Relatable with Allie Beth Stuckey - Ep 611 ｜ How Woke Ideology Has Ruined Therapy ｜ Guest： Dr. Sally Satel

00:00:00.000 Hey guys, welcome to Relatable.

00:00:01.700 Happy Wednesday.

00:00:03.120 This episode is brought to you by our friends

00:00:04.700 at Good Ranchers.

00:00:06.160 American meat delivered right to your front door. 0.94

00:00:08.300 Go to goodranchers.com slash Allie.

00:00:10.100 That's goodranchers.com slash Allie.

00:00:21.560 I've got an amazing and fascinating conversation

00:00:24.780 for you today.

00:00:25.720 I am talking to Dr. Sally Sattel.

00:00:28.480 She is a psychiatrist who focuses on addiction,

00:00:34.160 drug use, rehabilitation, but she's written a lot,

00:00:37.560 especially over the past couple of years,

00:00:39.760 about how woke ideology, how progressivism

00:00:43.300 is really pervading, not just psychiatry,

00:00:47.100 but really medicine in general.

00:00:49.400 We're gonna talk about the consequences of that,

00:00:51.660 the consequences of an overemphasis on victimization,

00:00:56.040 how this idea of placing people

00:00:59.580 on some kind of intersectionality scale,

00:01:01.960 how critical race theory is really harming

00:01:05.100 psychiatrists' ability to treat people as individuals.

00:01:09.920 And we'll talk about counseling

00:01:11.800 and how counseling is being characterized by this as well,

00:01:17.140 and potentially harming people and keeping people away

00:01:21.680 from getting mental health care that they need

00:01:24.100 because of this wokeism and people's fear

00:01:28.420 of being treated by a therapist

00:01:30.200 who would be hostile to their conservative

00:01:32.560 or their, in our case, Christian views.

00:01:36.300 So we're gonna talk about all of this,

00:01:38.560 kind of where this came from,

00:01:40.420 and we're going to focus a lot on this loss of agency

00:01:45.240 that seems to be infecting not just this industry,

00:01:50.300 but the world, assuming that everyone's issues

00:01:53.080 are they're a problem of some grand systemic problem

00:01:58.200 rather than a problem of an individual's choices,

00:02:02.820 and how that can negatively impact our world

00:02:06.000 and people's mental health.

00:02:07.600 And just kind of putting this all into context,

00:02:12.220 the mental health numbers that we see,

00:02:14.500 especially among young people, are really not good.

00:02:18.140 They're really not good.

00:02:19.720 If we're looking back at 2020,

00:02:22.140 we see a 31% increase

00:02:24.140 in health-related emergency department visits

00:02:27.220 for kids ages 12 through 17.

00:02:29.900 For young adults, we are seeing 3.8 million

00:02:34.180 had serious thoughts of suicide in 2020.

00:02:38.360 And then recently, there was an article

00:02:40.440 written by the New York Times

00:02:41.920 talking about this epidemic among young people

00:02:44.940 of thoughts of suicide and depression.

00:02:47.220 And of course, the New York Times

00:02:48.720 doesn't come to the same conclusions

00:02:50.160 that you and I would.

00:02:51.740 It does talk about social media a little bit

00:02:54.040 and the problem there, and of course, the pandemic.

00:02:56.380 But also, I think that we would conclude

00:02:59.960 that there is just a loss of purpose.

00:03:02.540 There is a loss of community.

00:03:04.260 There's a loss of fellowship.

00:03:05.940 And from our Christian perspective,

00:03:07.200 there is a loss of faith.

00:03:09.380 There is godlessness that seems to be pervading

00:03:12.120 the younger generations.

00:03:13.400 Actually, we know for a fact that it is.

00:03:15.660 Pew Research does research on this regularly.

00:03:20.220 And the loss of church and religious affiliation

00:03:24.820 among young people is dramatic.

00:03:26.740 And we're not focusing on the younger generations

00:03:29.020 in our conversation with Dr. Sattel today.

00:03:31.800 But I think it is very indicative

00:03:33.700 of where we are as a country

00:03:35.760 as far as how we are serving people

00:03:38.520 in the mental health industry.

00:03:40.780 We talk about on this podcast a lot.

00:03:42.960 I wrote a book about it.

00:03:44.680 How it seems to be the solution

00:03:46.780 to all of our problems.

00:03:49.260 We are told on Instagram.

00:03:50.520 We are told by people like Brene Brown.

00:03:53.980 We are told by the popular authors

00:03:55.880 that are kind of targeting women, 1.00

00:03:58.640 and in particular, Christian women,

00:04:00.520 that really fundamentally,

00:04:02.340 our biggest problem

00:04:03.580 is that we don't love ourselves enough,

00:04:06.440 that we don't empower ourselves enough,

00:04:08.080 that we don't think about ourselves enough.

00:04:10.220 And anything that inhibits us

00:04:12.100 from being able to put ourselves first

00:04:14.820 is a form of trauma

00:04:16.560 and that we are really victims of most things,

00:04:19.860 if not all things that happen in our lives.

00:04:22.060 How's that working out for us?

00:04:23.600 How's that working out for us?

00:04:25.280 Is that kind of mentality

00:04:26.980 really pushing us towards viable solutions

00:04:29.540 to make sure that we are not riddled

00:04:32.960 with anxiety and depression,

00:04:34.520 that we are stable, insane people?

00:04:37.040 It doesn't seem to be helping very much at all.

00:04:39.800 And so we're going to talk a little bit

00:04:41.020 about that today

00:04:42.320 at the beginning of our conversation.

00:04:43.880 I'll ask her that question.

00:04:45.740 How is pop psychology

00:04:47.040 and this focus on ourselves,

00:04:48.500 how is that affecting the therapy world?

00:04:52.840 How is that affecting us as people

00:04:54.980 and as a society?

00:04:56.240 You're going to love this conversation.

00:04:57.860 She's a fascinating and brilliant person

00:05:00.000 who is doing very unique

00:05:01.940 and counter-popular narrative work

00:05:06.640 in this space.

00:05:08.040 And I always appreciate those voices,

00:05:09.740 and I know you do too.

00:05:11.080 So without further ado,

00:05:12.060 here is our new friend,

00:05:13.380 Dr. Sally Sattel.

00:05:16.920 Dr. Sattel, thank you so much for joining us.

00:05:19.980 I have read many of your articles,

00:05:21.800 listened to lots of interviews

00:05:23.320 that you have done.

00:05:24.480 We're going to talk about a few things today

00:05:26.600 that you've covered,

00:05:27.520 but I want to start with a question

00:05:30.200 that I know my audience has.

00:05:32.100 Majority women,

00:05:33.880 we are met with a lot of Instagram psychology,

00:05:38.840 a lot of advice on how we need to deal

00:05:41.900 with all of our problems,

00:05:43.040 and it seems to go back

00:05:44.460 to this one prescription,

00:05:46.280 and that is that we just need to think

00:05:48.200 about ourselves more.

00:05:49.320 We just need to think

00:05:50.180 that we are more awesome and wonderful

00:05:52.280 and that all of our problems

00:05:54.080 are a result of some kind of victimhood,

00:05:56.660 of other people,

00:05:57.360 of society,

00:05:58.040 of our circumstances.

00:05:59.580 There seems to be a real aversion

00:06:03.820 to talking about any kind of responsibility

00:06:07.480 that we might have

00:06:08.800 in the problems that we face.

00:06:10.300 Everything comes back

00:06:11.400 to just a lack of self-love.

00:06:13.300 So I would love to hear you talk about that.

00:06:14.860 Is that something that you see

00:06:15.940 kind of in the therapy world in general?

00:06:18.640 What are your thoughts?

00:06:20.500 Well, my first thought is

00:06:22.120 I wouldn't do therapy

00:06:24.020 with a stranger

00:06:26.380 who talks to me over Instagram.

00:06:28.400 And the main reason is because

00:06:31.180 one prescription

00:06:34.000 and one diagnosis, so to speak,

00:06:36.160 never applies to everyone.

00:06:38.180 So right there,

00:06:39.120 you're almost violating

00:06:40.180 one of the tenets

00:06:41.020 of real psychotherapy,

00:06:43.280 which is a highly individualized

00:06:45.920 kind of enterprise

00:06:46.960 where the therapist

00:06:48.060 gets to know the person.

00:06:50.100 And some people probably do.

00:06:52.440 I don't doubt that there's

00:06:53.760 a great deficit of self-love.

00:06:56.940 I wouldn't call it that,

00:06:58.480 but that's not the term I use,

00:06:59.840 but basically a feeling of self

00:07:01.800 or a lack of the feeling of self-worth.

00:07:05.240 And that can be devastating.

00:07:07.220 I mean, that is what can lead,

00:07:10.380 not always by any means,

00:07:12.400 but can lead to necessarily

00:07:16.200 clinical depression,

00:07:17.480 but a pervasive feeling

00:07:19.760 of demoralization

00:07:20.800 can lead to drug use.

00:07:22.460 I mean, that is a problem,

00:07:24.480 but A, you can't assume it.

00:07:26.020 And B, you certainly can't assume

00:07:28.680 that it's due to victimization

00:07:30.900 by parents,

00:07:33.500 by husbands,

00:07:35.340 you know, wives, 1.00

00:07:36.000 by others,

00:07:36.800 by society.

00:07:38.400 Now it's, you know,

00:07:39.740 of course, much systemic,

00:07:41.180 you know, oppression.

00:07:42.780 And even if that might be true,

00:07:45.660 which is something I would only know

00:07:47.100 after I talk,

00:07:47.980 get to know someone,

00:07:49.080 then I would not encourage them

00:07:52.400 to dwell on it,

00:07:53.600 which is another problem

00:07:55.740 that seems to be part

00:07:57.740 of this worldview,

00:07:59.620 which is that,

00:08:00.700 hey, you've been victimized,

00:08:01.960 and so you're entitled,

00:08:03.840 and so really,

00:08:05.680 you don't have to do anything.

00:08:06.900 You don't have to take

00:08:07.440 any responsibility

00:08:08.200 because you're the victim.

00:08:09.940 Listen, to be honest,

00:08:10.720 some people are victimized.

00:08:12.000 There's no question about it.

00:08:13.120 But the real purpose of therapy

00:08:15.340 is just to show people

00:08:16.600 how to put that in context,

00:08:18.500 to rise above it,

00:08:20.420 to make sense of it

00:08:22.400 in their life in some way,

00:08:25.100 to not let it,

00:08:26.200 it'll change them.

00:08:27.660 Any kind of victimization

00:08:28.740 changes a person,

00:08:29.860 but not to damage them.

00:08:31.780 Right.

00:08:32.460 It seems to me,

00:08:33.960 just as a person observing

00:08:35.740 all of this,

00:08:36.380 it seems to me

00:08:37.160 to be an overcorrection

00:08:38.820 because, of course,

00:08:39.760 there's a problem

00:08:40.340 of self-loathing

00:08:41.440 and self-hatred.

