Managing Expectations: Ketamine, "Cures," and Cognitive Distortions

An exploration of "All or Nothing Thinking" and other mental habits that hold us back. Google "cognitive distortions," and you're sure to recognize a few patterns from your own internal monologue. Maybe you catastrophize or you tend to disqualify the positive things in your life. Another common cognitive distortion is "all or nothing thinking," which can wreak havoc on our ability to manage our expectations as we try different treatments.

Molly and Lynn discuss their own experiences with treatments that aren't cures, and Molly cautions against expecting therapeutic ketamine to end treatment resistant depression. They also share some thoughts on how distorting "all or nothing thinking" can be in the arenas of personal wellbeing and service to others. We take a moment of mourning for Dr. Paul Farmer, whose vision and moral clarity continue to instruct and inspire us.

We reference a wonderful Ezra Klein Show episode in which he interviews the incomparable Robert Sapolsky. That episode (called "Robert Sapolsky on the Toxic Relationship of Poverty and Stress") is here https://pod.link/voxconversations/episode/34b7e4b6820f3877279f47e0b38224c1 

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Our hosts are Lynn Schneider and Molly Dunn. 
All of our music is by Solid State Symphony.

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Transcript

[00:00] Theme Song: You. She's sometimes sad. She's sometimes happy. She's doing things to make her life less crappy. Trying a treatment that's new on the scene. Let's sit back and talk about get on me. She's sometimes sad. She's sometimes happy. She's doing things to make her life less crappy. Trying a treatment that's new on the scene. Let's sit back and talk about ketamine.

[00:40] Molly: Hey, everybody. Welcome to the final episode of season one of ketamine Insights. We're very happy that you're here with us. We're going to talk today about cognitive distortions, which are basically inaccurate habits of thinking. Or you can think of them as, like, inaccurate thought patterns that we all have to some degree. Today, we're going to focus on one cognitive distortion in particular, which is "all or nothing" thinking. It's also called "black and white" thinking. This kind of thinking can be particularly common among people like me with mental illness. But you also see it everywhere, like in American culture. We see it in our politics. We see it in the way we judge each other, especially online. And we often see it in the way we judge ourselves and the way we evaluate our impact on the world. And this episode veers into a discussion of that last one, the question of service and impact on the world. So I just want to provide some context, which is that Lynn and I both built our careers around service to others. In fact, we met in 2011 as colleagues doing that kind of work, and that flavors this conversation. We end up talking a bit about how easy it is to slip into the "all or nothing," "either or" type mindset when thinking about our own well being and our impact on the world. It's just a really difficult topic and an intricate topic, and it's one that I'm kind of obsessed with. I don't think we could ever do it justice in such a short conversation. But I do think it's an important conversation to have.

[02:23] Molly: So to go back to treatment resistant depression, chronic illness, and disability, people like me come up against all or nothing thinking all the time. For example, one of the things we talk about in this episode is that we have to manage our expectations around how much we can heal or feel better, and on what timeline. And this is clearer for some illnesses than others.

[02:50] Molly: Like with serious depression, it is often really unclear how much better a given patient can expect to feel or when. So for me, I've struggled for years to walk the line between two things that at first seem like opposites: acceptance and fighting, or like acceptance and vigilance. And by this, I mean, like, on the one hand, accepting my situation, accepting the pain, whether it's psychic or physical, accepting the loss of a lot of my abilities, the loss of the person I was in a lot of ways, versus being vigilant and fighting to end that pain and fighting to regain my abilities. For me, I eventually realized that this is not a situation that is all one thing or all the opposite. I actually have to do both. And in fact, I already was doing both. I have to accept my current level of suffering while working hard to improve my mental health, because it turns out that these things are not "either, or" at all. But when we are able to do any measure of acceptance, we often come up against other people's all or nothing thinking.

[04:13] Molly: So I've had the experience, for example of trying to explain to others that a cure may not be a reasonable goal for me and having them say shit like, oh, no, don't ever give up, which is really, really hurtful.

[04:28] Molly: So this is another reminder to be like Dr. Paul Farmer. Try to be generous in your interpretations of other people's actions. And when in doubt, be curious. And with that, here is our episode on all or nothing thinking.

