Episode 1: What Are We Doing?

Welcome to Shrinking America…this time, for real. This episode, recorded in January before any of our other content, dives into a conversation about what got us going on a podcast, who we are as individuals, friends, psychiatrists and as Americans, and demonstrates a bit of how conversation flows so often in long-term therapy. The distillation? Kyle captures it with “seeking to understand what is happening in our country in this moment through a biopsychosocial and dare I say philosophical lens.”

Deeper Learning Points

• 🧰 Defenses: Intellectualization: “Anna Freud defined these defense mechanisms as ‘unconscious resources used by the ego’ to decrease internal stress.” Basically, they’re things our brain does fairly automatically to help us cope with life.
• The speed of modern life and how this is all probably too much
• 🧰 Erikson Stages are a useful construct for understanding different phases of life and what we seek to accomplish, in the world and internally, in each era
• The Savior Complex is what it sounds like…a tendency, to varying degrees, to help or try to save others, sometimes too much, often because you get something from it too
• Vulnerability
  • The Power of Vulnerability by Brené Brown
• Creativity: The process of creating and of appreciating the creations of others are both deeply human and deeply therapeutic. We didn’t discuss it beforehand, but ending our episode with a poem felt like a spontaneous moment of feeling into the power of art to define the human experience.
  • Ranier Maria Rilke, “Live the questions now”
• “Big 5” : We talked about the Introvert/Extrovert divide that makes up part of the "five-factor model" of personality: Openness, Conscientiousness, Extraversion, Agreeableness, and Neuroticism. If you don't know where you fall on these scales, taking an online test can be a fun way to get to know yourself a bit better. 
  • Quiet by Susan Cain
  • Brian Little and personality
  • Culture and Introversion: Country by country, even state by state, this differs
• The Enneagram is another one of many tools for personality exploration (just like the “Big 5”). These tools certainly aren’t the only way to understand ourselves (if you prefer astrology, that’s alright too); but  they can provide a useful jumping off point for introspection.
• Daniel Kahneman's "Thinking, Fast and Slow"
• 🧰 Rupture and repair is a core theme in human development and long-term therapy; this quote captures the concept nicely: “Rupture and repair are key ingredients to connection. When ruptures in relationships occur, which they will, it is important to revisit the situation to work on restoring safety, regulation, attunement, and understanding. Through engaging in this process and providing consistent secure base and safe haven supports, conflicts have the opportunity to heal.”

Transcript

Episode 1 Introductions

SPEAKER_01 0:04

I'm Sarah. I'm Kyle.

SPEAKER_00 0:07

And I'm Jeremy.

SPEAKER_01 0:08

We're three psychiatrists, military bats, and friends. And this is Drinking America.

SPEAKER_00 0:15

Where we put America on the couch.

SPEAKER_01 0:27

Something is happening in America. You felt it. Maybe in your family, your town, your feed, your gut. The ground feels less stable than it used to. The story we were told about this country, about what it promises, who belongs, what we're all doing here. Feels like it's shifting under our feet. And maybe it has been for a while. We're three psychiatrists, military veterans, and friends. We spend our careers sitting with people in their hardest moments, trying to make sense of what's driving them, what's hurting them, what they're defending against. And somewhere along the way, we started wondering what would it look like to turn those same tools on the country itself? Not to score points, not to take sides, to actually understand it. We called it shrinking America. Partly because shrink is what people call us. And yes, it's a weird profession with a bizarre history. We'll get to that. But also because so much of what we're watching feels like a shrinking. Of the American dream, of the middle class, of community, of the shared story that used to give us some sense of who we are together. We're not going to pretend we have the answers, but we do have a process. The same one we use with our patients. More honest conversation, curiosity, and a willingness to sit with uncomfortable things can be a path toward understanding. Maybe even towards something like healing. This first episode is us figuring out in real time what we're even doing here. Which, if you've ever started therapy, you might recognize. Honestly, it feels like the right place to start.

SPEAKER_02 2:24

So what are we doing, guys? How are we doing?

SPEAKER_00 2:26

Wait, can we try something where what's the first thing that comes to mind when we say, well, what are we doing? Why are we doing this? Oh you look like you're gonna say something.

SPEAKER_04 2:38

No, I just like the idea so much. Um yeah, because my mind kind of goes big abstract concept with that.

SPEAKER_03 2:48

It's like we are are fine trying to within ourselves too figure out what what we can do in this moment to feel purpose, to feel connection, um,

What Are We Doing, Guys?

SPEAKER_03 3:05

to create all three of us are doctors, we have some savior complex, what the hell, you know. Um, but also I think have fun. Yeah, I can I go back to that too. I think friendship is so important, you know, that's that's such a big value, I guess, of mine.

SPEAKER_04 3:28

Um and I love shared visions and purpose with other people that I feel like you know are part of my my tribe and like-minded or whatever.

SPEAKER_03 3:42

With that, and so um I think we it's been fun to like develop okay, if we if we want to do something like this together, what is what do we want to say? And um, so I think right now we're figuring that out. And the scariest thing at a time like this is to feel isolated in your fear and your experience and your not knowing and your that that's like a if we're gonna talk about the things that we try to do to manage this, this is for us as much as it is for our savior complex, right? It's it's to like be honest with where we're at, with where we're at, with where the world's at.

SPEAKER_00 4:20

Uh is this your answer?

SPEAKER_03 4:23

No. Well, maybe I was looking at the bookshelf trying to find a word that's talking about the answer.

SPEAKER_02 4:28

Integration, maybe, like which feels like a very therapy-y term, but like everything, but yeah.

SPEAKER_01 4:34

Like, how do we take what's happening out in the world and like bring it into our daily experience in a way that's healthy, not too much, not too little, not too avoidant, but not too anxiety-ridden, like, and trying to help other people, like to that one of those first concepts of like we learn how to do these things sort of slowly through training, and now we know a little more than the average person. And so trying to share something of how we understand the world, how we connect through these ideas, how we process our own stuff, um, and thinking there might be value for that, and especially value in how a couple people with the same training do it together, um, and how they do it pragmatically. Cause so much of what's happening in the world feels helpless, hopeless.

SPEAKER_03 5:20

Um, and people are looking for like what do we do individually, collectively, whatever.

SPEAKER_04 5:26

So that feels I don't know, integration. I'm not sure how I got from Yeah.

SPEAKER_03 5:34

No,

Coping and Creativity

SPEAKER_03 5:35

I think it's it is something that there's comfort in that all three of us have some of the same background of training too.

SPEAKER_04 5:43

Yeah, you know, that like, okay, you're navigating this too with me, like me and like finding similar ways.

SPEAKER_00 5:50

And we've done therapy group together where we've sat in spaces like this before where I feel like I know both of your strengths and how well they complement areas that are not as strong for me. And so I also trust that with you too.

SPEAKER_04 6:08

Yeah, and that we neither of us have weaknesses, just strength still not strengths are not as strength.

SPEAKER_00 6:17

Not as strong. That's a reframe.

SPEAKER_03 6:22

Um yeah, there's something to be said for going through, like, not everyone understands medical training or even our shared experience in the military is like some there's something about going through shared experiences like that beyond the language, you know, professional training that really lets you see other people and have something that is is binding and bonding. So you're right, like we really do know each other from some pretty interesting at times stressful, quite developmental experiences.

SPEAKER_04 6:50

Yeah.

SPEAKER_03 6:50

And I do hope that this venture will also be an exercise in in vulnerability. I mean, it already is, right? Just we our reluctance to press before guys like yeah, um I placed many crystals around the room. Not evidence-based whatsoever. We're doctors, but still we look for alternative methods as well. And that's what also what's the therapy dog in the corner.

SPEAKER_00 7:26

Edding the therapy dog, which we should mention because we're not sure about our editing skills yet. You may be hearing some farting that's happened already.

SPEAKER_03 7:35

Um you're taking the brunt of that, Jeremy.

SPEAKER_00 7:39

Uh, that's the therapy dog. I want to say my answer. Um, okay, why am I doing this? But the thing that I keep coming back to, like it's kind of meta for me, be allowed to say. I'm gonna leave that one in. It's it's uh this is my coping with what's happening right now. Like, this is one of the ways I am coping, which is to do something creative with people that I really love and care about, and get to have fun in the process, get to challenge myself a little bit to learn more from each other, to be reading up and studying, and then also to be able to give back a little bit with the training that we've all had. It feels very apropos for this time.

SPEAKER_04 8:24

Yeah. And maybe this is a transition into yeah, like you were talking about, Sarah, like when we first started developing this, I don't know how long ago, maybe it was close to a year.

SPEAKER_03 8:36

Yeah. Um I think we were overflowing in our Google Doc

Collective Awareness and Insight

SPEAKER_03 8:41

bears have like ideas and like themes and feeling, like, okay, we can see all these things that are happening a little bit, and like some of the psychological under happenings, you know, um, and and all of that, but I think I think there's almost like this this anxiety of like you know, we ha we see all these things, but like, you know, we we have some insider knowledge and and like there was uh anxiety in wanting to to share that, yeah, you know. Yeah. Um and it's interesting now it's almost like um it it's it's defin it's almost like it, yeah, it feels even more for us now. Like less of like a hey, here's a warning of this is an interesting sort of like, you know, take a step back. Let's, you know, all these different like themes, even talking about like pop stars or whatever. Like it is a little bit more now, like we want to really make ourselves feel better, um, and help out in some real tangible way if we can. Yeah. And I go that's like your point about understanding and insight. It's like I think we feel like things are picking up pace. You'll also hear the the rattling of a crystal bracelet. That was that also recently purchased for good luck. Toolkit, crystals, yep, definitely. Uh, they're on sale currently right down the street.

SPEAKER_00 10:12

Anything that makes you feel grounded is actually worthy. Use it.

SPEAKER_03 10:18

Um, but I think we feel like if if these things cannot be brought to awareness on a collective level, how can we figure this out as a group, as a country, as a people?

SPEAKER_01 10:29

Like we feel the need to help name it for people to the extent we can, to the extent that we can see clearly, but we do have some training.

SPEAKER_03 10:36

So that feels so that's fundamental to what we do, right? Can you name what's happening with you?