00:08:43.120 And that, to me,

00:08:44.520 it would make sense

00:08:45.220 that that could lead

00:08:45.980 to different forms

00:08:47.140 of addiction

00:08:48.400 and demoralization

00:08:49.840 and anxiety, of course.

00:08:52.560 But the constant focus,

00:08:54.140 at least that we hear

00:08:55.220 on Instagram and pop culture,

00:08:57.600 on what I would call

00:09:00.020 kind of a glorified narcissism,

00:09:01.860 that nothing really cares,

00:09:03.040 nothing really matters.

00:09:04.580 Your relationships don't matter

00:09:07.060 if they are not perfectly

00:09:08.400 serving your wants

00:09:10.100 in every moment of every day.

00:09:12.540 That doesn't seem

00:09:13.620 to be working

00:09:14.460 because we've been told

00:09:15.480 this for a while now,

00:09:17.700 for years,

00:09:18.960 and yet our mental health,

00:09:22.580 our state of mental health

00:09:23.960 as a country,

00:09:25.400 particularly,

00:09:26.100 I would say,

00:09:26.460 people under 40,

00:09:27.600 seems to be worse

00:09:28.480 than it's ever been.

00:09:29.960 I mean,

00:09:30.140 my generation millennials

00:09:31.220 have been told

00:09:31.980 our whole lives

00:09:32.720 that everything should

00:09:33.500 revolve around us,

00:09:34.620 that we deserve a trophy

00:09:35.660 no matter what we've done.

00:09:37.480 and yet it's not translating

00:09:40.780 into us feeling better

00:09:42.140 about ourselves

00:09:43.020 or our lives.

00:09:43.960 So do you see

00:09:44.940 that kind of relationship

00:09:46.120 that the more we're forced

00:09:47.420 to just focus

00:09:48.240 on ourselves constantly,

00:09:50.320 that it's actually

00:09:51.320 making us feel worse

00:09:52.600 rather than better?

00:09:54.540 Yes,

00:09:55.140 I can easily see

00:09:55.840 how that could happen.

00:09:56.700 First is prescription

00:09:57.540 for selfishness,

00:09:58.500 and we know that

00:09:59.180 one of the great things

00:10:01.920 people can do

00:10:02.480 to make themselves

00:10:03.160 feel better

00:10:04.080 is to help others.

00:10:07.120 So you want to direct

00:10:09.360 as much of your attention

00:10:11.620 outside yourself

00:10:12.560 as you can.

00:10:14.260 A,

00:10:14.460 at the very least,

00:10:15.500 it's distracting,

00:10:16.560 so you're not ruminating

00:10:17.520 about your problems,

00:10:18.600 but it also helps others,

00:10:20.180 and that's very gratifying.

00:10:21.600 And as you know,

00:10:22.820 in AA

00:10:23.660 and other kinds

00:10:24.440 of self-help,

00:10:25.180 that's one of the tenets

00:10:26.180 of it,

00:10:26.540 is that it's a fellowship

00:10:27.660 where you're helping others

00:10:28.800 and connected to others.

00:10:31.380 And the other problem

00:10:32.780 with focusing so much

00:10:35.300 on yourself

00:10:35.800 is that everything

00:10:36.500 is blown out of proportion.

00:10:39.560 Every little slight

00:10:40.480 is taken as evidence

00:10:41.780 of I'm not lovable

00:10:43.000 or that person

00:10:43.800 is terrible.

00:10:45.440 Right.

00:10:46.220 It just distorts

00:10:47.560 your whole view

00:10:50.680 of, frankly,

00:10:51.800 of others

00:10:52.540 because people

00:10:54.080 are always attuned

00:10:55.080 to the negative

00:10:55.820 much more than

00:10:56.560 the positive,

00:10:57.300 unfortunately,

00:10:57.880 but I think we're wired

00:10:58.660 that way

00:10:59.180 through evolution.

00:11:00.880 We always have to be

00:11:01.540 on alert

00:11:02.520 and it blinds you

00:11:06.800 to, for example,

00:11:08.640 that what you

00:11:09.320 might be doing.

00:11:10.380 I mean, listen,

00:11:11.000 this is one of the purposes

00:11:12.000 of therapy.

00:11:13.720 I mean, there's therapy

00:11:14.560 for people.

00:11:15.760 I'm a psychiatrist,

00:11:16.860 so we deal,

00:11:17.780 well, my personal interest

00:11:19.040 is people who are

00:11:19.760 really mentally ill. 0.68

00:11:21.400 For example,

00:11:22.420 they have psychotic problems, 0.53

00:11:23.940 so their symptom,

00:11:25.660 you know,

00:11:25.800 we want to get rid

00:11:26.460 of the hallucinations

00:11:27.280 and the delusions

00:11:28.120 and that kind of thing,

00:11:29.260 but in the kind

00:11:30.380 of therapy

00:11:30.800 you're talking

00:11:31.460 about,

00:11:33.060 you know,

00:11:33.360 which is for people

00:11:34.080 who have problems

00:11:34.620 in living

00:11:35.500 or even people

00:11:36.600 who are very,

00:11:37.200 very distressed,

00:11:38.700 but, you know,

00:11:40.120 one of the things

00:11:41.460 is to,

00:11:43.720 as I say,

00:11:44.660 not only get out

00:11:45.400 of yourself,

00:11:45.880 but to develop

00:11:47.000 some insight

00:11:49.620 and introspection

00:11:52.640 so you can see

00:11:53.740 how you sabotage yourself.

00:11:55.540 I mean,

00:11:55.700 that is such a big part

00:11:57.180 of psychotherapy

00:11:59.120 is to help people

00:12:00.040 understand

00:12:00.700 how unwittingly

00:12:02.640 they're working

00:12:03.100 against their own

00:12:03.840 best interests.

00:12:05.300 And, again,

00:12:06.080 if you have this mindset

00:12:07.000 of blaming everybody else,

00:12:09.040 it's not conducive

00:12:10.540 to gaining much,

00:12:13.340 to not being introspective.

00:12:14.940 So it's just destructive

00:12:16.660 on so many levels.

00:12:18.140 I mean,

00:12:19.040 when you first get

00:12:19.660 to know a patient,

00:12:20.700 and, again,

00:12:21.120 we're not talking

00:12:21.820 about a patient relationship

00:12:23.380 on Instagram,

00:12:24.620 I mean,

00:12:25.160 you listen to folks

00:12:26.400 talk,

00:12:26.880 you basically spend

00:12:27.840 the first several sessions

00:12:29.060 listening to them

00:12:29.880 blame everybody else.

00:12:31.500 But then,

00:12:33.220 you know,

00:12:33.460 because you can't

00:12:34.080 challenge someone

00:12:34.740 out of the gate,

00:12:35.680 you know,

00:12:35.860 you want to develop

00:12:36.520 a relationship

00:12:37.200 that you're,

00:12:38.020 you know,

00:12:38.480 concerned and you're

00:12:39.400 open to their,

00:12:40.420 you know,

00:12:40.880 their perspectives

00:12:42.340 and their complaints.

00:12:43.620 But then you start,

00:12:44.940 if they're open-minded

00:12:46.560 and if they're not

00:12:47.340 psychologically minded,

00:12:48.520 why are they in therapy

00:12:49.360 at all?

00:12:50.160 If people are so awful

00:12:51.200 to them or if they've

00:12:52.000 really been so misused

00:12:53.540 by the system,

00:12:54.180 they need a lawyer 0.91

00:12:54.960 and not a psychiatrist.

00:12:56.520 I mean,

00:12:56.740 our job is to,

00:12:58.060 again,

00:12:58.660 is to help people

00:12:59.580 cultivate a kind of self,

00:13:02.520 a posture of self-observation.

00:13:04.660 Why do you think

00:13:06.300 a segment of psychiatry,

00:13:08.100 whether it's just,

00:13:09.180 you know,

00:13:09.540 pseudo-psychiatrists online

00:13:11.200 or whether it's,

00:13:12.140 you know,

00:13:12.740 an actual therapist

00:13:13.880 in the office,

00:13:14.860 why do you think

00:13:15.380 it's moved this direction

00:13:16.340 towards taking all agency

00:13:18.680 away from someone

00:13:19.940 and trying to soothe

00:13:21.140 someone's anxiety

00:13:22.880 or depression

00:13:23.720 or distress

00:13:24.300 simply by blaming systems

00:13:27.520 outside of them,

00:13:28.400 blaming other people

00:13:29.740 and basically just telling them,

00:13:31.340 telling them that everything

00:13:32.760 that they're doing is right

00:13:34.580 and any of the problems

00:13:35.720 that they're facing

00:13:36.440 really can be placed

00:13:37.980 on other people's feet.

00:13:39.380 Like,

00:13:39.560 what ideology

00:13:40.620 or what trend

00:13:41.840 is moving

00:13:43.620 mental health medicine

00:13:45.380 in that direction

00:13:46.520 if you think

00:13:47.220 it really is going

00:13:48.020 that direction?

00:13:49.120 I don't see it going

00:13:50.120 that direction

00:13:50.680 in psychiatry,

00:13:51.980 but a lot of these people,

00:13:53.340 let's say,

00:13:53.680 to be honest,

00:13:54.640 well,

00:13:55.060 good psychiatry.

00:13:56.480 Yeah.

00:13:56.680 And that is a big qualifier,

00:13:57.900 I realize,

00:13:58.600 but,

00:13:58.960 you know,

00:14:00.000 if you're not trained,

00:14:01.800 then you're going

00:14:03.120 to imbibe

00:14:05.340 all these cultural tropes,

00:14:07.320 you know,

00:14:07.860 which have been,

00:14:09.060 you know,

00:14:09.520 victimhood,

00:14:10.180 and as you said,

00:14:10.820 everybody gets a trophy

00:14:11.920 and everyone needs self-esteem.

00:14:14.180 Well,

00:14:14.300 you have to earn self-esteem.

00:14:15.440 Yes,

00:14:15.740 of course,

00:14:16.240 there's a basic level

00:14:17.300 of,

00:14:17.620 you know,

00:14:18.520 self-worth

00:14:19.060 everyone should have,

00:14:21.380 but above that,

00:14:23.880 you know,

00:14:24.500 you have to earn

00:14:25.100 these things,

00:14:25.760 and I think

00:14:27.040 that some of these therapists

00:14:30.760 are probably extremely,

00:14:32.300 I'll just say it,

00:14:33.520 they're just immature,

00:14:35.240 and it's gratifying to them

00:14:38.080 to have the kind of gratitude

00:14:40.900 that the public would

00:14:43.940 perhaps offer them,

00:14:45.540 because that's a very quick way

00:14:47.880 to get,

00:14:48.660 to have people be grateful to you

00:14:50.260 and to attract them,

00:14:53.580 is to exonerate them.

00:14:54.880 I mean,

00:14:55.380 everyone wants to be exonerated.

00:14:56.980 I do.