[04:44] Molly: This is the all or nothing episode. I am your host, your co host, Molly.

[04:53] Lynn: And I'm your co host, Lynn.

[04:55] Molly: So today we're talking about the temptation to think about things as being, like, all one thing or all another. So this is called black and white thinking, or all or nothing thinking. And the way it applies in our topic here is thinking that something will either cure you entirely or that it's a complete failure. And I think a lot of, I bring this up with ketamine because a lot of people come in like it's been in the press as, like, a miracle cure for depression. You've probably read articles like that, Lynn, where it's like, don't worry, ketamine exists. It isn't. It's very, you know, it's. It's more helpful than anything on the market right now as far as, like, has a higher success rate so far than any antidepressant that you can take in pill form. But that doesn't mean that it's going to cure everybody or going to help everybody, even. It helps most people. But there's a difference between a good thing and a cure. And I guess I'm just trying to say in this episode, be happy for the good things, even if they're not cures entirely, which is the role that ketamine has played for me personally.

[06:18] Lynn: That's great. And I would just say I think a lot of medications in general, or even different kinds of treatments and therapies often can be seen as like all or nothing, right. And people or companies or therapists can say that these are the miracle cures and this is what's going to do it. And I think besides just ketamine, other psychedelics over the last couple of years, I've seen a lot of press around them as the cures for different types of conditions, whether it's like PTSD for veterans or for addictions or depression. And I mean, it's great that they're getting this attention and so much progress has been made, but it's really important to acknowledge this and your experience that it's not a cure-all, that you made significant progress, but it's not for everyone. Like, okay, do this ketamine or another type of psychedelic for treating depression or another issue and you're going to be cured or you're not. It's not that simple. It's not a black and white thing.

[07:24] Molly: Right. And I think a big point of the converse of this conversation in general is to manage your expectations and to set yourself up to be like, you know, to be happy with a 10% increase in your mood, a 30%, a 40%, whatever it is, that's progress. And a lot of the time, like you're saying, there's no one thing that's going to cure you. You have to try and you have to not just try, but implement several different. Maybe you do have to exercise more, maybe you also have to be on a different medication and practice. Ketamine is one of the stop drinking, right?

[08:06] Lynn: Yeah, the pie charts big one of different things you should be doing.

[08:11] Molly: Totally have to do that. Whatever works for you, continue to do it, even if it doesn't feel like a cure. I think the all or nothing thinking it is one of the long list. Well, longish, maybe there's like 15 or so recognized cognitive distortions that like, if anybody has been in therapy, and in particular I think cognitive behavioral therapy is where the term comes from and it's really helpful. I find it like, I've had friends call me because I talk about depression all the time. Whenever anybody knows anybody that's going through something, they often call me. I'll really recommend just googling the term cognitive distortions because it helps you realize that you're not the only one thinking weird. You're not the only one that thinks it's a problem. In fact, it's so shitty that people have dedicated themselves to trying to make it better. You know what I mean?

[09:08] Molly: That's always helpful in my mind, is to be like, oh, not only are other people suffering from this, but other. People are trying to help us. 

[09:18] Lynn: Cognitive distortions. Ok.

[09:20] Molly: Yeah, cognitive distortion is like, they're all very common. All of us are in the habit of thinking irrationally about certain things or in certain ways, but some of us just do it more often than others. Some of us do it in more destructive ways than others. There are people who think they have cognitive distortions that make them feel better about themselves, and that could be great for them and sometimes makes them annoying to be around. But anyway, I'll list a couple cognitive distortions here. There's, like, one that a lot of depressed people tend to have is disqualifying the positive. So that's to say, like, yeah, sure, this one thing went well, that just happened, but that was only luck, and the next thing is sure to go bad. We've all felt that way, right?

[10:05] Lynn: Yeah, totally.

[10:09] Molly: And then someone looks at you and goes, you just won the lottery. Like, what are you sad about? You're like, but I'm not going to win it next time. That kind of thing. I got this promotion, but I barely deserved it. And there's not as much money involved. It's like, well, okay, but another one is personalization, which is taking responsibility for things that are outside of your control. So taking things personally. A lot of people suffer from this during grief. They think somehow it's their fault. If they had only... Or even if it's not their fault, they just wish that they had said something different before the person passed.

