] At our house.

[1566] This dinner conversation.

[1567] Sometimes I got to go to a dinner party at your house.

[1568] You must.

[1569] I said, here's your choice.

[1570] You find out that your spouse drove drove the car.

[1571] They would have blown a point two oh.

[1572] They are fucking dangerous.

[1573] They drove your kids.

[1574] A point two Or they had oral sex with someone else.

[1575] What's your choice?

[1576] You have to pick between those two things.

[1577] And unanimously, they all picked, I'd rather have them drive my kids drunk.

[1578] Wow.

[1579] That's telling.

[1580] I mean, they were in a very safe environment.

[1581] They wouldn't have said that in an interview.

[1582] But in our house, they admitted they would rather have had that happen than be cheated on.

[1583] Maybe they don't.

[1584] And I just think that's incredibly telling about how important all that is to us.

[1585] Or a lack of understanding.

[1586] how dangerous driving drunk is.

[1587] I think even when they understand how dangerous that is, if they're being dead on us, they'd rather find out that that happened than that their partner cheated on them.

[1588] And I would prefer that Kristen cheated on me than drive our kids at point too well.

[1589] I'm kind of with you.

[1590] But it's hard and it shouldn't be hard.

[1591] That's my point.

[1592] That's how outsized our fear is over this topic.

[1593] Either that or we have thought something through you and I that others don't normally do.

[1594] Maybe we have realistic reasons of our spouse.

[1595] houses or something high likelihood your kids are going to get very hurt in this scenario but why are we different that's we got to figure out why are we why are we having a different reaction because if that's the typical reaction that's the typical reaction why are we different why are we having something a little different and i'm wondering if it's because over we're overly confident in our relationships no no no i think it's the therapy and the work and the because it makes you realistically accept human beings right yes and and you have to realistically accept your spouse and failings are part of that.

[1596] But endangering children is not really a failing.

[1597] To me, that's a non -starter.

[1598] That's a criminal behavior.

[1599] No matter what option you give me after that, I'm probably going to pick it.

[1600] But I also very much understand why it was kind of unanimous.

[1601] Yeah, I get.

[1602] No, I understand the feeling I get totally.

[1603] Yeah.

[1604] And I just think there's a whole world of inquiry that's not happening for whatever reason.

[1605] Because they've been to your dinner parties.

[1606] It's got to be my thing.

[1607] Everybody running up the back door.

[1608] Jesus, shut the axe up.

[1609] I find out a lot, oh, maybe I can ask you this.

[1610] I find out a lot of, these are very informal studies I'm doing, but you'll like this one.

[1611] So Chris and I were doing a movie together.

[1612] The costumer came into her trailer, and she was talking about cleaning up the boys.

[1613] There were a bunch of boys on the movie and just cleaning up their boxer shorts that they were wearing in the movies.

[1614] And I said something like, how many do them have shit streaks in that, right?

[1615] And she said, very high amount.

[1616] And I was like, oh, my God, that's so pathetic.

[1617] Why on earth are these guys they can't wipe their butt?

[1618] What is going on?

[1619] This led to a conversation where Chris and I were talking about how often do you poop your pants?

[1620] And I said, you know, it happens to me once every year and a half or something, right?

[1621] And she goes, that's insane.

[1622] That's insane, right?

[1623] She goes, I've never poop my pants.

[1624] And I go, okay, right after that movie rep, we went to Michigan, we go camping with like 40 of my friends.

[1625] We're all around this huge campfire.

[1626] And I tell them about this conversation.

[1627] I go, look, man, I poop my pants once a year, once a year and a half.

[1628] And then we go around.

[1629] the whole campfire and every single guy was like yeah you know once a year twice a year whatever they get to this guy who's in town from germany he's an engineer he goes i would like to say never but twice times per years and what we found at the end of this is all the guys had experienced pooping their pants none of the women had but then Kristen said how often do you pee your pants go around the circle that's a different every woman has peed their pants within a year no guy peas their pants.

[1630] We have a, but we have a more ironclad mechanism down there.

[1631] Yeah, but it is very interesting.

[1632] Women are handicapped.

[1633] They're handicapped down there.

[1634] Okay.

[1635] Okay.

[1636] It's a much shorter distance, much easier thing.

[1637] It happens much more commonly.

[1638] And if you've ever had a baby delivered a baby, you're going to be doing that all the time.

[1639] Right.

[1640] But who would have thought there was some kind of sexual indicator of those two things?

[1641] It's just bizarre.

[1642] It is weird.

[1643] But yeah, I put my pants.

[1644] So women have an excuse for the ping, but men do not have an excuse.

[1645] Well, no, I know.

[1646] We know of.

[1647] But it's always, is it not always, is it not always the case when that happens?

[1648] You're going to fart and you have diarrhea.

[1649] Well, is it not always the case.

[1650] Well, that's one of the theories Chris and I have come to is that men are just innately more cocky.

[1651] Like they'll test it like, this could be diarrhea, but I'm going to see.

[1652] And then, oh, boy, I was wrong.

[1653] So it's like an arrogance to male.

[1654] Maybe driven by testosterone and daring to pass gas and wherever it's the bottom of.

[1655] Because it's probably all all wired into like our daredevil tribalism.

[1656] It's so good.

[1657] But it's not the case.

[1658] Is that not the way it happens?

[1659] That's how it happens.

[1660] You're like, I can't, well, I'm just going to test.

[1661] Either we get, A, we get diarrhea more often.

[1662] And B, we are willing to pass gas more often.

[1663] And that's that.

[1664] Yes.

[1665] Okay, great.

[1666] The last thing I kind of want to ask you about is, is you've, you've had a very public career as a doctor.

[1667] And throughout, you got on the radio, how long ago?

[1668] 25 years ago or something?

[1669] 1983.

[1670] 1983 so still a medical student oh wow so I'm going to quickly do the math monica 37 years that's not very fast but anyway you've had this very public life and um when have you blundered what what are some moments that you had that were hard to get through that like well I remember one at one time just what occurs to me as you mentioned it I would I have panic attacks you do yeah and uh because you said you had trauma and you're not an addict so I was assume work was away for you.

[1671] Work was out.

[1672] Work was one of the mechanisms and but I had depression and panic, attacks, anxiety, stuff like that.

[1673] Okay.

[1674] It's all way better from therapy.

[1675] And, um, but there was, you also exercise a lot, right?

[1676] I think that's a little bit of a crazy thing too.

[1677] Okay.

[1678] I think I have like little exercise bulimia or something.

[1679] Okay.

[1680] Good.

[1681] But I, but I get a lot, I listen to all the podcast when I'm organized.

[1682] It's my study.

[1683] It's really important.

[1684] Good for me. Yeah.

[1685] The thing that occurs to me, I was, I was on the Today show.

[1686] I used to do it a lot.

[1687] and I'd not slept and I was you know and I was and I was talking to New York and I just you know got in there seven hours before I'm sorry four hours before and it was like three in the morning at US time California time and I'm doing something and Matt Lauer's interview me on a topic that I probably was not that into and I remember I started having a panic attack and so I started blocking and I started like not making sense and Matt Ler leaned into me like looking like are you okay and I and I thought oh man I got to get together And I just sort of powered through.

[1688] Oh, wow.

[1689] But that was a moment where I was like, oh, you're live on national television having a panic attack.

[1690] And it could get, you know, it can get out of hand.

[1691] Yeah.

[1692] You can say, all of a sudden I have to go.

[1693] You think you're having a heart attack, right?

[1694] No, no, I know my panic attack.

[1695] My panic attacks are psychological in nature.

[1696] I just feel like I'm, like I'm, it's, imagine you're drowning at sea, even though you know you're not at sea, just that you can't, you can't find a way to get, you just can't find purchase on anything.

[1697] And I block my thinking stops.

[1698] That's the biggest problem.

[1699] for me. I block in my thinking.

[1700] Have you ever tried beta blockers?

[1701] I know because I was because I need my I need full faculties when I go into battle.

[1702] Do beta markers affect that?

[1703] I have never tried it but I was fear that anything that's in any way my altering is going to affect my ability to do it because I'm I'm needing everything I've got to express myself.

[1704] Yeah.