00:14:57.440 I don't want to sometimes

00:14:58.620 take responsibility for,

00:15:00.200 you know,

00:15:00.360 or acknowledge that

00:15:01.180 I may be contributing

00:15:02.580 to the trouble I'm in

00:15:05.620 or trouble I,

00:15:06.720 or the distress I feel,

00:15:08.620 but that's,

00:15:10.380 again,

00:15:10.760 that's the mature stance,

00:15:13.420 and,

00:15:13.940 you know,

00:15:14.580 part of therapy

00:15:15.340 is to learn

00:15:16.520 how to deliver

00:15:17.180 some of these hard truths,

00:15:18.500 but in a,

00:15:19.600 you know,

00:15:20.260 in a respectful

00:15:20.980 and caring way.

00:15:22.200 I mean,

00:15:22.400 so much about the training

00:15:23.780 is learning

00:15:25.160 how to deliver these,

00:15:28.140 you know,

00:15:28.400 ask these questions

00:15:29.460 about,

00:15:29.860 well,

00:15:30.020 maybe,

00:15:30.520 you know,

00:15:31.180 did you ever thought

00:15:32.180 of maybe there's something

00:15:33.020 you're doing,

00:15:33.980 you don't quite realize it,

00:15:35.340 but what might you be doing

00:15:36.460 that maybe elicits

00:15:37.860 this response all the time?

00:15:39.360 Because it seems

00:15:39.960 to be a pattern.

00:15:41.340 I mean,

00:15:41.500 clearly,

00:15:41.980 if something's a pattern,

00:15:43.060 that's your,

00:15:43.540 you know,

00:15:44.300 that's your wedge

00:15:45.020 into helping the person

00:15:46.660 become curious about,

00:15:48.320 gee,

00:15:48.640 you know,

00:15:48.960 maybe,

00:15:50.020 hmm,

00:15:50.360 why is this happening

00:15:51.160 to me all the time?

00:15:52.160 Could I possibly be contributing

00:15:53.700 to it in some way?

00:15:55.120 Yeah.

00:15:55.680 And all that takes time

00:15:56.940 and it can't possibly be just,

00:15:59.100 you know,

00:16:00.680 in a Instagram,

00:16:02.160 isn't Instagram like,

00:16:03.640 it's really short,

00:16:04.700 right?

00:16:05.360 Yes.

00:16:05.760 You can't get into any detail.

00:16:07.900 It's mostly graphics.

00:16:09.420 Subtlety.

00:16:10.120 Yes.