[10:48] Lynn: That kind of, if only you had a chance to do this, or if you'd called and said this. Yeah.

[10:56] Molly: And it's like, the truth of the matter is, in most cases, you didn't know what was about to happen. It's not your fault. That's something that can be really. It creates a lot of suffering when you think things are your fault, especially things that are outside of your control entirely. Another example is, like, magical thinking, which is to say, kind of making illogical leaps, like, oh, if I try really hard, nothing bad will ever happen. Which is, like, I think, very common in America. We believe we live in a meritocracy.

[11:31] Lynn: Yeah, totally. I had a friend once in high school who was like, I believe in karma. And she wasn't like a buddhist or anything. She was just like, I believe in karma, and I've been working really hard and doing a lot of good things. And so a lot of crappy things have happened to me. So I've got good coming to me.

[11:53] Molly: Exactly.

[11:54] Lynn: Yeah. I don't think that's how it works. 

[12:03] Molly: The thing that is bothersome to me about that is like, so what do you think of people to whom bad things do happen?

[12:08] Lynn: Yeah, they've been really awful to people, and they deserved that. They deserve that. That's their karma.

[12:14] Molly: Right?

[12:15] Lynn: That's not fair. That's not fair at all.

[12:17] Molly: Right. Surely they did something to deserve it.

[12:20] Molly: It's like, oh, have you ever loved someone who was suffering?

[12:23] Lynn: Exactly. Yeah.

[12:25] Molly: You probably actually have for sure. So that's magical thinking. And then catastrophizing is just turning things into a disaster.

[12:38] Lynn: I know about this. I have someone in my life when they're catastrophizes, and I know about this because I have someone in my life who is a therapist and taught me that. I didn't know about cognitive distortions, but I knew about catastrophizing specifically and. Oh, my gosh. Yeah, it's really useful. And once you know the term and you kind of understand it, you're like, wait a minute, wait a minute. I think you're catastrophizing. Yeah. Like, you're taking this one thing and you're turning it into a disaster, a catastrophe, and maybe it'll go this direction, but let's not turn this into a catastrophe every time something negative starts to happen or could potentially happen.

[13:13] Molly: Right. And I think, for me, going through this list and being like, oh, shit, I do this one, I do this one. I don't really do that one, I do this one. It helps you get some perspective on your own thought pattern.

[13:27] Lynn: Yeah, totally.

[13:28] Molly: And you kind of see easier. Like, what are your bad mental habits?

[13:32] Lynn: Yeah. And this person, I think now that they're aware that they do this, they're like, oh, I think I'm catastrophizing again. I think I'm catastrophizing again. And that's helpful, right? So that it's not like, oh, this is real. No, this is real. This is going to happen. This is going to happen. It's like, I think I'm catastrophizing. And to catch yourself, that's probably really useful. That's an insight. This isn't reality catastrophizing.

[13:55] Molly: It can help you ground yourself. I think catastrophizing in particular happens a lot to people who have anxiety. You worry, you worry and you think, oh, what's the worst possible thing that can happen? I've heard therapists recommend spend just a minute imagining a good outcome.

[14:14] Lynn: I like that.

[14:15] Molly: And that might not stick, but at least you

[14:17] Lynn: Let your mind go there.

[14:20] Molly: You're not always let your mind go there, exactly. Back to kind of the all or nothing thinking idea. I would say no matter how long or how severe a depressive episode is, it's still important to realize that being depressed doesn't mean that your life won't be meaningful. Of course, doesn't mean even for that, if it's a three month long depression, there are better moments within those three months. There will be moments of joy, even for me, with very serious lifelong depression, just similar to any chronic illness, or any illness, really. It's not all one thing. It's not all devastation and gloom and doom, necessarily.

[15:19] Lynn: Okay.