[1705] I've never personally done a beta blocker but my my wife is a proponent of them as a singer who sings in front of large audiences and like a concert musicians often take them?

[1706] Listen, it's a no, it's a non -problem.

[1707] It's an easy one.

[1708] And maybe I'll do it one day, but I don't have them right now.

[1709] I panic and stuff.

[1710] One day it will happen.

[1711] Right, right when I least expect it.

[1712] And do you think that that was the result of being tired?

[1713] Tired and blah, blah, blah, whatever.

[1714] I don't know.

[1715] Who knows what else is doing.

[1716] And did you have fear over talking with Matt Lauer?

[1717] Yeah, fear and anxiety.

[1718] Again, the reason I say it's a topic that I didn't really care about because people push me to talk about things that I'm like, hmm, do they I didn't really have much to say.

[1719] Do they want you to.

[1720] I'm like, come on.

[1721] Right.

[1722] And they just say, no, you need you to do it.

[1723] oh, okay, okay.

[1724] Yeah.

[1725] And do they, do they want you to generally comment as a physician on someone in the public eye that's going through something?

[1726] Yes.

[1727] That's typical.

[1728] That is typical.

[1729] Or somebody died or something.

[1730] And it's like, or a parenting thing, a lot of parenting stuff because I talk with adolescence for so many years.

[1731] Uh -huh.

[1732] And things that are like, this is not really a topic or I don't really know about it.

[1733] but okay, I'll do the research and I'll do the best I can't.

[1734] Yeah.

[1735] And how do you, like when you feel it, because I, I'm now on the other side of a lot of those triggers for me. Yeah, me too.

[1736] Like when I was first with Kristen, my insecurity and self -loathing was if I was on a talk show and they want to talk about her, my thought was, oh, they're not even interested to me. They just want to talk about her.

[1737] Right.

[1738] And so I couldn't help but be defensive about that or try to read her.

[1739] You know, stupid.

[1740] Now I don't feel that way at all.

[1741] Right.

[1742] And I also started noticing everyone.

[1743] when she's on a talk show as her about.

[1744] Yeah, it's just like, it's like talking to your grandparents.

[1745] They don't want to, they just ask you how your brother's doing.

[1746] They don't ever ask you what you're doing.

[1747] But yeah, that feeling of going like, oh, fuck, here they go again.

[1748] They want me to do this trick.

[1749] And yeah.

[1750] A lot of that.

[1751] Yeah.

[1752] A lot of that.

[1753] Like when Bourdain recently.

[1754] You have like moral, moral.

[1755] Does it feel a moral?

[1756] No, it doesn't.

[1757] Because I always think of it is, well, if I really don't understand the topic, oh, yes, yes.

[1758] But if it's something where it's like, yeah, there's stuff.

[1759] something to be learned here.

[1760] I should really make the effort.

[1761] You know what I mean?

[1762] Yeah.

[1763] Even though it's sad like with Cade and Cade and Anthony Bordane, everyone's me. Everything's about suicide.

[1764] And then it's like, oh, you know a lot about that topic?

[1765] I know a lot about suicide, but this is, this is, none of these cases are exemplary.

[1766] They're all very different.

[1767] I mean, I think of Bordane, heroin addict drinking.

[1768] I mean, very different situation.

[1769] I was always impressed by that.

[1770] I had Red Kitchen Confidential.

[1771] I absolutely loved it.

[1772] I never watched a show, but I'd see it advertised all the time.

[1773] And I was like, oh, that's cool.

[1774] He can drink.

[1775] He's the next junkie, but he can drink.

[1776] That's impressive.

[1777] Now I'd like you to think about that realistically.

[1778] Well, look, I'm not one of these people in A that's like, thanks my.

[1779] No, no, no, good for him.

[1780] It's my thing.

[1781] But like some people smoke pot who consider themselves sober.

[1782] I'm not here to say, all I know is I can't.

[1783] I talked to Anthony 15 years ago.

[1784] He's in danger.

[1785] Okay.

[1786] Now, I don't know how it was going to go bad, but I knew it was going to go bad.

[1787] Yeah, it's dicey.

[1788] You can't do that.

[1789] I mean, you can.

[1790] You can do it for a while.

[1791] But it always goes bad.

[1792] It always goes bad.

[1793] If you're an opiate addict and you're drinking, please.

[1794] But I do think the thing that, again, I know next to nothing about the Bourdain thing, other than I saw his commercials and he seemed to be a guy living a fantasy and I was happy for him.

[1795] Yes, me too.

[1796] Like, I just had this great feeling about that.

[1797] Yes.

[1798] And with people.

[1799] Yes.

[1800] I think that's how he kept it together so long.

[1801] He made it about other people and that will keep you going for a while.

[1802] Right.

[1803] But inevitably, the biology kind of unraveled.

[1804] But I did find.

[1805] Because I can be very cold to people on the outside when people in our group OD.

[1806] Because I have this weird thing because I'm sober.

[1807] It's like, yeah, that's what happens.

[1808] It's not shocking to me. And of course, that's what happened.

[1809] Yes, that's this condition.

[1810] And it sounds kind of dispassionate.

[1811] No, no, no. It's like you're in war.

[1812] No, it's like cancer.

[1813] It's like if you were working with a bunch of cancer patients, somebody died of cancer.

[1814] You go, you know, that's what happens.

[1815] Right.

[1816] And it kind of sounds cold to people.

[1817] But I will say that this Bordane thing.

[1818] I found myself feeling sadder about it than I have in the past when I've heard about people who have killed themselves.

[1819] And I do think it speaks a lot to the condition of depression because it's so scary to think someone could have everything they would want.

[1820] Yeah, that's what people are commenting on.

[1821] But again, but I'd like that.

[1822] That's a great, that could be more helpful for depression than any other thing.

[1823] Absolutely.

[1824] When someone's 800 pounds overweight and they've been, they're living on the streets, it's no, it doesn't.

[1825] scare anyone.

[1826] The one that still hangs over most of us that was really a depression story was Chester Bennington.

[1827] I don't know, Chester.

[1828] From Lincoln Park.

[1829] Oh, very sad.

[1830] That is just, yeah.

[1831] I mean, that was recalcitrant depression for a guy long -term recovery, going well in recovery.

[1832] Oh, yeah, it's so terrifying.

[1833] I just had my mother on here, which was so wonderful.

[1834] And she had two different bouts, suicide attempts at different times.

[1835] One, when you would expect it.

[1836] Like, everything was going wrong, three kids can't support them, all this stuff.

[1837] But way more importantly and informative was, one was at the height of everything in her life.

[1838] Kids are succeeding at everything.

[1839] She'd hope they'd succeed at her business is thriving and her marriage is perfect and just fucking rock bottom out of nowhere.

[1840] Which to me is such a good indicator that is so much biochemical.

[1841] Is she bipolar?

[1842] She's not bipolar.

[1843] Or at least she's not been given that diagnosis.

[1844] She had never been medicated up until that second time.

[1845] Since then, she's totally fine.

[1846] I mean, she's not totally fine.

[1847] She has a great game plan now and she's medicated and now nothing.

[1848] But to me, that is a more informative scenario than the person that we can write off is just having been a failure or something.

[1849] Or in misery or pain or something.

[1850] Look, it's a brain thing.

[1851] It's a brain disorder.

[1852] And we get disorders of the brain just we get disorders of the heart and disorders of the knee.

[1853] Yeah.

[1854] No different.

[1855] And we shouldn't treat it any differently.

[1856] And do you know the whole history of the DSM and why that even came about and how there was a disease?

[1857] I just remember fascinating.

[1858] I don't know the details.

[1859] I know psychiatry is always trying to make itself medicalized.

[1860] I was always trying to make it, you know.

[1861] Yeah, there was this guy who was a prankster.

[1862] He was like an English guy who would debunk things.

[1863] I forget his name, but he came to the U .S. And he had an experiment where he had 10 colleagues go check into psych wards.

[1864] And all they could say was, I hear a thump in my head.

[1865] And then beyond that, they had to tell the truth.

[1866] And then all 10 people were admitted to these psych wards, and they were given a litany of different diagnoses.

[1867] and then this became an expose and it caused the whole psychiatric community to go, okay, we need some kind of standardized thing and it kind of created the DSM came out of that.

