The Peter Attia Drive - #146 - Guy Winch, Ph.D.： Emotional first aid and how to treat psychological injuries

00:00:00.000 Hey, everyone. Welcome to the drive podcast. I'm your host, Peter Atiyah. This podcast,

00:00:15.480 my website, and my weekly newsletter all focus on the goal of translating the science of longevity

00:00:19.800 into something accessible for everyone. Our goal is to provide the best content in health

00:00:24.600 and wellness, full stop. And we've assembled a great team of analysts to make this happen.

00:00:28.880 If you enjoy this podcast, we've created a membership program that brings you far more

00:00:33.280 in-depth content. If you want to take your knowledge of the space to the next level at

00:00:37.320 the end of this episode, I'll explain what those benefits are. Or if you want to learn more now,

00:00:41.720 head over to peteratiyahmd.com forward slash subscribe. Now, without further delay,

00:00:47.740 here's today's episode. My guest this week is Guy Winch. Guy is a psychologist, an author,

00:00:54.700 a speaker, and now recently a podcast host. Guy received his PhD in clinical psychology from NYU,

00:01:01.100 where he also did his postdoctoral work at the medical center. He's been in private practice

00:01:06.080 in New York for nearly 30 years. And as we learned on this podcast, he shares office space with my

00:01:12.880 therapist. And that probably speaks to the state of mind I'm in when I walk in for therapy and that

00:01:16.680 I haven't noticed the names of anybody else on the wall there. Guy has authored three books,

00:01:20.960 The Squeaky Wheel, How to Fix a Broken Heart, and Emotional First Aid. We get into a pretty good

00:01:26.340 discussion on two of these three. He's also the co-host of one of my favorite podcasts,

00:01:32.660 Dear Therapists, which he hosts with Lori Gottlieb, a previous guest on this podcast.

00:01:39.080 He's given three fantastic TED Talks and a number of great Google Talks, all of which I recommend

00:01:45.140 highly. I wanted to talk with Guy after I had a chance to get to know Lori a little bit,

00:01:49.600 and obviously, since their podcast came out, which was late July, I've been pretty obsessed

00:01:56.200 with it. And I think getting to familiarize myself with the style with which Guy and Lori

00:02:01.080 worked together, I realized he'd be just a fantastic guest. In this episode, we talk a lot about his

00:02:06.120 journey to the path he's on now through psychology and what he learned along the way, both about

00:02:10.360 himself and perhaps more interestingly to the listener, what he's learned about the human

00:02:14.560 conditions. We get into a lot of things that he later acknowledged he doesn't get asked a lot of

00:02:19.180 during his frequent interviews. And so I'm grateful that we were able to have kind of that nuanced

00:02:23.040 discussion. I could have spoken with Guy for many hours, but before I knew it, we were nearly two

00:02:28.240 hours into a discussion and he was already in Israel and it was getting late at night. So where we did

00:02:34.000 end though, was I think a really interesting discussion around emotional health, specifically

00:02:37.620 vis-a-vis the challenges that many people have experienced through the pandemic. And Guy would actually

00:02:43.760 say during our interview that he thinks it is the biggest sort of seismic shift that's probably

00:02:48.800 impacted our ability to recognize the importance of psychological and emotional health. And so if

00:02:54.120 you've found yourself interested in other episodes we've done that have covered mental health,

00:02:59.160 emotional health, I think you're going to find this one very interesting. And without further delay,

00:03:02.940 please enjoy my conversation with Guy Winch. Guy, it's fantastic to be speaking with you here today.

00:03:14.620 I almost feel like I know you because I have been listening to your podcast, yours and Lori's podcast,

00:03:22.720 pretty religiously since it came out, which I think was in about August. Is that right?

00:03:27.100 Correct. July 30th, actually.

00:03:28.420 Okay. And I don't know, well, you can probably imagine the fondness I have for Lori that probably

00:03:33.900 came across in the interview I did with her. And so now by extension, I see you two as left and right

00:03:40.920 hand. And I've really just enjoyed listening to you guys. I do have to ask you a quick question about

00:03:46.140 this. When you read the letter at the beginning of each episode, actually before I do that, explain to

00:03:52.660 people the format of the podcast and then I'll ask my question. How do you guys set it up? Because you

00:03:57.100 have a pretty specific format.

00:03:59.480 Right. Well, Lori is the advice columnist for the Atlantic and I write an advice column for Ted.

00:04:04.120 So our initial concept was, hey, advice, but we wanted to do something different because number

00:04:08.840 one, we're both therapists, which is not always the case when it comes to advice. And number two,

00:04:13.300 the thing that's always frustrated me about advice is that you can give the most brilliant advice,

00:04:20.080 but you never find out what happened. Sometimes people will write and tell you,

00:04:23.240 but even then it's very curated. So our format is such that we bring a letter each week. We start

00:04:29.800 by reading the letter to one another and we do a very brief case consultation like we would in a

00:04:35.020 therapy office. And that gives you a little bit of a fly on the wall in a therapy office perspective.

00:04:39.620 And then we immediately bring in the guest and we do a session with them. And then after the session

00:04:45.700 or the end of the session, we jump in to give them very actionable advice that they have to do

00:04:51.980 within a week. And then we give some predictions about what we think will happen. And then we hear

00:04:58.240 back from the guest and hear what happened when they implemented the advice, how they felt about it,

00:05:04.360 how it went, what they took from it. And after that, we give our closing thoughts as therapists to the

00:05:10.300 situation. So it's a really complete and satisfying or not depending on the resolution arc that you get

00:05:17.140 and you get to find out what happens. And that's what I really like about it. You get to find out

00:05:21.540 how therapists think and you get to find out what happens after the session.

00:05:26.400 One question I have, Guy, is it's usually you trading off. Sometimes you will bring the letter

00:05:31.500 and read it to Laurie and sometimes it's the reverse. And immediately upon doing that,

00:05:36.940 the two of you have kind of a back and forth banter before you have the consultation with the client

00:05:45.140 before they zoom in. And that'll be three to five minutes, I guess, is about what it seems as I'm

00:05:50.760 not actually timing it as I'm listening, but that's about what it feels like. Are you guys doing that

00:05:55.100 cold or is that scripted? We're doing that entirely cold, completely cold. The only thing we say to one

00:06:01.400 another before practically every taping of that section is, okay, but let's keep it short because

00:06:07.920 we can't go on too long. So that is as warm as we go in. I don't know what she's thinking about

00:06:14.000 this letter. She doesn't know what I'm thinking about this letter. We might be thinking different

00:06:17.900 things. And when we agreed to do this podcast together, you know, I'll just say this way. I met

00:06:23.960 Laurie once in June of last year. That's the sum of our acquaintance before we started doing this.

00:06:30.820 So it's not as if we've been working together for years on end and I know how she thinks and she,

00:06:34.920 you know, she knows how I thinks she doesn't. And I don't, or I didn't now I do. So we're entirely

00:06:41.420 cold. And that's, and the idea there was, let's keep it organic. Let's keep it spontaneous because

00:06:45.820 that will be more interesting than getting all our ducks in a row and then sounding like the same person.

00:06:50.960 Well, you answered another question, which is kind of amazing to me, which is how do you have that

00:06:56.860 pretty apparent chemistry without a long track record together? That's not a simple thing,

00:07:02.160 actually. That could have flopped. That could have gone badly so many ways. And I think what

00:07:08.760 saves us is that I have tons of respect for Laurie as a therapist. And I think the same goes for her.

00:07:17.400 And what that means is that if I see her leading in direction A and I want to go in direction B,

00:07:23.240 I'm assuming direction A is not going to be bad. So yes, let's explore A for a bit and then we'll get

00:07:28.900 to B. It has not happened. We've taped a whole season of 20 episodes. It has not happened that Laurie

00:07:35.720 went in a direction that I'm like, oh my goodness, why are we doing that? It's all valid because she's a

00:07:41.380 very good therapist. And I think she feels the same. And so we indulge one another because we haven't

00:07:45.920 come across something that's making us wince and kind of, you know, start to hit the panic button.

00:07:52.980 Well, let's back up a little bit and kind of talk about you and how you got here. You've written

00:07:58.360 about and spoken about the fact that you kind of wanted to be a therapist from day one. So just as

00:08:03.420 the way that some little boys want to be firefighters or professional footballers or whatever, you sort of

00:08:09.720 wanted to be a therapist. When did you realize that?

00:08:12.080 I wasn't sure when I realized that, but I think when one of the first articles that I was interviewed

00:08:17.680 in came out in the press, I got a message from, I think it was pre-internet. So it was a phone

00:08:23.720 message, actual phone message with rotary phones, you know, with a cradle. Yeah. And, and the person

00:08:29.400 said, and it was a high school friend. And she said, oh my goodness, I remember you talking about

00:08:33.740 wanting to be a psychologist when you were 14 years old. Now to any psychologist, ding, ding, ding,

00:08:39.480 what was going on with him, that he wanted to be a psychologist at 14 years old. But that aside

00:08:44.380 for a minute, apparently very young is when I wanted to be a psychologist.

00:08:48.760 You grew up in Israel or you grew up in the United States?

00:08:51.520 I was born in England and you know, I had some years there and then some years formative ones

00:08:57.800 in Israel. Okay. You have a twin brother. Is he an identical twin or?

00:09:02.600 He's an identical twin.

00:09:04.100 What other siblings do you have?

00:09:05.380 That's it. It's just us.

00:09:06.940 Just the two of you. How close were you? Which sounds like a dumb question perhaps,

00:09:10.940 but I don't know. I've met twins who are not that close. So.

00:09:13.380 Yeah. As, as have I, we were always very, very close. We were one of the lucky ones or

00:09:18.760 I guess, I mean, my philosophy is if you can't get along with the person that's most like you in the

00:09:23.260 world, then, you know, you have some work to do to figure out why you don't like yourself.

00:09:27.700 Really. I mean, I think that just because twins, especially identical ones, this is your carbon

00:09:32.120 copy. Practically. If you love yourself, you should love them. We always did get along.

00:09:36.440 We always had a very strong bond. So did you finish high school in Israel or in the United

00:09:41.960 States? In Israel. I came to the United States after my undergraduate degree with two suitcases

00:09:49.080 and maybe a thousand bucks and hope. Okay. So you went to NYU, if I recall,

00:09:54.220 and you did both your graduate degree and postdoctoral work there. Is that right?

00:09:58.500 Yeah. I did a master's and PhD at NYU. And then I did a postdoc at NYU medical center.

00:10:04.660 Got it. And during that process, how did you refine your interests? So I assume at 14,

00:10:12.960 when you're thinking, I want to be a psychotherapist, or I want to be a psychologist, or I want to be

00:10:18.200 some sort of therapist that helps people's minds and emotions, it becomes a lot more nuanced by the

00:10:24.980 time you're writing your dissertation. So what was that journey as you went from a 14-year-old to a

00:10:30.400 high schooler to an undergraduate to a graduate student? How did you refine your objectives?

00:10:35.440 The good thing about an undergraduate degree in psychology is that if you do it right, it gives

00:10:40.820 you a lot of exposure to different areas of psychology, because psychologist is a general

00:10:45.960 term, but you can be a psychologist who runs rats through mazes, or you can be a psychologist that does

00:10:51.300 consulting for organizations, you can be a clinical psychologist and do therapy, which is what I do,

00:10:56.260 you can work with children, etc. There's just, psychology is very broad. So you do get the

00:11:00.660 exposure. And it was very clear to me, from the beginning of my education, because really, before

00:11:05.920 then, I didn't have that exposure, that I am thoroughly disinterested in severe psychopathology.

00:11:11.760 In other words, everyone that I was studying with were fascinated by schizophrenia, for example,

00:11:17.400 and hallucinations, and because people, it was so wild to see, and people fervently believing in

00:11:23.120 delusions, and having paranoia, and all those things. It just never interested me. It did seem a little

00:11:28.740 bit like a sideshow, rather than, and I felt I wanted to help regular people deal with regular life. That

00:11:34.800 was always my interest. And I don't know why or when I had that interest. I think my interest in psychology

00:11:41.180 all along was because I was looking at the adults around me, probably at age 14, and going, I'm not

00:11:46.820 sure you guys are communicating very well. Or I had other notes, probably, for them and thought, you

00:11:51.820 know, I need to study this to understand this, because I'm really interested in, you know, because

00:11:55.440 I could see mistakes, and I could see things, and I just didn't have a framework with which to

00:11:59.860 understand them or categorize them. And so the interest probably started there. But it continued in

00:12:06.060 that I was always interested in just working with regular people, improving their quality of life.

00:12:13.300 Now, when I think back to my undergraduate, which was in engineering, my girlfriend, for at least half

00:12:19.180 of my time in college, was in the psychology department. But she overlapped with the business

00:12:25.000 school, and ultimately went on to do her PhD in organizational behavior. And she never stated this,

00:12:32.020 but my impression was that the superstar people in the psych department were the ones going off

00:12:39.500 doing these other things. And there was fewer people sticking around to do the, how do I help

00:12:45.980 regular people suffer less? Now, is that true? Was there something less sexy about wanting to do what

00:12:54.340 you wanted to do?

00:12:55.500 I will tell you, and if that girlfriend's around, she will confirm, the sexiest thing you can do with

00:13:02.460 a PhD is finish it. And there is a point at which you just don't care about anything else except just

00:13:09.480 finishing it. And so really, everyone is really oriented toward how do I just get done? That aside,

00:13:18.440 my program at NYU for graduate school was just clinical. So it was just 10 people studying clinical

00:13:24.100 psychology undergraduate. I split between psychology and film. So I was in the film school. And the

00:13:31.300 feedback I got from the psychology department was, oh, you're good at this. And the feedback I got from

00:13:35.180 the film school is, they love you in psychology. So I took a hint.

00:13:40.960 How do you think about your undergraduate tour? Because I only took probably two courses in psychology,

00:13:46.500 and I remember thinking, wow, there's a lot here. I mean, there are so many different schools of

00:13:52.920 thinking. There are so many great thinkers in this space, and they're often at odds with each other.