[15:20] Molly: And there are ways to build a meaningful life even with severe illness, whether that's depression or schizophrenia or all kinds of different illnesses that people end up having. And like I said earlier, the thing about this whole conversation, really, the point is just to keep your expectations realistic. And when I started ketamine, I was told it would probably, chances were good that it would cure me within four sessions. So after a lifetime of depression, I thought, like, oh, in a month I'll be better.

[15:56] Lynn: Of course. So exciting.

[15:58] Molly: It didn't have to be that way. Right.

[16:01] Lynn: So you wish you had tempered your expectations a little bit.

[16:07] Molly: Exactly. I thought that when session three and four were coming and going and I felt better, but not perfect.

[16:15] Molly: Instead of being glad I was better, I felt disappointed that I wasn't perfect. That was just because of the expectations. Had I not had those unrealistic expectations, it wouldn't have been so devastating. And that's a hit, right? Like, you're trying to improve your mood. And it's a hit to your mood.

[16:35] Lynn: Maybe it's bad karma. Molly, what did you do?

[16:44] Molly: It's bad karma. The thing is that I once accidentally.

[16:47] Lynn: Maybe it was in a previous life.

Both: Laughing

[16:52] Molly: And the truth of the matter was that that medication had helped me more than anything else ever had. So the disappointment was a real, like, it was really avoidable.

[17:03] Lynn: Yes. If you had not been thinking, like, okay, by this fourth session, I'm going to be feeling perfect. If you had just thought, just been hoping that you'll feel better as you were, then you would have avoided the disappointment and you just would have been happy with the fact that you were feeling significantly better. Right. So if it hadn't been for the.

[17:21] Molly: All or not super grateful.

[17:23] Lynn: Yeah. You would have just been feeling good because you were feeling good. Just were feeling good but disappointed, which worse than you would. Yeah, man. Right.

[17:33] Molly: Good but disappointed. It's like. Son of a bitch. Really?

[17:35] Lynn: Yeah. I can imagine. Okay, so this is important. This is an important point for listeners, right?

[17:42] Molly: I think so. I mean, yeah, it's huge. I don't know. I guess it is worth putting in a word about acceptance versus vigilance when it comes to most illnesses that last a while. Like, if you have a cold, I don't know, and it lasts three days and you're angry about it, that's not going to ruin your month even. But if you have a longer term illness and you also are angry about it, it is going to make it harder, in my experience.

[18:16] Lynn: Absolutely.

[18:17] Molly: Having watched people and having felt a lot of anger and frustration. At the same time, some people don't want to let go of that anger because they feel like it's motivating to fight it, find a cure. Yeah. And in a lot of cases, it can be motivating. So the idea of a lot of people who study mindfulness or try to practice mindfulness do have this dichotomy, especially people who are engaged in social justice or see problems with the world that they want to participate in fixing or helping to fix. The idea that you can accept something feels counterintuitive. It feels very like condoning things that you don't want to be true. Right. Have you ever felt that way, Lynn?

[19:03] Lynn: Yeah, absolutely. What is it we can accept? I know, I know. I've been thinking about this, like, the serenity prayer and that it's been actually playing in my head a lot. I've been thinking about it like an echo chamber in my head. The serenity prayer is what God grant me. The remind me the strength to change. Remind me…

[19:28] Molly: The things I can and accept the.

[19:30] Lynn: Things I can't and the wisdom to know the difference. Yeah, it's more or less like that, but basically to. Basically to try to change the things you can and just accept that what you can't. I've been thinking about that. Who decides what we can't change? What we can and can't change? How is that decision made exactly? And this has been running through my head. Yeah. About, like, what. What is it that we have to accept and what can and can't we change? Yeah.

[20:03] Molly: I feel like for most people. Yeah. It's a lifelong conversation with themselves. Absolutely right. And hopefully you have people in your life who you can have this conversation outside of just. I feel the exact same way. I've had that conversation in my head. For I don't know. Years I was studying not Alcoholics Anonymous, but the Alanon, which is for family members. And one of the things that they say is a lot of people who are young, like, if you grow up around a lot of alcohol, you often take responsibility for things later in life that are not under your control. So similar to one of the cognitive distortions we were talking about earlier. And I think that serenity prayer question is very important for people like that who tend to take responsibility or tend to say, like, things are wrong in the world. You could do two things about it. You can like it or you can change it. It's like, well, I remember thinking that. I remember thinking like, okay, if I don't like it, I got to work to change it. And it's too big of a task. It's too big of a task.