[1868] If you should read the DSM 2 and the DM3, they're hysterical.

[1869] Oh, really?

[1870] Because they're so, yeah.

[1871] I think that's part of the reason people have a hard time buying into psychology in general is that it's, there's been a lot of bad psychology, right?

[1872] Yeah, there's been a lot of terrible psychiatry.

[1873] It's a hard thing to...

[1874] I've got a picture of how they used to do frontal lobotomies in here.

[1875] I used to care of those patients, you know, years later.

[1876] disastrous.

[1877] Disastrous.

[1878] Yeah.

[1879] So when the DSM actually came out and was standardized and they started giving it to people, what they found, if I have my history correct, is that mental illness is probably pandemic.

[1880] That was the conclusion.

[1881] Hmm.

[1882] Which I mean a universal or affecting a majority of us in this country.

[1883] Okay.

[1884] And I kind of agree with that.

[1885] Well, that's true.

[1886] It is, right?

[1887] Yes, it's true that symptomatology affects the majority of us.

[1888] The question, when do you want to call it an illness?

[1889] Sure.

[1890] Yeah.

[1891] But my broad question for you is, let's assume for a second, that the majority of us have some kind of mental.

[1892] Yeah, it's like 60%.

[1893] We're all sitting in a room right now.

[1894] Literally a majority.

[1895] Yeah, I'm owning my addiction stuff.

[1896] You're saying you have panic attacks.

[1897] Monica, you had a spell where you thought you had anxiety.

[1898] Yeah.

[1899] anxiety.

[1900] Yeah.

[1901] So I don't hear that any different though in my mind is going, well, a lot of us had the flu.

[1902] Pretty much everybody here has had the flu.

[1903] Yes.

[1904] Or most has been a lot of appendicitis in this, you know, yes.

[1905] Part of the human experience includes this brain thing that does some weird stuff to us.

[1906] Yes.

[1907] So my broader question is, A, are we as a species, a species with mental illness?

[1908] Yes.

[1909] Or did we live in a certain way in that we've stopped living in a certain way?

[1910] And that has has given this great.

[1911] rise in it.

[1912] And I have kind of a little armchair theory on it.

[1913] Okay.

[1914] I'm certain both.

[1915] Okay.

[1916] And I'm certain that some of it is also we.

[1917] I was peppering seeds throughout this.

[1918] Yes, I got it.

[1919] Yes.

[1920] You're going to see it.

[1921] Have an awareness of it and an ability to identify it and give it a name and to, you know, understand it as a feature of our brains function that may be misfiring in the moment.

[1922] Now, or we just, we got super smart and here.

[1923] Sorry, there's a byproduct of that.

[1924] Right.

[1925] And we may be pathologizing things that always in the past was never pathologized or never barely even noticed.

[1926] Yeah.

[1927] But yeah, sure, if I had to worry all day about hunting mammoths, it'd be hard to have my panic attacks we experienced very differently.

[1928] Right.

[1929] Very differently.

[1930] And here's where my theory comes in is that I believe that we...

[1931] By the way, we'd both be dead now too.

[1932] Oh, sure, sure, sure.

[1933] We wouldn't have lived this long.

[1934] Well, I would have challenged...

[1935] If we made it through childhood, which would be very unlikely.

[1936] I would have challenged a 23 -year -old to a fight so I had access to a female and I would have been killed by a strong...

[1937] I know exactly how I would have gone out.

[1938] And by the way, back then, just a single sword wound somewhere would have been it because it would have gotten infected and that's over.

[1939] That's right.

[1940] You don't have to get run through.

[1941] We're forgetting the fact that I would have died of asthma as a kid anyways.

[1942] We wouldn't even made it to that point, but let's just say I made it.

[1943] My theory, though, is that having studied anthro, you know, for 99 % of the time we've been on this planet, we were hunting and gathering.

[1944] And we had a very labor -intensive lifestyle.

[1945] And we had all this physical activity.

[1946] And that physical activity is rewarded with endorphins.

[1947] Yeah, and our biochemistry was much different.

[1948] Yes, and proper sleep.

[1949] When we lived that way.

[1950] And so you mentioned that you have to work out.

[1951] I have to work out.

[1952] I don't think we're doing a good enough job letting people in America know, not just for your vanity, although great motivator for me. Physical activity is really, I think, essential for our mental health.

[1953] Agreed.

[1954] And I don't see the program promoting that.

[1955] I don't see, I see, like, eat organic.

[1956] Talk to Robert Downey, man. That guy made a big point about that.

[1957] He feels like he over -emphasized that, in my opinion, in terms of who he was able to get through and finally into recovery.

[1958] But good for him.

[1959] And he talks about all kinds of spiritual and physical practices and things.

[1960] Yes.

[1961] And there are people that do it.

[1962] They're always marginalized.

[1963] I don't know why we do that.

[1964] Right.

[1965] But you're right.

[1966] It should be at the core.

[1967] And by the way, and now when you have podcasts and things you can listen to and be expanding while you're focusing on your exercise, I mean, to me, it's a perfect combo and a perfect time.

[1968] Yeah.

[1969] I said on here that weirdly if there was a single thing I hope my kids do by the time they graduate, forget an SAT score, any other habit.

[1970] That one thing I'd hope is that they had a habit of exercising.

[1971] If you do it, they'll probably do it.

[1972] Well, I do it and they come down there with me and they watch cartoons when I lift weights and they occasionally lift them.

[1973] I'm hoping that.

[1974] Perfect.

[1975] My gyms in my garage and my kids, my sons at least still do.

[1976] My daughter is too.

[1977] That's pretty fantastic.

[1978] Well, the one thing I was wondering, I was hoping maybe you would, bringing it up.

[1979] But do you regret the Hillary thing?

[1980] Oh, that was a sort of a blunder.

[1981] So let me explain what happened.

[1982] Yeah.

[1983] So, well, sure, I regret it.

[1984] That's the answer your question.

[1985] Okay.

[1986] But let me tell you what happened.

[1987] So I have to imagine just politically my guess would have been, that would have been your pick of the two.

[1988] Yeah.

[1989] Yeah.

[1990] Yeah.

[1991] And you would never wish her any ill. No. But you got to hear what happened.

[1992] Okay.

[1993] What you think happened is not what happened.

[1994] Okay.

[1995] Great.

[1996] I know so little about what happened.

[1997] Yeah.

[1998] So, so I was on Don Lemon one night, and I did 10 or 15 minutes on Donald Trump's mental health.

[1999] We talked about it.

[2000] It was right in the beginning days.

[2001] We were talking about hypomania and narcissism.

[2002] But I would say, you know, you don't know.

[2003] Is that a good thing or bad thing?

[2004] Teddy Roosevelt was a narcissist and hypomanic.

[2005] And like, we can't, hard for me to judge, but that's what this is?

[2006] You know, and I was just sort of being very agnostic about it.

[2007] What's the little rule that you're not allowed to diagnose someone who you've not studied?

[2008] Yeah, but the Goldwater rule.

[2009] But most people are objecting to that now.

[2010] I mean, because it's so easy to characterize what you're saying.

[2011] You can't talk about psychological nuances, but I can characterize the way I can characterize a rash.

[2012] You know, you can kind of characterize it.

[2013] Yeah, okay.

[2014] I'm not saying, this is his diagnosis.

[2015] I'm saying, these are these kinds of things and this is what they look like.

[2016] Sure.

[2017] These are some red flags.

[2018] Yeah.

[2019] And so, and so I went to, I do a radio show in Los Angeles.

[2020] I went to the radio station next day.

[2021] And my program doc goes, that was great.

[2022] Would you do 30 seconds on that for the radio for our website?

[2023] I went, okay, so I sat down, I did 30 seconds on summarizing what I'd said on Don Lemon.

[2024] Yeah.

[2025] Mind you, I was 15 minutes.

[2026] on CNN talking about Donald Trump.

[2027] Okay.

[2028] And as I was walking, I was getting up to get out of the chair, my program director at radio goes, why should you probably do 30 seconds on Hillary, too?

[2029] Do you have something for her?

[2030] And I go, you know what?

[2031] They just released her medical records.

[2032] And the care she's getting is shit.

[2033] I would love to talk about that.