00:13:58.860 So it was less like physics, which was where I spent much more of my time, where Schrodinger is

00:14:06.880 building on the guy before him. And like, in other words, there's a continuity of the science,

00:14:12.600 and a new discovery can upend an old one, but there's general agreement about it. You know,

00:14:18.840 relativity built upon Newtonian mechanics, and people could understand where the Newtonian

00:14:25.780 laws broke down. I didn't feel that way in psychology. I really felt like there were different

00:14:31.360 camps. Does that sort of resonate? Did you sort of experience that as you went through it?

00:14:35.980 Oh, yes. I mean, you can't not, right? I mean, you mentioned Schrodinger, because that's one of the

00:14:40.120 few areas in physics where there is uncertainty, but psychology is all about uncertainty. We don't

00:14:45.120 have that grasp of the human mind. We don't have that grasp of the brain. We don't have that grasp

00:14:49.620 of emotions. We don't even have that grasp of consciousness yet at all. And so we're very much

00:14:55.140 in the infancy of understanding how we tick and how we operate. I mean, I'd love to be at the point

00:15:01.480 where we have an operator manual for the human mind that we can all use to maximize our potential,

00:15:06.200 but we're very, very far from that. So you approach a science like that with like,

00:15:11.200 I'll take what we, you know, any certainty feels like an oasis because there's so much

00:15:15.620 of uncertainty. Right. We don't have a unifying set of theories or principles the way we do in

00:15:20.700 physics and mathematics. And I guess that just speaks to how much more complicated humans are

00:15:25.260 than the natural world around us. Well, also how much newer psychology is a

00:15:30.020 science than physics or mathematics, right? Physics and mathematics have a couple of thousand years or

00:15:34.140 more, well, several thousand years on psychology. Do you think that as you're going through

00:15:39.360 your training, your impressions of which camps you tend to be in as students is potentially

00:15:46.800 influenced by the people who present the information to you and the affinity that you

00:15:52.580 have for, Hey, I, you know, the way that professor teaches that resonates with me or alternatively,

00:15:58.600 like an experience that you've had where that school of thinking actually fits with my personal

00:16:05.040 experience. I guess what I'm trying to ask in a clumsy way is how do you think a young student

00:16:12.060 slash therapist creates the scaffolding that is going to become their mental model? And more

00:16:18.500 importantly, how malleable is that over time? I can tell you about my scaffolding and it's such a,

00:16:24.560 such an interesting question. I've never been asked that. And I'm already enjoying this because

00:16:29.020 it's really good that you get to ask me to think about things that I haven't thought about

00:16:32.540 necessarily in that way. But here's my answer to that. When you go somewhere and you're presented

00:16:38.140 with 10 different religions, that everyone who presents them, each one is presented fervently.

00:16:44.320 My response to that was to be an agnostic. My response to that was not to believe in any of them,

00:16:50.060 but to curate and say, what there can I take? What in that one can I take? What aspect of this

00:16:55.720 resonates with me? And that's from the beginning was how I treated it and how I thought of it.

00:17:02.120 These are all ideas from which I get to pick what seems right to me, but I don't need to endorse or

00:17:09.020 embrace fully any of them. And I never did. You know, the highest compliment I can pay somebody

00:17:14.300 in that scenario is to compare them to Bruce Lee, but that's effectively what, you know, what is referred

00:17:19.380 to as Jeet Kune Do, which is this, the way of no way, which was his sort of model of martial arts,

00:17:25.320 which was every one of them offers things that are useful. And every one of them has things which

00:17:29.400 are useless. What if you could dissociate yourself from being a student of one exclusively? And so he

00:17:36.740 created this technique, which actually the privilege of studying for two years, and you study it one-on-one

00:17:43.120 with one teacher. It was very, very interesting. He spends three months interviewing me to confirm I'm

00:17:50.760 worthy of learning this, by the way. Oh, wow. Yeah. But it was beautiful. And it was true to how it was

00:17:57.120 presented, which was, it was never about being wed to one style. So that's an amazing kind of way that

00:18:04.840 you described it. Did that ever put you at odds with your colleagues who couldn't understand why you

00:18:09.620 didn't fit in one box? Yes. My program back in the day was pretty psychoanalytic. It was a very

00:18:16.700 New York kind of thinking. And so in that approach, for example, when the first patient I ever had,

00:18:24.560 because you have to start somewhere, right? They don't know you're there, you're first, but you do.

00:18:28.960 Ask me where I'm from. And my supervisor said, if somebody asks you where you're from, you can't tell

00:18:34.120 them. And I'm like, why can't I tell them? So because it's, it's, you're introducing extraneous

00:18:38.740 material. You should just ask them what their thoughts and feelings and associations are about where you

00:18:43.060 might be from and what that means to them. And I had a really hard time with that. And I said,

00:18:49.160 but if my accent were more obvious, then I wouldn't have to go through that charade. And it

00:18:53.960 just seems withholding and irrelevant because I don't know if they're there to spend their time

00:18:58.160 discussing where I might be from. It just makes me the center of something that I don't think I

00:19:02.000 should be the center of. So I had issues with some of the techniques that I was presented with

00:19:07.880 from the beginning, but I was very fortunate because the professors there, at least the ones that

00:19:12.800 interacted with were very open-minded. They didn't assume that you had to buy things lock,

00:19:17.900 stock and barrel. They assumed that, you know, you get to wrestle with these things and reach your own

00:19:22.900 conclusion. The students were sometimes a little bit more, should I say, devout, but the professors

00:19:28.420 typically were more flexible.

00:19:31.400 You know, I remember, I think it was even Lori wrote about it in her book. And I'm sure many have

00:19:37.600 commented to this effect because it seems like such an important finding that it, it's probably

00:19:42.100 been out there for some time, which is the training of the therapist, the credentials

00:19:49.540 of the therapist. All of these things probably don't matter as much as the rapport that is built

00:19:56.620 between the therapist and the client. Maybe I'm stating that slightly incorrectly, but what I took

00:20:01.020 away from it was it's at least as important how much of a rapport the client and the therapist have

00:20:07.200 is how, you know, voluminous the knowledge is of the therapist. Is that, is that an accurate

00:20:12.120 statement? It's very accurate. In fact, my dissertation back in the day was about what are the aspects of

00:20:18.820 the therapist, their experience, their gender, their age that might influence therapy outcome. But since

00:20:25.280 then it's been very clear and the research is very, very clear about it, that the most active ingredient

00:20:31.860 in therapy is that fit between the therapist and the patient. And specifically a patient, if you're going

00:20:40.740 to therapy for the first time, what you want to feel is that the person you're, that stranger that

00:20:46.700 you're spilling your guts out to gets you, that they're responding and saying things and asking

00:20:53.480 questions that shows that they get it. We have a very clear, it's like a bullseye. It's a bullseye

00:20:59.860 or a miss. You either feel that person gets me or they don't. Either they don't a lot or they don't

00:21:04.420 a little, but it doesn't matter. The ding, ding, ding of gets me is very, very specific. That's what

00:21:09.740 you want to feel when you go to speak to a therapist, that at least they get you. Now the work starts from

00:21:14.320 there, but without that, it's going to be a slog. Yeah. Maybe it may be an easier way to say it,

00:21:20.920 I guess, is it's a necessary, but not necessarily sufficient criteria for great therapy. That's been my

00:21:26.880 experience in my own journeys of therapy. And I think it comes, the reason I asked the question,

00:21:31.900 of course, it comes back to your original point, which is if you sit down for the first time with

00:21:36.020 a therapist who has an accent and you ask them where they're from and they dodge the question,

00:21:41.360 it becomes awfully hard to feel you have some rapport with them. When instead, if you can spend

00:21:47.380 two or three minutes having a relational discussion about where someone is from and, oh, wow, you're from

00:21:52.060 there. What a beautiful place. I've been there. Oh, that's lovely. It strikes me as a non-therapist,

00:21:57.440 at least, as an elegant way to at least try to capture some of that relationality.

00:22:03.540 Absolutely. I mean, I remember when I graduated and I started my practice and for the first time,

00:22:08.780 I could absolutely just do what I wanted. And I went on vacation and one of my patients said to me,

00:22:15.620 where are you going on vacation? And I answered the question and I beamed, not because of where I was

00:22:21.420 going, but because I could just answer it. And the minute I answered it, all the curiosity about it

00:22:27.060 evaporated because who cares where your therapist is going on vacation unless the therapist is making

00:22:32.800 a big deal out of it. It's funny. There are parallels in medicine as well. I remember being

00:22:39.480 scolded for something when I was in my third or maybe fifth year of residency. A young boy came in,

00:22:46.940 this is a sad story, but you'll understand the parallel. So a young boy was in a car that was

00:22:51.740 T-boned. So he was in the passenger seat. It was hit on his side. Someone had run a red light and he

00:22:56.680 was killed. It was just unbearably tragic. And so I was the senior resident that received him in the ER

00:23:03.240 and tried in failure for 30 minutes to resuscitate him. And that meant I was the one that went and spoke

00:23:09.240 to his mom after and explained what had happened. And I don't think there's a harder scenario

00:23:13.840 than telling a mom who just saw her son two hours earlier, perfectly normal and healthy that now he's

00:23:20.600 dead. Through that experience, I became close to the mom. I went to the funeral three days later.

00:23:26.780 And for years, I stayed in touch with her and would speak with her on the anniversary of her

00:23:31.580 son's death and such. I really took a shit kicking for that from one of the senior fellows. When he found

00:23:39.620 out I went to the funeral, he said, that is an absolute mistake. You had no business going to

00:23:45.720 that funeral. You must draw a line between you and the patients. You cannot. And again, I don't think

00:23:53.400 he was saying this to be malicious. I think that was his way. I guess I never probed enough to

00:23:57.940 understand what he was saying. Was he saying you have to protect yourself from that or you have to

00:24:03.820 protect the Institute of Medicine from that? I've never fully understood it, but I don't think his view

00:24:08.780 was alone. I think probably a number of people would have thought I made a mistake by doing that.

00:24:14.340 Again, in Lori's book, I think she talked very eloquently about going to her patient's funeral.

00:24:19.140 Now, that's a different situation. She had such a long relationship with that patient and the

00:24:22.620 patient insisted that she go to the funeral. But I guess there are just different ways of thinking

00:24:26.840 about it. You know, it's interesting because I've been in both experiences. I've gotten the lecture

00:24:31.480 that I shouldn't go. When I started out my practice, you know, how do you feel a practice when

00:24:35.660 you're in New York City and there's four therapists for every resident, roughly? It seems that way.

00:24:41.600 Maybe not. But so how do you distinguish yourself when you're, you know, young and just out of school?

00:24:46.220 And so I would take on the cases that people didn't want. And some of them tended to be

00:24:52.020 kids with terminal illness. And so I've had that experience of being told by a, not a supervisor at

00:24:59.680 that point, because I was, I had graduated, but by a senior colleague that I really should not go

00:25:04.640 to the funeral. And what they said was, A, you'll find yourself that the more time you spend in

00:25:10.480 practice, the more funerals you'll have to attend. And then at some point, there'll be a point where

00:25:14.220 you just can't attend all of them because over the years, you'll have met many people. You can't

00:25:17.380 keep going to all the funerals. But I don't think that meant I had to go to all the funerals.

00:25:21.500 But I then, later on, somebody died and they left me a letter that I got after they died in which

00:25:30.200 they said, I would like you to go to my funeral and speak at it. So now it's a lift because now,

00:25:37.080 fine, I can go, who knows who I am, but they want me to speak and they're HIPAA laws. So I actually

00:25:41.760 can't say anything about anything. And so I went and I was surprised that almost everyone knew who I was,

00:25:50.020 not from the internet or anything, just, you know, I was the only one unfamiliar and it was,

00:25:55.520 oh, it's his therapist, it's his therapist. You know, so that's a fun room to go into.

00:25:59.600 And then when it was my turn to speak, what I decided to do was to say, you know, I can't talk

00:26:07.500 about him because of privacy laws, but I can talk about you because I knew all those people.

00:26:14.460 These are the people that sessions were about. And, and, and obviously I spoke about the good

00:26:20.060 part of it because these are people at his funeral. And I just spoke about how this one was meaningful

00:26:24.580 and this one was meaningful and this one and this one. And that's how I chose to handle it at the

00:26:28.960 time. And it was, it was, it gave me so much closure. It, it, it was so meaningful to me. I'm assuming it

00:26:37.020 was meaningful to the people who were there. I, there was a lot that I got out of it. I remember

00:26:43.180 it as a very important experience. I'm curious about whether you feel the same about the funeral

00:26:48.100 you went to. I absolutely do. I just think it's a privilege to be in the position you're in or the

00:26:54.200 position that I was once in where obviously the most delicate situations of a person's life,

00:26:59.500 you can sometimes be a part of. And, and sometimes it's very unpleasant. I mean,

00:27:03.820 I had another patient who I had connected with very closely. He developed a pulmonary embolism.

00:27:10.800 We tried to resuscitate him and couldn't, and he basically suffered a catastrophic neurologic injury.

00:27:15.960 So he was now basically on life support and he was brain dead, very young. He was my age. So,

00:27:21.860 you know, I was in my probably early thirties at the time, as was he. And after a few days,

00:27:27.900 his family decided to withdraw support, but his mom asked, they said, look, we can't be here when

00:27:35.200 you take the ventilator off, but we would like you to be the one that stays in the room with him

00:27:40.160 because we know how much he liked you. And we remember the first day we walked in the hospital,

00:27:44.640 how much he just connected with you. And he was so happy that you were going to be part of his team.

00:27:49.200 And that's another one of those asks, which is, boy, ordinarily, I would not want to be in the room

00:27:54.380 having to watch a person take these, what are called chainstokes breaths, which are, you know,

00:28:00.500 not real breaths, but look like real breaths as they're sort of gasping and dying. But I also thought

00:28:06.280 like that's the responsibility that comes with this. And I think that that's a reasonable ask of the family.

00:28:11.300 Yeah. I'm, I'm, I'm sitting here thinking, and this is why I didn't go into medicine

00:28:15.340 because I don't know if I could do that.