SPEAKER_01 10:42

Can you bring it up from the unconscious, bring it into your awareness, and then decide what you need to do with it? That's not always sometimes that's super clear, sometimes it's less clear, and it takes a process. But my gosh, you gotta, you gotta name it.

SPEAKER_03 10:54

You gotta identify what is going on.

SPEAKER_00 10:58

Because we're asking the question now, who are you? Yeah.

SPEAKER_04 11:00

For each of us. That's where we were going. Mm-hmm.

SPEAKER_03 11:04

Who are we? We can really talk. Who are we as a group? We all get into this.

SPEAKER_05 11:10

Can you start there?

SPEAKER_03 11:10

Yeah, maybe we start there and then because we all started this journey together. 2015, 11 years ago. Eleven is a very important number in numerology.

SPEAKER_04 11:24

And in life, yeah, apparently. It was my best phone number. Yeah, Adam and I also um started our relationship on 1111. Oh, Veterans Day.

The Journey of Self-Discovery and Numerology

SPEAKER_04 11:40

Oh yeah. Do you get to pick your number when you play sports?

SPEAKER_03 11:44

Like why'd you get higher levels as long as there's not a better player that has your number? Beat him up for it. How'd you pick 11? Brenda Pantoha was uh women's basketball player for the University of Arizona when I was um went to a basketball camp there, and she was like my coach. So became my favorite player.

SPEAKER_05 12:05

She's number 11. Okay. Is 11 lucky for you now?

SPEAKER_04 12:12

You know, I don't know. I don't think I like necessarily pay. I'm not a very um superstitious person, and I don't I don't pay a lot of attention to to luck.

SPEAKER_03 12:27

But I'm starting to more now, I think. Synchronicity, let's call it that. Yeah, not psychological legitimacy. Yeah, and I think um I think it I my brain interpretes sit, like sim is like the cultural parlance for it now. Like so sim. SIM. I've never heard of it. Simulation, like it's a part of the simulation, and I see those things everywhere. Well, and it's hard not to too. It's like, okay, well, what part of it is my phone's actually listening to me that one sentence the first one that are lined up with what's happening in life, or is this a weird synchronous? Did this just keep start happening for you? I think once I started getting into psychedelics and woo-woo's, I was way more aware of it. Okay. Because I've started it comes and goes, but in the past couple weeks, I've been writing down when I'll hear something two or three times really a day, like the same thing. I had like a little list recently when multiple patients mentioned something or on the world. Man, this seems to be heating up a little bit, which is not always the case, but it is 50%. You know, that's funny though, because I do remember as a kid, I thought there was like this is like going into the nurses of like something special about me because I would like read a word and then hear it on the TV. And like I know that happens to everyone, but it was like this is happening at a rate that like doesn't make any sense. And like the weirdest words were that such a rare favorite for that in the mental status exam, I think.

SPEAKER_00 13:58

Oh, ideas of reference.

SPEAKER_03 14:00

Yeah, so you were child, so we're not gonna call.

SPEAKER_00 14:02

I mean, I had that too. I thought that if I said the opposite of something, I could make it happen. And I swear it happened a few times. And then going under street lights and they would like turn off. Wait a second, and I would notice this.

SPEAKER_03 14:18

What is it? You had a you had a um a universal remote street lamp remote. Well, that's a that's in the like very first chapter of Harry Potter.

SPEAKER_05 14:29

Oh, yeah.

SPEAKER_03 14:30

That dumbbell door has the what is he put light like putter out?

SPEAKER_05 14:37

Yes,

The Intersection of Science and Magic

SPEAKER_05 14:38

this is say it with a British accent.

SPEAKER_02 14:40

But this is the light out. Get real close to the mic. Don't lose your crystals. That'll be good. Audio. This is good though. What what is kids? It's magical. It's okay.

SPEAKER_03 14:51

We're connected with something like this kind of woo-woo.

SPEAKER_00 14:54

And then building ourselves concepts. We're building ourselves concepts. There is something special about me, something I have to offer.

SPEAKER_03 15:01

Oh, yeah, yeah, yeah, yeah. Yeah. Your autonomy, your and how much you're oversubscribing to you, you're the control. But then you like, then you said Gnosticism. We said magical things. We start using these pathologizing terms, which is true. Like, to some extent, these things that are okay in childhood can become like not okay as adults, but also we like shut down things that are magic and cool and maybe unexplainable. There's like the flip side of not all of this is pathological. Why are we nervous to say like we see synchronicities? We kind of think numbers are special. Like, what has made us think that that makes me a little crazy? That makes me not. I can't I can't say that. Um, is it because we're people of science? Is it because we've been told to not believe in things we can't see? Oh no. I know that wasn't the direction we were going. That's a really good yeah.

SPEAKER_00 15:48

My answer to that is I feel like science actually makes me think more about the things that I can't necessarily see. And wanting to understand. I think now where I would fall on if something like that was happening is oh, there's probably some scientific explanation for this that I just don't fully grasp yet.

SPEAKER_03 16:06

Like the things that people thought were magic 50 or 100 or 200 or 300 years ago, and now we understand them. Back then they would have said, That's that's crazy. That's not real. Yeah. Well, that's what that is, and this is what I talk to my impatients about a lot of times. See, when we're doing trial and error, and I'm just gonna like also life is trial and error. And like with science, it's like we we think we have the answers, and then you know, 20 years later it's flips to the opposite because we've learned more or whatever. But but science is that pursuit, it is the pursuit of proving what you think you know wrong. Yeah, that's what a hypothesis is. Yeah. And starts with observation, right? Starts with seeing something in the world happening and being like, what, yeah, creating hypothesis, trying to answer a question about it. And it's not fear of that. It's like that's actually okay that we keep proving ourselves wrong. That's actually the point. And and that is how we build our knowledge. And yeah, yes, sometimes sometimes we'll we seem hypocritical or look stupid, but but that's kind of the whole point. And then you erase that.

SPEAKER_00 17:14

Can I say what this touches on for me culturally right now is this idea of people doing their own research.

SPEAKER_03 17:19

Yeah. I was wondering if you were getting into like defending

Understanding Psychiatry: The Doctor of the Mind

SPEAKER_03 17:22

a bit of our field science, yeah.

SPEAKER_00 17:24

Because it's it it feels like in that realm, it's less about looking to prove your hypothesis wrong in the pursuit of trying to understand truly what's happening instead of I'm trying to prove my hypothesis right.

SPEAKER_03 17:39

Yeah, the anchoring bias. Yeah, yeah.

SPEAKER_00 17:42

Uh, all this data to support that and pushing away the data that speaks against it.

SPEAKER_03 17:48

Yeah. What's what's funny too is I'm realizing I was really saying we've used terms ideas of reference, magical thinking, anchoring bias. Like when we were talking about like, can you get away from how you say as a psychiatrist? Like, and and talking about it as a language, like yeah, it makes me realize more and more like and this, but being around you guys, it's like, okay, these are my friends that I speak, I speak Spanish. I think you know. Um, but it's your point about science, like that maybe that when people ask, like, are you guys always analyzing us? It's like, no, but we're observing and we're asking questions frequently. I'm seeing this behavior, I wonder what's happening there. I'm seeing this behavior in myself. Where did that come from? Like, we are always hypothesizing, speculating. I have a question though. And especially for like, because we have what what did Pacho say? Um, super punishing the hard punishing superior. Like, if you don't observe something in your friend, or you like in in your own life miss things or like feel like you were unobservant in a way, the do you kind of beat yourself up more for that because we're psychiatrists? Oh, yeah, good question. Yeah, because intellectually we'd say, Oh, of course we all have blind spots. That's why we go to therapy, we go to organ therapy. But you're right. Like, do we hold ourselves to a higher? I think of course we hold ourselves to a higher standard, right? Like we kind of have to because if you're given this great power, it's like doctoring in general. Like, if you're given this power to save lives, there has to be some arrogance and confidence, confidence question, arrogance behind that. Same with being able to interpret other people. Like, you can't even interpret yourself, right? How do you interpret other people? So there has to be some like holding yourself to this higher standard of trying to minimize the blind spots, trying to yeah, um, but which I do think is why I like do feel fully comfortable saying I have a therapist now and stuff. Yeah, it's like you usually have to. Yeah, that'll be an interesting. I pupped that.

SPEAKER_00 19:50

And to go back, Pacho was our program director for the listeners.

SPEAKER_03 19:54

Yeah, yeah, yeah. Introduce we I'm sure we all referenced Pacho multiple times for our for our real listeners. And that's like a like program director. So we went, we didn't we don't we don't like humble circle, we went to resident B. Let's do it together starting 26. Yeah, this is sorry.

The Role of Psychiatrists in Modern Medicine

SPEAKER_03 20:14

This was a preventative measure to bring him back in because he was gonna get more annoying outside. Tear the door open, let's down in here. Well, maybe we should start with for people who are not aware, psychiatrists are medical doctors. And we say that a bit defensively because um, I mean it's it's important to like understand. Like, we all get offensive about it. Yeah, I do get defensive about it.

SPEAKER_00 20:36

I just got defensive last week about it. Did you? Yes. It's frequent.

SPEAKER_03 20:39

No, it's frequent. I think it's important to say, well, to this because like it's our story. We all went to med school separately. You go to med school, you decide what kind of doctor you're gonna be. We all decided we wanted to be doctors of the mind and the brain, so we became psychiatrists, and then you go to a separate training called residency that we all met in 2015 and spent another four years learning specialized doctor stuff to be psychiatrists. So Pacho is our kind of the chief doctor for running all the little baby doctors and helping them become, you know, what we are today.

SPEAKER_00 21:11

What is a psychiatrist to each of you?

SPEAKER_03 21:14

I like that just plain description you had, doctor of the mind.

SPEAKER_04 21:18

And I think the mind is a very um like help, like very well chosen term because it encompasses all the parts we know and we don't know.

SPEAKER_00 21:35

Sorry, Tim, you're not the main real close to that microphone.

SPEAKER_03 21:42

Timmy Salad.

SPEAKER_00 21:43

Timmy ASMR.

SPEAKER_03 21:45

And that's what's cool about our field, too. I think we are the most like we have evolved in the and taken the most different kinds of forms, you know. The the bio so we we formulate our patients and the bios. psychosocial models taking in biological, psychological, social. Now of course we want to add cultural and whatever else, different types of identities. Yeah. Um but but yeah I think um psychiatry yeah tries to to make sense of our consciousness and and unconsciousness um and and how that plays out in our lives and people's problems and trying to help them either cope with or fix those. Yeah.