[2034] Yeah.

[2035] So I discussed her medical record that was released that day.

[2036] And I was critical of the doctor's decisions and what they were doing in terms of her health care.

[2037] So I was critical of the doctors.

[2038] Yes.

[2039] Drudge picked it up.

[2040] and their headline was finally a physician is willing to take the position that Hillary's not fit for doing.

[2041] Yeah.

[2042] So, right.

[2043] You must have, what was your, I mean, tell me about the sinking feeling.

[2044] It's a horrible feeling.

[2045] I've been in so many shitstorms like this in my life.

[2046] I don't know why I get in them, but I get in them.

[2047] Yeah.

[2048] And so this was another one where I was like, oh my God, you've got to be.

[2049] I just sort of think duck.

[2050] That's my first note was just duck.

[2051] Yeah, yeah.

[2052] So I was trying to duck.

[2053] Yeah, do you have a strategy now?

[2054] Like just.

[2055] Now?

[2056] Yeah.

[2057] At that point, at that moment?

[2058] I mean just saying having been through some of these before do you at least they're all like I just need to ignore this for 20 days we live in such a weird world now if you don't have people loving and hating you don't exist well that's good if you're not in some kind of shitstorm you don't exist and so right but so I was I was not yet schooled on that so I was freaking out pretty good yeah but at any in any event I felt like I could duck and it will pass and no big deal well the CNN brass started calling oh boy and came down hard oh boy and how dare you and this kind of stuff and they didn't want to hear it and I said fine I trust me I'm not because you had a show at that time at HLN but we had already decided a month earlier to end the show oh really we decided a month earlier okay this had nothing to do with me ending the show right three weeks later we ended the show and the whole world went uh -huh see oh they kicked him off the air because of what he said about Hillary okay so none of it is what you thought it was right I don't even know that I thought I still regret it I still regret it but it was and I still stand by my value of the physicians.

[2059] And in fact, they responded to everything I said as though where they were interrogatories and they changed her treatment a little bit.

[2060] And they got some evaluations that I thought she needed.

[2061] They did it.

[2062] Good.

[2063] And so.

[2064] And was it the thing that you thought maybe it was just like doctors she had had forever entrusted and they just had a state of rest of things.

[2065] You have to watch out for this.

[2066] Celebrities get horrible health care.

[2067] Doctors that get turned on by taking care of whomever in the public.

[2068] Disaster.

[2069] They have to not care.

[2070] They have to treat you nobody different.

[2071] Oh, yeah.

[2072] You're all the same.

[2073] You get the standard of care.

[2074] The standard is the best.

[2075] That's why it's the standard.

[2076] Nothing special.

[2077] As soon as somebody starts giving you special attention or special care, watch out.

[2078] When my prostate cancer was diagnosed, I thought they were doing that to me. And I was like, I'll come back at six months.

[2079] I get retested.

[2080] Don't worry.

[2081] It's me. I know it's me. Do you identify with me as a doctor?

[2082] It's me. Don't.

[2083] Just do what you normally do.

[2084] And they go, this is what we normally do.

[2085] And I'm like, God damn it.

[2086] And so I ended up with a biopsy, pissed.

[2087] And then with diagnosis, they did exactly the right thing.

[2088] They used their judgment properly.

[2089] our judgment as physicians it's it's honed in a certain emotional interpersonal context and we step out of that take care of our family take care of ourselves our judgment doesn't work it goes out of a special person or think that's a special person we're not using our judgment are you saying Elvis's doctor wasn't a great dog I'm saying he was not so when you're in one of those storms yeah is your um is is your natural thing to do I'm hoping we can bond on this do you go home and just talk like a four -year -old to your wife and then you eventually have to police yourself and go, Jesus, my wife does not want to fucking hear about this anymore.

[2090] And I'm being a narcissist.

[2091] Sometimes.

[2092] It depends on the thing.

[2093] I try not to bring it home.

[2094] But there's times.

[2095] But that's why you have a partner at the same time.

[2096] What happens to me when I start verbalizing too much, that drives her crazy.

[2097] But I can't stop talking about something.

[2098] Yes.

[2099] I know that's silly.

[2100] And that makes her crazy.

[2101] It makes me crazy.

[2102] Yeah.

[2103] So I try not to do that one.

[2104] And you have to recognize.

[2105] or I tried to recognize I'm just being a narcissist like I have this whole thing where the world thinks A about me or B about me has nothing to do with our life in this house or our children or our friends it's all because I'll tell you the shit storms I get very threatening dude because then they threaten to call my professional societies and I'm off to Philadelphia to stand I mean there's crazy stuff that can happen to physicians you don't know yes and that is the logical defense of it but that's that's the part I would say is bullshit like so so what we'll tell ourselves is no no I've gotten I've had that stuff happen.

[2106] Oh, I believe that.

[2107] Yeah.

[2108] I totally believe that.

[2109] But when I've done something where I feel like I'm under attack and a lot of people have some certain opinion of me, I'm making a logical case.

[2110] Ooh, I got another blunder for you.

[2111] Oh, great.

[2112] But go ahead.

[2113] Finish it.

[2114] So I'm building a logical case of why it's appropriate for me to feel this way, right?

[2115] But in doing that, I'm failing to stop and say, all these people whose opinion I think I'm concerned about, none of them are my friends.

[2116] Yeah.

[2117] Not one of my friends has this opinion of me. Not one of my family members has this opinion about me. My wife doesn't and my kids don't.

[2118] So what really is going on?

[2119] Yeah.

[2120] I am prioritizing people's opinions who I don't even know.

[2121] That's the vast majority of these kinds of things.

[2122] Yes.

[2123] And that's actually my narcissism who's actually concerned that the greater world loves me. And that's just wrong.

[2124] Absolutely.

[2125] And I need to police myself about that.

[2126] 100%.

[2127] Here's a blunder.

[2128] Ready for a blunder?

[2129] Yeah.

[2130] In 1997, 21 years ago, I, accepted a fee from a drug company to do a two -year campaign to raise awareness of the side effect of antidepressants.

[2131] But because, and it was before anyone knew about the sexual side effects, I knew about them.

[2132] Okay.

[2133] And people's lives were being destroyed by it.

[2134] So I went on a campaign and I did lectures.

[2135] I mean, it was most of my - You seemed anti -SSRI inhibitor?

[2136] Yes.

[2137] Well, at least awareness about it.

[2138] The company that funded me had Welbutrin.

[2139] Okay.

[2140] And of course, they had their position was, well, our, drug doesn't do that.

[2141] I'm like, okay, well, I don't care.

[2142] I'm going to go educate about all the stuff.

[2143] I wrote a book on it.

[2144] I did, had multiple psychiatrists and people that toured with me and stuff.

[2145] Yeah.

[2146] The company got caught in a billion dollar federal lawsuit for, essentially for advocating off -label use of their drugs.

[2147] That was their lawsuit.

[2148] Okay.

[2149] They found a radio interview with me where I said they, I said, I was going to these SSRIs, he caught sexual dysfunction.

[2150] And the radio interview who said, well, what do you?

[2151] What do you do?

[2152] I said, what are I doing practice?

[2153] In my practice, what do I do?

[2154] Well, I switch into Welbutrin or Sarazone or Remron, which I did.

[2155] Or sometimes I'll add Welbutrin to the SSR -I, which I did.

[2156] I'm entitled to say that.

[2157] That's my practice.

[2158] That's what I do.

[2159] Yeah.

[2160] I forgot to say, oh, by the way, I'm this, the Wobutron company, they're funding this campaign that I'm on.

[2161] I just left it off the interview.

[2162] You didn't disclose.

[2163] I just didn't disclose in the interview.

[2164] I assumed it had been disclosed, I guess.

[2165] I just didn't remember to disclose it when I was saying that.

[2166] Yeah.

[2167] Huge, huge, It made you look like a shill for well.

[2168] Exactly.

[2169] And to this day, people will bring that up from 22 years ago.

[2170] Well, even hearing that, though, was your overall message that we shouldn't do SSRI?

[2171] Yes.

[2172] Are you anti?

[2173] Are you still anti?

[2174] I am generally the anti -medication guy, generally.

[2175] Oh, I didn't notice about you.