00:28:17.940 Well, but I think what you did is harder. I mean, I want to go back to something you said

00:28:21.240 a moment ago. Talk to me about the early part of your practice when you're taking children with

00:28:26.340 terminal illnesses. I mean, at that point you have two clients, you have the child and you have the

00:28:30.520 parents, right? Yes. And I was doing a lot of family therapy for that reason. I mean, I,

00:28:34.380 my training in graduate school, I had published some research before as an undergraduate and that

00:28:40.440 exempted me for some research courses in graduate school. And that was enabled me to double up on

00:28:46.800 practicum to really study couples and family therapy from year one. And so usually you get

00:28:52.860 to take that as a module at some point, but I had four years of intense practicum and seeing patients.

00:28:59.200 And the way we teach couples and family therapy is with one way mirrors, you know, as opposed to

00:29:04.660 coming in and saying, this is what I said, this is what the patient said. Is that what the patient

00:29:09.480 said? Or is that your recollection? You don't know. But when you're doing it and the team and the

00:29:14.840 supervisor are actually watching you and calling in with suggestions, if they have them, et cetera,

00:29:19.400 it's, it's a great way to study because you really, you can't hide number one. So you learn more.

00:29:24.100 And so I did that and I had a lot of qualifications with that. And so that's part of why I got that

00:29:28.320 gig as it were of working with these families because I could do family therapy as well as see

00:29:33.480 the parents for consultations individually. And so it was a lot of that. And when I started out,

00:29:38.620 it was couples, for example, where the husband was deemed aggressive. And so if it was a female

00:29:44.220 therapist, they felt uncomfortable, I was fine with it. Bring me these aggressive husbands. Now,

00:29:48.920 they were not, they were not aggressive. They were upset or, you know, angry, you know, sometimes a

00:29:54.360 little, maybe with, with other issues that triggered their anger, but they weren't violent people,

00:30:00.320 at least not the ones I, I worked with. So I would take the cases that people would kind of

00:30:05.360 fob off. And the other trick that I learned was that stay in town in August, when you're starting out,

00:30:10.600 especially in New York, and then there's no therapists in town and people will come to you.

00:30:15.900 What year did you begin your private practice?

00:30:19.300 92.

00:30:22.420 So you're going to run out of toes and fingers. You're going to run out of toes and fingers.

00:30:26.380 I love the idea of stay in town in August. I mean, that is, yeah, New York is a ghost town. I guess

00:30:31.640 the only thing that could be better is go out to Long Island in August and then you'll, you'll be

00:30:36.560 overrun.

00:30:37.120 Well, yeah, you can go to Martha's Vineyard. That's where all the therapists used to be, apparently. I

00:30:40.780 don't know. I never went.

00:30:42.620 Why did you decide to go into private practice versus stay in academia?

00:30:47.500 It's very simple. The dissertation was traumatic. You know, it is for a lot of people. It was for

00:30:52.920 me. I had a difficult situation. I was on a five-year visa. I had to complete. I'm an immigrant,

00:30:59.820 essentially, to the US. So I was on a visa that allowed me to study and stay for five years,

00:31:05.280 but I had to be done by then.

00:31:07.160 You were on a J1?

00:31:07.940 I was on a J1. And when I was done, I was allowed to stay for another 18 months

00:31:12.300 for practical training. But if I wasn't done, I would actually have to leave.

00:31:17.120 So the average of graduation in my program was eight years. And I didn't have eight years. I had

00:31:25.420 to do it all very, very quickly, you know, and as soon as possible. And so, you know, just,

00:31:32.200 that just impacted everything in terms of, you know, just how I did things, what I did,

00:31:37.640 the dissertation I did. And I had a dissertation advisor who was difficult, a little difficult to

00:31:43.300 work with. And there were moments I thought, if I have to do this, I'm not going to finish.

00:31:47.760 She just gave me so much to do. And it was objectively an unusual amount of the study she

00:31:53.240 wanted me to do was way too big. So it was very, it was very stressful. And it took me,

00:31:58.360 literally, I'm telling you this, it took me three to four years after graduating before I could walk

00:32:03.360 into a library without feeling a real surge in anxiety. That's interesting. How did you help

00:32:09.840 yourself through that? I mean, did you have a therapist at this point that you could process

00:32:14.760 that with? I did. But A, I just stopped going to libraries for a while. I was really traumatized.

00:32:21.000 I mean, I was really like, I, it's just truly anxiety. Like your heart starts racing when you walk in.

00:32:26.820 Libraries don't usually do that to most people. They're usually considered boring rather than

00:32:30.960 activating. Because when you, everything you have and, and, and every investment you've ever made,

00:32:37.820 talking about emotionally, intellectually, not financially, might go down the tube if you don't

00:32:42.980 finish and someone just is making it very difficult to finish it. It was very difficult. And it's very

00:32:49.220 difficult for many people. Many people are traumatized by the dissertation process. Academia is a

00:32:53.940 very difficult place, but nonetheless, it took me some recovery time. The therapy was extremely useful

00:32:59.700 at the time, but it was very useful to also be able to start my private practice. And at that point,

00:33:06.180 it was like, I don't want to do research. It was associated. I have to have to go to libraries. I

00:33:10.600 don't want to do that anymore. It just soured me on something that I'd been very interested in. It's

00:33:14.720 unfortunate. Now, why did you decide to stay in the United States versus, for example, returning to

00:33:19.380 Israel or going to Europe where you had spent some time, you still had a fondness for New York?

00:33:23.720 I had a fondness from New York for my first time I visited New York. The first time I visited New

00:33:30.200 York, I said aloud to several people who remind me of it, I'm going to live here. I was captivated by

00:33:39.080 New York. And so, yes, to me, New York was where it was at, number one. But number two, when you go

00:33:44.700 through five years of school, then you do a postdoc, then you do a year and a half of practical

00:33:48.840 training, all your contacts are there. So I could start a private practice because I had enough

00:33:55.300 contacts to do it. If I was going anywhere else, even if it were Israel, that's not where my

00:34:00.940 professional contacts were. I would really have to start from scratch. Plus, not to quote Frankie too

00:34:07.580 much, but really, if you can make it there, why would you want to make it anywhere else?

00:34:16.580 I read once that you, I don't know where I read this, but in some of my preparations for our

00:34:21.420 discussion, one of the things you struggled with when you went into practice right away was sort of

00:34:26.120 endless rumination and an inability to turn it off when you went home. Can you tell me a little bit

00:34:32.440 more about that?

00:34:33.000 Yeah, that was my third TED Talk. So that's probably where you saw that. And it was about

00:34:36.880 that exactly. It was, that talk was actually about rumination. It was about that we experience work

00:34:44.100 stress, most of it actually outside of work. Because when we're at work and working, when you're absorbed

00:34:50.920 in your work, you're not conscious about whether you're stressed, you're just doing it. It's when you

00:34:56.020 stop and you're driving home, or in my case, walking home, or you're sitting at dinner, or you're trying

00:35:02.340 to fall asleep at night, that all those worries and, you know, ruminations come. And if you're not

00:35:09.780 diligent about managing them and limiting them, they can really take over. And rumination is actually

00:35:16.160 really harmful psychological practice. What I find interesting about it is that the assumption is

00:35:21.660 that psychologists would welcome any kind of self-reflection, like, oh, reflect away, that's a

00:35:27.040 great thing. Well, no, there's healthy and adaptive self-reflection, and there's unhealthy and maladaptive

00:35:32.140 self-reflection. And it's very clear what's useful and what isn't. If you're thinking about things in a

00:35:37.160 way that's trying to gain insight or understanding or meaning, you're trying to problem solve something,

00:35:42.620 you're trying to tackle it, that's adaptive. If you're just replaying the same upsetting memory or idea

00:35:50.700 over and over again, if you're just walking around your house in the evening muttering,

00:35:54.700 so much to do tomorrow, I have so much to do tomorrow, it's not useful. You're stressing

00:35:59.160 yourself out. Because when you do that, actually, you activate your stress response. So you're really

00:36:02.400 stressing yourself out. It's associated with lack of sleep, with eating unhealthy foods,

00:36:07.260 with irritability, you're checked out with your family. You know, it's bad in all kinds of ways,

00:36:11.480 but it's not something we pay enough attention to. So that talk was about, you know, stress from work

00:36:16.920 happens outside of work. So you need to control it, because you'll like your job much better

00:36:21.080 if you're not burnt out. So how did you start coping with that? How did you begin to treat

00:36:28.820 yourself as you realized this thing was happening? And I guess before I ask you that question, let me

00:36:33.940 start with another question, which is, do you think that this rumination was the natural consequence of

00:36:39.720 now being the final person? In other words, you didn't have a superior or a supervisor, the buck stopped

00:36:45.800 with you. Do you think that was really the source of the rumination? Absolutely. Because you, you know,

00:36:51.020 I opened a private practice, and suddenly the responsibility of that sits on you. You know,

00:36:57.400 you're advising people. And again, half my practice has always been couples and families. Those are very

00:37:02.140 active, live, sometimes intense situations, right? This couple has had an affair, this couple is

00:37:08.980 dealing with this, this family is fighting about that. Individuals don't go nuts in a session,

00:37:14.580 usually by themselves, but a couple, you take your eye off the ball for one second, can go very wrong

00:37:19.960 very quickly. And people were coming to me with their kids who were dying, with their husbands who

00:37:26.540 they were afraid of, with their, you know, like, you're responsible for helping and for having an

00:37:30.380 impact. And that is a huge responsibility. And I think it just is a process of adapting to get used to

00:37:37.380 that, to the enormity of it, and to the responsibility of it. And that's what was, and if you're conscientious,

00:37:43.520 which I tend to be, then you ask yourself whether you're doing the best, you ask yourself,

00:37:47.300 am I experienced enough to do this yet? Am I qualified enough to do this yet? You seek help,

00:37:51.380 you try and do the best you can. But if you're conscientious, it's stressful.

00:37:56.680 Yeah. And I imagine that, again, to your point about adaptive versus maladaptive,

00:38:01.040 a certain amount of stress is actually very adaptive, right? Without it, you become so complacent.

00:38:06.380 But it's really an inverted U. And at some point, you go beyond it, and it becomes quite

00:38:11.780 maladaptive. And it sounds like for you in the early years, you probably went a little too far

00:38:17.400 on the rumination. Did you recognize it at the time? Or is this more of something you now see

00:38:21.640 in retrospect? Well, part of the story I tell in the TED Talk, and I'll just tell it briefly,

00:38:26.400 because it's a quick one, was the moment that made me realize it was, it was a Friday night,

00:38:30.180 it was July, it was very, very hot. And I was coming home from my office, and I lived in

00:38:35.220 Manhattan, my office was there, I was walking, and I get into the elevator in my building with

00:38:39.180 a neighbor who was a doctor in an ER. And the elevator, you know, rose a couple of floors,

00:38:44.920 then shuddered and stopped. And the man who manages emergencies for a living started banging

00:38:51.460 on the door and poking all the buttons going, this is my nightmare, this is my nightmare.

00:38:56.240 And instead of being compassionate, which I would have been in any other circumstance,

00:38:59.240 I found what came out of my mouth was, and this is my nightmare, which was,

00:39:05.220 funny to my ears at the time, not so much to his, and really horribly obnoxious, and really

00:39:11.820 unkind, and plus to remind me, this is a neighbor, I'm going to see them again, it was just not wise.

00:39:15.740 But it was so unlike me. And I felt so bad about it. The minute those words left my mouth,

00:39:21.920 I literally said, what is going on with me? That's not me at all. And that's when I started

00:39:26.360 realizing I am burnt out, but I've only been in practice for a year, how is that possible?

00:39:30.520 And that's when I started thinking about, well, how many hours am I working? And that's when I

00:39:35.740 started realizing it's not the hours that I put in my office. It's the hours that I'm working in my

00:39:40.860 head afterwards. Those don't stop. And that's when I started realizing I need to get a handle on it.

00:39:47.080 This is really an epidemic, isn't it? I think this concept is probably not appreciated by,

00:39:56.200 I certainly don't think I've appreciated it as much until kind of recently. And I think certainly

00:40:01.040 in the era of nonstop electronics, it's only harder to detach yourself from work. You're more

00:40:09.400 tethered to it, even when you're not there. I mean, look, these days, most of us are working from home,

00:40:13.940 which is kind of nice, but also means you're kind of at work all the time. I think that distinction

00:40:20.120 is a really good one, right? Which is burnout can not just result from how much time you are at work,

00:40:26.420 but how much time you're thinking about work when you're not at work.

00:40:28.820 And that's the part you can control, right? That's the part you have control over. And yes,

00:40:32.580 to amplify your point, the pandemic has been terrible for people in that way, because it's not

00:40:36.820 that you're home all the time. It's that your bosses know you are. So, and you know, they know you are

00:40:42.300 like, why didn't you respond to the email? It's not like you were anywhere. It's not like you had

00:40:46.840 something to do is the, is the kind of subtext of a lot of that. Right. You weren't commuting for an

00:40:52.640 hour and unable to respond because you were out. You weren't out of the movies because most of them

00:40:57.700 don't, don't exist. You went to the Broadway show. You weren't doing anything important. Yeah. So it's,

00:41:02.680 it's been a real problem because it's difficult enough to make a separation when you don't have

00:41:07.200 that physical space door to close and you have to do it psychologically. But then when you keep

00:41:12.060 getting bombarded with emails and requests and all those things, then it's actually, unless you

00:41:16.480 create firm guardrails for yourself, unless you have the discipline to really determine, I finish

00:41:22.980 at this hour, then you're going to struggle with it. What do you think are some of the antidotes

00:41:30.480 to rumination? What would you say to, I could just give you the case study, right? I have many

00:41:36.480 patients that fit this description, very successful man or woman professionally, right? So by any

00:41:42.500 external measure, whatever the world could bestow upon them as a measure of success, financial

00:41:48.060 company building, entrepreneurial spirit, you name it, they look like they've done it all.

00:41:54.100 And yet when they're home, they can't interact with their kids because they're constantly lost in

00:42:00.880 thought or their spouse. They struggle to sleep. They don't have a hard time falling asleep,

00:42:05.900 but once they wake up, they can't go back to sleep. And that's usually somewhere around one

00:42:09.760 or two in the morning. They tend to numb that behavior with maybe a little more alcohol than

00:42:17.320 they should. What I just described is like, sometimes that's me, sometimes that's my baby.