SPEAKER_00 22:41

I always fall back

The Art of Therapy: Balancing Science and Emotion

SPEAKER_00 22:43

on so people get confused by psychologists, social workers and psychiatrists in our field. And um I always find myself explaining one that I went to medical school I prescribed medications. I also if I feel like I'm working at the top of my training I'm also doing therapy with my patients. So really integrating those biological psychological social aspects.

SPEAKER_03 23:09

Say more about working at the top of your training doing therapy because I think people would be surprised by that.

SPEAKER_00 23:16

Yeah because I think a lot of psychiatrists have moved more to the biological model where they're thinking more about um just kind of brain medications, ancillary treatments.

SPEAKER_03 23:26

Which to be fair, I think there was a movement to like legitimize our field at some point. It was like we're doctors too like let's talk about the science let's do the neurotransmitters but maybe we've gone too far and and there's money parts to this but yeah I mean let's be honest you can make more money quicker um if you are doing shorter appointments and just prescribing medications.

SPEAKER_00 23:47

Yeah. Maybe we should talk about how we feel about working in that system. But for me that's a miserable system for myself and I think the patients are really frustrated and tired of uh that treatment in general. Yeah.

SPEAKER_03 24:00

Looking for more yeah maybe this is where my defensiveness comes from is people not understanding why we've gotten where we are as as doctors slash therapists. Because that's I think what a full psychiatrist should be is able to to kind of balance both and why we're not doing more what they think and we think we should be doing. And so there often feels like we're the face of a a medical system that's kind of broken and not giving people what is optimal care. Because it would be it would be knowing your patient totally holistically understanding them biologically providing them the therapeutic interventions while you're also saying but does this go beyond and we need to you know work with your serotonin that's optimal that gives us the most satisfaction that gives I think most of our patients most satisfaction. Yeah. The other description that comes to mind that maybe is like a little more succinct I always say this when people ask why I became a psychiatrist is like there was a WA doctor at my med school that said I became a psychiatrist so I could get paid like a doctor to be a philosopher. Yeah. That's it. And it and it's it's it is that right it is like the prestige and the money security that comes with being a doctor and that's great. But you you get to philosophize and that and that's ultimately what is probably the most important for our patients. But it is also kind of cool to have the medical training and at times you have these experiences where you're like I figured out you're hallucinating because you know you have

The Unique Power of Psychiatry

SPEAKER_03 25:41

phronotemporal dementia or whatever it may be like you actually like to do it while the doctor did you do the doctor thing. That's so cool and satisfying too yeah you have all these parts yeah this knowledge that you can tap into it's so varying. Yeah which is what's so cool about psychiatry too that just it's the my most diverse medical field I think by far. I think that's it. I mean I assume um I'll speak for myself but I think all of us had interests outside of pure science and biology and most psychiatrists do. They've other things are important in their lives they've loved philosophy or spirituality or art or whatever the case may be something that is seems like the antithesis of medicine and they were like wait a second I get to being an expert in that is important because I'm just dealing with the human experience at the physician.

SPEAKER_00 26:30

Great, sign me up like that's did you all have a time that you remember a hook that pulled you into psychiatry when you decided that was the specialty for you.

SPEAKER_02 26:41

Well no for you it was watching Silence of the Lion I can't believe I shared that with you that's the best friends and here we are a decade later you just shared it with the world I mean to be fair the late great Hannibal Lecter one of our best shining stars for winners.

SPEAKER_03 27:02

That's some nice therapeutic interna we should go to like psychiatry in in pop call like how we've been uh painting lighter episode yeah that's odd not so light out there yeah um yeah Sarah do you have did you have a moment um I feel like I had a great rotation as a third year in med school and that was big but knowing like philosophy I'm like come on like I I love philosophy I want to think about big thoughts and stuff it that clicked very quickly. I remember though like in in our residency was pretty cool because we talked about T group we got to like sit down do group therapy together we got they paid for us to do therapy with psychoanalysts for an extended period which is super cool. They did that in my med school rotation you got to sit down like twice a week with an old psychoanalyst like in their home office like um and I remember telling him I'd had a bunch of dreams about tornadoes when I was on my surgery residency. I was like I don't dream a lot but I was having all these tornado dreams he's like sounds like you shouldn't be a surgeon and I was just like it's something about that moment was so he just had that like just a little look on his face that was like I he could there was so much he knew just from that brief interaction we

The Intricacies of Human Experience

SPEAKER_03 28:30

had that he from experience from yeah interpreting dreams he just immediately had a take on who I was and what I should do and what I should and there was something about that that was like yeah there's like so much depth to humans and to those brief interactions and that's what psychiatrists do is we're just like distill it. Yeah and reflect it. Yeah yeah working at depth like working with the depth of a single statement a single dream and have like so many layers like yeah the other crazy thing too like with what we do when a patient will come back after three months for me unfortunately like you said this to me and I was like you remember that I put that in my note even are you sure that was me? Yes you do listen to me. It does matter that we're meeting yeah yeah and I similar to that like I remember because I was you know fighting the different parts of myself you know in third year or whatever when you're deciding and um wanted to be a surgeon in a lot of ways because that fed into yeah the competitive you know and sports like I liked the I liked the atmosphere of the OR. Of course I liked people yelling at me because that's the sports um and my family no and so and the prestige right and um so like I very much wanted to do surgery and then the I don't remember if it was a psychiatrist but I think it's a pretty common surgeon saying like if you can do anything else you should do it. Yeah and then I did fall in love with psychiatrist and I loved the the weirdness of psychiatry in a way I was like this is not like any of the other rotations why am I just like sitting here listening to this person talk like that's so cool. I just get to like do that okay you know and also like the things you you would see on the inpatient ward these the spectrum of humanity that you don't get access to that much in real life and you're just like and then you just go in the team room and they're just like well yeah like Mr. Jones was talking about you know whatever the delusion is again and you're and you know he's ready to go and he starts forging with the nurses it's like what okay I guess this is the medical field I can do that sounds fun you know yeah you said something I that I I thought was super great and then I completely lost it which happens in session all the time for you guys. Great thoughts have great one-liners uh yeah there's something

Navigating Difficult Conversations

SPEAKER_03 31:14

maybe this is apropos to our time of like just looking at parts of humanity and like human experiences that are so on the far ends of the bell curve that that other people would be scared of look away from and in psychiatry you just like you have to become comfortable doing that. Oh yeah things that seem almost like um taboo or like just inherently because they they press the bounds of like what is normal human um but you just you just become it's normalized but that allows you to see like you said earlier yeah well that actually what we were talking about a little bit earlier and and goes back to the why are we doing this the the comfort with really disturbing things. Yes yes and side on civil yeah yeah but but that we we have to have conversations in with really difficult people like continuously and with people that you might like vehemently disagree with and dislike but you have to find some common ground with them or move them towards something and try to heal them or whatever it may be. Yeah yeah um I think that is what so many people are struggling with right now too like we were just saying like people family members friends or just seeing people in the news just being like how are these people doing this how do we like talk to these people or continuing some kind of relationship. And the pro tip we'll probably talk a lot about this like one of the reasons we go to our own therapy one of the reasons our program had us do all these different forms of personal therapy not like learning to do therapy on others was that ability to like know what's happening in the moment for you. People don't realize like when we're doing our best work doesn't always happen but like when you're doing therapy you're very cognizant of what's happening internally to you. How are you reacting to this person? Like how should you navigate what is the what is the kind of timing or input you want to help them see something but you're also trying to be spontaneous and organic. You're trying to do all these things at once but it really a lot comes down to understanding your own reactions. Yeah internal regulating exactly managing them because everything should be focused on what's happening for the person you're working with. That's hard. But I think that does let us see a little bit of the world right now because sitting with discomfort and not reacting but just being like wow this is what's happening for me inside related to this thing and then thinking about how do I move forward with this? How do I help myself handle this? How do I make an intervention with this person? Like is is our best work. Um yeah that's a skill set that like it's such a soft skill set that you don't always know that you're building but yeah that that is kind of what we become specialists in. And again I we're figuring out this podcast as we go but I as you're saying that right like there's a part of me that's like we can teach about monitoring counter transference here. That's that's what you're describing. Like that's our trade term for it is like and so Freud

The Soft Skills of Psychiatry

SPEAKER_03 34:38

talked about transference and and countertransference which is basically like how you can transfer past experiences onto someone that's in front of you. And it'll bring up things and your emotions trigger things within you and you you can want that that's happening for the patient and you can you can recognize that and that's happening to you and that's the countertransference and like how to how to manage that and um yeah.

SPEAKER_00 35:10

This takes me back to actually the question around like do we beat ourselves up than if we don't know ahead of time things that are happening even in our own lives. And because I I find that being a fantasy and in fact we kind of touched on it in our what pulled us into psychiatry a little bit was this fantasy that somebody could see you within a few minutes and know things about you that you don't know about yourself or or can't see in yourself. And um what I've landed on my my way to counteract that because there was a time that that's what I wanted to be you know I wanted to be that type of psychiatrist that could just read you immediately and pick up on things and what I've landed on is I don't have to be that what my skill set really is the soft skill set that you're talking about is the ability to stay in the present moment to get interested in things and get up close with them and notice if I'm having a reaction where I'm trying to push them away or but just noticing these things and then asking the questions in the moment. Yeah. Which we spend a lot of our lives avoiding.

SPEAKER_03 36:15

Yeah oh that is it's funny you made me think of we were all in the military together there's a joke about psychiatrists being wizards or magicians in the military which comes from disappearing people but what you were describing magical thinking what you were describing yeah that's like magical power almost people think psychiatrists have to read minds literally and it really is pattern recognition it's paying close close attention but yeah there is some interesting you said like surgeon right like there's power there's prestige there but psychiatry has a different kind of power that even surgeons don't right like we can see inside your mind we know things about you that you don't even know yourself.

SPEAKER_00 36:49

That's an interesting yeah and there was some interesting discussion around sometimes like residents then weren't making it in surgery were going to psychiatry at higher rates. Yes uh which they were trying to understand like what would be the underlying psychological drive there.