00:16:10.580 It's mostly kind of graphics

00:16:11.780 that people,

00:16:12.800 there's just a lot of,

00:16:13.820 even if the people posting

00:16:15.500 these things

00:16:16.780 don't consider themselves

00:16:18.240 therapists in some way,

00:16:20.280 it's just a lot of

00:16:21.380 very trite phrases

00:16:23.180 that I think people

00:16:24.080 internalize

00:16:24.720 and they think

00:16:25.320 they think counts

00:16:26.900 for like helping

00:16:27.620 their mental health,

00:16:28.540 things like,

00:16:29.440 if, you know,

00:16:30.240 if someone thinks

00:16:31.120 you're too much,

00:16:32.180 they should just

00:16:32.680 go find less

00:16:33.900 and you need to cut

00:16:34.900 all the toxic people

00:16:35.940 out of your life

00:16:36.480 and you deserve more

00:16:37.580 and maybe those things

00:16:38.840 are true

00:16:39.320 in some people's

00:16:40.160 situation,

00:16:40.920 whatever,

00:16:41.360 but as you mentioned,

00:16:42.640 the people that are

00:16:43.600 posting those graphics

00:16:44.640 for likes,

00:16:45.240 which you just said,

00:16:46.260 that's why they do it

00:16:47.160 because people like

00:16:48.380 to feel exonerated

00:16:49.520 and so if you're posting

00:16:50.520 these things on Instagram,

00:16:51.380 people are going to

00:16:51.980 follow you

00:16:52.360 because you make

00:16:52.800 them feel better

00:16:53.380 about their circumstances

00:16:54.920 perhaps because you are

00:16:57.600 kind of alleviating

00:16:58.440 any responsibility

00:16:59.140 they may feel

00:17:00.200 but it's all of just

00:17:01.280 these little trite

00:17:02.520 mantras and sayings

00:17:03.960 that are,

00:17:05.240 they're aimed at making

00:17:07.040 women feel better 0.99

00:17:07.800 about themselves

00:17:08.600 but at the end of the day,

00:17:09.640 I think it really just

00:17:10.580 makes a lot of people

00:17:11.720 more selfish

00:17:12.380 and justify their selfishness

00:17:14.460 as saying it's a form

00:17:16.060 of like growth

00:17:16.580 and maturity

00:17:17.080 but really

00:17:18.020 it's just

00:17:18.820 it's actually the opposite

00:17:19.740 it's immaturity

00:17:20.420 because they're blaming

00:17:21.100 everyone else

00:17:21.640 for their problems

00:17:22.300 but it seems to be linked

00:17:28.340 it seems to be linked

00:17:29.060 to an ideology

00:17:29.740 that you've talked

00:17:30.540 about a lot

00:17:31.420 that seeks

00:17:32.740 to remove agency

00:17:33.820 from people

00:17:34.420 and put it on systems

00:17:35.460 and you kind of got

00:17:36.620 in quote unquote

00:17:37.600 like trouble

00:17:38.620 maybe a controversy

00:17:39.860 for this

00:17:40.560 at Yale University

00:17:41.540 last year

00:17:43.000 when you were talking

00:17:43.740 about the opioid epidemic

00:17:46.300 you gave a lecture

00:17:47.240 at the Department

00:17:48.020 of Psychiatry

00:17:48.780 there at Yale

00:17:49.560 and you talked about

00:17:50.740 both the internal

00:17:51.740 and external factors

00:17:53.200 that can lead

00:17:53.880 to substance abuse

00:17:54.960 but there was

00:17:57.520 an unidentified group

00:17:59.400 of concerned Yale

00:18:00.420 psychiatry residents

00:18:02.240 who took issue

00:18:03.080 with what you said

00:18:03.840 basically said

00:18:04.880 that it was racist

00:18:05.680 that it was classist

00:18:07.800 and I don't know

00:18:08.780 I guess that you didn't

00:18:09.600 blame the system

00:18:10.460 quite enough

00:18:11.060 can you talk about

00:18:12.240 what happened there

00:18:13.200 and how that

00:18:13.860 may be indicative

00:18:14.680 of something pernicious

00:18:17.080 that's happening

00:18:17.920 in psychiatry

00:18:18.820 as a whole

00:18:19.300 well this is happening

00:18:21.140 in medicine

00:18:21.640 as a whole

00:18:22.280 it's very worrisome

00:18:23.380 to me

00:18:23.760 it's what I call

00:18:25.620 kind of a woke intrusion

00:18:27.060 I always send

00:18:27.660 quotes around woke

00:18:28.660 because people

00:18:30.820 criticize you

00:18:31.740 for that not being

00:18:32.860 a real issue

00:18:33.440 well it is a real

00:18:35.260 it certainly is a real issue

00:18:37.020 and the way

00:18:37.920 it often manifests

00:18:38.900 again is that

00:18:39.900 frankly almost

00:18:41.920 every problem

00:18:42.620 in the case

00:18:43.280 of health

00:18:43.620 of medicine

00:18:44.360 it's a health

00:18:45.060 problem

00:18:45.560 is due

00:18:47.600 to systemic

00:18:49.360 forces

00:18:50.000 and you know

00:18:50.540 look again

00:18:51.180 sometimes

00:18:51.740 I'm not saying

00:18:53.240 that's not

00:18:54.640 never the case

00:18:56.020 the question is

00:18:57.380 what are psychiatrists

00:18:59.220 supposed to do

00:18:59.740 about it

00:19:00.060 we can diagnose

00:19:00.980 we can treat

00:19:01.880 and believe me

00:19:03.400 doctors don't get 0.50

00:19:04.220 to spend enough

00:19:04.900 time with patients

00:19:05.700 that's the real

00:19:06.900 one of the real

00:19:07.600 problems

00:19:08.160 but

00:19:09.800 you know

00:19:10.720 we can inform

00:19:11.460 policy makers

00:19:12.420 about the kind

00:19:13.200 of external

00:19:14.200 forces that

00:19:14.880 affect health

00:19:15.500 and hopefully

00:19:16.000 they can

00:19:16.540 enact some

00:19:17.420 reforms

00:19:17.900 but we already

00:19:19.080 have a job

00:19:19.800 and if the public

00:19:20.420 sees this as

00:19:21.000 too politicized

00:19:21.900 it's really going

00:19:22.460 to damage

00:19:22.840 our credibility

00:19:24.300 so

00:19:25.020 but one of the

00:19:26.460 big themes

00:19:27.140 that was pretty

00:19:28.000 hundred thousand feet

00:19:29.580 but you know

00:19:30.820 but one of the

00:19:31.300 big themes

00:19:31.940 is that

00:19:32.740 in this talk

00:19:36.320 well this talk

00:19:36.980 I gave

00:19:37.480 was

00:19:38.060 about a year

00:19:40.160 I spent

00:19:40.780 in this

00:19:41.280 a fairly small

00:19:42.440 town in

00:19:42.960 southeastern Ohio

00:19:44.000 it's called

00:19:45.260 Ironton

00:19:45.700 for anyone

00:19:46.360 who's

00:19:46.800 may have

00:19:47.360 heard of it

00:19:47.860 and

00:19:48.400 I was just

00:19:49.600 back visiting

00:19:50.280 and it's a town

00:19:51.480 of ten thousand

00:19:52.240 and it's

00:19:52.780 in some ways

00:19:53.840 like so many

00:19:54.800 of the towns

00:19:55.360 you know

00:19:55.640 we've read about

00:19:56.320 where the

00:19:56.800 you know

00:19:57.440 the economy

00:19:57.920 is struggling

00:19:58.480 and

00:19:58.920 drug abuse

00:20:01.220 is a huge

00:20:01.860 problem

00:20:02.400 and now

00:20:03.040 the opioid

00:20:03.520 crisis

00:20:03.940 has largely

00:20:04.540 moved on

00:20:05.060 to fentanyl

00:20:05.620 which is

00:20:06.000 very deadly

00:20:06.620 so

00:20:07.200 lots of

00:20:08.040 overdoses

00:20:08.540 it's really

00:20:09.040 very tragic

00:20:09.720 so right

00:20:11.820 I was talking

00:20:12.440 about

00:20:12.960 addiction

00:20:13.780 which

00:20:14.320 I frankly

00:20:15.520 think is

00:20:16.120 kind of more

00:20:17.280 productive

00:20:17.700 to see as a

00:20:18.440 symptom

00:20:18.820 even than a

00:20:19.840 disease

00:20:20.200 because it

00:20:21.220 often points

00:20:21.980 to something

00:20:22.680 a person

00:20:23.140 is trying

00:20:23.620 to either

00:20:24.180 medicate

00:20:25.240 within themselves

00:20:25.900 or if they

00:20:26.500 live in a

00:20:27.180 community

00:20:27.680 that appears

00:20:29.680 to hold no

00:20:30.240 future for them

00:20:31.160 as I said

00:20:31.760 as economically

00:20:32.460 distressed

00:20:33.280 where the

00:20:33.640 educational

00:20:34.180 system is so

00:20:34.940 bad

00:20:35.280 when their

00:20:35.600 parents

00:20:36.160 maybe

00:20:37.320 have drug

00:20:38.300 problems

00:20:38.660 as well

00:20:39.160 and you

00:20:41.320 know

00:20:41.420 you live in

00:20:41.980 places where

00:20:42.600 you feel

00:20:42.960 trapped

00:20:43.460 that in

00:20:44.380 itself

00:20:45.020 I think

00:20:45.500 we've heard

00:20:47.000 of deaths

00:20:47.340 of despair

00:20:47.980 well these

00:20:48.380 are lives

00:20:48.820 of despair

00:20:49.380 and that

00:20:49.800 also

00:20:50.780 makes drugs

00:20:52.260 look attractive

00:20:52.920 but we

00:20:56.300 also know

00:20:56.820 how

00:20:57.100 most people

00:20:58.080 recover

00:20:58.560 actually

00:20:59.740 that's not

00:21:00.180 known

00:21:00.500 but most

00:21:01.000 people

00:21:01.280 actually

00:21:01.760 recover

00:21:02.200 and they

00:21:02.540 recover

00:21:02.940 without

00:21:03.440 professional

00:21:04.320 help

00:21:04.740 but I'm

00:21:05.760 not arguing

00:21:06.360 you shouldn't

00:21:06.860 get professional

00:21:07.520 help

00:21:07.860 anyway

00:21:08.700 so I was

00:21:09.120 talking about

00:21:09.960 this

00:21:11.620 and then

00:21:13.080 afterwards

00:21:15.600 one of the

00:21:16.420 residents

00:21:17.240 said

00:21:17.900 he was

00:21:18.560 offended

00:21:19.140 because

00:21:21.220 I talked

00:21:22.640 about

00:21:23.020 agency

00:21:23.740 and addiction

00:21:24.460 and

00:21:25.740 right

00:21:26.900 and that

00:21:27.860 didn't I

00:21:28.380 know

00:21:28.820 that people

00:21:29.600 were

00:21:30.120 basically

00:21:30.960 using drugs

00:21:31.800 because of

00:21:32.380 systemic

00:21:32.760 forces

00:21:33.340 and

00:21:34.160 you know

00:21:34.880 again

00:21:35.240 even if

00:21:35.640 they are

00:21:36.060 then what's

00:21:36.600 the solution

00:21:38.300 to that

00:21:39.200 for us

00:21:40.620 as psychiatrists

00:21:41.640 and he said

00:21:41.980 well our

00:21:42.360 job

00:21:43.100 you know

00:21:43.400 I try to

00:21:44.580 remind him

00:21:45.260 really as

00:21:46.180 nicely

00:21:46.540 as I could

00:21:47.680 but you

00:21:48.440 know our

00:21:48.740 job is to

00:21:49.440 take those

00:21:49.900 remnants of

00:21:50.500 agency

00:21:51.080 that everyone

00:21:52.180 has

00:21:52.720 I mean even

00:21:53.160 when you're

00:21:53.480 in the midst

00:21:53.860 of addiction

00:21:54.280 you make

00:21:54.780 all kinds

00:21:55.360 of choices

00:21:55.920 you know

00:21:56.340 is this

00:21:56.680 the day

00:21:57.180 you know

00:21:58.100 I

00:21:58.560 you know

00:21:59.460 a lot of

00:21:59.860 people who

00:22:00.520 are addicted

00:22:00.880 are actually

00:22:01.460 fairly functional

00:22:02.680 I think we

00:22:03.160 have this

00:22:03.600 sense that

00:22:04.360 there are

00:22:04.640 people are

00:22:04.980 just strung

00:22:05.540 out nodding

00:22:06.320 out all

00:22:06.840 day and

00:22:08.060 some people

00:22:09.120 are but

00:22:09.440 that's not

00:22:09.880 typically you

00:22:10.660 know people

00:22:11.740 do things

00:22:12.500 actually people

00:22:13.280 hold jobs

00:22:14.180 now probably

00:22:15.040 not as well

00:22:15.680 as we think

00:22:16.340 they you know

00:22:17.120 they don't work

00:22:17.760 they're not the

00:22:18.120 best workers

00:22:18.760 necessarily but

00:22:19.740 they do or

00:22:20.800 they go pick

00:22:21.540 up their kids

00:22:22.100 from school or

00:22:22.880 does your dad

00:22:23.540 pick up you

00:22:24.120 from school or

00:22:25.000 you know or

00:22:25.580 whatever you know

00:22:26.200 all these kinds

00:22:27.100 of choices people

00:22:27.980 can make and

00:22:28.740 and you know

00:22:30.340 those choices of

00:22:31.100 course could be

00:22:31.880 today's the day

00:22:32.560 I go to

00:22:32.920 treatment the

00:22:33.840 problem is so

00:22:34.720 many people

00:22:35.500 who've used

00:22:36.240 drugs for so

00:22:36.980 long already

00:22:39.300 were attracted

00:22:39.940 to drugs because

00:22:40.780 of some sort

00:22:41.440 of pain that

00:22:42.200 they were trying

00:22:42.680 to to medicate

00:22:43.700 and I don't

00:22:44.120 mean physical

00:22:44.640 I mean

00:22:45.000 psychological

00:22:45.560 and then there's

00:22:46.560 a second layer

00:22:47.400 of distress

00:22:48.500 that's built up

00:22:49.520 by all the

00:22:50.240 trouble and

00:22:51.520 problems that

00:22:52.280 have been

00:22:52.720 generated because

00:22:53.540 of the addiction

00:22:54.420 all the friends

00:22:55.200 you've lost

00:22:55.700 all the relationships

00:22:56.680 you've burned

00:22:57.300 all the jobs

00:22:58.340 you may lost

00:22:58.900 the money you

00:22:59.580 spent the health

00:23:00.480 that you know

00:23:01.040 you may have lost

00:23:01.880 because of it

00:23:02.460 and and that

00:23:03.860 in itself is so

00:23:04.900 distressing that it

00:23:05.700 becomes even harder

00:23:06.680 to stop so I'm

00:23:07.640 very sensitive to

00:23:08.820 the notion that it

00:23:10.120 can be very hard

00:23:11.280 to break the habit

00:23:12.100 but people do do

00:23:13.440 it all the time

00:23:14.380 and and they do

00:23:16.720 it by largely

00:23:19.320 by us being able

00:23:20.320 to to you know

00:23:21.400 show them that

00:23:22.100 there's some kind

00:23:23.120 of hope and

00:23:23.780 there's some kind

00:23:24.460 of help so they

00:23:25.080 can feel that they

00:23:26.280 can can do it

00:23:27.660 and there are

00:23:28.000 strategies called

00:23:28.880 relapse prevention

00:23:29.780 and we have

00:23:30.440 medications if

00:23:31.480 you're if it's

00:23:32.380 an opioid problem

00:23:33.380 you can be on

00:23:33.940 methadone or

00:23:34.500 buprenorphine all

00:23:35.500 these things to

00:23:36.080 break the cycle

00:23:36.900 and then start

00:23:38.160 helping people

00:23:38.820 rebuild their lives

00:23:39.920 but I told him

00:23:41.080 I feel I'm going

00:23:42.000 on here but I

00:23:42.740 basically told

00:23:43.780 this kid I

00:23:45.300 mean it was

00:23:45.920 24 year old I'm

00:23:47.160 sure that's a kid

00:23:47.780 yeah a resident

00:23:48.960 that well thank

00:23:50.900 goodness there

00:23:51.840 there is some

00:23:53.020 some traces of

00:23:55.720 of agency still

00:23:57.040 left because

00:23:57.680 that's what we

00:23:58.240 can work on

00:23:59.160 and that is our

00:24:00.640 job to help

00:24:01.460 people basically

00:24:02.500 you know weave

00:24:03.640 those tatters

00:24:04.480 into a tapestry

00:24:05.780 of self of

00:24:06.580 mastery because

00:24:07.620 that's really you

00:24:09.660 know again unless

00:24:10.420 unless we're

00:24:11.240 talking the

00:24:11.760 severely mentally

00:24:12.660 ill folks who

00:24:13.380 need a real

00:24:14.280 symptom relief

00:24:15.200 you know that's

00:24:17.060 ultimately what we

00:24:18.020 are talking about

00:24:18.980 is the kind of

00:24:20.160 of of self

00:24:21.860 control that

00:24:22.680 lets you have

00:24:23.360 more choices

00:24:24.260 and so you

00:24:25.820 don't feel you

00:24:26.940 know constrained

00:24:27.560 that there's only

00:24:28.220 one way for me

00:24:29.020 to act that you

00:24:30.100 can step back and

00:24:30.980 see that there's a

00:24:31.960 an array of things

00:24:33.120 you can do and

00:24:34.840 I mean that's the

00:24:35.600 ultimate freedom but

00:24:37.040 that only comes with

00:24:38.220 responsibility and

00:24:39.240 self-control I mean

00:24:40.380 that I mean that

00:24:41.920 seems I think

00:24:42.680 somehow counterintuitive

00:24:44.180 to some people but

00:24:45.120 you have you have

00:24:46.980 more freedom when

00:24:48.080 you have self

00:24:48.700 discipline

00:24:49.200 mm-hmm and

00:24:50.940 you know we

00:24:51.500 this is a

00:24:52.160 Christian podcast

00:24:53.020 and so people

00:24:54.260 listening to this

00:24:54.860 know that self

00:24:55.640 control is a

00:24:56.980 fruit of the

00:24:57.820 spirit self

00:24:58.520 control is

00:24:59.320 something that

00:24:59.880 Christians are

00:25:00.580 supposed to

00:25:01.200 don and supposed

00:25:02.280 to emulate and

00:25:03.860 unfortunately I do

00:25:04.700 kind of see a lot

00:25:05.480 of Christians fall 0.92

00:25:06.220 into this woke

00:25:06.860 ideology of only

00:25:08.100 blaming other

00:25:08.980 things for people's

00:25:10.120 problems and as

00:25:10.900 you said it's not

00:25:11.600 either or it

00:25:12.760 really is both

00:25:13.940 and and you've

00:25:15.280 talked about this

00:25:16.080 problem within

00:25:17.680 psychiatry or I

00:25:18.840 guess as you

00:25:19.520 said earlier in

00:25:20.260 medicine as a

00:25:21.340 whole of removing

00:25:24.660 agency and taking

00:25:27.000 away a doctor's

00:25:29.340 responsibility to

00:25:30.600 more look at the

00:25:32.580 more proximate causes

00:25:34.240 of what's going on

00:25:35.440 and to kind of just

00:25:36.260 become activists and

00:25:37.960 experts in things that

00:25:39.180 you guys didn't go to

00:25:40.580 school for like housing

00:25:42.420 and things like that

00:25:43.140 that doesn't mean that

00:25:43.800 you shouldn't care

00:25:44.340 about that but I've

00:25:45.200 what I've heard you

00:25:45.860 talked about is

00:25:46.640 that trying to get

00:25:48.640 doctors to only

00:25:50.320 look at these big

00:25:51.280 systemic problems

00:25:52.320 potential systemic

00:25:53.380 problems or verified

00:25:55.100 systemic problems and

00:25:56.620 taking them away from

00:25:57.580 actually treating the

00:25:58.740 symptoms that are right

00:25:59.720 in front of you and

00:26:00.940 looking at the

00:26:01.680 possibility of agency

00:26:02.940 and the role that it

00:26:03.700 plays in a person's

00:26:04.640 problems that's

00:26:05.540 actually hurting the

00:26:06.660 industry as a whole

00:26:07.700 correct?