00:42:22.800 Like, I mean, I think we all fit in this description, right? We can all put pieces of us in this

00:42:26.820 description. How do you start helping that person?

00:42:29.200 So the first thing that person has to realize is that this is not going to happen naturally. It's

00:42:35.400 not that you can say to yourself, yes, I'm working too much. I'm going to do better. That doesn't work

00:42:39.540 because the intentionality will be good for a day or two, and then it will fade. You can't direct

00:42:44.940 yourself to not think about something. You can redirect your thoughts to think about something else.

00:42:51.100 And that will work to the extent that the other thing that you're thinking about

00:42:54.260 requires concentration and is absorbing. If you're trying to drown out work thoughts by watching

00:43:00.400 television, you won't get through the first commercial with knowing anything about what's

00:43:04.300 happening in that show, because your mind will drift immediately. The same with reading, unfortunately.

00:43:08.380 So it has to be something active where you're actually engaging your head and doing something

00:43:13.760 that requires concentration. That's one thing. So if you're really caught in a loop, distracting

00:43:19.060 yourself by doing something that requires concentration, whether it's a memory task, a puzzle,

00:43:23.880 or what have you, the research is two to three minutes of a distracting task that requires

00:43:29.500 concentration should be enough to make that initial urge or the craving to ruminate go away.

00:43:37.460 The other thing people have to understand is that it feels very satisfying to ruminate,

00:43:42.320 because it feels like you're doing something important. Here's something that's troubling me.

00:43:46.340 I am thinking about it. What possibly could be wrong with that? Well, you're not thinking about it.

00:43:50.780 You're just replaying it. You're just obsessing. You're in an emotional hamster wheel and just

00:43:55.580 spinning your wheels. You're not trying to figure anything out. So the second key is take whatever

00:44:00.500 it is that's troubling you. It's usually one or two things. People tend to ruminate on a day or

00:44:04.680 one in the morning about the same thing that's troubling them. Whatever that is, pose it as a

00:44:10.120 problem to be solved. Because when you pose it as a problem to be solved, let's say the really common

00:44:15.880 rumination of, I have so much work to do, or when am I going to do this? When you pose that as a

00:44:20.220 problem, it's a scheduling problem. It's when in my schedule, am I going to have time to deal with

00:44:24.120 this? What can I move to make that time? And if you actually think about it in that way, and you put

00:44:29.060 it in your schedule, move things around to do so, the stress you'll feel about it will ease and the urge

00:44:34.220 to ruminate will ease with it. The other thing you can do, and I think this is the most important,

00:44:39.680 is these guardrails. And it's not just about that one night. It's about at what point can your family

00:44:47.700 or you, if you're without one, rely on you to show up and not be at work mentally. And you have an

00:44:55.600 obligation to them. So when you think about it that way, what you should do is if you decide that's

00:45:00.420 eight o'clock at night or seven o'clock at night or nine o'clock at night, whatever it is, then that's

00:45:04.260 the time you let everyone know. And then you have to create rituals of transition, which make you feel

00:45:10.220 like you're no longer at work. So you have to change your clothes out of work clothes, and you have to

00:45:14.340 put on some music and change the lighting. And if you have kids, you have to get into the 10-year-old

00:45:19.020 mode or the four-year-old mode or the four-year-old shouldn't be up that hour. But anyway, you know what

00:45:23.100 I'm saying? You know, you really have to kind of, or if you have a spouse, you have to get into

00:45:25.960 romantic mode. You have to get into the mood and really engage with them. You can't just sit there

00:45:31.500 passively engage with them, which means you plan the evening, you organize the game, you organize

00:45:36.300 the outing, you curate dinner. You really have to purposefully mark out territory to have a life.

00:45:44.660 And if you don't, you won't. How often do you collaborate with psychiatrists where they

00:45:51.920 incorporate also pharmacotherapy that can help with that? You know, medications that can help with

00:45:58.640 sleep by easing some of these circuits, you know, things like trazodone or Thorazine, things like

00:46:04.340 that, where you can sort of start to short circuit it a little bit, and it becomes kind of accretive

00:46:10.140 with that process that you describe. I work with psychiatrists all the time. My first instinct

00:46:16.800 would not be to refer someone to a psychiatrist when they're ruminating in this way, simply because

00:46:23.840 there are so many things they need to try. I give a few examples. I can give you four more examples

00:46:29.400 of techniques and things you can do to limit ruminations that will work. So if there's one

00:46:34.640 of those things that you can do without meds, you should. If it's difficult to do without meds,

00:46:38.760 I'm actually for meds and I work with psychiatrists all the time, but this thing specifically, it will be

00:46:43.700 more effective to change the habit that sets you up to ruminate rather than just medicate the

00:46:49.140 lumination away because the habit is setting you up to do it so much. Yeah, I completely agree with

00:46:54.600 that. It's more durable, of course, and it's a lot harder. I mean, that's the reality of it. To have

00:46:59.100 the durability of the response comes at a price, which is you have to work harder upfront. It's

00:47:03.900 much more difficult to change the habits, as you described, than to take a pill. One of the things

00:47:08.000 for me, from a ritual perspective that I have found to be so helpful, you touched on it briefly,

00:47:14.800 is the ritual of playing with kids. So if you're lucky enough to have kids, which doesn't always

00:47:21.700 feel lucky sometimes, playing with them in a truly engaged way. So that means, at least for my two

00:47:29.440 youngest, that's on the floor. Like they're never sitting. On the floor. Yeah, you have to be on the

00:47:34.140 floor. Get on the floor. Yeah, you have to be on the floor and you have to be doing exactly what

00:47:40.120 they're doing. You can't be half doing it. That is a real antidote to sort of rumination and that

00:47:49.600 negative loop. But it's also not easy to do initially. It turns out to be a bit of a shock

00:47:54.980 to your system because we, I think, lose this ability to play pretty quickly. It fades from us.

00:48:02.680 By the time we're adults, we've sort of lost. We don't know what that means anymore. So it's

00:48:06.960 actually a beautiful thing. I don't know. I'm sure there are other ways to capture that if you

00:48:11.140 don't have children. But for me, at least, that's been a very powerful tool in that toolbox.

00:48:16.140 Let me tell you how to capture that if you don't have children. There are many aspects of everyone's

00:48:20.180 identity. You're not just a professional. You're an individual. You're an amateur tennis player.

00:48:25.740 Perhaps you're an amateur cook. Perhaps you have this hobby. You're a sports fan. Perhaps you can

00:48:32.500 access any one of those aspects of your identity and bring it forth in that moment. Because when

00:48:38.640 you're screaming at the television because your team is doing something you really wouldn't like

00:48:42.360 them to do, you're not thinking about work. You're just thinking about just get the ball down there.

00:48:47.800 You know, like, you know, that's where your mind is. So you can access that. You know, you sign up for

00:48:53.840 a race and go train. And then the question is, can you improve your time? Can you put in the miles you

00:48:57.740 need to put in? Or if you're an artist, then go into the studio because that's where you'll create

00:49:03.260 best or create a studio-like atmosphere. So there are many aspects of our identity that we can access

00:49:09.080 that actually get short shrift when we're too preoccupied with work. And we will suffer from

00:49:15.280 not accessing these parts of ourselves that are meaningful or to the extent that they're meaningful

00:49:19.620 to us, that they, you know, they make us feel like us and they make us feel important. We do need to

00:49:24.760 give them stage time. And by doing so, it's a good way to, you know, two birds with one stone in the

00:49:30.720 sense of give that stage time, access that part of your creativity, your personality, whatever it is.

00:49:36.620 And at the same time, if you're doing one thing, there's not room in there for the other.

00:49:41.180 So how long did it take you to undergo this transformation at the sort of beginning of your

00:49:47.800 career? Well, actually it's a long story. So I'll just give you very, some highlights of it

00:49:52.640 because I went through an exploration. It didn't take me long to limit the hours and to limit the

00:49:58.000 rumination. But what it brought up for me was, okay, here I am a year or two now into my private

00:50:05.540 practice. I have been full steam ahead since my undergraduate days, undergraduate and graduate

00:50:12.940 degree, then postdoc, then practice. I hadn't stopped to consider how I feel about what I'm doing.

00:50:20.420 And when I did at those times, in addition to limiting ruminations, I realized I cannot do

00:50:28.520 psychology 50, 60 hours a week. It's too much for me. I need to do something else. I need to balance

00:50:38.200 that. It can be related to psychology, but it has to be different. And then I went through a two-year

00:50:43.260 exploration of what that would be. That exploration took me through some unusual, perhaps, stations.

00:50:51.700 There was a point where I was in conversation with the head of behavioral science at NASA because I

00:50:56.460 wanted to be an astronaut. I'm not saying that was a wise tangent on my part because actually I did not

00:51:01.900 become an astronaut. But I was curious. Then I decided to maybe I should enroll in the space university.

00:51:06.960 Again, astronaut dreams. Then I realized, you know, there's not a lot of behavioral science going on

00:51:12.160 in space. That's not maybe the best place. Plus, I heard about this idea of floaters, which is, you

00:51:18.420 know, the problem with bathrooms in space that you end up with. Sorry. So that turned me off. These

00:51:23.980 small things sometimes make a difference. And so I ended up realizing that I wanted to write.

00:51:29.800 And at that point, I decided to limit the hours of the week and of the day in which I see patients

00:51:36.120 and create space for writing. And that's what I did for many years. How good were you at writing when

00:51:45.300 you started? I'm going to answer you this way. I did that for 14 years. I didn't publish a word.

00:51:53.560 I didn't get paid a penny. That might hold within it some hints about my skill set at the time

00:52:01.020 as a writer. Now, to be clear, I was writing screenplays at that time. I went back to I had

00:52:08.080 a rapprochement with film and I was writing screenplays. A couple of them did get optioned.

00:52:12.700 So I wasn't completely on a fool's errand. But, you know, there's the luck of the draw. I was in New

00:52:18.240 York. I wasn't in Hollywood. And it was in 2008 that this one screenplay got optioned for a second

00:52:26.720 time and started looked like it was it might happen. And I got my hopes up and I was working

00:52:32.820 with this company. And then the financial collapse happened. And that went by the wayside. And that

00:52:38.780 was when I was like, oh, my goodness, it's been 14 years. And then an agent I knew who I knew already

00:52:45.780 said to me, like, I've been telling you just write psychology. And I didn't want to write psychology,

00:52:50.820 right? The whole writing thing was to not do psychology. And then I'll tell this very briefly,

00:52:56.300 just because it's so stupid. But it's like how life don't tell it briefly, just tell it.

00:53:00.340 I love the story. I went to Best Buy to buy earphones. And I tried to get the attention of

00:53:07.060 someone there to help me and three people walked by and didn't help me. And so I got annoyed and I

00:53:12.280 left the store. And as I'm leaving the store, there's a big picture of the manager, like I'm

00:53:15.840 talking about like a four foot picture of the manager smiling and saying, how is our customer

00:53:21.980 service? Email me and let me know. So I emailed them and let them know. And the surprising thing

00:53:29.560 was that I got an email back the next morning saying, I'm so sorry that happened. Here's my

00:53:36.780 personal phone number. Let me know when you're coming by. I will make sure someone helps you in

00:53:41.820 whatever you need. And that email made me think, wow, if I would have gone to a customer service

00:53:48.620 hotline or stood in a customer service line, that would have taken forever. It really made me think

00:53:53.140 that the squeaky wheel gets the grease. And that gave me an idea. I'm like, huh, what's the psychology

00:54:00.160 behind that? And I started doing a search to see what books have been written about the psychology

00:54:05.960 of complaining. And there weren't any. And a week later, I saw that agent at a Christmas party. And I

00:54:12.000 said, oh, I had this idea for a psychology book. And she goes, finally, what is it? I said, no,

00:54:15.600 I'm not even sure it's a book. It's just an idea. And it's about the psychology of complaining. And

00:54:19.060 I would call it the squeaky wheel. And she looked at me and she goes, I can sell that. I'm like,

00:54:23.240 there's not a that to sell. And she said, I'm telling you, do the research, write a proposal,

00:54:28.600 I can sell it. And it sold at auction. So let's talk a little bit about the book.

00:54:33.920 I've watched your Google talk, I think from back in 2011, where you presented this. I love the story,

00:54:39.760 by the way, of when you walk into the bookstore ready to sign your copies.

00:54:43.000 We'll let you tell that. But where did your research take you? How did you begin to sort

00:54:50.260 of uncover what was known? And more importantly, what the downside of complaining was? Because

00:54:56.460 that to me is what you take away from that talk, right? There's a hidden cost of complaining

00:55:02.040 incorrectly.

00:55:04.080 Right. Well, at that point, I was cured from my anxiety-related libraries. I could enter a library

00:55:12.040 without having a panic attack, which was super useful when you're researching a book.

00:55:16.800 So back to the libraries, I went. And I started looking at the research, but most of the research

00:55:21.700 was actually in the customer service domain, or in the couples therapy domain, but very little of it

00:55:27.320 about our individual psychology. But from, I started interviewing people, I started thinking a lot about

00:55:32.620 it. And the thing that came up over and over again was that complaining is a form of expressing

00:55:41.480 empowerment to the extent that we're trying to get a result. But the research was, for example,

00:55:47.880 that 95% of people who have a customer service complaint with a product don't voice it, even though

00:55:54.820 they're very upset. Why? Because they feel and they fear that it will be too difficult and too

00:56:01.360 time-consuming and too aggravating to do that. Instead, and this is the part that's fun, they will

00:56:07.880 tell 12 to 16 people on average about that incident, spending way more time getting aggravated each time

00:56:16.120 all over again and getting zero result. And that fascinated me. I'm like, wow, our complaining

00:56:22.480 psychology is really broken. We just don't, you know, it used to be a transactional tool. And now

00:56:29.860 it's just a venting thing that we do. And the problem is that when you tell 16 people about how

00:56:35.840 you were wronged and you don't do anything about it, you're going to feel like a victim. You're going

00:56:41.320 to feel powerless because that's the story you're telling. Here's a story of my getting aggravated and

00:56:46.700 not being able to do anything about it is the subtext of the story you're telling, whether you realize that

00:56:50.680 or not. Because it really reinforces it, right? I mean, it'd be, it's one thing to not complain to the

00:56:56.260 entity who could right the wrong. And if it stopped there, that could be problematic enough. But to then go

00:57:03.160 and tell the story to 16 people who are not empowered to fix it. I mean, boy, that really myelinate, I'm using

00:57:11.300 the term myelination loosely, but that almost, you know, myelinates excessively a whole new set of pathways that

00:57:17.460 create a narrative that's probably quite unbearable, right?