[2176] Well, generally.

[2177] I mean, I think there's way over, you know, the, certainly the benzopoeate thing I'm way against.

[2178] Yes, yes.

[2179] I think there is a tendency not.

[2180] to be willing to move through ordinary misery.

[2181] I'm very concerned about primary care physicians prescribing this stuff.

[2182] Trust me, they don't have the training.

[2183] They don't.

[2184] I worked in a psychiatric hospital for 25 years.

[2185] And the first thing I noticed when I got there was like, oh, man, I thought I understood a psychiatry.

[2186] I do not.

[2187] 10 years in, I thought, probably I know enough now.

[2188] 10 years of working there that I could really be a decent prescriber, but I would not.

[2189] I sent it all to an expert to a psychiatrist.

[2190] And most, the vast majority of SSR is prescribed by primary care guys that don't have the training.

[2191] They just don't.

[2192] So I'm concerned about it.

[2193] I also concerned about people getting left on them and not getting out of psychotherapy.

[2194] I have very concerns about it all over the place.

[2195] And at that point, no one, the companies were denying that they caused the sexual side effects and relationships were getting destroyed all over the place.

[2196] Yeah.

[2197] And so that was what I felt, I felt good about that campaign for, and by the way, back then was a whole different world.

[2198] You routinely worked with drug companies.

[2199] That's what you did.

[2200] Right.

[2201] They were sort of seen as allies in the in the fight.

[2202] So then you just have to make the unilateral decision.

[2203] Like I'm just never going to be in bed in any capacity.

[2204] No, never.

[2205] I will do supplements sometimes when they really look good.

[2206] Uh -huh.

[2207] Just kind of like if I think, like if something I'm going to take and somebody wants me to help them with that.

[2208] If I'm taking it, I'm willing to say I'm taking it.

[2209] But I know nothing with pharmaceutical companies.

[2210] Zero, zero.

[2211] Nothing sense.

[2212] So you do have a ton of, is this from doing Love Line that you had to be.

[2213] super knowledgeable about sex?

[2214] Yeah.

[2215] Yeah, because of that, right?

[2216] Every night we'd talk about it.

[2217] Because when I was on, you would never remember this, but the time I did Loveline, there was a caller, and the weird thing about doing Loveline that people probably wouldn't imagine is the problem, is I'm a comedian, so I go there and I want to be funny on your show Loveline, and I have to keep reminding myself, these are real human beings calling with real problems, and I'm like regularly trying to avoid making a joke, right?

[2218] and that subsides and I'm really listening and this was the call that came in and I couldn't believe what you said oh this woman called and she said um yes um dr drew I um I have a girlfriend and I love her a lot and um we we still are very connected and everything and I just um you know we stopped having sex about um three months ago and I'm just a little concerned and you said okay so you've been with your partner you stopped having sex three months ago so I'm going to say have you guys been together six months and she goes yes that's exactly right we've been together six months how did you know and you said oh this is a female female female relationship and you go well you are in the pattern that many lesbian relationships fall into that once all the oxytocin and fun stuff wears off of falling in love there's no testosterone in the relationship to drive the sex life and I was so blown away that you actually developed I actually developed a term.

[2219] It's called Lesbian Bad Death.

[2220] And people will object to that in the strongest terms, but we were hearing about it all the time.

[2221] That's just the pattern.

[2222] It just was there.

[2223] It just there it was.

[2224] Yeah.

[2225] And it's interesting.

[2226] So I wonder now would you be as readily to give out that same?

[2227] By the way, you're stating something that you've observed factually many, many times.

[2228] There's no judgment behind it.

[2229] And right.

[2230] And you're not saying so therefore that you guys shouldn't be in a relationship.

[2231] No, what I say is you need to pay attention to sex because it's important.

[2232] And you don't have to drive.

[2233] There's no drive there for it necessarily.

[2234] And you should miss it.

[2235] And it's an important part of intimacy.

[2236] And you got to push it.

[2237] And what's the solution?

[2238] You got to schedule it.

[2239] Yeah, pay attention.

[2240] Make it for it.

[2241] It's interesting.

[2242] Would you feel as comfortable today saying that?

[2243] I wouldn't jump to it today because since those days, I know exactly when you're talking about.

[2244] Lesbians, I don't know, gay relationships with women seem to have prioritized.

[2245] sex a little more.

[2246] I hear a lot more of quality.

[2247] I don't know.

[2248] Who knows why?

[2249] Why?

[2250] Because I'm not there with them, but there's much more engaged, satisfying, satisfying persistent sexual contact than back in those days.

[2251] I don't know.

[2252] Because ever since I did that, that episode of Love Line with you, over the years as we've had lesbian friends, I always bring that up.

[2253] Like, oh, I was doing Loveline and they said this.

[2254] Did you?

[2255] And they would have go, oh, yeah, lesbian, bad death.

[2256] Right, right.

[2257] But not us.

[2258] Right, right.

[2259] But I don't know why six months, too.

[2260] It was a weird number.

[2261] But we kept hearing that number six months, six months, six months.

[2262] Yeah.

[2263] And I wonder now would you be nervous to say it because you feel like it could be weaponized or just now?

[2264] Oh, I worry about everything being weaponized.

[2265] Yeah.

[2266] I worry about everything we've talked about here being weaponized.

[2267] Yeah.

[2268] But you just got to say fuck it.

[2269] I have to be honest.

[2270] Just be truthful and forthcoming.

[2271] forthright.

[2272] And when it comes to observation about human behavior, I cannot divert from the facts.

[2273] It just is what it is.

[2274] Right.

[2275] If people want to weaponize it or the way to, I always want my mind to be expanded and changed.

[2276] So if people want to give me alternative data or explain why the data I'm seeing is the way it is, please bring it.

[2277] I'm delighted.

[2278] Yeah.

[2279] You don't have to weaponize it.

[2280] Well, I've gotten so much pleasure out of since meeting you that very first time when you said that comment and it stuck with me. And I remember to this day.

[2281] And it's, spurred on a lot of these conversations I have at my house.

[2282] One thing I know for sure is I do not want to go to a dinner party with Dr. Shepard.

[2283] Sounds very scary.

[2284] It sounds very frightening.

[2285] You love it.

[2286] Is it a scary experience?

[2287] No, I like it because nothing's being written down and recorded.

[2288] Because I will say that.

[2289] It's 10 times worse than this conversation.

[2290] 10 times worse.

[2291] Like I said, I'm not sure I want to go to a dinner party, but it does intrigue me. I sort of feel like I would tantalize me. Well, this is the one thing Sam talks about a lot and I totally agree with, which is what's eroded in academia is that through discourse is how we make discoveries.

[2292] So we have to have opposing viewpoints.

[2293] Socrates for God's.

[2294] It's required that people go too far, then retract, then see the error in their ways.

[2295] But we have to have the latitude to go too far to come back.

[2296] It's the only corrective mechanism we have.

[2297] Yes.

[2298] Otherwise, we're going way one way or way the other.

[2299] And it doesn't stop.

[2300] Without it, there is no forward movement.

[2301] But anyways, Dr. Drew, I love you.

[2302] I love that I get paired with you on this prostate cancer.

[2303] I know I love that too.

[2304] It's a great excuse for us to see each other.

[2305] And then these podcasts are an excuse.

[2306] And dinner party is the next excuse.

[2307] Yes, absolutely.

[2308] Although I will come with my beta blockers.

[2309] That's what I'll experiment with beta blockers.

[2310] Go old school and bring the lunch sack.

[2311] You just breathe into.

[2312] The brown paper bag.

[2313] Yeah, yeah.

[2314] Okay, well, thank you so much for coming by the addict.

[2315] And I hope to talk to you again on here soon.

[2316] All right.

[2317] And now my favorite part of the show, the fact check with my soul.

[2318] Homeate Monica Padman.

[2319] Let me see here.

[2320] And the requests?

[2321] Oh, I have so many requests.

[2322] They're piling up.

[2323] Oh, wow.

[2324] They are piling up.

[2325] All right, you ready?

[2326] My Anna Kana don't want none unless you got facts, hon. You can do side bends or sit -ups, but please don't leave those facts.

[2327] Baby got facts.

[2328] Oh, that was great.

[2329] Was it?