00:26:08.220 Well it's a very

00:26:10.500 worrisome experiment

00:26:11.600 that's going on.

00:26:14.000 I mean you mentioned

00:26:14.860 for example housing.

00:26:17.360 Now we know that

00:26:18.660 especially for kids

00:26:20.560 you know some of this

00:26:22.380 public housing and

00:26:23.580 other kinds of really

00:26:25.460 you know poor quality

00:26:27.280 housing lots of

00:26:29.200 roaches lots of

00:26:30.360 mold lots of allergens

00:26:31.700 and for kids with

00:26:32.700 asthma that's terrible

00:26:34.580 and it was important

00:26:36.860 research that that

00:26:38.360 doctors and other

00:26:40.020 scientists did to

00:26:41.060 to discover what

00:26:42.820 kinds of

00:26:43.860 you know what kinds

00:26:46.780 of irritants are

00:26:47.660 are out there and

00:26:48.720 are part of housing

00:26:49.920 and I'm sure

00:26:51.100 ventilation is not

00:26:52.280 good in these places

00:26:53.220 and that was an

00:26:55.060 important research.

00:26:56.520 I'm not saying that

00:26:57.160 by no means should

00:26:58.320 that not have been

00:26:59.020 done.

00:26:59.240 That's very important

00:27:00.180 and that has to be

00:27:02.340 and people who run

00:27:04.240 housing you know

00:27:06.500 housing systems have

00:27:07.440 to know that and

00:27:09.120 and doctors should 0.87

00:27:10.080 even frankly ask

00:27:11.240 about that you know

00:27:12.040 where if the kid

00:27:12.740 comes in with these

00:27:13.640 problems you know

00:27:14.320 where are you living

00:27:15.040 and is there mold?

00:27:16.020 I think that's

00:27:16.440 perfectly reasonable

00:27:17.360 for a doctor to ask

00:27:18.440 and and that then

00:27:20.520 goes to the social

00:27:21.400 worker.

00:27:21.820 Listen we have to try

00:27:22.640 to help you know

00:27:23.940 get this family a 0.68

00:27:24.840 better house.

00:27:25.520 We you could even

00:27:26.800 report it.

00:27:27.640 There's nothing wrong

00:27:28.340 with that reporting

00:27:29.040 it to the housing

00:27:29.860 authority but to

00:27:31.140 take on housing

00:27:32.120 policy you know

00:27:34.140 is absurd.

00:27:35.100 It's a distraction

00:27:35.960 from what we do

00:27:37.240 plus we don't know

00:27:38.320 how to do it.