00:57:20.900 Yes. And I love that way, that phrase. So we should be using that from here on. But yes, it does. And

00:57:26.980 especially when you think about how many complaints we have on a daily basis, it's not one. So that's

00:57:32.400 one thing. The other thing is when you work with people in psychotherapy and individual psychotherapy,

00:57:38.300 and they bring up issues with their sibling, with their sister, with their brother, with their friend,

00:57:42.100 with their mother, with their partner, whatever it is. And you ask the most obvious question was,

00:57:46.580 and did you discuss that with them? The alarming amount of times in which you hear no, and the

00:57:55.300 stupefying amount of times in which they look at you like, why would I discuss it with them? That's just going

00:58:01.360 to cause an argument, not stupid. It's really powerful when you think about it. Like people absolutely are

00:58:07.260 convinced that to voice something that's really important for them, meaningful for them, is an

00:58:15.160 impossibility. Now, they're right. They're right because the vast majority of people express

00:58:20.900 complaints so poorly. It actually does get the wrong result. It actually does cause the argument.

00:58:27.520 It actually does piss off the customer service representative. It turns out that when strangers

00:58:32.660 scream at you on the phone and curse at you and threaten you, you're not necessarily moved to try and

00:58:37.780 help them as best you can. Wait, wait, just let me confirm that. So all kidding aside, do you get the

00:58:45.840 sense that this is a process that has changed over time? So let's take a very extreme example.

00:58:54.320 What did complaining look like when we were hunter gatherers? Obviously we don't have data, but can we

00:58:59.900 rely on any insight to say when we walked around in tribes of 18, if Johnny was supposed to go out and

00:59:09.400 get dinner that night and didn't, and the tribe doesn't get to eat, do we have any sense of how that

00:59:16.300 was handled? And then what has been that evolution to where we are today? So how did we get to the point

00:59:21.580 where we're at today where 19 out of 20 people won't voice the complaint to the entity that can

00:59:30.020 address it, but we'll go and spend an average of 12 to 16 times, you know, lamenting it to the wrong

00:59:36.180 people. Like I want to understand that transformation through our history in as much as you think it's

00:59:41.360 understandable. I can't say much about hunter gatherers in that domain, except to say that what

00:59:47.700 happened with hunter gatherers is that the research on ostracism and rejection tells us that the risk

00:59:56.700 you took as a hunter gatherer of offending your tribe mates was severe because the implications

01:00:03.120 were that if you got ostracized from the tribe, you weren't going to make it. So to really piss off

01:00:10.880 your fellow tribe mates was something you probably did very judiciously. So I don't know how that was

01:00:16.140 expressed at the time. I can go back 150 years to the origin of the term, the squeaky wheel. It came

01:00:24.520 from a poem by a guy called Josh Billings, who was a humorist in the days of Mark Twain. And the poem

01:00:32.280 was something like, whatever, now I forget it. But it's something about, I hate to be a kicker and I

01:00:36.860 always long for peace, but the wheel that does the squeaking is the one that gets the grease. It's

01:00:41.000 something like that. The issue there is the word kicker. The word kicker was the very insulting word

01:00:46.660 associated with people who complained too much. In other words, as a society at that time, 150 years

01:00:53.040 ago, complaining was frowned upon. And because it was, it was used mostly transactionally. If the

01:00:59.400 blacksmith didn't put the horseshoe on correctly, you'll go and say, you know, my horse is limping.

01:01:03.360 But if your horse was only limping slightly, you might not, because you didn't want to be a kicker.

01:01:08.640 So it was frowned upon back then. And now it's, now you're going to become a reality TV store if

01:01:16.040 you complain enough, or if you, you know, voice something on social media. In other words,

01:01:20.600 the idea today, and I think it's, it's really developed because culturally complainers, the

01:01:28.220 squeaky wheel did, I'm not sure if they got the grease, but they got attention. And sometimes

01:01:33.220 the attention was better for them than the grease. And, you know, the grease is supposed to quiet the

01:01:37.920 wheel, and they weren't looking to be quieted. They were looking to actually get a megaphone and be

01:01:41.480 louder, a lot of people. And culturally, they were rewarded in that way, number one. Number two,

01:01:47.900 we, our expectations have grown over the industrialization of society such that we would never,

01:01:56.360 you know, complain about discomfort. Back when we were sharing four people to a bed and going to the

01:02:01.880 outhouse to go to the bathroom in the snow. But today, you know, if there's anything slightly

01:02:06.420 wrong with something, we're going to make, because we, our expectations are so high and

01:02:10.680 complaining in general gets triggered when there's a big gap between expectation and reality.

01:02:15.660 And because expectations have risen, the gap has risen and complaints get triggered and then they

01:02:21.360 get reinforced by culture and society.

01:02:24.720 How much general discontent do you think can be attributed to what you just said, this gap between

01:02:32.640 expectation and reality? I mean, do you, like, what percent of, this is probably an unanswerable

01:02:37.840 question, but just directionally, like, how much human suffering, psychological suffering comes down to

01:02:44.200 that single delta?

01:02:46.460 A lot, right? I mean, you're asking for numbers I don't know, but a lot. And more so because of social

01:02:50.980 media, because if your expectations were that, you know, you could see what your neighbor did,

01:02:56.800 was all about, right? I mean, keeping up with the Joneses was keeping up with the people next door

01:03:00.100 because you could see what car they had. But now you don't have to be next door. You can see that

01:03:04.220 that person you grew up with lives very far away. Now they have this car and they have this house

01:03:08.340 and their wife looks like that. You know, in other words, social media has, and because it's so

01:03:13.280 curated, right, it's a highly curated best of, in most cases, set very poor expectations

01:03:19.720 or very wrong expectations for what we should expect out of life and how much work we should

01:03:26.140 be expected to put in to get that. So that's not helped.

01:03:31.020 Do you think that people, say, of your generation who didn't grow up with social media and now as

01:03:36.500 adults experience social media have one set of potential downsides from that, from what you just

01:03:43.500 described? But say a 10-year-old today who's never known a world without social media by the time

01:03:49.460 they're your age is going to be in a different situation. How would you compare the experiences

01:03:53.580 of someone like you versus the person who's going to be you some years from now who's never known in

01:03:59.580 any other way? And I guess what I'm trying to get at is if there's a harm to someone as an adult

01:04:04.940 today, will it be greater to someone who's didn't have some sort of a grounding, at least without

01:04:11.360 social media?

01:04:12.040 I think so. Because for me, you know, I grew up without social media. So for me, what stands out

01:04:18.180 about the internet, social media, apps, all of those things are the convenience of them. Because

01:04:24.760 I remember that before social media, I actually had to call people to see what was going on with

01:04:29.220 them or write to them and post it in a mailbox. And now I just need to look at my phone. And so that

01:04:37.480 convenience of being able to keep in touch with so many people at a distance, you know, and see what's

01:04:42.820 going on with them and enjoy their pictures here. And they're just knowing what's happening or, you

01:04:46.980 know, reach out if I see something not great is happening. It's very, very convenient. But for

01:04:52.660 someone who grew up with it, it's not about convenience. It's about image curation. It's about

01:04:57.560 comparison. It's about how everyone else has more followers than I do. Why does he get more

01:05:04.500 followers? Or why did, you know, it's, it's just a very, it's looked upon very, very differently.

01:05:09.480 It's looked upon as a, as a way to measure your worth rather than as a way to get something done.

01:05:16.420 You've talked about, and I want, I want to talk about it with you. You've talked extensively about

01:05:20.220 the impact of failure on our emotional health. A lot of what you just described can be viewed as a

01:05:27.520 failure, right? By definition, if you're willing to compare yourself to a broad enough array,

01:05:34.000 you're a failure. I mean, there's always someone who is smarter, better looking, richer, more

01:05:41.300 popular. There's no metric by which I couldn't in 30 seconds come up with 10 people who are better

01:05:47.980 than me. So what is the antidote to that misery that comes from comparison? First of all, it's a

01:05:56.460 true misery. And the issue is that, for example, I work with a lot of successful people. They don't

01:06:03.040 think of themselves as failures. It's more painful. They just don't think of themselves

01:06:07.860 as successful because they've only made 20 million. And they're looking at the person who

01:06:14.760 made 50. And there's something extraordinarily tragic about someone who went from nothing to

01:06:20.540 20 million dollars and doesn't think of it as a success, right? I mean, that's just unfortunate that

01:06:25.980 you would spend so much effort to get somewhere and have zero appreciation for the fact that you're

01:06:32.380 there. I worked with somebody once who tried to climb Everest and only made it to base camp.

01:06:38.480 And I was like, oh my goodness, you made it to base camp? And they were like, but it didn't get to

01:06:42.140 the top of Everest. I'm like, again, you made it to base camp? In other words, that's actually

01:06:47.520 impressive. It's not that simple. It's not that easy. And if you keep looking up, you will never,

01:06:54.940 ever be satisfied. You will never, ever be happy. And one of the things I say to my patients all the

01:07:01.780 time is if you just pause and celebrate these stations along the way, it doesn't mean you're done.

01:07:10.500 This idea that I only celebrate when I reach the top of a heap that doesn't have a top

01:07:15.440 is such a bad life plan because you will never be satisfied. You will always feel envious. You

01:07:23.660 will always feel insufficient, even though you've done so much. How unfortunate. And it is very

01:07:32.980 difficult to get people to look down or look sideways rather than keep looking up.

01:07:37.560 Was it ever difficult for you to find empathy within yourself for patients of yours who by any

01:07:48.140 objective metric were enormous successes, but who couldn't appreciate it? For example, when that

01:07:54.820 person comes in and says, I started with nothing, I'm worth a hundred million dollars, but I don't feel

01:08:00.140 like a success because my peers are all worth five times that. One could take a very jaded view and

01:08:07.740 say, I mean, shut up. I can't even relate to what you're complaining about. I'd give anything to have

01:08:14.280 a fraction of what you have, but I don't sense that in you. I sense a genuine empathy for that person is

01:08:20.880 actually suffering as odd as that might sound to someone on the outside. Was that natural for you to

01:08:26.040 be able to have that empathy and to be able to communicate what you just said?

01:08:31.640 Yes, it was natural for me. The job of a therapist as I see it, right? I'm not saying it for all, but as

01:08:36.380 I see it is my primary job is to see the world through that person's eyes, to really understand

01:08:44.180 their experience. And if they're saying to me, I am ridiculously successful financially, but I don't feel

01:08:50.160 like a success. My job is not to react to that as I would if I'm hearing it from a stranger. My job is to

01:08:55.900 really try and understand, well, why? What's going on? Why can't they allow themselves this? What

01:09:03.460 happened in their childhood that put them on this path of just keep barreling forward and don't pause

01:09:10.240 to celebrate anything? Because if you dare take your eye off the goal or your foot off the pedal,

01:09:16.420 you will come to a shuddering halt and never get going again. It's usually some kind of fear there.

01:09:21.000 It's very old, that fear. It's obviously not something from their adult lives. But once I find

01:09:26.480 that once you really understand someone, once you really see the world through their eyes, two things

01:09:34.260 happen. Number one, you have compassion for them. And number two, for me, again, personally, you like

01:09:41.740 them. Because when you really get someone, there's a fondness that gets triggered, at least for me.

01:09:48.720 And one of my, and I discuss this sometimes with people, and they look at me like I don't

01:09:53.720 understand these terms. For me, customer service, as a therapist, is very important. And customer

01:09:59.260 service, what does that mean? It means that because I have those feelings, it's important for me that

01:10:05.800 when I go to see you in my waiting room, or these days when you show up on my Zoom, I'm generally happy

01:10:11.520 to see you. You're going to see that in my face. And I think there's something very powerful about that

01:10:17.020 for people who come to see you, and you look like you're genuinely happy to see them, that you're

01:10:23.220 genuinely interested in how they've been, and what's going on, and that you're generally compassionate

01:10:29.520 for the things that are not going well for them. And to me, that's a natural outcome of using empathy

01:10:37.960 to gain understanding, to be able to do your job.

01:10:40.700 I love what you said earlier, and I actually want to go back to it and even come up with some

01:10:45.500 of the kind of thoughts and behaviors that one can use. Because I certainly see this a lot in my

01:10:51.780 patients, and I see it a lot in myself, which is an inability to simply acknowledge something done

01:10:58.900 as being successful. And certainly what you said resonates with me. I suspect it also would resonate

01:11:05.340 with anybody who's going to be honest with themselves. There is a fear that if I stop and

01:11:10.780 acknowledge this, I will lose it. I'll give you even the most trivial example. People who listen to

01:11:16.860 this podcast know how much I love archery and race car driving. And so I'm driving my simulator almost

01:11:22.420 every day. And, you know, when you take a new car onto a new racetrack, you'll start to set goals.

01:11:29.180 Like, I want to achieve this. I want to break a minute and 14 seconds on this circuit in this car.

01:11:38.140 And it could take me months to achieve it. Invariably, Guy, whenever I finally achieve my goal,

01:11:46.700 the happiness lasts for maybe 13 milliseconds. And then I immediately think, well, how much faster can

01:11:54.780 I go? It's almost like I'm afraid to just say, wow, Peter, that was amazing. Look at that. You

01:12:01.520 literally, it took you six months to shave two seconds, which is a big deal, right? Two seconds

01:12:06.180 off a minute, you know, a minute 16 to a minute 14 is a big deal. But what, you know, what are we

01:12:10.980 afraid of? Like, what are we afraid of losing and why? And instead, wouldn't it be, I like the way you

01:12:16.760 said it, which is how about doing both? How about saying, that's a wonderful achievement, Peter. You

01:12:21.740 should be really proud of yourself. And yes, by all means, try to take more time off, but not at the

01:12:27.880 expense of appreciating what's going on. How do you help people do that for things that are much more

01:12:33.860 important and much less trivial than what I just described? For example, building a business or

01:12:39.240 achieving financial security or mending a relationship, like, you know, things that actually

01:12:46.020 matter in life. It's okay. So we'll trade secrets. Fine. I'll tell you. Here's one of the things I do.