[2330] I think I might have collapsed two different.

[2331] Well, that's okay.

[2332] Can't be perfect.

[2333] I haven't heard the song in 25 years.

[2334] Well, you did, yeah, I think you pulled something.

[2335] Yeah.

[2336] The chorus, you moved it up.

[2337] That's still good.

[2338] Maybe got facts.

[2339] Someone wanted to hear that.

[2340] I love that.

[2341] I love these requests.

[2342] Yeah, the requests are really fun.

[2343] Okay, you're ready for this one?

[2344] Oh, you're doing more?

[2345] Yeah, I'm going to do a bonus one.

[2346] You ready?

[2347] Okay.

[2348] I ain't nothing about a fire checker.

[2349] Checking all the time.

[2350] I ain't nothing but a fact check I'm checking all the time Well, you ain't never called me lying But you're still a soul made of mine Oh, I like you screwed up the Like the rhythm there at the end No, it's good I'm not the modified check I'll take it all the time All right, well that was another one Good job.

[2351] Two for one Oh my goodness, here's another screen grab I someone Well, we have a lot of episodes I know, I just want to let you know, there are seven suggestions in this one.

[2352] Wow.

[2353] Okay, good.

[2354] It's good.

[2355] It's good.

[2356] It's good.

[2357] It's good.

[2358] It's good.

[2359] It's good.

[2360] It's good.

[2361] It's good.

[2362] It's good.

[2363] All right.

[2364] Dr. Drew Pinsky.

[2365] It's so interesting when a doctor gets known by their first name.

[2366] Dr. Drew.

[2367] Very rare.

[2368] Very rare.

[2369] Very.

[2370] Yeah.

[2371] Something air.

[2372] Air.

[2373] Yeah.

[2374] You say like.

[2375] Deben air?

[2376] No, that's also accurate, but in thin air, in fine air, in, you know what I'm saying?

[2377] I sort of know what you're saying.

[2378] You're up really high.

[2379] I see.

[2380] Okay.

[2381] I got my head itches.

[2382] Okay.

[2383] Oh, you got a little bit of a head itch?

[2384] A lice?

[2385] Dander?

[2386] I hope not.

[2387] You might need to use a head and shoulders or a neutergina T -gill.

[2388] No, thank you.

[2389] I use.

[2390] Celsen Blue?

[2391] Nope.

[2392] I think it's called Living Proof.

[2393] Oh, okay.

[2394] I think that's what it's called.

[2395] This is I'm really nervous that we have a shampoo.

[2396] Oh.

[2397] I don't think we do.

[2398] We don't.

[2399] But we're open to living proof.

[2400] Or Celsen Blue.

[2401] Or head and shoulders, I guess.

[2402] Or Nutrigena T -Jel.

[2403] Any of the many great, great cleansing products?

[2404] You know, my first commercial, my first real commercial was a hair product.

[2405] Well, yeah, where you played a mermaid?

[2406] Yeah.

[2407] I'm with you.

[2408] Sometimes you forget stuff.

[2409] You're right.

[2410] You're right.

[2411] So it was shampoo.

[2412] Herbal essence.

[2413] Yeah.

[2414] Your hair was luxurious your hair.

[2415] Thick, flowing.

[2416] I wonder if I can say that I had extensions in.

[2417] Well, you can now.

[2418] The terms of the endorsement are.

[2419] I was going to say your hair, you already have crazy thick hair.

[2420] I do.

[2421] And they put even more in there?

[2422] Yes, and they dyed it.

[2423] Oh, my goodness.

[2424] Yeah, and it was the first, and I've never, that was the first and only time I've ever had had my hair dyed.

[2425] I was a little bit, I didn't really want to do it.

[2426] Well, it probably felt like peer pressure.

[2427] I had to.

[2428] You know how you feel about peer pressure.

[2429] Yeah, but I did it this time.

[2430] I let myself get peer pressure.

[2431] And did you love it?

[2432] No, it was the same color.

[2433] I think they were just like giving it a shine or something.

[2434] Trying to get all the gray out.

[2435] Yeah.

[2436] I do have some gray, so that's sensitive.

[2437] No, no. Wash that gray right out of my hair.

[2438] Do you know that jingle?

[2439] Yeah, I do.

[2440] I'm going to wash that gray right out of my hair.

[2441] What's it for?

[2442] Can't remember the product, but I do remember the song.

[2443] Isn't that so sad that that sounds like all I'm talking about is all my commercials.

[2444] I'll probably cut it out.

[2445] No, that's okay.

[2446] We like to hear about your commercials.

[2447] Everyone's tweeting me every five seconds about you and that Geico commercial.

[2448] Yeah.

[2449] I've gotten more updates on when and what channel you're on over the last.

[2450] two weeks.

[2451] Well, my parents texted me. Oh, they did?

[2452] Yeah.

[2453] Oh, that's good.

[2454] Were they watching football?

[2455] I don't know what they were watching.

[2456] Are you ready for some football?

[2457] Jesus.

[2458] I'm sorry.

[2459] Sometimes you can't even, you just can't help yourself.

[2460] It's in the middle of people's sentences.

[2461] You're right.

[2462] It's an impulse control issue.

[2463] What a song, though.

[2464] Do you remember that one?

[2465] No. They've gotten rid of it.

[2466] I think it was Hank Williams Jr. And it was Are you ready for some football?

[2467] And it was like, how simple could you make it?

[2468] They're like, listen, total discretion, creative freedom, go crazy.

[2469] Whatever you want to say and just, are you ready for some football?

[2470] And it was almost too much create.

[2471] It was like too much of an open space.

[2472] Maybe it was.

[2473] Maybe it was some boundaries.

[2474] But yeah, are you ready for some football?

[2475] Oh, I never finished my point.

[2476] I did a car commercial and it was for Volkswagen and every, it was for Volkswagen and And everyone came up to me was like, oh, are you, was that, you were in that Honda commercial.

[2477] Everyone thought it was Honda.

[2478] And I was like, that's not a very good commercial because no one can even remember the product.

[2479] I remember having a marketing class in high school and the guy said, okay, who remembers where's the beef?

[2480] Which is the most popular commercial from my child.

[2481] I even know it.

[2482] No, I knew it was Wendy's for whatever reason.

[2483] But 90 % of the class didn't know what burger chain it was from.

[2484] Wow.

[2485] And did you love being the person who knew?

[2486] Absolutely.

[2487] I'm going to know it all.

[2488] I know.

[2489] I loved it.

[2490] I would have loved that too.

[2491] But I wouldn't have known.

[2492] Right.

[2493] So I would have been mad at you.

[2494] Well, he was smart enough to not just let people call it out.

[2495] You had to raise your hand because he didn't call on me. Yikes.

[2496] Okay.

[2497] So you said we've been.

[2498] been studying psychology as a discipline for a hundred years.

[2499] Psychology was a branch of the domain of philosophy until the 1870s, when it developed as an independent scientific discipline in Germany and the United States.

[2500] Psychology is a self -conscious field of experimental study, which began in 1879, in a part of Germany that I can't pronounce.

[2501] You want to try?

[2502] L -E -I -P -Z -I -G.

[2503] Leipzig?

[2504] Leipzig.

[2505] Yeah.

[2506] I don't know.

[2507] Yeah, that sounds right.

[2508] Sure.

[2509] Yeah.

[2510] Um, so I was off by 50 years, sounds like.

[2511] Yeah.

[2512] I can live with that.

[2513] Well, now you know.

[2514] Now I'll always know.

[2515] Now you'll say 1870s.

[2516] The second someone brings up psychology.

[2517] They will.

[2518] And then they'll go, no, Dax, no one asked what year it was, became its own discipline.

[2519] And you'll say, who cares?

[2520] Where's the beef?

[2521] Wendy's.

[2522] They got the beef.

[2523] They got the beef.

[2524] Everybody jumping your neck.

[2525] They got the beef.

[2526] They got the beef.

[2527] They got the beef.

[2528] beat they got the beef do you recognize that song no that's the go goes they got the beat that's oh the beat yeah this is a very musical the guy yeah the malcolm gladwell book with the baseball is blink blink yes so people can check out blink if you haven't already it's a great book bring it up all the time sure do all those gladwell books can't talk about them enough you love them I'm surprised no one has done.