SPEAKER_03 37:05

I had a resident tell me that um and

The Journey into Psychiatry: Personal Stories

SPEAKER_03 37:08

he was like well they're both the they're like the two most intrusive fields. Like you're operating within s the sphere the somebody's body or within somebody's mind not in a direct way but like they're that is kind of a cool like way to draw parallels between two seemingly very different medical fields is like yeah they're pretty darn intrusive.

SPEAKER_00 37:27

Well and they will even talk about therapy as like in surgical terms at times like we need to sew them back up before we put them back out into the world or you know um which is which is interesting language to use about therapy.

SPEAKER_03 37:42

Yeah well yeah and I use the surgical metaphor a lot of times when I talk about trauma focus psychotherapy where it's like the the avoidance cycle like if you if you let an abscess just you know faster um or you don't don't go in and like actually process memory then you're not really actually doing anything therapeutic or curative not that we ever cure but yeah and then I think there is a lot a lot of people in our field you know um present company I'm sure like included to some degree right um like go into it to understand ourselves too yeah um yeah and I I imagine too with people that aren't cutting it in surgery like trying to figure that out or they get their program director's like we need to go to therapy shit out because you're stressed because you're not cutting it um and then they're like oh this is kind of cool also the hours are much better like yeah if you had an hour I get to wear cardigans yep glasses um so the first time that I remember being pulled into psychiatry was when we were doing residency it was actually it was prior to that it was our addition rotation for it was a military residency.

SPEAKER_00 39:08

So it was a patient on the end patient ward it was just my first time witnessing mania up close and like trying to understand what was happening like behind her eyes like the the way she was speaking was so interesting the amount of thought she was having and the themes that kept coming up for her. And I just remember being completely just enthralled with this and it's like that's what I want to learn. That's what I still want to understand at the end of medical school. And then also I realized that with my performing background you do a lot of people watching in acting because you're trying to emulate and and look like another person. And this is a field where it is people watching. You know you're you're watching their movements the way that they talk the way they move their mouth their facial micro expressions you know how they respond to different people in the room like it's just uh such a powerful opportunity to get up and close with the person and to watch so many different aspects of them to try to understand them.

SPEAKER_04 40:17

Yeah I mean I think yeah there's so many parallels between theater and and what we do in in therapy and even like we call it roles right like the the role of the therapist there is a patient illness script sometimes you know all these different parallels but I really do

Exploring Identity and Vulnerability

SPEAKER_04 40:44

want us to like spend a little time talking about who each of us are too you read my mind I'm so right now because you mentioned your theater background and you know so what like parts of our identity are we bringing to this are salient to us to we think for our listeners all of our listeners to me's our first this is maybe this is uncomfortable because we don't do this in a whole lot when we are in professional roles sharing maybe that's why you want to it too yeah it's not about us it's uh she can focus on the patient.

SPEAKER_03 41:25

Exactly it's like very mindful when you share things and can be very powerful all that stuff.

SPEAKER_00 41:30

So like it's also a way that to see and we're avoiding talking about it right now but it's also a way of um interacting socially and still protecting yourself from you know sharing about yourself or becoming vulnerable. Like it it was a side effect of training that there was a time where my social relationships and interactions I found myself entering that kind of more psychiatry role so that I wasn't actually having to you know almost be on the same level in some ways and be vulnerable in those social interactions.

SPEAKER_03 42:05

That's a great I think it also like recalibrates what feels like a healthy back and forth in an because so many interactions are eight hours a day or whatever like that person's speaking 75% of the time and you might be commenting 25, 20, 10, 50, whatever very mismatched and you've mentioned narcissism at least once like now it's become very like well known in our culture, talked about maybe over talked about but I think we're all aware of that as a pathology we don't want to have uh and so yeah I I feel the same way like the idea of an equally matched dialogue yeah kind of feel felt weird or even still feels weird. Like if you're taking up equal space it's like wait am I taking up too much space which also might be a woman thing like there's a lot of complexity there. But yeah it it kind of like screws up your sense of what is a normal dialogue sound like well most of my dialogues sound like me listening and telling someone else's story. That's a really interesting point.

SPEAKER_00 42:59

That's had not really thought about when I was religious in the past I had a road answer for this um yeah when someone would ask you like who you are which I feel like was one of the drives for religion for me and a way to treat like existential anxiety because it has all those very short easy answers.

SPEAKER_03 43:21

And I think that's a big part of who you are too is the the fact that you said when I was a religious person. Yeah. So now yeah that's a huge perspective I think okay what's also hard about this question is it feels like we do need a blurb and it's like but that's the anti this is what we do. Like I don't know who I am like we start figuring it out.

SPEAKER_00 43:41

Like I'm not a resume like that's we just free associate uh what first comes to mind who answered the question. I don't know for me. Yeah the answer nice I'll take that one.

SPEAKER_05 43:54

Fluid creative yeah well and I you're not playing

SPEAKER_02 44:00

leader. No, oh yeah.

SPEAKER_03 44:03

Yeah, exactly. I'm gonna bring in a learning point here. But it like you said, it we do try to be present focused and and free associate. And there's the value in that and learning about, you know, what's in our minds with that. But but one of our

The Dialectic of Preparedness and Flexibility

SPEAKER_03 44:25

biggest themes I think is is the dialectic and like the value of both like having some some preparedness, right? And some direction. But a flexibility and willing to like explore somewhere you maybe didn't expect to go or whatever it may be. And balancing that and and figuring out okay when when should I be a little more rigid and when should I be a little more flexible and adapted. Let's start easy. Introvert extrovert.

SPEAKER_02 44:59

Yeah yeah oh we could do big seven big five yeah yeah the Enneagram or something. Yeah that would be that's like an easy access.

SPEAKER_00 45:07

That's like a well maybe this is partially why people use these. Yes. Because uh we're all looking to understand ourselves more. It's partially why psychiatry is so interesting. But it's little snapshots astrology. Yeah exactly trying to sprigs yeah like reading something that tries to describe it's easier to say yes or no that is that isn't introverts for we got it's not gonna surprise you an ambiverty part to nail down there nail me down in any category dialectic baby it's my favorite wearing an openly gray uh yeah yeah living in the gray space yep yep yep moving on Jeremy see how we did that um I would say the same I think I'm I'm both like I can be extroverted in I extroversion for me feels more like acting sometimes like I I can I can act like a very extroverted if you personally control it if true you will be extroverted to the environment. But if I I would say more so and especially as I'm aging I'm using what I'm saying like my recharge time as introvert so I guess I would need to say introvert. I just learned what I am so thank you all.

SPEAKER_03 46:31

Yeah for good power of good therapy uh introvert for sure why lifelong prove it Kyle got me this little gift it says something about books and people and for that I don't know deeply I I explained this like what is the definition I read in that book Quiet I think it was the book quiet that definition and that many years ago many many that how do you recharge do you recharge with other people or do you recharge on your own Brian Little he's a Harvard psychologist who did introversion and extroversion is that the the actual there you go and it's restorative niche is the um the term of like yeah how do you recharge which setting yep hey buddy

Understanding Introversion and Extroversion

SPEAKER_03 47:17

it's no star therapy dog more to me as I for everyone don't wish you guys would hear he's really too bad you can't experience snout you explain that pro just explain that a little bit more because I think it's pertinent I feel like people don't so he talked about kind of like okay where's your your set point for like your level of tolerance for like stimul external stimulus input yeah and so for introverts um you're kind of chronically overstimulated and so you seek less environments with less stimulation um and so that is how you recharge too and so anyone who is um innately more introverted like you can obviously go give a speech or go to a party but then you will need you will crave an environment of less stimulation after that and need to recharge extra vice versa they will um they they're chronically understimulated they like caffeine that's their you know mind-altering substance of choice they seek you know high stimulating adventurous activities or lots of people more stimulation and then if they need to go listen to some music quietly with their spouse or whatever because their spouse wants them to then they'll like be like okay but then I'm gonna go to the club after or whatever to get their their level of stimulation. Yeah their recharge introverts can like hang out with people often very much like hang out with people but their limits are different there yeah yeah I do think it's interesting I think in social media you know you you maybe this is just my algorithm because maybe I am a little more introverted but like the the recharge right and I think that's in part though because our our society's level of stimulation right is has on average like we have leveled up. Yeah we're all chronically overstimulated well I wonder about the numbers on I think they say it's like 6040 how people scale on 60% of society is extroverts at least in our culture I think there is variability 40% are introverts. But I wonder is that because extroversion has been more societally acceptable for a long time and now I wonder if the numbers are changing because it's it is so overstimulating and people are just by necessity. Like I really wonder how much of this is like internally driven versus introverts don't probably make as much money, get promoted as much, like aren't as cool as people are extroverts like I wonder if there's a lot of uh try to put on like act performance perform mask whatever term you want to use for like playing the role that you think you're supposed to play yeah yeah what if you had to distill who you are down into a sentence

The Nature of Self-Description

SPEAKER_03 50:10

that's it I'm a little like improv games we'll have to cut out some of the silence of this one. No that's what their silence more oh true get our listeners comfortable with the silence of our podcast. We're back to the original question.

SPEAKER_00 50:27

Who am I? Who are you?

SPEAKER_03 50:30

I think I'm I don't know I I don't know good answer.

SPEAKER_00 50:34

I think I'm still feeling yep there it is um I okay I want to go if I wait let me hold my crystal um if I had to describe myself and this was part of honestly like a hallucinogenic therapy experience that I had um I would say now I'm extension of source which is something that I never really thought about in the past or that's not a word I used in the past. I used to call myself a son of God was uh raised Mormon so there was definitely a religious component there. That's really shifted for me now. So I think I'm an extension of source I picture it as like we're all in this ocean together connected interdependent on one another and each of our lives is like a wave on the ocean very Buddhist idea.

SPEAKER_03 51:34

And I kind of like uh we had a I had a mentor at Resensi that was Hindu and one thing he would always say and I can't remember exactly which um beta this was from but he would say you know that the whole moral of the story was do your duty so I feel like that's where I am like I'm uh connected to some sort of source and I'm here fulfilling some duty and trying to figure out what that is and what I'm called to and when it feels authentic I know it and I follow it

The Role of Connection and Duty

SPEAKER_03 52:05

I know that was super nebulous but no but I mean going back to how we all met each other too like in residency whatever that award was was that you won our our our um fourth year where it was like this is this is the resident we can kind of all depend on this is our most empathic kind of person I think um whatever that duty is for you can like you you are very present focused and and you are such a good friend to two people and I I I'm sure it makes you a great psychiatrist too you know um that you really do listen you really do empathize and like um yeah and I think are so willing to adapt and flow um I think that's very cool to who you are.