[21:13] Lynn: In terms of, like, a social justice kind of thinking. Yeah. Well, that's the other thing, too, is it's like so overwhelming. And that's why often people that work in social justice, you can become overwhelmed. We can all become so overwhelmed in so many ways. Right. By how daunting it all is. But we do all have to continue the good fight in some way and on some level. And some of us have maybe more strength and energy to put toward it than others.

[21:47] Molly: It's important. Right. To prioritize rest.

[21:51] Lynn: Exactly.

[21:52] Molly: To these things, to play the long game, because these problems are long term, whether it is like treatment resistant depression or social injustice all over the world, in your own country or somewhere else.

[22:08] Lynn: That's right.

[22:09] Lynn: And we all have a fighting. We all usually have multiple fights. We're fighting simultaneously. That's right.

[22:15] Molly: And it aligns with that idea of all or nothing thinking really well. Right. Making a tiny difference is not nothing. It might not be everything, but it's not nothing either.

[22:26] Lynn: Yeah, that is important. Absolutely. But there's a lot of interesting stuff that's happening. My work is international, and I'm very passionate about that and social justice and equity and an international level.

[22:40] Molly: I think a lot of this is really important in therapists lives, too. Right. Like, anybody who kind of tries to do good in their job has to battle with this.

[22:51] Lynn: Yeah. What scale are you making a difference at? And it's so hard. I don't know. Yeah, this is a whole other interesting conversation. It is, yeah.

[23:05] Molly: I feel like we could do not just one episode.

[23:07] Lynn: Oh, my God.

[23:08] Molly: Whole podcast.

[23:09] Lynn: I know. And David sometimes talks about the evidence, says that you can make a greatest impact by giving money directly to the poorest people. In the world. Right. But I'm like, does that mean you're not making an impact by giving money directly to a homeless person in America or supporting some other cause, like an abortion clinic? There's so many things. What does that really mean to the greatest? You define the impact. I don't know. Right?

[23:51] Molly: Yeah. And also, when you're thinking about your own time, more than your money, like your own time, it is, in my experience, helpful to think about not just the greatest good that can be done, but what's the good that you fit best with.

[24:11] Lynn: Yeah. And that's absolutely right. That's absolutely right.

[24:15] Molly: Because it's really hard to shape yourself into the person who, if you're an artist and you're trying to be an economist, it's just a rough life.

[24:24] Lynn: Yeah. Or vice versa.

[24:25] Molly: You might end up getting super depressed, honestly. God, that's not far from what my story is. The wisdom to know the difference between the things you can change and the things you can't, I think is a really, like, that's a really valuable nugget that we all. I feel like the conversation is really valuable. And also, I was really grateful to hear about the. Do you know what the Nap Ministry is? There's this woman, I only heard about her. A friend of mine was like, oh, yeah. There's this Instagram account called the Nap Ministry. I really recommend it.

[25:06] Molly: It's about how sacred rest is, especially ministry.

[25:13] Lynn: Okay.

[25:14] Molly: Literally napping. Yeah. It's not an acronym. And she does these public events where people nap nice in public places.

[25:22] Lynn: Okay.

[25:23] Molly: And it's about the value of rest.

[25:25] Lynn: I love it.

[25:26] Molly: And how rest, especially for oppressed people. Can be a revolutionary act.

[25:28] Lynn: Oh, that's awesome. 

[25:32] Molly: Yeah. I really love her work. And I think the thing that aligns well with what you were saying about international work and international equity is like, it's important. It's been very, very valuable for me in this conversation about acceptance versus fighting, like, vigilance versus rest, is to zoom out and say, as a person with lifelong, pretty serious depression, I wasn't dealt the best hand. Like, fair enough. Right. But I know for a fact that I wasn't dealt the worst by any stretch of the imagination. Not even close. It is very easy. My partner also has a disability. And we've both kind of shared stories laughingly with each other about how people. Are so quick to give up on us.