00:27:39.500 That's not what

00:27:40.180 we're trained in and

00:27:41.880 and also since to

00:27:44.200 be honest so many

00:27:44.900 doctors these days

00:27:45.760 are quite progressive

00:27:46.740 they might have a

00:27:47.880 different notion of

00:27:49.820 how one fixes

00:27:50.620 housing policy that

00:27:52.860 might be you know

00:27:54.300 in a direction that

00:27:55.480 is you know

00:27:58.160 frankly not

00:27:58.740 compatible with

00:27:59.660 the you know

00:28:00.940 the general view

00:28:01.600 of patients which

00:28:02.500 is why is my

00:28:03.220 doctor getting so

00:28:04.160 involved with this

00:28:04.920 they should be

00:28:05.960 spending their

00:28:06.500 their time you

00:28:07.520 know with me

00:28:08.300 now that may sound

00:28:09.580 like a slightly

00:28:10.140 tortured example

00:28:11.060 but but honestly

00:28:12.100 if you read

00:28:13.340 you know

00:28:14.200 it's a new

00:28:14.540 publication from

00:28:15.440 the American

00:28:15.920 Medical Association

00:28:17.180 and others

00:28:17.800 they truly want

00:28:19.300 doctors or they

00:28:20.540 urge doctors to

00:28:21.720 you know

00:28:22.080 dismantle racism

00:28:23.660 and I mean

00:28:25.960 I don't even

00:28:26.500 frankly I don't

00:28:27.640 know quite what

00:28:28.160 that means I'm

00:28:28.660 not denying that

00:28:29.400 there is some

00:28:30.400 but not denying

00:28:31.320 that there's

00:28:32.240 remnants of

00:28:33.040 systemic racism

00:28:33.820 probably still

00:28:34.900 some that's

00:28:36.000 active not denying

00:28:37.100 that and as a

00:28:38.560 citizen I'm a

00:28:39.800 doctor but as a

00:28:40.680 citizen if if

00:28:42.200 that were my

00:28:43.040 passion then I

00:28:44.180 should work on

00:28:45.220 it all my spare

00:28:47.060 time that's

00:28:47.840 completely fine but

00:28:49.540 but but framing

00:28:51.100 them as part of

00:28:52.040 the mission of

00:28:52.820 medicine is really

00:28:55.080 destructive my

00:28:55.880 mission is not to

00:28:56.800 be a social

00:28:57.320 justice warrior my

00:28:58.560 mission is to

00:28:59.560 treat health I

00:29:02.160 mean treat

00:29:02.600 illness and my

00:29:04.540 identity again

00:29:05.980 would be that of

00:29:07.200 you know a

00:29:08.140 healer not an

00:29:10.280 act not an

00:29:11.040 activist that's

00:29:11.840 something I can

00:29:12.320 do in my own

00:29:12.900 time for sure

00:29:14.080 but that's not

00:29:15.140 part of my

00:29:15.800 identity as a

00:29:16.680 physician and

00:29:17.300 there's a real

00:29:17.980 effort to to

00:29:19.520 try to to

00:29:20.760 try to change

00:29:21.960 that and I

00:29:24.900 mean here's just

00:29:25.820 one example you

00:29:27.360 know folks who

00:29:28.240 have diabetes and

00:29:29.440 this is over

00:29:30.700 represented in

00:29:31.480 minority

00:29:31.880 populations you

00:29:37.360 know some people

00:29:37.880 need insulin some

00:29:38.680 people need other

00:29:39.280 medications but

00:29:41.140 everyone even the

00:29:43.000 one even folks who

00:29:43.800 don't need the

00:29:44.560 medication can

00:29:46.820 control it with

00:29:47.720 diet and exercise

00:29:49.120 and these kinds

00:29:49.960 of kinds of

00:29:51.640 self elements of

00:29:53.380 self-care that you

00:29:57.240 know doctors have

00:29:58.000 to bring to their

00:29:58.700 attention you know

00:29:59.400 these are other

00:29:59.840 things you can do to

00:30:00.720 control your you

00:30:02.720 know control your

00:30:03.320 diabetes I personally

00:30:05.600 find it just it's

00:30:07.300 still unbelievable to

00:30:08.300 me that a doctor

00:30:09.200 once the door is

00:30:10.400 closed and once

00:30:11.340 they're with the

00:30:11.800 individual patient

00:30:12.820 would not bring

00:30:14.300 these up because

00:30:16.400 they require you

00:30:18.040 know they require

00:30:18.960 initiative on the

00:30:20.300 part of the

00:30:20.780 patient and of

00:30:21.620 course if we're

00:30:22.260 conceptualizing every

00:30:23.780 patient as a victim

00:30:24.740 of you know

00:30:26.520 systemic injustice

00:30:28.180 then that you know

00:30:30.020 that doesn't fit but

00:30:31.460 but that is

00:30:32.620 practically what is

00:30:34.440 being that the

00:30:36.240 nature of some of

00:30:36.980 the discussions are

00:30:38.340 such that you could

00:30:40.060 get in trouble for

00:30:40.800 that I was in a

00:30:41.560 discussion or excuse

00:30:42.680 me a colleague was

00:30:43.460 in a discussion

00:30:44.040 about the you know

00:30:45.220 awful increase in

00:30:46.620 suicidal and

00:30:48.220 depression and

00:30:49.040 suicide in young

00:30:49.960 black teens I mean

00:30:51.540 the rate of increase

00:30:52.600 there is higher than

00:30:53.640 any other group the

00:30:55.060 absolute prevalence of

00:30:58.600 suicide is less but

00:30:59.780 the increase is higher

00:31:01.460 than in any other

00:31:02.700 group and the only

00:31:04.720 explanations that were

00:31:06.340 entertained was that

00:31:08.000 of against systemic

00:31:08.940 racism and police

00:31:10.400 brutality and the

00:31:12.680 not about and

00:31:13.680 we weren't allowed to

00:31:14.720 talk about you know

00:31:16.080 what do I mean

00:31:17.400 allowed well you

00:31:18.360 would you basically

00:31:19.220 get a lot of

00:31:19.700 criticism from your

00:31:20.540 colleagues but to

00:31:22.660 talk about the

00:31:23.880 bullying in school

00:31:24.740 which is just awful

00:31:26.000 for some kids and

00:31:27.860 the violence in the

00:31:29.280 neighborhoods which

00:31:29.980 is utterly terrifying

00:31:31.360 but that was not

00:31:33.620 considered a

00:31:35.640 legitimate hypothesis

00:31:37.880 about what could be

00:31:39.520 going on in this

00:31:41.780 community to contribute

00:31:43.100 to the to the

00:31:44.240 distress and and

00:31:45.620 hopelessness of these

00:31:46.560 kids and that's

00:31:47.700 dangerous

00:31:48.240 gosh I have my mind

00:31:54.160 is bursting with so

00:31:55.420 many things when you

00:31:56.700 start with the premise

00:31:58.040 of critical race theory

00:31:59.160 which is basically in

00:32:00.320 crude forms that all

00:32:01.840 white people are 0.70

00:32:02.460 oppressors and all black 0.73

00:32:03.520 or brown people are

00:32:04.340 oppressed by these

00:32:05.220 oppressors and if that

00:32:06.560 really does characterize

00:32:07.780 how you diagnose someone

00:32:09.220 and how you look at the

00:32:10.620 causes of their

00:32:11.640 problems I mean that's

00:32:13.100 going to lead to you

00:32:14.680 know disparate

00:32:15.800 treatments it also

00:32:16.880 could lead to wrong

00:32:18.580 treatments because you're

00:32:19.400 not willing to look at

00:32:20.500 the real problems at

00:32:21.420 hand like you mentioned

00:32:22.320 if a young black man if

00:32:24.440 he is suicidal because

00:32:25.540 he's actually being

00:32:26.380 bullied by people of his

00:32:27.500 own race but you're

00:32:28.720 not allowed to look at

00:32:29.620 that because it has to

00:32:30.800 be some form of white

00:32:32.280 oppression well then

00:32:33.440 you're going to miss

00:32:34.020 you're going to miss the

00:32:34.960 problem you could miss

00:32:35.860 the diagnosis and you

00:32:36.880 could miss the treatment

00:32:37.720 that that person could

00:32:38.600 suffer and really gosh

00:32:40.300 we see this in so many

00:32:41.420 areas when it comes to

00:32:42.500 this so-called anti-racist

00:32:44.520 work that you have to

00:32:46.080 assume that the problem

00:32:47.240 is white supremacy and

00:32:48.460 again that's not to say

00:32:49.660 that that racism is never

00:32:51.080 the problem but if you

00:32:52.260 assume that then you

00:32:54.220 could actually miss the

00:32:56.140 other issues that are at

00:32:57.660 hand and you fail to

00:32:59.700 address the real problems

00:33:01.060 that are causing this

00:33:02.160 group to suffer we've

00:33:03.520 talked and I've heard you

00:33:04.260 talk about this a little

00:33:05.100 bit but we've talked

00:33:06.040 about this before about

00:33:07.180 how the maternal mortality

00:33:08.540 rate among black women

00:33:10.300 is higher than that of

00:33:11.900 any other group and you

00:33:14.260 know there are probably

00:33:15.760 various reasons for that

00:33:17.080 but the assumption the

00:33:19.340 only assumption that I've

00:33:20.400 heard is that it is

00:33:21.340 systemic racism that it's

00:33:22.640 racism against these

00:33:23.560 black women I'm not sure 1.00

00:33:25.540 the CDC also says like the

00:33:27.320 number one cause for

00:33:28.420 maternal mortality is high

00:33:30.000 blood pressure and heart

00:33:31.560 disease and I know that to

00:33:32.700 be we know that to be more

00:33:33.760 prevalent among the

00:33:34.560 African-American population

00:33:35.720 so maybe that's part of

00:33:36.780 it but something that I

00:33:38.060 found interesting in my

00:33:39.180 research is that actually

00:33:41.180 the number one cause of

00:33:42.440 maternal mortality that is

00:33:43.660 not included in the CDC

00:33:44.840 numbers is homicide and it

00:33:47.880 is about eight times more

00:33:49.520 likely among black women

00:33:51.960 who are pregnant than women 0.98

00:33:53.620 of other races and I think

00:33:56.600 it's three times more

00:33:58.160 likely when those black 1.00

00:33:59.660 women are pregnant versus 0.99

00:34:00.500 when they're not pregnant 1.00

00:34:01.260 and it is typically by a

00:34:02.540 domestic partner that's

00:34:04.220 one example of okay we're

00:34:06.660 focusing only on the

00:34:08.040 problem of potential

00:34:08.960 systemic racism we'll look

00:34:10.860 at this huge problem over

00:34:11.800 here that is actually much

00:34:13.320 more prevalent and killing

00:34:14.480 many more women more 0.85

00:34:15.960 black women in particular 0.93

00:34:17.260 than this problem I'm not

00:34:19.500 saying we can't focus on

00:34:20.440 both but when you are

00:34:22.360 missing this huge problem

00:34:23.700 over here because you only

00:34:24.920 want to focus on systemic

00:34:26.180 racism people are going to

00:34:28.320 die because of that like

00:34:29.580 you're creating more

00:34:30.440 victims so I'm just

00:34:32.560 interested to hear you

00:34:33.500 know more of your

00:34:34.020 thoughts not necessarily on

00:34:35.200 that but how this idea is

00:34:37.120 dangerous and manifesting

00:34:38.180 itself in the industry

00:34:39.120 that you're in oh it's

00:34:40.860 very dangerous apparently

00:34:41.900 we're not I don't work in

00:34:44.140 a hospital but I've been

00:34:45.140 told that doctors shouldn't

00:34:47.560 even bring up obesity I'm

00:34:50.080 right my goodness it's just

00:34:51.940 it's unconscionable I've

00:34:55.160 noticed it more in collegiality

00:34:59.080 actually that there's every

00:35:01.720 you know there's a people

00:35:03.620 are sensitized to or younger

00:35:05.860 people there's a

00:35:06.520 generational dimension to

00:35:08.360 this but you know sensitized

00:35:10.260 to microaggressions where I

00:35:13.840 mean that obviously we should

00:35:16.380 also treat each other with you

00:35:18.680 know respect and concern and

00:35:20.400 try to try to always give

00:35:22.980 people the benefit of the

00:35:23.880 doubt but basically a

00:35:25.980 microaggression is a very

00:35:27.360 it's truly in the eye of the

00:35:29.480 beholder and so but but

00:35:33.740 these things are just

00:35:34.640 completely taken out of

00:35:36.080 context and and colleagues

00:35:38.620 are walking on eggshells and

00:35:40.180 some of my some of my

00:35:41.820 colleagues are to the extent

00:35:43.980 they have discretionary time

00:35:45.500 that they can spend teaching

00:35:47.040 versus let's say going being

00:35:48.480 in their lab or you know

00:35:50.280 writing or something they

00:35:52.480 they will not choose that

00:35:54.800 suspend that at a time

00:35:57.020 interacting with residents and

00:35:59.640 medical students out of fear

00:36:01.180 that they're going just to

00:36:02.080 step on a some sort of that

00:36:04.520 they'll commit a microaggressor

00:36:05.840 because you know step on some

00:36:06.800 landmine like I did I mean

00:36:09.460 those students asked the

00:36:10.720 chairman to revoke my you

00:36:14.120 know appointment and you know

00:36:16.500 good for him that he didn't of

00:36:17.980 course but but that's their you 0.56

00:36:20.900 know that's their solution to

00:36:22.160 things is oh my talk took

00:36:25.280 place on January 8th 2001 so

00:36:29.640 they said that I re-traumatized

00:36:31.740 them after January 6th the other

00:36:34.340 re-traumatized apparently the

00:36:35.540 other thing that was so

00:36:36.660 offensive was to call my talk

00:36:38.540 my year abroad and then you know

00:36:42.480 about being in this town and that

00:36:44.260 wasn't you know because that to

00:36:46.340 them that was so othering and so

00:36:48.180 dismissive and I I thought well

00:36:50.300 that's an interesting you know

00:36:51.780 way to think about it and maybe

00:36:53.600 I'll be more sensitive to it in

00:36:55.000 the future but let me tell you

00:36:56.820 other let me tell you my intent

00:36:59.680 behind it you know the idea that

00:37:01.540 we all live in one country and yet

00:37:03.040 there are so many differences and

00:37:04.720 and that that trope of my year

00:37:06.840 abroad is almost always it's almost

00:37:11.200 always heard in the context of I had

00:37:16.000 a fascinating experience I met new

00:37:17.980 people my horizons were broad you

00:37:19.960 know right there was no tolerance of

00:37:21.940 this you know these alternative

00:37:24.100 explanations so it's that plus there

00:37:27.380 are certain things you can't

00:37:28.520 question there was a professor at the

00:37:31.420 University of Pittsburgh medical

00:37:33.440 school brilliant man electrocardiac

00:37:35.560 electrophysiologist who was beloved

00:37:38.080 teacher and he wrote a very scholarly

00:37:40.960 article that was peer-reviewed in the

00:37:43.800 Journal of the American Heart

00:37:44.800 Association questioning affirmative

00:37:47.100 action in medical schools and

00:37:49.680 presented the data which showing that

00:37:51.800 you know for you know reasons of being

00:37:53.780 folks just not being not prepared

00:37:56.640 nothing about their basic you know

00:38:01.480 worth as people just that you know

00:38:04.800 they often come into into medical

00:38:07.060 school or residency you know just less

00:38:09.480 prepared than let's say well white 0.87

00:38:12.200 students is largely a black white thing 0.50

00:38:14.300 and take longer to graduate and come in

00:38:17.480 with poor scores and all this that he

00:38:20.580 was questioning whether this is a

00:38:22.500 policy God knows he's not the first

00:38:24.740 that we should you know the medical

00:38:27.540 schools should pursue because you know

00:38:29.840 advanced advanced education is not the

00:38:32.500 place where you compensate for people

00:38:34.300 who sadly have been you know not

00:38:36.520 trained you know not given the best

00:38:38.440 primary school educations and that

00:38:40.600 compounds itself and you know people

00:38:42.340 get you know passed on in school

00:38:46.220 without having mastered certain things

00:38:47.840 anyway point is he was fired for this