SPEAKER_04 53:06

Thank you.

SPEAKER_00 53:07

This is also how therapy helps us see ourselves to get to hear your perspectives of me and also helps me define myself well I'm trying to think I just remember this from talking with one of our uh third year uh mentors that we all share.

SPEAKER_03 53:27

Yeah um yeah in talking about how like whether it's through writing or or through talking yeah that that's how you organize your thoughts. And that's a huge theme of Harry Potter um which maybe that's belongs in my sentence somewhere the influence of that in my life but but um but yeah like talking through it isn't just talking too it is organizing yourself and your life and how you think about things and that that give and play in therapy is helping that whole process. Yeah you are creating your reality yourself which is kind of cool because it does give you some efficacy but like you're you're forming synapses as we're talking right now exactly like you were co-creating your reality with yourself with source with yeah yeah yeah and strengthening that yeah um yeah how do you want to describe yourself hmm well it's funny we started with kind of like big five traits or Meyersberg or whatever um but yeah I mean I do think that that any what I mean the opposite yeah then you are like I'm a Buddhist monk and I'm the ocean but isn't that like that's what we started out with. That's why we went into psychiatry because like this is your career is that the way you described yourself like that perfectly yes encapsulates what a really deep connected psychiatrist does like they're a guide a mentor a teacher like coming from their own experience of of figuring out where they fit in the universe and like helping other people like that we're gonna pay to do that we're getting like and to think about you know Prozac whatever two two thoughts two thoughts on that I have to

The Influence of Personality and Astrology

SPEAKER_03 55:16

one that is so key to who you are you like have this very deep like thought connected to all of that you pull this this really profound thought about all of that that is again so core to who who you are and to me the whole time I'm hanging on to this I have such a good joke to have right now this is why we're doing this together because Jeremy's also water signed and that's very important to who oh true I didn't even think of that wow yeah yeah astrology is becoming Scorpio Pisces a Leo and yeah I'm very much Leo energy right we've got a lot of water signs over on the side yeah I know that's what I was gonna bring up I'm a Leo that's where I'd like to start from no but my Enneagram is a seven which is enthusiast okay which I think truly does just like I I identify with that so hard like as you know in my role as like a team captain in various forms, right? I love doing that. I love having a shared purpose and a team around me that we can like and experience this same thing together and and and all the hardship of it together and like go towards something that we all believe in. So that's big for me as well as like the like the jokes all the fun like there's this clip of um March Madness which is like my favorite time of year the whatever I don't even remember what team he's on but they lost and and the um journalist asks him like what are you gonna miss the most the senior um and he cries and he like takes a moment and he just goes yeah he goes team dinners and it's like it everyone that does like team sports is that yep. I remember too true. Yeah and it's about it's about that for me. It's about like friends are huge for me and just laughing with friends I think is like what I what I enjoy most in life and when I had my own profound experience that was a huge part of it was that that's part of my purpose is to help to to laugh at friends to help people laugh to but um yeah just enjoy humor and because we kind of have to yeah that's one thing I would say about you is you you always kind of the hype person you know help everyone around you understand their strengths feel empowered you create a team wherever you go it's just natural yeah for you and really funny and fun.

SPEAKER_00 58:08

Thanks.

SPEAKER_03 58:11

What where am I now? Um yeah I've been trying to see if I can receive that not feel too uncomfortable with it. This audio but I'm looking at something about Kyle's face or something about I don't know something as he finished making that statement and Jeremy started talking I don't know maybe it's the energy in the room this is what we tell there's something yeah well and I think again going back to why we're doing this too then I probably am repeating myself a bit but that's that is the big part of this.

SPEAKER_04 58:43

So yeah.

SPEAKER_03 58:44

I think we do need to acknowledge Timmy's uh it's not any of us through that whole conversation which I was also noticing by the way we all came together at my house and I'm very uh grateful that you guys made

The Dynamics of Friendship and Teamwork

SPEAKER_03 59:01

this journey in a cold staff in Florida or in Cold Staff. Yeah um and uh yeah Florida we'll it we'll just use as a placeholder name for um you know Taylor Swift's favorite um place to write a song about um I mean as I was thinking Taylor Swift as you're talking I'm like this ex you you speak about Taylor Swift in so many similar terms to what you described yourself as and I think it's why aren't we diverge on like oh yeah not that yeah like because I'm gonna say something about depth for me right depth and like intensity and authenticity Scorpio Scorpio Pisces Pisces like divide there. But like you for you a a concert like what she puts on the energy the hype the connection that's like so core to you and for me hyper introvert I'm like I'm not sure that like however many tens of thousands of people in a stadium and like done the same that doesn't feel the same way to me because but hearing you describe yourself just all stuff I know about you but yeah like we've been having a like a longitudinal discussion about Taylor Swift who we love all of us to greater and lesser degrees. But we've been trying to figure out like our different vibes from her and how yeah do we actually describe ourselves in relation to Taylor yeah that's we we know why don't we then even try and get on that vein but I think we start that eight your five pops on but that makes it makes a lot of sense but what I think about is cool for our friendship too is like we have a lot of shared quality we do and shared background we should do and do you all want to talk about that thoughts there I mean mostly that perfectionism yes we'll get there stick with um it's round one next episode. But then yeah we have these like diverging yeah traits as well but I think what's cool though one of the things we do share is I think we can appreciate those about each other to there's like a it's interesting we're sitting in a triangle right now and it's like we we well we all overlap things with each other but it's almost like a little stool right with like three legs where different parts are of each of us are shared but also different parts of each other propping up the dynamic. So yeah I I there are parts of you that I very much wish I were more like and have come to terms with I will never be a hate person. I will never be uh not an enthusiasm enthusiastic but not like you not like the energy that you bring for leadership for for drawing other people out in like a group in a group or leadership setting that just ain't it for me. I've probably a lot of going to military for me was trying to find a version of myself that was more like and then realized I'm not I'm like a quiet death seeking what's interesting for me is like I've always felt pretty uncomfortable and not very skilled if I'm like getting up in front of the residency and giving a speech or like same thing in the locker room. I will do that and I'll do I'll enjoy it if it's like there's a there's a big humor aspect and I'm just like trying to be funny.

SPEAKER_04 1:02:05

But like if I actually have some like some more in you know uh prof profound message I want to deliver or like you know actual like I need to look um confident here or whatever then I my anxiety gets to me um so I don't know if that's like one of your barriers at all with that with that too um but but yeah I mean just to kind of when you're saying like you know was there a part of me that wants more that's like hey there's whenever I've like observed you and like we were talking about tea group I I it there's just like this admiration in that for me and it's like part of me still you worth ruining everything um you are a great mascot I think I was just like thinking like did I do I want that am I jealous of it do I want it or envious or whatever the right term there is for na brown um for myself or do I just kind of know the value of it and um and and what I've what truly what like what I've said to two people behind your back is like I would want you as my psychiatrist you know because the depth that you're able to pull and but the irony is the flip side like what you said about yourself your ability to employ humor and spotten and you like doing improv and I'm like God my worst nightmare is doing improv like what a hellscape for me.

SPEAKER_03 1:03:42

But I wish like I had more spontaneity because that is probably the kind of psychiatrist that I would gravitate towards like I would love somebody to like match my depth and give me probably in some ways the kind of psychiatry that you do but other ways the kind that you do like to to be able to draw out the sort of like energy that you bring that it might be in there probably not to the extent that it's in in you but like probably I'm under connected to that part of myself. So it's interesting that like we both have a like you're saying we both have a portion of the other but like we also represent um something that we're drawn to but also now well that's okay that's not fully who we are yeah and we're now in our 40s so we're like okay this is kind of who we are I keep working on it but uh yeah but I think as you're saying that it's like I think you wouldn't even just want one psychiatrist throughout your life to it's like what time what time of life are you in? What season is this the growth season? Is this a a validation season, you know, um or support or whatever. We'll do an episode on finding therapists how do you pick a good one? How do you move to a new one? How do you take a break from them? How do you because we've all had yeah lots of experiences that's a great point. Yeah I don't yeah but I haven't heard who you are I well yeah I've been waiting oh your intro myself yeah my exactly go first. No I think as you all said words that like resonated I think I've said some of the things like depth is big. I think that's the whole history of my life is like operating and trying to figure out the nature of the world and reality and thus myself and thus other people um everything has meaning everything

The Importance of Depth and Meaning in Life

SPEAKER_03 1:05:21

I probably overinterpret but not in like an overthinking way just in a like constantly trying to understand way. And like Jeremy I mean Jeremy and I share I think a lot of spiritual sort of perspective on things to it might be broadly encapsulated by Buddhism but also other stuff. There's something about that philosophy that resonates with me is sort of like parts of the whole here with some kind of um I guess what makes our feel cool is like I don't think any of us over identify as psychiatrists like like our role and our profession is important as like part of our identity. I don't know I've never felt that but it's weird that our profession as psychiatrists is part of being healers in the world And walking with people and their experiences, and that feels important to um I'm sorry. This is even more perfect.

SPEAKER_02 1:06:16

I'm so sorry. We're gonna add that picture. No, we're good.

SPEAKER_03 1:06:19

That actually herself. Ridiculous self. I think I I think I said it like that uh um yeah, I don't know.

SPEAKER_04 1:06:30

I've always been a seeker.

SPEAKER_00 1:06:32

Yeah, I like that term. I feel like with you, so we led a mindfulness um group together during residency, and and it was so powerful for me once again to like see your strengths versus mine. Like you are so good at paying attention to the words that are being said, and as Kyle's kind of alluded to, like taking everything that's being said and bringing it back together in total. It's trying to make sense. It's trying to make sense, but also so empathetic. Um, you know, like you were I I told you this in residency, and I still think about it that like you really felt like the mother, the residency.

SPEAKER_03 1:07:19

A lot of lessons have been learned.