[2529] They Got the Beef for an ad campaign for a burger stand.

[2530] It's probably expensive.

[2531] I don't think so.

[2532] You barely remembered the song.

[2533] No, I got the beef.

[2534] I knew the song.

[2535] I thought maybe you were saying it all wrong.

[2536] Well, I was intentionally.

[2537] That's true.

[2538] They got the beat.

[2539] We talk a little bit about rate of divorce for autistic kids.

[2540] Parents of autistic kids.

[2541] Right.

[2542] Yeah, I don't think many autistic kids are wedding to begin with.

[2543] Well, they do.

[2544] Well, on the playground, we don't know what's going on.

[2545] Well, those all end in divorce.

[2546] Playground weddings?

[2547] Your daughter got, I think she got married on the playground.

[2548] Yeah, yeah.

[2549] Twice in one week.

[2550] Oh, wow.

[2551] Yeah, that's right.

[2552] Then I married her on Friday.

[2553] You did?

[2554] Yeah, she had a ring and I actually put it on her finger and everything.

[2555] I loved it.

[2556] You're sick.

[2557] What?

[2558] So cute.

[2559] It is so cute.

[2560] You, it is.

[2561] To be able to put a ring on her finger.

[2562] Her little fat finger.

[2563] Yeah, silly little fat finger.

[2564] Okay, because there's, there's an 80 % is the like number.

[2565] Oh, it is that.

[2566] That's even higher than I think I guess.

[2567] But a lot, but there's some research saying that's not true.

[2568] Oh, really?

[2569] So there's some discrepancies here on that.

[2570] But 80 % is the general number and then people are sort of fighting back on that.

[2571] Okay, they're pushing back.

[2572] Sure.

[2573] They're leaning in.

[2574] Okay.

[2575] So the hot book right now.

[2576] There's a hot book out about psychedelics, how it can help you.

[2577] And his name is Michael Pollan.

[2578] Michael Pollan.

[2579] Like the kind that would give you the sniffles?

[2580] P -O -L -L -A -N.

[2581] Paul -an.

[2582] Sure, but I think you would.

[2583] No, you're saying it correctly, but I'm just.

[2584] Phonetically, it is spelled like Paulan, yeah.

[2585] Paul -an.

[2586] Yeah, Michael.

[2587] I guess if we're going to, Mike yell, Mike Yale.

[2588] Oh, my God, I thought you were going to say.

[2589] just Mikey, Mikey, Paul, Ann.

[2590] Mikeale.

[2591] Okay, McAll, Paulan.

[2592] Paul, Ann, yeah.

[2593] And it's called How to Change Your Mind, what the new science of psychedelics teaches us about consciousness, dying, addiction, depression, and transcendence.

[2594] And people are liking this book.

[2595] I know a few people who have picked it off the shelf.

[2596] Yeah, and I hope you don't wait until you're on your deathbed to try psilocybin's to get a handle on your, sense of self.

[2597] I hope you do it when you...

[2598] I'll probably do it on my death, babe.

[2599] Okay.

[2600] Maybe.

[2601] And I won't be there to administer it to you.

[2602] Why?

[2603] Because you're going to die at least 20 years after me. You don't know.

[2604] We don't know, but insurance actuary would say for sure you're going to.

[2605] I don't think so because you have more money than me. So you'll probably get that blood, that vampire blood transfusion so that you'll live way long than me, I won't be able to afford it.

[2606] Yeah, right.

[2607] First of all, I don't think that's the truth.

[2608] And secondly, I will buy vampire blood if it's unavailable.

[2609] They bring it to market.

[2610] I know.

[2611] Oh, we're watching a vampire movie right now.

[2612] Let the right one in.

[2613] Uh -huh.

[2614] Great Swedish movie.

[2615] We're halfway through.

[2616] You've already seen it.

[2617] Danish.

[2618] I thought it was Danish, but then remember one of the characters said there was they found the body by Stockholm, which is Sweden.

[2619] So then I had changed my two.

[2620] I thought it was a Danish movie.

[2621] So did Kristen.

[2622] Yeah, but it appears to be a Swedish film.

[2623] But do you think it's a Danish film set in Sweden?

[2624] I guess, but why would they do that?

[2625] That would be like doing a Michigan movie shot in Ohio.

[2626] Just stay in Michigan.

[2627] It's not like it's that different.

[2628] I mean, no offense to anyone in Ohio or Michigan.

[2629] Okay, so he referred to Bob a couple times, and Bob is Bob Forrest.

[2630] Yeah.

[2631] Bob is his partner on Celebrity Rehab.

[2632] Coolest dude ever.

[2633] He tells it like it is.

[2634] Yeah, like you?

[2635] Even more than me. If you find me to be direct, you should tune in to Bob.

[2636] Interesting.

[2637] He's a real no bullshit guy.

[2638] For people who are getting sober.

[2639] Yeah.

[2640] Yeah, he tells it like it is.

[2641] And he's got a real good bullshit meter.

[2642] He knows when people are full of it.

[2643] I was starstruck by Bob Forrest.

[2644] I saw him at this like, meditation event.

[2645] And I was staring at them and stuff across the room.

[2646] And I introduced myself to him and he didn't seem to give a shit.

[2647] Ooh, cool move.

[2648] Very cool move.

[2649] Okay.

[2650] You said 80 % of people with trauma become addicts.

[2651] So I could not find that statistic.

[2652] But I did find sort of the converse of that, which is two thirds of all addicts have experienced some type of physical or sexual trauma during.

[2653] childhood.

[2654] So it's kind of semantics, but it is different.

[2655] Well, it is different because a lot of, there's way more addicts in general.

[2656] You can come to addiction many ways.

[2657] But if you are sexually abused, the odds of you becoming an addict are quite high.

[2658] But again, just knowing that two -thirds of addicts we have, 66 % have experienced trauma, It's a very small way to go to say that 80 % of people with sexual trauma become addicts.

[2659] Well, I did read that it's likely, but I couldn't get a percentage.

[2660] I'll try to find it.

[2661] Okay.

[2662] I'll ask Laura LeBow.

[2663] One thing we were talking about sex addiction and you were saying, you were bringing up like Tiger was saying that he was a sex addict.

[2664] Oh, Tiger Woods.

[2665] Uh -huh.

[2666] I couldn't think of his last name for a second.

[2667] That was scary.

[2668] Well, I went straight to the only tiger I know is the son of a friend.

[2669] And I thought, I hope I wasn't talking about my friend's son on the podcast, especially under the veil of sex addiction.

[2670] Well, you do know Tony the tiger, too.

[2671] That's true.

[2672] Yeah.

[2673] That's true.

[2674] But no, Tiger Woods.

[2675] Tiger Woods.

[2676] You said that when all that stuff was happening, he said he was a sex addict and they.

[2677] He went to rehab for it.

[2678] Well, yeah, but you were saying that you felt that that was an explanation.

[2679] not an excuse, and then you said, you get infuriated by people who can't make the distinction.

[2680] Yeah, but then you also say that I can't make the distinction.

[2681] Well, I think sometimes our arguments are circling that misunderstanding that you're interpreting what I'm saying is offering an excuse when I'm offering an explanation.

[2682] Right.

[2683] Yeah.

[2684] Uh -huh.

[2685] So you get infuriated by me. No, no. Can you recall when Tiger made that?

[2686] speech did you go what an excuse that was just a baby so no no you weren't a baby i know wasn't that long ago um i don't remember i bet at the time i probably felt like it was an excuse right um it's still i still might think it's an excuse i don't think but really quick you i believe in sex addiction by the way sure and you almost can't I can't think it's an excuse because he didn't say it's not my fault.

[2687] That's an excuse when you go, oh, I'm late because I got hit by a car.

[2688] That's not, it's not my fault.

[2689] He never was saying it's not my fault.

[2690] I'm a sex addict.

[2691] He was saying, yes, I have a problem and I'm going to go to treatment.

[2692] I'm a sex addict.

[2693] So I think people interpreted what he said was saying it was not his fault.

[2694] But that is in no way what he was saying.

[2695] Well, I think that's true.

[2696] That's true.

[2697] But if he's saying this happened, I don't remember what he said.