00:38:51.920 yeah he was lost his the chairman

00:38:55.180 excuse me he lost the directorship of

00:38:57.480 his fellowship I am the state of that

00:39:00.020 he wasn't fired from being a doctor

00:39:01.500 from the school but he lost his

00:39:03.180 directorship of the fellowship he and

00:39:05.620 he's not allowed to have contact with

00:39:08.280 residents or medical students and here

00:39:10.580 he is this brilliant teacher who's won

00:39:14.560 awards and I mean that's insane the same

00:39:17.900 thing with some researchers who are

00:39:20.120 looking into genetic differences that

00:39:23.480 that may in one case may translate it

00:39:26.020 into why I mean there are probably many

00:39:27.540 reasons and some of them definitely were

00:39:29.620 class reasons of the kinds of jobs

00:39:32.560 people have the fact they have to take

00:39:33.920 transportation public transportation but

00:39:36.140 you know why african-americans were 0.99

00:39:38.220 disproportionately felled by by covid there

00:39:42.520 are lots of reasons but one of them might

00:39:44.380 actually have been

00:39:45.440 I mean we'll get into it in depth but

00:39:49.400 basically some sort of genetically

00:39:51.360 mediated metabolic dynamic in in the in

00:39:57.040 lung function okay and that was written

00:40:00.600 up I believe it was in JAMA

00:40:02.600 general of the American Medical Association

00:40:04.680 and there was all kinds of pushback because

00:40:07.400 we're not allowed to explore genetic

00:40:12.080 differences that may associate with race

00:40:15.320 and of course I have to underline associate

00:40:17.240 because look every educated person knows

00:40:20.560 there are no discrete racial excuse me

00:40:23.280 genetic differences between race but there

00:40:27.780 are differences in what's called gene

00:40:29.860 frequencies um in other words how common a

00:40:34.020 certain gene might be a gene might that that

00:40:36.360 might predispose to illness uh based on where

00:40:40.600 one's ancestral heritage is I mean the

00:40:43.260 classic one being sickle cell that people

00:40:45.340 whose ancestors have grown up in the

00:40:47.900 Mediterranean or African region can have

00:40:50.180 right but to your point to your point I was

00:40:53.960 actually just reading an article because I

00:40:55.460 met a young woman recently um whose son was

00:40:59.960 born premature he had sickle cell anemia

00:41:01.820 and gosh it was just so hard listening to

00:41:04.500 her and what they're going through and I

00:41:06.140 I decided to just do some research on it

00:41:08.160 just to find out more about it I knew it was

00:41:10.220 more prevalent among African Americans but

00:41:12.120 the article that I found was actually

00:41:14.300 debunking the myth that it's more prevalent

00:41:16.960 in African Americans because it seemed like

00:41:19.320 because of what you're saying that for some

00:41:21.580 reason you're not allowed to talk about that

00:41:24.760 that is somehow racist but to me that would

00:41:28.080 lead to worse care for for black people because

00:41:33.580 I mean the doctor is not even allowed to see

00:41:36.480 something that's true because it might come

00:41:39.740 across as prejudiced in some way that's crazy

00:41:42.180 uh yes I mean one thing I've seen people

00:41:46.220 complain about is it's not just uh an

00:41:49.440 African American affliction and that is true 1.00

00:41:51.940 it could be a Mediterranean flesh okay well

00:41:54.020 that's that's good to know yeah um but we

00:41:56.600 have to know this about people who are from

00:41:58.200 Greek heritage you know as well it's more

00:42:00.580 information and you know of course uh

00:42:03.300 some you know it has echoes uh to me very

00:42:08.120 diminished echoes but to some people obviously

00:42:10.240 louder echoes of eugenics you know this kind 0.99

00:42:12.840 of stuff um but we are well past that um we

00:42:17.020 have very very vibrant bioethics uh um you know

00:42:21.960 bioethical um we're all very they're all very

00:42:27.280 very sensitive to to you know to these histories

00:42:30.680 and you know in fact of course with the uh

00:42:33.860 vaccine you would hear it's funny I I heard

00:42:37.480 both things but uh you would hear well I'm

00:42:40.340 hesitant to take the vaccine because of

00:42:42.800 Tuskegee and then I heard black people say

00:42:44.820 oh stop it yeah that's uh you know they'd say oh

00:42:48.180 come on that's just an excuse people just say

00:42:50.080 that as an excuse but but other people seem

00:42:52.480 sincere and every time you know there were an

00:42:54.660 article in the New York Times that was always

00:42:56.760 gets a million um comments I mean it would be

00:43:00.000 interesting and I did look through them and

00:43:02.040 and there were a number of of people you know

00:43:04.700 identified as African American and said I'm not

00:43:07.360 going near that and they invoked Tuskegee and uh so

00:43:10.480 to them I think they were sincere and it was

00:43:12.480 real so what do we do about that well um I mean

00:43:16.020 one uh very um common and often effective

00:43:19.920 strategy is to um enlist pastors and other people

00:43:25.380 who are respected in the community to try to

00:43:27.760 demystify um you know these uh interventions

00:43:31.740 in this case a vaccine but to you know help folks

00:43:36.520 realize that um you know those days are passed

00:43:40.220 and uh white people are taking the vaccine so

00:43:43.160 obviously if it were so dangerous you know they

00:43:45.440 wouldn't be doing it and I took it and nothing

00:43:48.620 happened to me and uh this kind of thing but you

00:43:52.680 know so those vectors are still around and they

00:43:55.400 flare up from time to time but you know they

00:43:57.780 should never never be used to suppress information

00:44:01.080 or to suppress uh research that's done in good

00:44:04.040 faith never

00:44:04.880 right and I just want to clarify for people that our

00:44:12.460 point really isn't about the vaccine there's plenty of

00:44:15.300 controversy about the vaccine and side effects and

00:44:17.680 things like that the the the point um is that

00:44:21.980 when any industry is is basically saying that all

00:44:29.980 or like this fear of microaggressions towards people of

00:44:34.820 one group that is considered marginalized is actually

00:44:39.100 inhibiting is actually inhibiting medical professionals from

00:44:44.320 treating these people in a way that is right in a way that

00:44:49.220 has to do with the actual causes and the actual symptoms um that

00:44:53.360 they are seeing before them when you kind of move outward and

00:44:56.500 say I'm only allowed to look at these kind of systemic

00:44:59.320 issues and you become an activist rather than a healer

00:45:02.560 um then we have we have a problem and it kind of is

00:45:06.460 it oh I love hearing the little meow that's cute

00:45:09.520 um it's kind of indicative of everything that we're seeing that if you don't say

00:45:14.060 that a disparity is caused by discrimination that there are possible

00:45:19.120 other causes for this disparity then you are considered an unempathetic

00:45:23.820 person like what how did this how did this start how did it start that

00:45:28.160 people that that kind of activism started pervading the medical industry and that

00:45:34.160 everything just became some kind of symptom of trauma

00:45:38.020 everything is considered trauma nowadays um what how did that start and how did it

00:45:43.300 really start infiltrating the industry that you're in in medicine in general

00:45:46.640 well in about 1990 there was a a concept called social determinants of of health and it was

00:45:55.780 coined as a concept obviously it's been around forever and it's it's very legitimate and when

00:46:02.240 i was in medical school i don't think we spent enough time on considering um we mentioned these

00:46:07.980 earlier but considering these other dimensions that affect health and affect affect people's um

00:46:13.840 ability to you know what kinds of choices they have about their health like just for example

00:46:18.700 um it might never occur to to i mean i'm a psychiatrist i don't give medications i need to be refrigerated but

00:46:26.880 some medications need to be in a refrigerator right and it would never you know often never occur to

00:46:33.460 a doctor to to to inquire do you have um you know is your electricity working um do you have people

00:46:42.360 living in your household who might steal your medication and and those things are you know important do you

00:46:48.040 have transportation you know you're going to have to come back i'm going to have to check this uh

00:46:52.680 dressing um you know if you've burned yourself and now i've you know the put dressing on it and

00:46:59.080 antibiotic cream that's going to be have to be changed and and uh checked to make sure it doesn't

00:47:05.040 get infected it never occurred to them that the person couldn't come back because they had no um you

00:47:12.300 there's an older person let's say um you know they couldn't come back so um because they have take

00:47:20.360 three buses or they lived in a place where there wasn't um you know good uh public transportation

00:47:25.560 these things are important um you don't have enough money to um you know sometimes uh certain diets are

00:47:33.100 are indicated and they're more expensive i mean these things are very very important and um i don't think

00:47:40.420 doctors often paid enough attention to be fair and um and and they should have and i think they do now

00:47:47.260 and that was called social determinants of of health um but over time uh that got um i said i would

00:47:57.280 use the word almost got perverted into this view that people have um uh are completely at the mercy

00:48:04.760 of of of their environments and have no control and have no control at all um and and after george

00:48:12.200 floyd uh the murder of george floyd this just took off we're now uh most medical schools are

00:48:18.640 have courses on um implicit bias training which we know there's been ample research that shows implicit

00:48:26.680 the implicit association test which supposedly measures uh racist attitudes um is completely

00:48:34.720 allegedly illegitimate in terms of predicting how people interact with um minority individuals 0.99

00:48:40.580 uh but but that's required in some medical schools some some um departments of of health are requiring

00:48:47.700 that in order to get your license renewed or get your license you have to take this it's a waste of

00:48:54.280 time and it draws attention again to this um this conflict this as if it's pervasive this this

00:49:02.680 struggle between races and it's it's it's it's frankly it's pernicious but it's a waste of time um

00:49:10.640 and um and so this became after again george floyd this just became a big thing with medical schools

00:49:19.240 dedicating themselves to the phrase of course is dismantling racism some of that's posturing i'm sure

00:49:25.580 of it but um uh but but uh but some of it's not and it makes me wonder what they're displacing in the

00:49:32.620 basic curriculum which is very packed you know to enter to to um offer these courses in intersectionality

00:49:40.860 and it's just it is not relevant um no one's saying that there aren't some cultural differences

00:49:47.260 and especially if you work um with populations that are are immigrant populations this is social

00:49:53.980 this is anthropology and you will you should know some of it you should know what the dietary habits

00:49:59.420 are you should know um in general how uh certain cultures uh uh think about illness um and what some

00:50:08.200 home remedies might be because um you know some of them might be even actually harmful sometimes but um

00:50:15.500 but that's important stuff so uh and that goes into the term cultural competence um which is fine

00:50:22.040 that's that's a kind of almost organic um knowledge you should have and would come to have more would

00:50:28.720 you work with immigrant populations so that that's all fine but again this uh now it's turned into a 0.72

00:50:36.480 uh um a very uh almost a kind of an intolerance and a kind of you know almost

00:50:45.400 surveillance uh of of having to look at everything through the lens of again you know racism or

00:50:53.680 oppression and uh you know it's something we should all be sensitized to because that's that is a reality

00:50:59.440 of life but not have it dominate our worldview and distort it yeah it prevents us in general but i

00:51:06.560 would imagine psychiatrists specifically from seeing people as individuals and really looking at their

00:51:12.040 problems well that gets into a whole other issue and you probably don't have time for it but i'll

00:51:17.280 mention it briefly and then um uh you can tell people where to read more about it but uh that's

00:51:24.700 not so much in psychiatry but in the counseling profession there is a very very aggressive effort

00:51:32.840 to introduce uh what a colleague of mine is called like social justice therapy there's kind of no name for

00:51:38.940 right but it's it's it is extremely worrisome and it is just as you started to say it's this um view

00:51:48.440 of the patient not as an individual but as a member of the group whatever identity group he or she is a

00:51:54.720 member of and it's it's a kind of approach a kind of therapeutic you know sort of movement where um

00:52:03.460 where the the therapist kind of comes into the session with almost a uh a pre-formed script or

00:52:10.920 narrative of what's going on so for example if you're a if you're a minority patient and you're

00:52:17.480 uh a client they would call him but you know when you're complaining about your boss you know it could

00:52:22.840 well be your boss is is prejudice against you that could well be but you don't my goodness you don't

00:52:29.240 approach the person with this uh this assumption that all your problems are you know are due to

00:52:36.080 uh a hostile environment um and if you're white i mean there's been

00:52:41.320 lots of vignettes um you know online about this uh about you know white folk especially white men

00:52:51.080 and god forbid they find out you voted you know for trump uh that you're pathological you've just 0.58

00:52:56.760 based on that plus of course you're an oppressor out of the gate right and i mean first off this is

00:53:02.680 not therapy it's it's it's ideology i mean it's it's um frankly it's malpractice is what it is uh but

00:53:09.840 um and i'm i've encouraged people to to be honest to sue and um and for people who are in training

00:53:16.740 programs where they're being inculcated with this kind of approach i think they should sue for fraud

00:53:21.940 that the program is really just not providing a competent um therapeutic uh training but uh

00:53:30.220 how do you have any kind of trusting relationships called a therapeutic alliance with a patient a white 1.00

00:53:36.460 kid who's walked in and wearing medsade god forbid a mega hat and already you're lecturing him right and

00:53:43.500 this is unheard of i mean it's a complete it's unrecognizable this therapy and yet and and as people

00:53:51.380 are you know rolling their eyes going i don't believe it unfortunately i can give you examples

00:53:56.560 well i absolutely know what's happening because we're talking about some of those instagram accounts

00:54:04.660 earlier and it seems like the whole therapy online world is absolutely the wokest world and the