SPEAKER_00 1:07:21

Yeah, yeah. Well, yeah, being a mother is hard in a lot of ways. But yeah, just so empathetic, always so caring. I've always felt so accepted by you, like there's never any pretense about it.

SPEAKER_05 1:07:38

Your creativity makes me think of your Pisces kind of energy and your depth there.

SPEAKER_03 1:07:48

And miss it with that because it's uncomfortable for me all to miss it with like kind feedback. But non-judgment, I think, is like something that we all should point out that I think we all bring. Yeah, but also is super important in what we aspire to do professionally, it's just it with people.

SPEAKER_04 1:08:05

Yeah.

SPEAKER_03 1:08:09

What I've been thinking about a fair bit lately though, too, is like I I always aspire to like the Ted Lasso, you know, bringing in the I think it's a Walt Fedman quote, like be curious, not just not judgmental. I think is also a guiding concept or or mantra for me. But I I have been realizing the ways in which I I think I can be hypocritical about that, right? Like noticing other people's judgments. I'm not wrong. Um and feeling like I'm not judging, and then I like will it'll be reflected on to me, yes, perhaps, um, where I have been judgmental. Um, and like so I think another very important concept for me is that rupture and repair, right? Like that's constant in life, and I think that's a therapeutic concept that's like I will at one point or another share with every one of my patients, right? Yeah, like these are how like we are relational creatures, these are how relationships work. Like you have ruptures in um, and unless you decide, you know, to set a major boundary. Um, if you want to keep that person in relationship, you want to have meaningful relationships in your life, and and relationships are strengthened by the repair. If, as one of my therapists wants that, if the relationship can tolerate the rupture. Yeah. Which brings us back to America. Can we repair? Can yeah. The rupture might be necessary. Can it bring us closer together? Can it Yeah.

Rupture and Repair in Relationships

SPEAKER_03 1:09:47

Are we better off?

SPEAKER_00 1:09:49

Then it makes me think about who are we? America. Like we've been asking this question, but shit.

SPEAKER_03 1:10:00

Look at that. There you go. Exactly. Are we done? Is that the end of that? That's it.

SPEAKER_02 1:10:05

We actually reached enlightenment or closing button podcasts. Um completely America.

SPEAKER_04 1:10:16

Yeah. Do we want to take a pause and come back and think we can answer that? Yeah.

Introduction to Bibliotherapy and Creative Collaboration

SPEAKER_04 1:10:20

All right, cool.

SPEAKER_03 1:10:26

Hi, everyone. This is Kyle, breaking the fourth wall. We recognize that you've been listening to us talk about what we're doing for nearly an hour now. This will probably always be one of our longer episodes, and we hope that doesn't turn anyone away, knowing our attention clip-driven economy. But we felt strongly about giving you the most raw version of this conversation about why we're passionate about this venture. A lot of therapy is about modeling, being raw and vulnerable, and practicing how to learn from mistakes in real time with our patients. So we wanted to do that here too. At the same time, giving you this pace allows you to learn a little more about who we are as people, which we think is important to this project too. So, for this next part, that's what we're gonna dive more into. We took a real pause and are now moving from what are we doing to exploring in this next part. Who are we as podcast hosts as a nation? Join us as we look to live these questions now. So I I think starting by summarizing what we were talking about two days ago. So we talked about who we are. We talked about why we're doing this. Um, so what are we doing, right? And then we all um became empty and our ego is dissolved.

SPEAKER_00 1:11:59

And um became the ocean.

SPEAKER_03 1:12:02

You became the ocean. No, but we started with what are we doing? And then so I wrote um distilled it down into seeking to understand what is happening in our country in this moment through a biopsychosocial and dare I say philosophical lens.

SPEAKER_01 1:12:20

Why dare I say?

SPEAKER_03 1:12:22

For sure. Yeah. For sure, that's what we're doing. Right. But that was that was part of the discussion too, is like psychiatry being philosophy in doctor's clothing. And so, yeah, we were kind of polishing our tagline with that. But that's I think what we are doing to summarize that. And summary is

Exploring the Purpose and Philosophy of Psychiatry

SPEAKER_03 1:12:42

also a part of what we do in session is we try to um feed that back and help it, yeah, form those synapses. Anything to add or add it to that? Did we talk through like the I can't even remember at this point. My gosh. Did we talk through kind of our process like when we were inspired to start this and kind of how it's like slow rolled over the past year almost? And then this timing We talked a little bit about how it feels more imminent now. Yeah. And that it's been about a year. I don't know that we necessarily talked about the initial seeds of it. Yeah. Um, yeah, I don't remember exactly who proposed or how we started, or yeah.

SPEAKER_00 1:13:25

I needed a um distraction and some eligible send something with my friends that was creative.

SPEAKER_03 1:13:32

Yeah. Yeah, I think I think we had thrown around the idea of recording ourselves because we we started a book club. And um, and then realized that, you know, the three of us were very energized by that and and talking a lot and wanted to figure out does it make sense to record these thoughts and share them? And yeah, there's some stepping back of realizing the conversations we have with ourselves and with people in session are actually interesting. And that's not like two narrow horns. It's just we dung routinely at a level that most people out in the world don't get to talk at because most of us are running through our lives just doing what we gotta do. You slow down on session, all of a sudden you get depth, you get honesty, you get reality. And it's pretty clear people are like uh looking for that or are hungry for that in a lot of cases, and especially in hard times um when they're trying to get their head around something that they have never seen before or don't want to confront, but have to.

SPEAKER_04 1:14:35

Um we started to think maybe we have something to offer.

SPEAKER_03 1:14:39

Yeah. I think that concept of framework or or language that we have to like keeps coming up for me too. That yeah, that that's that's what people need to understand. And and that's kind of the biggest skill of our trade is like, okay, here's a framework for understanding what's what's happening here. Yeah, you know, this behavior, this pattern that you're seeing.

SPEAKER_00 1:15:04

Well, we do it naturally every time we're together, you know, just trying to understand ourselves, what's happening in the world, talking about it together within that framework. Like, what are what are some ways to look at this? What are some of the skill sets that we can use to navigate this and work with it?

unknown 1:15:21

Yeah.

SPEAKER_03 1:15:21

Yeah. We have a lot of a lot of training,

The Role of Language and Framework in Understanding Mental Health

SPEAKER_03 1:15:25

a lot of years doing this, a lot of time talking with our patients over each other, but these are not inaccessible conversations. They seem to help us. We wouldn't keep doing it if they didn't. So I think that's what maybe we could offer the framework, the languaging, and also the sense that you too, you don't have to be a psychiatrist to start start to look at the world from a lens of depth, a lens of curiosity, a lens of understanding your own reactions to things and how to work with those and through them. Um these are skills anyone can develop even without, you know. Well, I think that's what's so interesting about what's happened with social media and and even AI now, too, is like pe people really are learning this language more and more than than I ever expected. Like, and that people are, you know, wanting to be like, am I autistic? And like, what are, you know, and looking for for tools on that themselves, um, you know, to to deal with these various challenges.

SPEAKER_00 1:16:21

Um but um yeah, I think I'm thinking about what your patient was talking about with you about recording your conversations.

SPEAKER_03 1:16:31

Yeah. That was the very there have been a couple of synchronicities. We seem to like synchronicities. I'm like, yeah, it's just uh right around as we were thinking about this. A patient mentioned to me doing a very similar thing. Like, we sh people would be interested just in what we're discussing here, which is was a bit of a revelation of like, yeah, this is cool stuff that just integrating philosophy, integrating history, like yeah, communing about our fears. It it um people are searching for that. And therapy is a place where it's allowed, it's welcome, it's safe. Um, yeah. I think a year ago we we were feeling that yearning and then felt the yearning within ourselves, and then we we planned for this, right? Because we we live our busy lives and um like okay, we we're piecing together the Google Doc and everything. And then um this moment that we're in now in late January and everything that's going on, um, because I don't know when this will be released, but uh with ice and everything, just feels like such an important moment to be trying to figure out what's happening in our country and what we can all do about it. If we can help in any way with that, you know, I think it's feels fulfilling for us in some way, helps with the helpless feeling of helplessness for us, and and hopefully we'll help that for others. You said about social media and language, because I think that's it. People are seeking this, and what we're hoping to do is not just teach people language, take it a bit deeper, like what is our yeah, um, yeah, about we're not putting label. We will, we will drop labels, we will drop terms, but like biopsychosocial, like it's about getting beyond labeling someone.

SPEAKER_01 1:18:15

Like diagnosis matters less to me than really understanding. The formulation, the fool. Yeah. So we're probably not gonna diagnose America with any specific illness.

SPEAKER_03 1:18:23

Uh and we'll try not to put too many labels without a backstory or a copper context. And that's what we won't tell people to do as well. It's like it's not just about being able to put a name to something while important, it's

Who We Are: Personal Reflections and Connections

SPEAKER_03 1:18:35

about understanding, conceptualizing, right? For any words we use a lot and we try to describe the neural situation. And finding that balance of like, okay, understanding in of itself is healing and transformative, but also looking to give people who are feeling helpless some steps, maybe tangible steps that they can take. Yeah um to help our country heal right now and hope that we can hope that we can heal. Um okay. Well, that's a good summary, I think, of what we're doing. Um so then I thought we talked about who who are we together. Um we kind of talked about our how our friendship formed our shared backgrounds um and histories as psychiatrists and training. And we talked about what drew us to psychiatry and um sort of defined psychiatry as understanding and treating the mind. We came to agreement on that, um, or shared our perspectives on that. And then we started to talk about who we are as individuals, which was, I think, again, not to use that that one perm of that has been stolen from us. Um, but we enacted who we are as we're describing ourselves too, right? Um so if I may take a stab, because again, this all consolidated for me in the middle of the night, as sometimes it does. Um, Jeremy, the things that that came up for you, um, both for yourself and I think reflected with us was um you are your presence and your mindfulness. And I think with that being so um valued by you, but also just who uh who you are, um, I think you give people a sense of safety. And I for me too, I think that's the essence of of being a friend too, is someone that you feel very safe with. Um, and you're also I and this came up for me as I was thinking about this too. We didn't really talk about it, but like you are extremely dependable as a friend, too. I think that's a very important quality in a friend, but like when uh I guess I'll just speak for myself, but I think again, I've seen this in your life too. Like when I've needed you, you have always been there. So I think those are important qualities of who you are. Um, Sarah, I think what came up for you and what you talked about was you are big time a seeker of truth, um, that you value depth

America's Identity Crisis: A Developmental Perspective

SPEAKER_03 1:21:31

and authenticity. Um and I wrote the word profundity. I don't know if I love that word, but I I do think like yeah, you you kind of tap into the sacred and the profound and and really try to like distill down to like truth and kindness, I think, you know. Um in a way that like I think you want all of us to be good.