[26:28] Molly: Like friends, like clerks at stores, like physicians you meet for the first time, be like, wait, you can't see well, how did you get here? How will you get home as if.

[26:42] Molly: You just now became blind. And they're devastated by the concept. And it's like, I've had some time, I've figured out how to navigate as best I can. Are you okay? I'm fine. How are you, doc? And it's important just to keep that in mind that the things that you might think are insufferable actually are not. They're really not.

[27:07] Lynn: That is a good point. And I think that is so important. And keeping it all in perspective and the global perspective is so important. And having lived in some of the countries that have just some of the most, the most extreme levels of poverty in the world. I know that and I've seen that. I know you have, too. And yeah, it's important. I also think we have to remember that the things that we do suffer as privileged as most of us as we are, and most of us listening to this podcast are. We have to also, I think it's good to keep that in perspective, but then also remember that we still do suffer with the things that we go through. We still are suffering and it's still valid. Right. And we have to validate ourselves and validate one. Yeah.

[27:59] Molly: It's legit. I really liked what Paul Farmer used to say about this, that illness especially, but all kinds of suffering tends to happen along gradients. And actually, Robert Sapolski, who you and I have talked about in the past, has really interesting things to say about this, too. He's got a great Ezra Klein interview about this where it's like, we don't understand suffering on a global level. We don't even understand it on like a city level. You look at your neighbors. And like, that's true of other primates as like, their stress hormones go up when everybody around them is doing better than. That's not. They're not looking at the next troop over, they're looking at their own troop. And that's it.

[28:43] Lynn: Can I just say that I'm devastated that Paul Farmer died suddenly and unexpectedly and decades too early. What a loss. Yeah. Yeah.

[28:56] Molly: Early sixties. Horrible.

[28:57] Lynn: Horrible. Yeah.

[29:04] Molly: Um.

[29:07] Lynn: Thank you for sharing your story and the important message of all or nothing. I think it is huge. And I will just share something like, one. One way that I can empathize a bit is that I do suffer from chronic migraine. I've really only been really dealing with it for a couple of years that it's been truly chronic. It started up in summer of 2020, and I just had a bit before that. And I would say I feel like I understand to an extent, it doesn't affect me anymore because of medications and lifestyle changes and different things that I've discovered over the last couple of years. I'm not completely laid out like I was a couple of years ago or even a year and a half ago, but I kind of understand some of what you're. I don't understand exactly what you're saying, because it's not the same as depression, but the sort of idea of a chronic illness and something that affects you on a daily basis and having to accept versus fight, and I do understand that. And having tried some different medications also, and having some that sort of wear off over time and dealing with that disappointment and kind of like, okay, do I try something else, or do I just accept that this isn't going to be 100% cure? But most people aren't 100% cured. Most people that have chronic migraine, they might still have five migraine days a month or 15 migraine days a month, or at least two. And so I'm lucky if I just have a handful. And coming to that realization, it's like, well, this is what I live with, and this is just a chronic illness. And actually, I can find ways to just manage this. I have my ice packs, and I sleep a little more than I used to, and I maybe don't do as much intense exercise as I used to. And I just have lots of my lifestyle has changed in many different ways, some small and some big. And I accept that for the most part. And I'm really glad it's not nearly as bad as it was two years ago. I've made a lot of changes since then, but I've. Medical and otherwise, but I'm cured. It's not over. And when people ask me about it, like, oh, are your headaches or your migraines gone? Or are they like, no, but managing. I'm managing. I'm not debilitated. I am sometimes, but I'm not debilitated all the time.

[31:48] Molly: Right.

[31:48] Lynn: But I'm managing, which is great.

[31:50] Molly: My therapist told me that I didn't know before that at all was that a lot of people who are, especially in the social justice world, hit a wall around 30.

[31:59] Lynn: Oh, interesting.

[32:00] Molly: And it is because your body starts to process stress very differently in your thirties. And so that stress that was motivating and exciting and thrilling in your 20's becomes, like, it starts to wear you down as opposed to kind of lift you up.

[32:18] Lynn: Interesting.