00:54:10.580 quickest to categorize people based on these preconceived notions that's informed by these

00:54:16.120 academic ideas like intersectionality and critical race theory which don't necessarily translate

00:54:21.360 to an individual circumstance and i just think of two things in my own life one i had a counselor

00:54:27.040 who helped me through an eating disorder when i was in college and then two i think about another

00:54:32.540 another thing when i was um when i was young i was a little bit of a tomboy and that i wouldn't wear

00:54:38.040 dresses and i had two older brothers and i didn't want to wear bows or anything like that and i just think

00:54:43.800 about if today's psychiatry or therapy world had informed those two different situations in my life

00:54:51.020 beyond testosterone now yeah right right and like if the preconceived notions of okay well this person

00:54:58.400 is dealing with this so it must be this without knowing anything about that person's you know

00:55:03.260 individual circumstances or what they're dealing with i mean who knows if i would have been helped if i

00:55:08.600 would have just been considered some kind of oppressor complicit in racism because i was white

00:55:13.580 in college and i didn't actually get the individualized help that i needed with my eating

00:55:17.060 disorder or if i had been young and they just assumed because i don't want to wear dresses that i must be a

00:55:21.560 boy like who knows how my life would have turned out but politics and these kind of the political

00:55:27.320 priors of progressivism that so many medical professionals are using as they go in to treat patients i mean

00:55:35.200 that really scares me that just scares me for what kind of care people and especially young people

00:55:41.600 are going to get it's terrifying you come into therapy and you're you're there because you have

00:55:46.680 a problem you're there because you're often kind of shaken in some way you're fragile and and you're

00:55:53.120 very vulnerable and then you get someone who's whose whole therapeutic stance is shaped by ideology

00:56:00.420 uh it's really therapy for them it's it's just it's it's well that's why i'm telling you i really

00:56:06.620 think that you know people should sue i know that sounds fairly aggressive and i've personally never

00:56:12.920 sued anyone in my life but um but if i were subject to this um you know i i would um and uh yeah it's it's

00:56:22.820 there are some groups that uh people uh you know can can uh appeal to to try to get names of i mean

00:56:29.860 i'm on some listservs where it says you know so and so has a patient who wants to work with um

00:56:37.180 they'll use the phrase like a non-woke therapist i mean people going out of their way they're almost

00:56:42.240 i absolutely would assuming that this is the uh way they'll be approached it's so i know it's crazy

00:56:49.780 but if i were looking for a counselor even you know as a christian there are plenty of woke people who

00:56:55.500 are you know in christian therapy too i would absolutely check to see i mean this is just me i'm

00:57:01.640 not saying everyone should do this but i would like to see if that person has pronouns in their

00:57:05.860 profile like what they're saying about things like gender and um how they're approaching the

00:57:13.200 subject of racism and social justice because i don't want to be hated that's what i would fear

00:57:17.480 that i would be hated walking into walking into a therapist's office and that they wouldn't take me

00:57:22.500 seriously because they just assume that i'm on the bad side because of my politics or my

00:57:26.540 worldview or because of the color of my skin i don't think we should have that kind of fear

00:57:31.940 talking to people who want to help us i'm scared that my views would be weaponized against me so

00:57:36.640 someone like me i just won't seek help then i just won't seek help because i'm too scared

00:57:40.880 that the institution has been so thoroughly captured that i'm going to be seen as the bad guy

00:57:45.340 when i'm really trying to get help for a problem i feel like i'm sure a lot of people feel that way

00:57:49.900 probably especially white men that's probably i would say a problem um you just fear that you're

00:57:56.120 going to be seen as the bad guy in all of this yeah or have been seen and then drop you know and

00:58:01.160 then and then drop out uh of therapies so pardon me you're right that's uh a major aversion um pardon me

00:58:11.260 to getting help uh it's uh it's it's it's so it's so painful to think about you know someone who's

00:58:19.000 who's who's desperate and and they're in those hands it's it's it's uh yeah anyway it's yeah just

00:58:27.320 awful so um yeah well um just to kind of close out i'm wondering if you can if you can just like

00:58:34.480 paint a picture just just summarize if the both the positive and the negative maybe the pessimistic

00:58:41.980 and the optimistic outlook on how this could how this could go so if this continues to manifest

00:58:47.940 itself the loss of agency the intersectionality and critical race theory kind of dominating someone

00:58:53.900 view of therapy and psychiatry like how would that look long term but then also if there's any

00:59:00.720 positivity that you see in this direction any positive change and people um kind of realizing

00:59:06.980 that that's a that that's a problem and really trying to work towards giving good individualized

00:59:11.720 care so if you could just kind of show us the good and the bad the possibilities the future of this

00:59:16.960 well actually i think you summarized the bad uh very eloquently a few minutes ago that um you know

00:59:23.660 people realize they're not being really they're not being helped i mean basically if pardon me

00:59:29.880 you may see something on my computer there i mean um uh to the extent that that a patient finds this

00:59:37.220 kind of gratifying in other words they want to hear this that they're a victim then i in some ways

00:59:42.780 you've got a support group of of two that's not therapy that's not challenging someone you know in

00:59:48.720 a constructive and gentle way but people need kind of need to be challenged because as we talked about

00:59:54.620 earlier they're they're they're often often not always but often contributing to their problems and

00:59:59.880 and uh you know ideally a person comes into therapy saying um you know i i feel i i want to understand

01:00:09.280 what i may be doing to uh make myself help or contribute to my you know unhappiness i want to

01:00:15.900 understand myself better and um but then you need a therapist who says well that's that's a uh that's an

01:00:23.800 important question and let me you know let me hear everything i will sit back and listen uh probably

01:00:30.400 for two to three sessions uh you know really it's just gaining a lot of information developing trust

01:00:35.820 that's how it should work if that doesn't work frankly and you get told uh day one what your

01:00:41.160 problem is frankly run for the hills um the good news is that so i think patients although god knows how

01:00:48.680 much damage will be done before this happens you know we'll start to realize that uh this is not

01:00:54.720 not constructive i'm not learning about myself my life isn't changing uh i'm uh if anything it's

01:01:02.160 getting worse but um but the good news right now is that there is a group that has formed uh kind of

01:01:09.500 a almost as like a remedy to the american counseling association which over you know which is the

01:01:15.660 professional organization for so many counselors now there's a group called the international

01:01:19.800 association for psychology and counseling uh international association for psychology and

01:01:26.840 counseling which is a group that's been uh started uh by a frankly a former president of the american

01:01:35.520 counseling association who says no ideology there should be no ideology in counseling good uh short of

01:01:41.660 short of what we short of you know of course theory about what we know about the human mind and

01:01:47.360 behavior and how people change uh but uh but that's fine that's that's clearly what one is trained to do

01:01:54.000 uh in these jobs you know one takes these jobs and uh and we will be a clearinghouse for uh training and

01:02:02.180 we will we could refer people if they you know need uh counselors who are you know classically professional

01:02:08.260 and uh so that's that to me that was very encouraging yes that is an encouraging development

01:02:14.440 that people are recognizing this and organizing to push back against it it's gonna be a battle um

01:02:22.480 and so i i'm i'm hopeful though based on what you just said and i'm hopeful that people like you exist

01:02:28.500 and that you've been talking about this and writing about this um for a long time i agree it should be

01:02:33.820 without ideology the goal is to help people the goal is to heal people and we can't do that if we

01:02:40.460 are blinded by our preconceived notions of what we just assume they're dealing with based on our

01:02:46.460 politics um right or turn them into activists which is another agenda item man and there's just so much

01:02:53.220 that seems to be the problem um one problem in education too and just to touch on i know we got to

01:02:58.300 go but one thing that you said earlier that i thought was so interesting and is my question too and

01:03:03.520 like k through 12 education where we're seeing some of this ideology come about in the curriculum

01:03:07.920 you asked for psychiatry students what is being displaced what's being displaced by this over

01:03:15.840 emphasis on things like um critical race theory and victimology because everything you would probably

01:03:22.940 argue that a psychiatrist has to learn just about psychiatry that's a lot in itself that's you know

01:03:28.360 full-time i wonder the same thing about curriculum and k through 12 as they are having hour-long

01:03:33.900 sessions about you know intersectionality like okay are you taking how much time are you taking

01:03:40.280 away from science how much time are you taking away from math how much time are you taking away from

01:03:43.640 reading and do our numbers show that kids students in america need less of that i don't think so

01:03:49.660 um so gosh this is such a pervasive problem and i'm very thankful for your voice and how you're

01:03:54.580 talking about it in such a professional and persuasive way so thank you so much oh thank you

01:04:00.120 very much just to close this out one thing that i wanted to make sure that we mentioned that i didn't

01:04:08.100 get into with her because it wasn't a theological conversation that we are having but as christians

01:04:14.300 one thing that i want to point out is that while i think that professional help when it comes to mental

01:04:20.160 health is really important and necessary for a lot of people i think medicine when it is necessary for

01:04:25.880 people's problems is a gift of common grace that people should feel no shame when they need those

01:04:31.400 treatments when they need that care they should feel no shame in taking part in those things ultimately

01:04:37.260 we believe that the answer to our individual problems and to societal problems is the gospel the reason

01:04:45.660 why professional help even though it can be so important will ultimately fall short is because

01:04:52.040 it doesn't deal with the problem that is in our hearts like it doesn't deal with the real reason for a lot

01:04:58.680 of the emptiness that we feel or the purposelessness or the loneliness that we feel the only person who

01:05:03.740 can truly tell us who we are is the god who created us who tells us who we are and what we're worth

01:05:10.380 and why we're here who gives us the ultimate hope not just moment by moment hope but the ultimate

01:05:16.620 hope and so if we really want to be known if we want to be understood if we want to know what it

01:05:21.320 means to be um accepted if we want to know what it means to be truly loved then we have to look at

01:05:29.220 the gospel because in christ in christ we are accepted by this perfect holy god who created us

01:05:36.460 and created the universe in the gospel we are given purpose we are given hope the hope of eternity

01:05:43.760 in heaven the hope of goodness and joy forevermore and so the real ultimate eternal antidote for any

01:05:52.140 despair that we have and this doesn't preclude you know tangible help here on earth but it is the

01:05:58.440 ultimate answer to all of the problems and the feelings of lack that we have here in this life

01:06:04.680 is the god who created us is the gospel so i would be remiss if i didn't mention that on a in a

01:06:11.720 conversation about all the problems that we're facing as individuals and as society that only

01:06:16.480 the god who made us can really truly know us see us fix us um and so in all of the steps that we take

01:06:26.340 here in this life to help our mental health let us not forget that the god who made us and loves us

01:06:32.940 is the ultimate and eternal answer to all of our problems all right i hope that was an

01:06:37.780 enlightening and encouraging conversation for all of you i will be back here tomorrow

01:06:42.140 you

Relatable with Allie Beth Stuckey - May 04, 2022

Ep 611 ｜ How Woke Ideology Has Ruined Therapy ｜ Guest： Dr. Sally Satel

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