01:12:51.480 There are many avenues that you can take, but here's one of them. What I would do, and it's

01:12:57.240 difficult, might be a little difficult to do with a race car example, just because it's, it's a short

01:13:02.040 timeframe. But if you take somebody who's been working on something for a long timeframe,

01:13:06.700 or the person who just finally made their first million dollars or whatever it is,

01:13:11.060 or made the first exit, what have you, is I will take them to a visualization exercise.

01:13:15.620 Now, the key about visualization exercises is the detail. The more detailed the visualization,

01:13:23.340 the more you'll connect to it emotionally. And so you actually, you're not just quickly thinking

01:13:28.800 about, you're actually in a therapy session, you're going to spend time really painting the picture.

01:13:34.840 So I want to take you back to when this was a dream, a hope. Where were you? Let's find a time

01:13:42.100 where you were thinking about this. Where were you? What was the weather like? What were you wearing?

01:13:47.300 Who were you with? How were you feeling back then? What was the context for you? What did this mean

01:13:52.320 to you, that idea of one day? You know, and if you can really help connect people to what it felt like

01:14:00.400 at the point where they were just dreaming of it, thinking of it, wishing for it, and hoping but truly

01:14:07.560 not knowing if they will ever have it. And then you have them insert into that visualization

01:14:14.500 their present selves that comes to give the news to their past selves about the success. And you have

01:14:22.540 them really visualize and imagine that entire conversation. How do you say it? How do you reveal?

01:14:29.160 And what does that younger version of yourself think when you're a bit told, yes, this is not

01:14:34.280 just a dream, you do achieve it? How would they react? How amazing would they feel? How excited

01:14:39.580 would they feel? So that's one way that you can really try and connect someone by giving them the

01:14:47.100 perspective of the person who hasn't achieved yet, them at a younger age, and looking at the achievement

01:14:53.080 from that point, rather than from the point of the person who the day before was close to achieving

01:14:57.860 and now they just did. So that sounds an unbelievable amount like EMDR and trauma work, where you take

01:15:06.640 the adult version of you and you go back to the child version who's been traumatized and you

01:15:13.580 experientially go back and almost sort of try to help them and rescue them. I mean, it's a pretty

01:15:18.880 profound exercise you just described.

01:15:20.900 It is very profound and it's very, very moving for them and me, truly. Those are the moments that

01:15:27.580 I remember very strongly in certain treatments of when the person really connected and you could

01:15:33.140 see on their face that they were experiencing it from that perspective rather than the present one.

01:15:37.080 But it doesn't have to be about trauma, right? I'm not necessarily, as opposed to EMDR,

01:15:41.580 I'm not necessarily going back to a trauma. Oh, no, that's my point. Yeah, yeah, yeah.

01:15:43.800 Just to an earlier perspective. And you're right, because from any one day to the next,

01:15:50.000 it's very difficult to appreciate a change. But over a decade, I mean, it could be a step function.

01:15:57.140 Right. Now, the other thing that's very, very useful is a lot of the times these people who don't

01:16:01.220 want to celebrate have people around them who do. And what I'll sometimes say is that, and I'll say this

01:16:07.200 because it's going to sound silly, but it does work. I'll say, you know, if you don't want to go

01:16:11.400 and have a celebration for you, do it for them. They want to celebrate you. Indulge them. And the

01:16:17.580 thing is that they might start out thinking that they're indulging them, but they will get swept

01:16:21.180 up most likely in that moment when they're actually out celebrating that thing that they really didn't

01:16:25.640 want to, but their family or friends really thought was important to. They get caught up in it and

01:16:30.840 they can connect to it at some point. So actually, sometimes from the outside in works to just

01:16:36.480 start celebrating, you'll connect at some point to what it is you're celebrating.

01:16:42.080 So how was your book received?

01:16:45.140 Which one?

01:16:46.080 The first one. Sorry. Yeah. Going back to 2008. So the squeaky wheel book. And how much of an itch

01:16:51.720 did that scratch for you vis-a-vis you are now, you're an author. It's a new part of an identity,

01:16:58.220 right?

01:16:59.160 Well, remember those 14 years, right? So it wasn't-

01:17:01.980 Yeah. Well, now you're a published author, right? So there's like your name is on the book.

01:17:05.540 Made for the first time, you know. And when somebody says, oh, what do you write? I can

01:17:10.080 actually point to something and say, it's a thing. Here it is. The book was received not

01:17:16.520 well in the States and rather well internationally. That book sold in 12, I think, to 15 countries

01:17:25.440 and did rather well in them. What was funny to me was the first country was South Korea. And my agent

01:17:32.620 said, oh, we just sold that book in South Korea. And I said, why? What a book about complaining.

01:17:38.380 And they said, well, I'll send you the email. And the email said, oh, this is great.

01:17:41.580 Koreans are the biggest complainers. And then we sold it in China. And we got the same email. Oh,

01:17:49.180 this is great. Chinese are the biggest complainers. And then the French were the biggest complainers.

01:17:54.360 The Estonians, too. The Poles are biggest complainers. Every territory that bought that

01:17:59.340 book announced that they consider themselves the biggest complainers as if it was some kind of title

01:18:03.440 worthy of having. But my perspective is that it just touched a nerve with people. It didn't do that

01:18:10.240 well here. Primarily, I think, because the book is a mixture of psychology and business. And it's

01:18:19.560 difficult when it's not quite one thing or the other would be my guess. I think the book is quite

01:18:25.620 well written, actually. But if you're looking for the psychology parts, you have to get through the

01:18:29.960 customer service parts. And if you're looking for the customer service parts, then what's this thing

01:18:33.200 going on about couples? So I think it was a difficult book to mark it. But what happened

01:18:38.440 was, because it didn't do well, my agent said to me, book came out in January of 2011. By March,

01:18:44.420 it was clear that it's not taking off. And my agent said to me, if you want to sell another book,

01:18:48.740 you have to do it now. And I'm like, excuse me, the book just came out. She goes, yes, but it's not

01:18:53.320 doing well. And I can convince editors that it would do much better in paperback. But it's going to come

01:18:58.720 out in a year in paperback. And if it doesn't do well, no one's going to be interested in the

01:19:02.040 second book. So you have to sell one before that one comes out in paperback. I'm like,

01:19:07.940 I'm still doing publicity for this one. Like, can I take a break? She goes, no, you can't if you want

01:19:12.880 to have another book. And again, 14 years taught me that let's take the opportunities when we can.

01:19:19.500 So I put everything aside and started working on a second book.

01:19:23.920 Now, was that the emotional first aid book?

01:19:25.740 Emotional first aid. Yeah.

01:19:26.940 What was the motivation? How did you decide that that was going to be the next? I mean,

01:19:31.000 it's an unbelievably important topic and something I want to discuss with you now. But

01:19:34.680 how did you decide that that was the next book?

01:19:37.320 I decided that I definitely wanted the next book to be just full on psychology. I wanted it to be

01:19:41.200 about emotional health. And I wanted to really reflect the work I was doing with patients in

01:19:45.480 which I was at that point, you know, for quite a few years at that point, because I'd recovered from

01:19:49.960 the dissertation, regularly reading research articles and trying to find ways to apply findings

01:19:55.600 in my practice. Because research articles in psychology are not written for practitioners,

01:20:00.020 they're written for other researchers, but they might actually have a lot of information that's

01:20:03.020 very relevant to practitioners. You just have to translate the research finding into an intervention.

01:20:08.280 So I would do that when I found it necessary. And I would try things out with my patients and let

01:20:12.880 them know there's this research and it implies that this might be useful, try it out. And if it

01:20:17.680 was, I would recommend it to other people. And over the time, I had curated a lot of different little

01:20:22.480 tricks and tips and techniques for people to manage common emotional wounds like failure,

01:20:28.260 rejection, guilt, self-esteem, low self-esteem and such. And I always had this idea, it would always

01:20:33.780 piss me off that, you know, medicine cabinets were such a thing, but there were none for emotions.

01:20:39.960 There was no psychological medicine cabinet. And so I had this idea, like, I want to write a book

01:20:44.920 that's in essence, the psychological emotional medicine cabinet you should have in every home.

01:20:50.620 And so I started doing that. Let's contrast three types of injuries. And I want to better understand

01:20:56.300 why it is we struggle so much with emotional injury. So case one, a broken femur, and let's make it

01:21:04.300 really juicy. And it's a spiral fracture that's open. And you can literally see the femurs sticking

01:21:12.020 out of the thigh bone. Injury two or illness two, type two diabetes. I don't really see anything from

01:21:19.940 the outside, but, you know, we have a blood test that can tell us you have it. Injury number three,

01:21:25.840 rejection. Nobody sees it. And the point I think you make is we're far less likely to even acknowledge

01:21:34.580 it. Help me understand that spectrum and what it is about us as a species that is very quick to

01:21:43.400 acknowledge case one as an injury. And frankly, despite the fact that we don't really see case two

01:21:49.480 externally, we don't seem to have a hard time accepting type two diabetes as an illness that

01:21:55.480 warrants treatment and can't be left alone. And yet for many people listening to this, the idea that

01:22:02.980 being rejected or failing at something warrants treatment is going to sound stupid and you're

01:22:09.040 going to have to do some convincing. Is it okay if I answer by way of a story?

01:22:12.760 Please. Okay. So this is a true story. I'm sitting with a very, very senior executive in a financial

01:22:20.560 institution. And I'm talking about emotions and the importance of emotions. And he immediately shuts

01:22:27.360 me down, waves his hand and says, yeah, I don't, I don't believe in feelings. And, you know, I do what

01:22:36.540 most psychologists do when they're caught off guard. You know, you just repeat the statement in the form of

01:22:40.420 the question. I said, you don't, you don't believe in feelings. And he said, you know, I know people

01:22:47.660 have them, but it's not as if they're real. They shouldn't matter. Now he said this in the first few

01:22:54.460 minutes of a couple's therapy session with his wife sitting next to him, dabbing her eyes with a tissue

01:23:01.460 because she was having feelings. So it was an interesting time to make that statement that he

01:23:07.660 didn't believe in feelings when his wife is crying beside him in the first few minutes of a therapy

01:23:11.600 session. But so many people feel that way. And when he says, you know, they're not real, it's not

01:23:19.660 unicorns or aliens that you have to have proof of sightings or something. In other words, but he really

01:23:25.520 didn't think feelings mattered. And so what I did is I turned to the wife and I said, did you know

01:23:32.740 your husband doesn't believe in feelings? And she stopped crying. She looked at me and she said this,

01:23:39.320 no, but it explains a lot. And I started laughing really hard because I thought it was really funny.

01:23:47.280 And I laughed so hard that she started laughing. And then she laughed so hard that he did not start

01:23:54.220 laughing. He actually looked really irritated. So I looked at him and I said, what, you don't believe

01:23:58.220 in laughter either? And then he was literally about to get up and I said, you look angry. He goes, I am

01:24:04.180 angry. I'm like, well, there's one feeling you believe in. Now let's talk about some of the others

01:24:08.580 and how they might be impacting your marriage. And he sat down because I'd made the point. You can't

01:24:13.680 just curate. If you believe in anger, there are other feelings you have to believe in as well.

01:24:18.940 But many people think that feelings are not worthy of attention. And to be honest with you,

01:24:26.140 when we were earlier on in our development, societally, industrially, when it really was about

01:24:33.400 just keep alive, you know, roof, shelter, the hierarchy of needs, as it were, your emotional

01:24:39.480 well-being was very much at the bottom of that hierarchy. Actualization was at the bottom of that

01:24:43.980 hierarchy. And so we had to reach a certain level of industrialization and comfort and safety and

01:24:50.920 self-sufficiency as a society, as individuals, to be able to start looking at higher order needs,

01:24:57.500 beyond safety, shelter, et cetera, food. And that's when we started paying attention more

01:25:02.180 to emotions. It's a very recent development, relatively speaking. And if you go even today

01:25:07.700 to certain war zones, no one's going to be listening to podcasts about how to self-actualize

01:25:13.680 and be the best you. They're going to look at podcasts about what to do when your femur's

01:25:17.940 shutting out of your leg, or you have type 2 diabetes and no insulin. So that's going to be

01:25:23.660 a bigger concern. Fair enough. But for most of the industrialized in the Western world, probably,

01:25:29.260 we are at a point where we need to think about our emotional well-being, even because it has a huge

01:25:35.780 impact on our physical well-being and our longevity and our health. So even if that's the priority,

01:25:40.880 just staying alive, we know there are many emotional, psychological conditions that can

01:25:45.640 actually contribute to you dying much more quickly than you might otherwise. So that would behoove you

01:25:49.500 in that way. But we are finally at a point where our emotional well-being, our happiness,

01:25:53.800 our life satisfaction is something that's on our agenda. And then we're starting to pay more

01:25:57.620 attention to it, but not everyone is. By the way, I think, Guy, that is probably one of the most

01:26:01.900 eloquent explanations, both in terms of the story, but also I think drawing on the hierarchy of needs

01:26:09.400 is a great point I hadn't considered, which is you could argue since the domestication of crop and

01:26:14.960 cattle, we've had the only then, only since then have we had the luxury of even thinking about

01:26:20.300 stability with respect to food and infrastructure. And that would have started the clock on when

01:26:25.540 having the luxury of thinking about this began, whereas physical injury, we've had our entire

01:26:31.860 evolutionary history to worry about.

01:26:33.680 Right. And that industrial revolution was 11,000 years ago. It's just not that

01:26:37.640 long. And, you know, like writing's only been around 5,000 years or whatever. In other words,

01:26:43.340 yes, we're pretty new and it's only very recently that we can attend to this.