[32:19] Molly: I know it can also be destructive in your 20s, but in your 30s, it can really take a toll on your mental health. And on your physical well being. And he said, you can kind of expect that every decade of your life, and you have to adapt to it. You have to accommodate it, or it can be bad, and it's fine to accommodate it. That's what learning and growth is. It's when you don't accept change that it can really hurt.

[32:48] Lynn: Yeah, that's really interesting, and that's really good to know.

[32:53] Molly: I thought that was super helpful. You should learn that in grade school.

[32:58] Lynn: Yeah. And I feel like we should be learning about that in college and in grad school, too, depending on what field you're going into. I wish I had learned about that, too. Be prepared. If you're going into something that requires a lot of empathy, you need to be prepared for this. I mean, I know my job. Sometimes it can be very emotional and a lot of stress about real human suffering. It can be really intense. I sometimes really feel that the stress from that and, yeah, it can take a toll.

[33:33] Molly: Yeah.

[33:34] Molly: And again, as we were saying, with ketamine as a treatment for depression, it's a matter of expectations. If you expect things to change around 29 or 32 or whatever it is, and you're looking out for it, it won't catch you by surprise. It won't feel scary when it happens.

[33:52] Lynn: Yeah, that's good to know. Okay, well, I'm about to have a big birthday later this summer. Yeah, I'll be thinking about that. Yeah.

[34:06] Molly: Happy birthday in advance.

[34:08] Lynn: That's still almost two months away, but, yeah, something to think about.

[34:12] Molly: We'll ramp up.

[34:13] Lynn: Yeah, exactly.

[34:14] Molly: We got time.

[34:17] Lynn: I won't be thinking about it in an all-or-nothing way at all. It's not exactly. Well, when I have this big birthday, this is how I'm going to feel.

[34:26] Molly: Everything will be different.

[34:27] Lynn: Yeah. Definitely not going to catastrophize it either.

[34:31] Molly: I did that when I was turning five years old. I woke up early in the morning, went to the bathroom, got naked, stood in front of the mirror and started to cry. My mom came in like, honey, what's wrong? And I told her, I don't look five!

[34:47] Lynn: Poor thing. Oh, man. 

[34:51] Molly: She was like, that's not how it works. That's actually a perfect example of all or nothing.

[34:54] Lynn: You were kind of anxious as a little kid.

[34:58] Molly: I thought I was going to be a Big Kid all of a sudden.

[35:00] Lynn: And you're like, I'm just little Molly.

[35:03] Molly: I'm just the same old me.

[35:05] Lynn: Poor little thing.

[35:06] Molly: All right, thank you, Lynn.

[35:07] Lynn: Thanks, Molly. See ya.

[35:11] Molly: Where is the record button? There it is.

[35:16] Molly: That was episode eight, the final episode of our first season here at Ketamine Insights. Thank you so much for joining us. Making this podcast was a really big undertaking. My stamina and mental capacities are not what they once were, and that's something I still really really struggle with, which made making this podcast a real challenge, both logistically and emotionally. So I just want to spend a moment to thank all of the listeners who rated the show or sent in encouragement and positive feedback over the last two months. It's been really helpful getting that feedback from you. I also want to send out thanks to all of our patrons at patreon.com/Ketamineinsights. You've made this show possible. If you're a regular listener, please head over there and help us out. We really appreciate it. Season two is coming, so we are currently surveying Patreon subscribers and collecting suggestions for episode topics. Email us with suggestions or with anything at all at ketaminsights@gmail.com. Two last things I want to say to Lynn, that working with you has been an absolute joy. I'm really, really deeply grateful for your generosity and your curiosity and your unwavering support as a host, but especially as a friend. And finally, my boyfriend, Demond. Thank you. Thank you for your enthusiasm for my projects. Without you, this podcast absolutely never, ever.

[36:57] Molly: Would have been made. There's no question in my mind about that.

[37:00] Molly: And thank you for caring for me and for making me better and for making me laugh. You are a joy and a relief, and you inspire me to rest and heal and to relish life. And I love you.

[37:17] Theme Song: She's sometimes sad. She's sometimes happy. She's doing things to make her life less crappy, trying the treatment that's new on the scene. Let's sit back and talk about ketamine. Close.