[2698] I don't, I wish we knew the details of how it was presented exactly because I don't think either of us know.

[2699] It was a long press conference.

[2700] And the other thing I thought while I was watching it, did I say this with Dr. Drew Pinsky, that I was thinking of the people in France were just laughing hysterically at us like, oh my God, look at these.

[2701] Look at these Americans having to say apology for having sex.

[2702] Who cares?

[2703] Is that a good franchise?

[2704] Didn't he like, it was way more than just having sex.

[2705] It wasn't that he cheated on her.

[2706] He like, he had many.

[2707] Didn't he like a beat?

[2708] No, no, no, no, no, no, no. No, there was none of that.

[2709] No. There was something with a car and a, do you remember Rob?

[2710] No, his thing was.

[2711] He, he.

[2712] Something with the golf clubs.

[2713] There was some like, no, but no. Just the big news was he cheated on his wife.

[2714] He was married.

[2715] That was the big thing.

[2716] and his wife was leaving him.

[2717] And then after the first stripper came out, many more came out.

[2718] But there were no gross stories about him like being an aggressive or anything with him.

[2719] He then subsequently got into some DUI issues later down the road.

[2720] But his big admission is his big press conference was he was just at the height of his career.

[2721] And he represented Buick and some underpants, I think, and some shoes.

[2722] Nandis?

[2723] No, no, no, no, me and these is, come on, come on now.

[2724] Don't talk, don't bring meandies into this.

[2725] Why, I'm just wondering, you said underpants?

[2726] Yeah, he, I think more like a haines or a fruit of the loom.

[2727] Nothing that compares to me and these.

[2728] Exactly, exactly.

[2729] Okay.

[2730] That's all I was trying to say is, come on now.

[2731] Like he would never even be able to.

[2732] This is a pedestrian panties.

[2733] He was trading in.

[2734] Damn it.

[2735] I want to find it and I can't.

[2736] Anyhow, it was just to acknowledge his public humiliation.

[2737] And I think the French people were probably, I mean, Mitterrand's mistress was at his funeral standing next to his wife and everyone was fine with it.

[2738] Yeah.

[2739] Can you hear that?

[2740] I do hear it.

[2741] Is it gross?

[2742] No, I bet people won't know what it is.

[2743] It's me rubbing my beard there.

[2744] Is it gross?

[2745] It also sounds like someone walking through a forest.

[2746] It does.

[2747] Like stepping on leaves.

[2748] This is like a Foley exercise.

[2749] Axel Foley.

[2750] So this could be a fun game.

[2751] So what I'm going to do is I'm setting a scene and you're walking through a force and you're going to find facts.

[2752] So if you could go, oh, like you discover one.

[2753] Okay.

[2754] You ready?

[2755] Wait, no, I'm not ready.

[2756] Oh, okay.

[2757] Okay.

[2758] Oh, look at this.

[2759] Oh, the percentage of Americans who have mental illness is one in five adults in the U .S. 1 in 5 adults.

[2760] 43 .8 million or 18 .5 % experiences mental illness in a given year.

[2761] Approximately 1 in 25 adults in the U .S., 9 .8 million experiences a serious mental illness in a given year that substantially interferes with or limits one or more major life activities.

[2762] Yeah, that's crazy high.

[2763] One in five.

[2764] If one in five people had heart disease, it's all we'd talk about.

[2765] Yeah.

[2766] Well, we are talking about it more, but you're right.

[2767] Yeah.

[2768] You're right.

[2769] Yeah.

[2770] And then you also said I had a spell where I thought I had anxiety.

[2771] And I did have it.

[2772] No, you did.

[2773] I didn't mean to say it that way.

[2774] Oh, okay.

[2775] I guess what I meant is that you don't seem to have a permanent anxiety condition that requires medicine today or anything.

[2776] I don't require a medicine.

[2777] But that you had a pretty bad period of anxiety.

[2778] Yeah.

[2779] It's not gone.

[2780] Right.

[2781] No. Yeah.

[2782] Yeah.

[2783] You were really nervous when we were at the movies this weekend that there was a shooter.

[2784] I was.

[2785] I did get it in my head.

[2786] Oh, a shooter.

[2787] Oh, look.

[2788] Is that what I think it is?

[2789] A shooter?

[2790] I did think that, but I actually weirdly, I mean, I guess that was part of my anxiety, but my anxiety presented itself in a very physical way.

[2791] Okay, so yeah, I recall very much that you thought you had a couple.

[2792] different illnesses.

[2793] Tumers.

[2794] Yeah.

[2795] And you were going to the doctor kind of frequently.

[2796] Yeah.

[2797] But it was just anxiety.

[2798] Yeah.

[2799] No, I did.

[2800] But I was saying I didn't have like a panic attack because I thought so there's a perfect example.

[2801] Like that's not an excuse.

[2802] That's an explanation of what was going on.

[2803] An excuse.

[2804] What would I be excusing?

[2805] That you'd go into the doctor so many times with these hypocondriac kind of hypocondriac things.

[2806] Yeah.

[2807] And you'd go, you wouldn't be saying like, oh, it doesn't matter.

[2808] that I did it or it's not my fault you go oh I have anxiety and that's how it manifested itself and I you know yeah yeah I guess that's the same I think it's the same I don't know if it's the same I'm trying um that's it well hold on is you sure you want to how about this now you're walking and you realize there's just no more facts you like like you clear the forest okay Oh, look, we're on the other side.

[2809] Oh, no more facts?

[2810] No more facts.

[2811] Should I go back in for some more facts?

[2812] Did we get enough?

[2813] Depends.

[2814] Do you think there's more in the forest?

[2815] I think there might be more.

[2816] Okay.

[2817] No, I think we're good.

[2818] I think we got enough.

[2819] Oh, great, great.

[2820] Now you're like, now someone just said, like, you could hear them from outside the forest.

[2821] They go, Monica, do you want ice cream?

[2822] okay so Monica do you want some ice cream wait for me I want ice cream that's you run into the forest what a cool thing we just did what was that thing they do on YouTube where people they like get hot ASMR or something no I don't think that's right that's close enough and we saw a little thing on it and the people get kind of like high off of it and it treats people's anxiety speaking of anxiety yes it does this whole thing now seems set up just to bring up other cool tools in treating anxiety.

[2823] ASMRI.

[2824] See, the reason I never think that's right when I say it is because there's a riddle with letters spelled out.

[2825] And we did this the other day.

[2826] You read the letters and it says something.

[2827] Yeah.

[2828] One of the letters is O -S -A -R.

[2829] You're saying, oh, yes, they.

[2830] I don't want to give it away, I guess.

[2831] Yeah.

[2832] Oh, yes, they are.

[2833] Yeah.

[2834] Oh, yes, they are.

[2835] I got that riddle, remember?

[2836] Did you get it all the way?

[2837] You did?

[2838] Or like, I got 80 % of it.

[2839] Enough that people realized what the riddle was.

[2840] And then we all maybe did the last sentence together.

[2841] It's a good riddle.

[2842] Sean and Leander up.

[2843] Yeah.

[2844] Again, congratulations.

[2845] Congratulations, Sean and Leander.

[2846] And your baby.

[2847] Oh, you have a little baby.

[2848] All right.

[2849] Great.

[2850] Well, I love you.

[2851] and I love Dr. Drew.

[2852] I hope you enjoyed him.

[2853] I did, yeah.

[2854] Fun guy.

[2855] Oh, really cute, fun, sad thing about Dr. Drew is he heard we were going to have Sam Harrison and he came the morning Sam was coming and he was like at the very end of his like possible time window to get to work and he was here and he was panicking because he really had to go to work and you really wanted to see him.

[2856] Yeah.

[2857] And then he finally had to pull the plug and then honestly their car is passed.

[2858] He turned in and Sam turned in the second after Drew turned away.

[2859] We'll set up a wrong.

[2860] A rendezvous for them.

[2861] A little liaison.

[2862] France style.

[2863] Oh.

[2864] Bye.

[2865] Follow armchair expert on the Wondry app, Amazon music, or wherever you get your podcasts.

[2866] You can listen to every episode of Armchair Expert early and ad free right now by joining Wondry Plus in the Wondry app or on Apple podcasts.

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