SPEAKER_05 1:22:05

So that kind of came up for me when I was thinking about what um Oh Kyle, thank you.

SPEAKER_03 1:22:11

This is your middle of the airport. Mm-hmm. This is what happens to me sometimes. So, in that nature, I will do myself. I will do myself. I welcome your guys' thoughts, though. But what came up for me was obviously enthusiasts, right? And I'm very enthusiastic about you both. Um seeker of joy and bringing people together.

unknown 1:22:29

Yeah.

SPEAKER_03 1:22:30

Um uh my note says for a hated vision. I hope that's not what I meant. I probably meant a shared vision. Humor is also a big part of me. Um, and helping people to tap into what brings them most alive. So that's very important, I think. For me. I'm seeking that for myself and for others. You are an alive person. That's a great word. Like your energy feels dearly innate, perhaps. Like the leader, the uh the buyer.

SPEAKER_01 1:23:05

There's there's just there is an energy to you, but also like a peace and a calm that those that's balanced. I don't know what else is in your chart, but it's both, um, which is a special mix.

SPEAKER_03 1:23:16

It's like you've got two sides of the coin that need to be in balance and need to uh take the lead variably. That that isn't really that's a good description of yourself. Thanks. Yeah, I don't know if I resonate as much with the calm. I try and I've gotten a little better at like taking breaths and and pauses and like more and more lately, like I'll instead of listening to a podcast and music, which is kind of my default, I'll sit in silence. You know, your energy right now is like remarkably that's what I'm like feeling into is like you feel quite like level. How do you feel right now? I think it's it's the crystal, yeah, it's crystal that Jeremy You're gonna have an episode on crystals, by the way. Um but I

Judgment and Curiosity: Navigating Complex Social Dynamics

SPEAKER_03 1:24:01

I hope too, a little bit if there's any like calm that people feel around me, it's it's a little bit of what I was talking about with Jeremy. It's like I I do really try, and it's and I think it is a little bit of an innateness that I get from my mom too, that I see in her. Like, I don't think she really judges people too hard, you know, and she gets along with a wide variety of humanity. Like when you look at her friends, there's no like common thread, really. It's just she loves people, you know? Yeah. And um I think I think I I am grateful to kind of share that quality with her. That you may have distilled down. We have a lot of similarities across our triangle, a lot of differences. That may be the thing that psychiatrists as a group aspire to be is open and welcoming and interested in anyone in their story and not judgmental to the greatest degree uh humans can be. What a segue into who are we as America? Right? Yeah, yeah. Yeah. Like that is, I think our when we are our best as a country, yeah, we are that. We are welcoming of all types. Yeah. And we say all types, like equal opportunity. We are the land of opportunity. If you have a dream, right? Like we want to be the place where you can enact that, where you can build that. If you have the will, if you have whatever it takes, you know.

SPEAKER_00 1:25:38

Speaking of the, that'll be an episode.

SPEAKER_03 1:25:40

That'll be that'll be one of our first episodes. Yeah. Um, and non-judgment, like that, we should we should extend that. Yeah. Like judgment, you know, that's probably an episode somewhere coming along, but um such an innate human thing. We do it to ourselves, we do it to others. But like in psychiatry, we often use curiosity as the antidote to judgment, our own, right? If if we have a judgment that does come up, it's like get curious, ask questions, try and figure it out. And if there's one thing we can we can transmit from this little part of the conversation, it's like when you have a judgment about somebody else, when that strength that we see in America starts to hit you in the wrong way, starts to create fear or anger, curiosity about yourself, about that person, what is their experience like? How did they get to this point in their life? Like that is such a powerful antidote, I think is the right word. It it is, but just to follow on that thought a little bit, because I I do think about this. I think um judgment can kind of get a bad rap. And I do agree, and for most stances, we want non non-judgment, but also like we call what we do clinical judgment. True. Right. And

Cycles of History: Learning from the Past

SPEAKER_03 1:26:55

like even in the Myers-Briggs, it's like, are you intuitive or are you judgment? And like judgment is also like in the dialectic, right? There is some place for judgment. And maybe in America now, that is a little bit what people are saying is like, we need to call a spade a spade in some of these situations. This is a we're talking about wise judgment. Like there, there are they almost have different definitions, right? There's snap judgment that comes and leads to stereotype, leads to almost a reactive judgment. Thinking fast and slow. There are you, Daniel Kahneman. Nice toolkit doing it again, Kyle. You are like, Kyle's established herself as a teacher already in our podcast because our goal is to like bring some learnings in and try to just use some of our terminology and our knowledge more specifically. And she is like, she's really doing it.

SPEAKER_01 1:27:44

That's exactly it. Like, is it a judgment that is informed by wisdom and examination and then ultimately takes a boundaried stand or like a really uh principled perspective on something? Or is it a judgment that is reactive, driven by fear, driven by ignorance, driven by something else? That is not being named.

SPEAKER_00 1:28:01

So you're right. Totally agree. This is taking me to a religious space where like some of the religious terms around this are righteous judgment or right judgment, wise judgment that you were mentioning.

SPEAKER_06 1:28:13

Yeah.

SPEAKER_00 1:28:14

Um so yeah, there is a space for judgment. It's kind of coming back to the gray from the black and white space again.

SPEAKER_03 1:28:22

That's yeah.

SPEAKER_05 1:28:23

Beautifully put.

SPEAKER_04 1:28:26

Yeah.

SPEAKER_03 1:28:26

Because that does feel like the if America is a seesaw, we do seem to be balanced between people who are sometimes quick to judgment that isn't as informed, and then people who are scared to make judgments when it's appropriate, who overthink it and underthink it, maybe.

SPEAKER_01 1:28:44

And neither one is quite right. Um, there has to be that balance of like, hey, if you're if you're snapping your judgments, slow down a little bit.

SPEAKER_03 1:28:51

If you're withholding your judgments too long when something needs to be said or done, maybe you gotta assert a little bit more. What would be the word? We're gonna talk about aggression. I don't know if it's aggression. Assert a little bit more assertiveness. I mean, yeah, or or paternalism. Again, I I keep coming back to as we talk about these things in our role as psychiatrists, like we are in a position often to take away people's rights. And it's a huge responsibility, you know, and to figure out is it that time or not? Yeah, you know, um, it's the same thing. I mean, this is this, these are what judges deal with too, right? And um it was a whole job. Yeah. And I think it's it's even harder when we're talking about America. And it's like we have to take collective action to be like, what how do we hold people accountable if we need to set limits to things, um, do the hard things, you know, um, that people are gonna sometimes don't respond

Living the Questions: Embracing Uncertainty

SPEAKER_03 1:29:59

that well to. Yeah. And across a unlike us, we generally sit one-on-one. We're talking about over 300 million people with a lot of different views on what is right or wrong, many within the spectrum of normal and appropriate, right? Like we may be very far removed from someone else and what they think is justifiable, ethical. But many people fit within balance of like, well, it's that's okay. You can believe that. But how do you coexist um when when some of these beliefs, and then how do you call it the beliefs that are too far on the edges to live in a society like ours where there has to be some degree of overlap in beliefs so that we can be a democracy, be people who get along with each other. And how do you say your beliefs are too far? And that's kind of kind of gets into free speech and when free speech should be and can be limited, because that's that's probably beyond us. We're not political philosophers.

SPEAKER_00 1:30:48

But I'm also thinking of just the it feels like on different ends of the political spectrum, judgments become an important aspect where on one end it was like no judgment, we can't judge anything. And that's been the side that feels like is starting to struggle with. Can we start calling some of this out and say like this doesn't align with our values? Yes. Um and then maybe on the other side of the political spectrum, feeling more like it was just a lot of black and white snap judgments occurring all the time. Yeah. Um yeah.

SPEAKER_03 1:31:19

I mean, it is interesting the ways in which the current times have effed with. I mean, we'll do an episode on cognitive dissonance, but it's like the thing that you thought you believed in is doing the thing that you thought was, you know, wrong with the other side, right? And there's so much of that. And how do you make sense of that, you know? Um, which from is scary, but also good. Like it shows like the complexity of some of these views and the gray, right? Yes, oh, I thought perspective and empathy, and yes, yes, break down the cognitive dissonance, please.

SPEAKER_00 1:31:55

If we can To come back though, like what I'm taking from when we went around and tried to describe ourselves the first time. I wanted to come back to that too. And also America in general is maybe we're still figuring out who we are. Yeah.

SPEAKER_03 1:32:08

Oh, yeah.

SPEAKER_00 1:32:09

Maybe it's not fully defined yet.

SPEAKER_03 1:32:12

Well, that's what I love when people define America as the great experiment.

SPEAKER_00 1:32:16

Yeah.

SPEAKER_03 1:32:17

You know? And I have to look up the quote, but yeah, there's there's someone that basically says all of life is experiment, right? All of life is trial and error.

unknown 1:32:28

Yeah.

SPEAKER_00 1:32:28

The answers, what's the quote?