01:26:48.580 Yeah. I mean, even go one step further, language might only be 50,000 years old and yet clearly

01:26:52.980 prior to language, we still had to concern ourselves with a physical injury. There's no animal that isn't

01:26:58.120 concerned with a physical injury. I guess the one thing that would draw some concern is I don't

01:27:04.900 think we have another 50,000 years or 10,000 years or 5,000 years to figure out how to deal with

01:27:10.180 emotional injury because we probably won't survive it. That's been my conclusion as a person who has

01:27:15.960 come to this from the lens of the physical side, right? The longevity side of things. I think it hasn't

01:27:21.920 taken me my whole life, only half of it, to figure out that if the emotional piece is not working,

01:27:28.160 at best, you will continue to do okay physically and just be miserable, which strikes me as the

01:27:34.780 definition of torture. Or at worst, you'll have all of that plus an impaired physical existence.

01:27:41.440 So either way, if you're emotionally broken, I think you're in for a very difficult life.

01:27:47.200 So how do we shave 5,000 years off the next 50? And how does your work and the work of people like

01:27:55.500 you start to change this mindset? One of the reasons Laurie and I decided we want to do this

01:28:01.880 podcast is because we sat there and spoke about, wow, if we can really show people by doing this work

01:28:13.420 and putting it out in a podcast, that people who, you know, so we have this episode about heartbreak,

01:28:19.800 an episode about parental alienation, episode about this and that. But within those episodes,

01:28:25.080 there are a lot of insights that we're offering that are nothing to do with that, and that are

01:28:29.300 very transferable. And in the reviews that we have, in the letters that we get, it's the point that

01:28:34.520 people emphasize the most, that, wow, nothing to do with me and I learned so much about myself

01:28:38.520 regardless. And I think we, and I've said this before, I think any mental health professional

01:28:45.820 these days has to think of themselves as an ambassador because there is such ignorance that

01:28:54.580 we have about our emotional and our psychological states and how we operate and what matters.

01:29:02.480 And any professional needs to be able to talk about that and to let people know and to educate

01:29:10.200 because we are so in need of that education. One of the things I sometimes do in a session,

01:29:16.220 a lot of the sessions that I do from people who are foreign, they find me, they want to do sessions

01:29:20.900 obviously via Zoom way before the pandemic, and usually have an hour, say. And for me, if I have

01:29:27.920 one-off hour with you, I'm going to come in guns blazing right from the beginning because we're

01:29:32.840 going to get something done. And so it's going to be a little head spinning for the person because

01:29:38.000 I'm not holding back here. I'm not doing the, well, I don't need to do that now. We'll get to that in

01:29:42.000 week 10. All now. So I am, at this point, experienced enough that I can fill in a lot of gaps. I don't

01:29:49.320 need to hear a lot before I can figure out where the problem is and where the issue is.

01:29:54.340 And what people find really interesting is that, well, wait, how are you able to articulate

01:30:02.600 what I'm feeling better than I can when you just met me? And this is the thing that makes me sad.

01:30:09.160 It's something we should all be able to do if we were better educated in how psychology and feelings

01:30:14.740 work. Because there's a lot we don't know, but there's a ton we do. We know, for example,

01:30:19.560 that rejection hurts, even if the person who rejected you is someone you absolutely despise

01:30:25.240 and would never want to be associated with ever. But if they rejected you, it's going to sting.

01:30:30.240 Now, if you don't know that we are wired to respond that way, you're going to have a lot of

01:30:34.360 other ideas about what kind of loser you are or, you know, like, why is this hurting? Why?

01:30:38.800 Knowing our basics. And we have some basics about our emotional responses. Understanding that if

01:30:47.060 something happened to you and you feel this way about it, anyone else that happened to is going

01:30:53.260 to feel similarly. They might not show it. They might not display it. They might not confess it.

01:30:59.840 And they might not feel it to that extent. But feel it, they will. Our emotional DNA is global.

01:31:06.080 It's universal. It's evolved. We're all very, very similar in our emotional responses,

01:31:12.820 in our experiences. Our responses might differ, but our experience is the same. So there's so much we

01:31:18.660 can teach. There's so much we can inform. And there's so much that if we did would feel unifying

01:31:24.200 as humans, would make us feel more connected to one another because we're all so the same under the skin.

01:31:32.260 You said something there that really resonated. It's a bit tangential,

01:31:35.560 but I think it's worth mentioning. And I think you'll agree. But if not, please, please tell me.

01:31:40.500 I remember at one point I was saying something to one of my therapists. Her name is Esther Perel. You

01:31:46.140 I'm sure know Esther. You're both in New York.

01:31:48.900 If I may, Peter, Esther and I have shared offices for 27 years. We have been office mates for 27 years.

01:31:55.780 I don't think I knew that. Okay. Yeah, yeah, yeah.

01:31:58.180 If you've been to her office in person.

01:31:59.680 I have many times. So no, by the bell, you know, where I, so I've been in your waiting room

01:32:04.320 then. I don't, that's amazing that I didn't realize that. So Esther said something to me

01:32:08.180 once when I was explaining to her a thought pattern I was having, and I was explaining it to her as

01:32:15.460 though I was the only person in civilization that has probably ever had this. So of the 10 billion

01:32:19.980 people or whatever number of people who have lived to date, Peter Tia is the first one that has ever

01:32:26.260 had this pattern of thought. And as I start to explain it to her, she finishes the thought for

01:32:31.020 me. And I said, how do you know that? And she said, Peter, I hate to tell you this, and I'm not

01:32:39.140 saying this to minimize you as a person, but this isn't a very uncommon thing. Your mind when it's

01:32:46.880 poisoned is staggeringly unoriginal. Lots of people have the exact same poisonous sets of thoughts that

01:32:56.920 you do. And unfortunately, there's a very common set of beliefs that are maladaptive that people like

01:33:05.440 you have, and I've heard every one of them. And it's basically what you just said. It's the pattern

01:33:10.540 recognition that allows people like you and Esther and Lori to be so good at what you do.

01:33:15.700 And I actually took great comfort in that, right? I mean, she said it to me in a way that was like,

01:33:22.000 hey, I don't want you to not feel special because everyone wants to be special. But at the same time,

01:33:27.100 Peter, please realize you're actually not that special. And that's good news in this situation.

01:33:33.880 You're not alone. Yes, you're not alone. And it should be comforting, right? And the upsetting thing

01:33:41.280 is, you're not alone on the one hand. On the other hand, because you probably hadn't expressed that to

01:33:46.220 many people before other than to a therapist, as many others haven't, that's why you didn't know

01:33:52.020 that it was common, because people don't talk about it. And that's, again, why I believe that

01:33:56.940 it's the duty of therapists to be ambassadors in some way. Because even if it's a dinner table

01:34:03.420 discussion, and by please, by all means, I'm not trying to say, walk into a room therapist and start

01:34:08.000 taking over with your droning on about your work. Please don't do that. But if you have an opportunity

01:34:13.680 to point to a generality, to point to research, to say, yeah, this is how this works. This is a truism.

01:34:22.260 This is something that's always the case, then do so because you can educate people, we can crowdsource

01:34:28.220 this, we can really let people know, you know, I mean, I have the podcast, I write books, I give a

01:34:34.040 lot of talks, I do consulting, I am trying in these years of my practice, to really get the word out,

01:34:42.840 because I do feel a certain sense of mission. Because when you do, it's kind of upsetting

01:34:49.000 that we know so little and that people know so little. And for you, that's a moment of insight in

01:34:54.740 therapy, where for Esther, she could complete the thought, and she could probably have completed

01:34:58.780 it even before she told her she could complete it. If it's that clear to her, it should be clear

01:35:03.980 to everyone. But we just don't have any platforms by which we can disseminate that information.

01:35:10.520 It should be high schools, obviously, because that's when we have people captive. And that's,

01:35:14.560 we should be teaching life in school, not whatever esoteric information people will soon forget

01:35:19.180 when they graduate. We don't, it's unfortunate. But that's where it should happen.

01:35:22.780 Do you think the tide is changing? You know, you've been in practice for nearly 30 years.

01:35:29.420 When you think about where we're going to be 10 years from now, versus where we were as a society

01:35:34.540 10 years ago, specifically with respect to the seriousness with which we take emotional injury,

01:35:41.280 what does the derivative look like?

01:35:43.520 The most important event in that regard, the event that moved the dial more than anything else,

01:35:52.780 by far, is the pandemic. By far. Because there are very, very few people untouched. And I don't mean by

01:36:03.920 illness. I mean by stress, by anxiety, by grief, by loss, by loneliness, by tension, by relationship

01:36:12.080 rupture, by fear, by depression. Very few are left untouched. And I know that not just because

01:36:20.180 that's how we are and that's how we respond. But because I have been getting calls and talking with

01:36:28.280 entities who would never have contacted me before, because they would have been like, well, this is

01:36:33.120 just not something I can saddle my employees with listening to. And now suddenly, it's a necessity.

01:36:38.720 Now suddenly, I need the people who work for me to know how to deal with this, or with that, or how to

01:36:44.160 understand this and that. And all kinds of very specific kinds of organizations who truly would

01:36:49.680 have been at the bottom of my list of who would ever call me have called. It is something everyone

01:36:54.920 is very much aware of. And I wrote an op-ed for the Boston Globe about this in April, in which I said,

01:37:00.580 this pandemic is going to leave a legacy of mental health crisis that is going to be years to address.

01:37:10.220 And we should start thinking about it right now, because we cannot, as therapists, address the

01:37:15.960 needs of people where they're not enough of us. Therapy is not a practical solution for everyone.

01:37:21.700 We need to start working on online mass interventions that can be deployed psychologically

01:37:26.460 and emotionally, because we're going to have masses of people with trauma. What about all these nurses

01:37:32.320 and doctors in the front line who are truly traumatized? I gave a talk to 7,000 nurses in the

01:37:38.580 Duke nursing system in May, I think it was. And one of the questions I had was, it was a very simple

01:37:45.520 one, but it was just, it stayed with me. This nurse, she was very emotional. She said,

01:37:50.380 what do I do when I am risking my life and my family's life every day? And then I go on social

01:38:00.400 media and my own best friends, my own immediate family members are out there. They're not wearing

01:38:06.320 masks. They're not social distancing. Every image is a stab in my back. What do I do with those

01:38:12.640 feelings? And that's what we're going to have after this is all over. A whole cadre of nurses and doctors

01:38:23.280 and physician's assistants and all of it. Healthcare workers, frontline workers who are truly traumatized.

01:38:28.420 What do we have in place to help them? Nothing. Nothing. And we'll need it. And not just them.

01:38:36.080 What do we have for the kids, for the adolescents? We've been dying to like socialize because that's

01:38:41.460 what life is about and prevented from doing that. For the parents who don't have a break because

01:38:45.380 they're remote learning this and this. People are going through an extremely hard time emotionally.

01:38:50.720 And while most people are unscathed physically, emotionally, everyone is a little bit damaged

01:38:57.120 now. So the one thing it's done though, yeah, we don't have interventions. I can go on about that

01:39:01.720 for a while, but I'll get off the soapbox. What I really mean to say is that people are actually

01:39:06.160 paying attention to it now. They're more receptive to it now. They're more interested in it now. And I

01:39:10.940 think they will listen more now. How can the work that you do, that Esther does, that Lori does,

01:39:18.420 how can it be scaled? Because every time I meet a therapist, they don't have room for more patients.

01:39:26.020 There's just very difficult to get in to see a great therapist. And I know sometimes people will say,

01:39:33.340 look, I can do a one-off consultation, but I can't take a new person on as a regular. And so how do you,

01:39:39.600 how do you scale this given that it's not a widget, right? You can't just tell the factory to make

01:39:44.340 more. It takes years to, like, even if at this moment, Guy, you know, thousands of people were

01:39:52.380 listening to this as undergraduate students and felt, you know what, this is an amazing calling.

01:39:58.260 Rather than, you know, go and do X, I'm going to go and do this. I mean, we're still a decade away

01:40:03.100 from those people being on the front lines. So what do we do between now and then?

01:40:07.900 The answer is not make more therapists. That's not the answer because it's just not practical.

01:40:15.260 The answer is there are already all kinds of studies going on about online interventions

01:40:20.880 for things like loneliness or anxiety. There are all kinds of protocols and they are just

01:40:28.660 being used in like regular research, but they're not, you know, this vaccine effort

01:40:33.440 that was a global vaccine effort. If a fraction of those resources were allocated to finding useful

01:40:42.320 interventions that truly can be put online and anyone can do in the privacy of their home

01:40:47.620 in their own time, will it be as effective as one-on-one therapy? No. Will it be effective

01:40:54.160 and actually helpful to a lot of people? Yes. Not everyone needs the therapy. We have nothing

01:41:01.160 and we have therapy or read an article or read a book. There's a lot in the middle that we can do

01:41:05.860 that can be deployed and scaled really on a mass level. And then once you do it in one place,

01:41:10.600 you just translate it and, you know, you have to adapt things for culture always, but that should

01:41:14.660 not be that heavy a lift. And it can be really popularized in the sense that people can find these

01:41:19.980 resources to at least triage, at least do some first aid. Emotional first aid, the book I wrote,

01:41:26.120 it's a book. I don't come with it. And yet that book has done really well. It's in 27 languages.

01:41:33.480 And people write to me all the time saying, oh, I keep dipping back into it as needed. And it's very

01:41:38.940 useful because it is that medicine cabinet. And if you can do it in a book, you can do it even much

01:41:44.080 better with interactive online tools, with apps, with, you know, AR, with whatever you need to use.

01:41:50.900 But if the efforts were going to that, you can scale and you can actually do things that could

01:41:55.660 be really, really helpful for people on a mass scale. You can't do that with medicine because

01:42:00.140 a femur has to be set, a broken femur individually. You can't look at an online thing and do it yourself.

01:42:05.640 But some of this you can when it comes to psychology and emotional health.