SPEAKER_03 1:32:30

Oh the questions now, baby. Yeah. We're checking out some midlife tattoos that were achieved within recent years with some of us. Yeah. Rainier Maria Rilka to a poet. I sometimes think about America. Wait, we forgot our developmental stages last time. We're still not quite sure where we're at. I think about America and its developmental stage, like compared to many other countries. We're we're a young country, we're a country that has uh I can't say this like academically, but as diversity that I'm not sure size and diversity

Conclusion: The Journey of Understanding and Growth

SPEAKER_03 1:33:05

that I'm not sure another country quite matches. I'm sure so no. I I think that's why we are, you know, we consider ourselves so special and unique. Yeah. Because yet because of that. Yeah. Oh, we think about I think about teenagehood. Like when we think about teenagers rebelling against power structures, rebelling against their parents, trying to integrate parts of themselves, figure out who they are aside from who they were told to be, aside from who the world thinks they are. Like that's a that's a tumultuous stage. I'm sure many of us remember that. I'm like, is that where we're at? Like really trying to and and teenagers, we might talk about parts theory at some point that's gotten pretty popular. Um, IFS, like most humans struggle with different components and different parts and different values within themselves and trying to integrate those into coherent whole. And it's like, America, that just happens to be happening in terms of people and people groups and belief structures fighting it out. We have exiles, you know, and firefighters right now. Yeah. How do we make that into a coherent enough whole that we move forward as oneself? Um, yeah. No, and I think that um it's again, it gives me some calmness when you can put that kind of lens on it. Um and I think you're referencing if you, you know, if we think about ourselves as a in the teenager phase, then you know, we can talk. I think we'll bring up the Ericsson stages quite a bit, you know. And it's like, okay, what's the struggle for that stage? Yeah. Um, which I think it's like identity versus um role confusion. Role confusion. Whoa. Yeah. Hold on. Nice on the same wavelength, baby. That's why we're doing this together. Um what lets teenagers get through that successfully? Like a safe, still a safe holding space, enough like parents stepping back, but also still being present. Allowing them to actually try on some of the different hats and roles within still limits, setting limits. Yeah. And that's where I think we're at. We're gotta be like, where's the limit? Where's the parent? Yeah. Because boundaries do help people to say feel safe. Yeah. As much as they might hate them.

SPEAKER_00 1:35:22

Thinking about the next stage, which intimacy versus isolation. Oh, seems to be kind of apropos for where we're looking at right now.

SPEAKER_03 1:35:31

Shoot, the community episode, which is also one of our first upcoming.

SPEAKER_00 1:35:36

And even just our place in the world right now, as we're seem to be pulling back and isolating our America first um ideas. And then the next stage would be generativity versus stagnation.

SPEAKER_03 1:35:49

Millennials episode, baby. Yeah, so much. Yeah. We thought through these up these particular episodes to be early. Yeah. Yeah. And I think what's interesting about the Ericsson and stages is like um, is it we're actively looking at them now because again, you don't have photographs.

SPEAKER_02 1:36:10

This is Yeah.

SPEAKER_03 1:36:11

Well, because a couple of them are are kind of cyclical, right? And I think um, like when when we talk about generativity versus stagnation, that just makes me think of the industrial age. Like we were in a great era of generativity at that point, and we hit kind of a stride, and then we get ruptured again. There's disruption, right? And then like our can we reach generativity again, you know?

SPEAKER_00 1:36:36

I'm trying to remember, I think in his book, um, he mentioned that, you know, it's not necessarily just a linear movement that you move and kind of go for.

SPEAKER_03 1:36:45

For sure.

SPEAKER_00 1:36:46

But also that makes me think of industry versus inferiority stage, industrial age.

unknown 1:36:50

Yeah.

SPEAKER_03 1:36:51

And especially if you have not accomplished the goals of one stage, even if you move to the next one for whatever reason, you often circle back to try to like master that part. Um, and that we're in this weird, if we're looking at America as like an individual going through developmental stages, we're not. Like we think, why do we repeat history? It's like, well, someone else went through that history. We learned about it in books, ideally. Oh, yeah. But like recently have it. And is it is teaching history good enough? Is it good enough for some people to learn the lesson and then move to the next stage?

SPEAKER_01 1:37:22

And some people or periods of time have to go through it again.

SPEAKER_03 1:37:25

Right.

SPEAKER_01 1:37:26

So it's interesting to be like, didn't we do this already, America?

SPEAKER_03 1:37:28

And it's like me or grandparents did or great grandparents, yeah. Um, but maybe we have that urge to master it in our time. And some of those lessons are hard.

SPEAKER_01 1:37:37

Like, think about the aggression, anger, and depression of teenagers, the moodiness. Like it's just uh there's a painful time, a lot of interpersonal conflict.

SPEAKER_03 1:37:45

Yeah. No, that's I think a very poignant point, Sarah. No, but I mean, I think about that a lot, right? I mean, we that's what we deal with as a psychiatrist too. It's like, okay, we can talk through these things, and we're, you know, we have the the blessing to be the the most social learning creatures, even though, of course, we find out um we're not alone in our consciousness and all that. We are still creatures. Yeah. We can do that and we can read books and and get wisdom that way, but the the experiential learning always seems to win out to be the one. It's a thing we do, it's a thing we talk about amongst ourselves as psychiatrists and therapists of like we get decent at reading people or reading patterns, and we're like, well, that's what you need to do. And we see it, and we often kind of know a likely way forward for a person towards the goals they want. That is not to say they're not multiple, but you can't just tell somebody that. You can't just be like, hey, by the way, if you did X, Y, and Z and maybe cut that person out of your life and started doing that, you get exactly where you want to be. We know that doesn't work. Like part of the beauty of our field is helping people find their own way to solutions, even if it takes way longer than just giving them the like, here's the answer.

SPEAKER_00 1:39:00

Um Well, because oftentimes it doesn't seem to stick until they until they have experienced something or made some they're ready for it, really in their life. And and they are living the answers. Is that what it was? Yeah. Living the questions, I keep saying.

SPEAKER_03 1:39:19

You just want those answers so bad. That's the whole point. We're gonna get to the lack of answers and sitting with that discomfort in some episode too. Actually, do you want me to you guys can keep talking? I'll pull up the um episode, the quote.

SPEAKER_05 1:39:34

Oh yeah.

SPEAKER_03 1:39:35

Um Tuck on the screws. I had something based on what you were saying.

SPEAKER_00 1:39:41

I lost it. I mean, I as you were talking, I was thinking about like there seems to be a lot of people looking historically at the time leading into World War II right now. Yeah. That feels apropos to a lot of people. We were watching a bit of Nuremberg. Um, maybe we'll do an episode where we kind of discuss our thoughts around that. Um, but yeah, it's this idea of reliving history and in some ways now in our lifetime.

SPEAKER_03 1:40:11

Yeah. Right. A particular terror to thinking you're seeing literally things replay themselves and still not knowing, wait, how did we get here? What do we do? We know where this could end. That's not what we want. Most, most, most people, no matter what they believe in or who they voted for, right?

SPEAKER_01 1:40:29

Don't want that. That's not a thing. And yet that idea of like we have this 300 plus million person momentum in a certain direction.

SPEAKER_03 1:40:37

How does any one of us stop the role in that direction? I think, I think there's something about our field. You guys tell me students of history, I think, kind of get cycles. They see that these things happen and then pull back. I think in therapy and in psychiatry, we see people go through crises and come through them. We see them make moments of rapid change and increased awareness. Sometimes we don't even know how they got there from many, many interventions and sessions. So that might give me a little bit of hope of like, this is kind of how it happens. Change can be ugly and scary, and then all of a sudden progress is made. And sometimes backsliding happens. We're backsliding, right? So I think seeing enough individual, that's what we're doing. We're taking individual principles and trying to apply them at large, but for at large, seeing what individuals go through as they make progress in their lives, it's upheaval, it's conflict, it's pain, it's suffering often, and it's also joy, and it's also rapid progress and it's regression. And so those maybe we're a little more comfortable with the idea that that is part of life. That's as you're talking thinking about one of the skills I think that I have built so far in my wait, so we graduated 2019. Yeah. So we're like seven years down, and all of that work has been more comfort with uncertainty. Yeah. And and that is the essence of why I have this on my this quote on my arm too, um, of of live the questions now, you know. Um, because yeah, I mean, we're all seeking the answers. We're all trying to, okay, what's what were the steps towards, you know, the Holocaust, you know, that ultimately we can't like looking back, it's like no one really, you know, except for maybe a small minority of very bad people wanted that. So how did that all happen? Yeah. And are there different steps to take? Um but I so yeah, I mean, I think we're seeking those answers, but also like have to sit with the uncertainty uh that none of us really know, you know? Um so okay, I'll read in that vein, I'll read this. Um, do we want to finish on this quote? Do we have anything else you want to circle around to, or will that be kind of our close?

SPEAKER_00 1:43:03

I think the only other thing I wanted to mention with what you were saying was Sargon.

SPEAKER_02 1:43:07

No, that's great.

SPEAKER_00 1:43:08

During um during the time in the military, it was really hard to follow patients longitudinally because deployments, you know, um moving duty stations every two to three years, moving between multiple different jobs. But now having been on the civilian side and and followed a group of patients for two to three years, you see these cycles repeat themselves. And it it becomes a oh, do you remember uh the last time um this happened and kind of what we did or what we thought about? And it does feel like that spiral idea where you keep circling and you get a little bit deeper each time.

SPEAKER_03 1:43:49

Yeah, yes. Yeah. And I don't know if this is what you're saying, but like it's okay that we're back here again. Yeah.

SPEAKER_05 1:43:55

Yeah.

SPEAKER_03 1:43:56

You know, and we got through it last time. Yeah. And, you know, it the attachment to the idea that you're you're cured, or this is never gonna happen again. It like you were saying, like, what's the equation for actual suffering? Um, like, okay, we're here. We can we can cycle out of here again, too. Um, but either way, I'm here with you, and we're gonna figure it out. So, okay. This is very apropos. Um, so again, this is Rainier Maria Rilka. Um a part of this uh poem. Be patient toward all that is unsolved in your heart and try to love the question them questions themselves, like locked rooms and like books that are now written in a very foreign tongue. Do not now seek the answers which cannot be given you because you would not be able to live them. And the point is to live everything. Live the questions now. Perhaps you will then gradually, without noticing it, live along some distant day into the answer. You've been listening to Shrinking America, a good enough podcast for our times. This podcast is separate from our respective clinical practices and employers. The views expressed are our own and those of our guests and do not represent the views of our employers. We do not endorse the views or statements of our guests. This podcast is for educational, informational, and sometimes entertainment purposes only, and is not a substitute for professional medical care. Nothing in this podcast constitutes medical or mental health advice, diagnosis, or treatment, nor does it establish a doctor-patient relationship. If you are seeking personal medical or mental health care, please consult a qualified health professional. If you are in crisis, including thoughts of suicide or harming yourself or others, please contact local emergency services or a crisis hotline like 988.