01:42:09.420 One of the things you've written and spoken about that I can speak to from personal experience and

01:42:15.660 initially I would have never believed it is the use of affirmations. I was challenged at one point

01:42:22.320 to come up with an affirmation for every year I've been alive. So I'm 47 and that meant I had to come

01:42:29.640 up with 47 affirmations. And my experience with it, which I think you will understand because of the

01:42:36.180 way you've spoken about it is, and this was during a very intensive therapy, this was three weeks of

01:42:41.040 residential care, right? So this was 10 hours of therapy a day. For the first two and a half weeks,

01:42:47.280 I couldn't come up with two. I just refused to write anything down. And I wasn't pushed to because

01:42:54.600 I think the therapist understood I had to come up with these on my own. I had to believe them.

01:42:59.700 And then I had an enormous breakthrough at the very end of that experience and in one sitting

01:43:06.840 wrote them all out. And the important part here is believe them all, right? Talk a little bit about

01:43:14.160 the importance of believing an affirmation that you come up with versus going to an affirmation website

01:43:21.300 and downloading some posters.

01:43:22.860 So positive affirmations are defined as those typical sayings that you get on refrigerator magnets

01:43:31.500 and the bottom of calendars. I am going to be a great success. I am beautiful and worthy of great love,

01:43:39.280 et cetera, that kind of thing. What the research shows, and by the way, these are a multi-multimillion

01:43:46.380 dollar industry, these positive affirmations. What the research shows is that there is a very specific

01:43:52.200 group that benefits from them and a very specific group that is harmed by them. The people who are

01:43:58.160 harmed by them are people with low self-esteem. The very people these affirmations target. Why are

01:44:03.900 they harmed by them? Because when you're feeling very un-beautiful or very un-successful, looking in

01:44:10.120 the mirror and telling yourself that you're going to be a great success, when you feel like a massive

01:44:15.280 failure is not going to register as believable. And because it's going to register so unbelievable,

01:44:21.480 it's going to remind you that in fact you feel like a failure. Same with saying you're going to find great

01:44:27.480 love when your immediate experience has been that you're not. So who they do help is people with high

01:44:34.280 self-esteem because it doesn't contradict their internal beliefs, which is horribly ironic, right?

01:44:41.560 That the thing it's supposed to help, the people it's supposed to help get harmed, the people who don't need it

01:44:46.040 can benefit from it. But there's a way to change affirmations into useful. And the way you do that

01:44:50.840 is, as you said, you individualize them so that they sound believable to you. So don't say,

01:44:57.320 I'm going to be a great success. You can say to yourself, I'm going to persevere until I succeed.

01:45:03.860 That's believable. Don't say, I'm worthy of great love. Oh, I'm beautiful and I'm worthy of great love.

01:45:10.240 Say, I have amazing eyes and an amazing personality, and I'm going to keep putting

01:45:17.480 myself out there until I find the person who appreciates them. Individualize the affirmation

01:45:23.560 so that it sounds believable to you and yet is hopeful and optimistic and sets a goal.

01:45:30.720 That's the key to making them useful. And those versions don't usually come

01:45:35.620 on refrigerator magnets because they're too long. They don't fit.

01:45:39.640 That's exactly right. I mean, it took a couple pages to write them all out.

01:45:44.280 And I went through a phase of my sort of recovery slash journey where every single day I would take

01:45:52.140 five minutes out and I pegged it to getting dressed in the morning so that it would never

01:45:55.900 be missed. So I had a ritual that said, when you're getting dressed, you're going to also stand in the

01:46:00.660 mirror and you're going to read these and not too quickly. You're going to read them and sort of

01:46:04.600 reflect on what they mean. And truthfully, Guy, there were days it was hard to read them.

01:46:10.380 There were days I didn't fully believe them when I was having a bad day. When one of your

01:46:15.760 affirmations is, I am a good father, and you just yelled at your kid over something that you

01:46:21.060 shouldn't have yelled at them for, it actually becomes a little hard to read that. But it also

01:46:25.580 reinforces that you are a good father who just made a mistake. And that's okay too. And you get to

01:46:30.740 read it again tomorrow and come to it with a different light. But when I heard you speak

01:46:34.580 about that, which again, I think was in one of your other Google talks, I found it to be

01:46:39.020 an amazingly insightful view of something that I felt a little hokey about having done,

01:46:45.540 but personally found very valuable. And again, if you'd told me a year earlier, Peter, you're going

01:46:50.560 to find this valuable, I would have said, there's zero chance I'll find that valuable.

01:46:54.960 Right. Because what you would have associated with Stuart Smalley, right? Looking in the mirror and

01:46:59.420 Saturday night live and doing it or some kind of trite thing that to you sounds trite because it

01:47:05.460 is. To you doesn't sound personal because it's not. So yeah, you were thinking of that version,

01:47:10.600 but that's the whole point. You can individualize. And I would even say to you that on the day that

01:47:14.400 you just yell at your kid before you're about to say, I am a good father, adapt it. And that day,

01:47:19.860 don't say, I am a good father. You can say, I am trying to be a good father.

01:47:23.980 And I am learning from my mistakes. Say, you can always, always tweak it so that it has the

01:47:29.940 same sentiment, but it matches the reality that you're living in that moment.

01:47:35.380 That's a fantastic point. Do you think that there's something to be said, by the way,

01:47:39.960 for the fact that as a writer, it makes you a better therapist? I mean, I sort of,

01:47:46.560 obviously there's a enormous selection bias because we're more familiar with people who are out there

01:47:53.660 doing other things besides their clinical practice. And often it's their writing and

01:47:57.940 speaking that brings them to our attention. I mean, I sought out Esther years ago, but in part,

01:48:03.060 it was because of her work, right? And that's how I sought her out. But that said, do you think that,

01:48:09.220 for example, like you and Lori, when you're doing your podcast are able to do what you do because of

01:48:16.620 the discipline that writing has brought to your thought process?

01:48:21.380 It's an interesting question. I'll answer it two ways. One thing that's very important to me,

01:48:27.620 I'm sure to Lori, and I know it's important to Esther, is language. Because sometimes a lot of

01:48:34.840 people will say to me, oh, I'm really empathetic. I'm an empath, some people say, but I don't like

01:48:39.260 the word, but they'll say it anyway. I'm an empath. And I'm like, what does that mean? I really know how

01:48:43.440 people are feeling. I'm like, how do I know you do? In other words, if you aren't able to express it

01:48:49.940 in language that truly captures it, I have no idea if that's what you know or not. It's one thing

01:48:56.040 thinking that you know how someone feels, but it's another being able to articulate it very clearly

01:49:00.720 and very accurately. And so language is a very important tool for therapists because, for example,

01:49:07.740 our emotional language is very limited, tends to be its primary colors. We're angry, we're sad,

01:49:12.980 we're upset. There's no nuance. But there's tons of nuance in language. We have dozens of words for

01:49:18.920 certain levels or kinds of upset. And I try and choose mine very, very carefully because I want

01:49:24.860 to make the point that you're not just angry. You're also quite frustrated and you're also quite

01:49:30.480 resentful. And in that way, you feel a bit of rage too. And you can start teasing out the nuances.

01:49:37.220 And when I start going through that with someone in that context, they'll get it. They'll be,

01:49:41.580 yeah, that's true. That's true. It just would never be how they would have described it. They

01:49:44.720 would just be like, I'm annoyed, you know, but no, no, it's very nuanced. You're also a little

01:49:48.680 bit relieved because you've been waiting to vent and yell at that person. It's very complex,

01:49:53.500 our emotional experience, except we tend to think of it in just like one thing, which it's not. So

01:49:58.480 language actually is a very important tool for a therapist because when you're describing emotions,

01:50:02.360 which you are apt to do, you really want to be able to do so. But the other way it's very

01:50:07.040 important for a writer is that I, and I know Esther, I know Laurie, a lot of, you know, most

01:50:12.940 therapists I know use narrative psychology to a degree in, in anything that we do, because

01:50:21.240 when somebody comes to me for a first session, that's not a one-off. So what my duty is in a

01:50:26.940 first session is you will tell me your story and then I will tell it back to you at the end of the

01:50:32.520 session or midway at some point. I will tell your story back to you and it will be a different

01:50:36.940 story. And in my version of the story, why you feel the way you do or why you're stuck in the way

01:50:43.560 you do will become abundantly clear. And what you need to do in basic rough terms will also become

01:50:51.740 clear because in your version of the story, you're stuck. In my version of the story, you're not.

01:50:57.440 And I can explain why. But that means that I have to be able to describe your narrative.

01:51:04.080 Take the data points that you presented to me, shuffle the order, look at some of them from a

01:51:09.760 different perspective and tell a different story. The simple example I always use just to illustrate

01:51:14.420 this is if you're a survivor of a horrible plane crash and you lost a limb in that plane crash,

01:51:21.220 what is the story you have about that? Are you a horribly unfortunate person who became disabled

01:51:28.600 in a plane crash? Or are you the luckiest person alive? Because you're the only one who walked away,

01:51:35.340 albeit maybe hopped. Which is to say, those different perspectives are going to make you

01:51:40.140 recover in a very different way, feel very differently about yourself and feel very differently

01:51:45.640 about the life you go forward to live. It'll be much more adaptive to think of yourself as a very

01:51:51.900 fortunate survivor rather than have the self-pity of think, you know, you've been horribly, horribly

01:51:57.520 victimized. And we have choice in the stories we tell ourselves. We don't have choice about the facts.

01:52:03.200 We have choice about our organization, our perspective, and the narrative we create around them.

01:52:08.500 And as a therapist, you have to be able to create and present a different narrative.

01:52:12.220 And writing is certainly helpful. You bring up such a great point. And as I think about it,

01:52:17.660 you know, I can think of examples of people who don't write, you know, or haven't published books,

01:52:22.240 but yet have this. I have a friend, his name is Jim Kochelka, who's an amazing psychologist. Now,

01:52:27.580 he's a colleague of mine, a friend of mine, not a therapist of mine. But anytime I've sat down with

01:52:33.280 him to have dinner, unfortunately, I just suck up all of his time because I end up, you know,

01:52:38.580 it's always a one-sided discussion, but he's just so giving. And I come away from these discussions

01:52:44.440 appreciating what you've said, which is Jim's ability to articulate things is unbelievable.

01:52:52.880 And I could go in with a narrative that says, I'm upset about X and come out of that discussion with

01:53:00.740 12 more layers of complexity to that onion. So maybe that is the synquanon of a great therapist

01:53:09.240 is that ability to say, you showed me an onion. I showed you there were actually 12 layers to it.

01:53:16.160 Right. I do think it's a very important aspect that you have to be able to master at some point.

01:53:21.600 Guy, I could continue this discussion with you for hours, but we've been at it for quite a while. I

01:53:26.480 guess I want to conclude by just letting the listeners know that if they haven't already done

01:53:30.040 so, they really need to listen to the podcast you do with Lori. I absolutely love it. There's one

01:53:36.120 episode in particular, I'm just going to make a shout for people to start with. It's the one

01:53:41.160 called Molly's Father's Suicide. I found that to be a very, I don't know why. I just wanted to hug

01:53:48.920 Molly to pieces. Like I wanted to jump through my phone and just grab that woman and squeeze her

01:53:54.200 till tomorrow. Peter, can I tell you how I have to restrain myself? I said this to my brother. I

01:54:02.920 said, I am so dying to see how she's doing. I want to email her. I want to call her. I want to give

01:54:07.540 her a hug. And we've gotten those responses. We've forwarded her a lot of emails and texts of people

01:54:12.880 going like, oh, please send hugs to Molly. Please send hugs to Molly. I haven't done that because

01:54:17.420 I'm respecting her privacy and her distance, but oh my goodness, you feel for this woman.

01:54:22.160 Yeah. So I would say folks that haven't heard the podcast, start with that one. And that'll give

01:54:27.940 you a sense of the kind of work you guys are doing. Guy, thank you very much.

01:54:32.880 Peter, thank you very much. It's been so interesting. You've asked me things I've never

01:54:36.140 been asked and I've been doing interviews for many, many, many years. And when you get me to start

01:54:41.560 thinking about things and going, oh, I appreciate that so much. So thank you very much.

01:54:46.920 Oh, it's been a pleasure. And I'm sure this won't be the last time.

01:54:50.700 Thank you for listening to this week's episode of The Drive. If you're interested in diving deeper

01:54:54.900 into any topics we discuss, we've created a membership program that allows us to bring you

01:54:59.300 more in-depth exclusive content without relying on paid ads. It's our goal to ensure members get

01:55:04.800 back much more than the price of the subscription. Now to that end, membership benefits include a bunch

01:55:10.300 of things. One, totally kick-ass comprehensive podcast show notes that detail every topic,

01:55:15.720 paper, person, thing we discuss on each episode. The word on the street is nobody's show notes rival

01:55:21.060 these. Monthly AMA episodes or ask me anything episodes, hearing these episodes completely.

01:55:27.220 Access to our private podcast feed that allows you to hear everything without having to listen to

01:55:32.460 spiels like this. The Qualies, which are a super short podcast that we release every Tuesday

01:55:37.800 through Friday, highlighting the best questions, topics, and tactics discussed on previous episodes

01:55:42.540 of The Drive. This is a great way to catch up on previous episodes without having to go back and

01:55:47.580 necessarily listen to everyone. Steep discounts on products that I believe in, but for which I'm not

01:55:53.340 getting paid to endorse, and a whole bunch of other benefits that we continue to trickle in as time

01:55:58.420 goes on. If you want to learn more and access these member-only benefits, you can head over to

01:56:02.440 peteratiamd.com forward slash subscribe. You can find me on Twitter, Instagram, and Facebook,

01:56:09.500 all with the ID peteratiamd. You can also leave us a review on Apple Podcasts or whatever podcast

01:56:16.000 player you listen on. This podcast is for general informational purposes only and does not constitute

01:56:21.560 the practice of medicine, nursing, or other professional healthcare services, including the giving of

01:56:27.040 medical advice. No doctor-patient relationship is formed. The use of this information and the materials

01:56:33.120 linked to this podcast is at the user's own risk. The content on this podcast is not intended to be a

01:56:39.440 substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in

01:56:46.780 obtaining medical advice from any medical condition they have, and they should seek the assistance of

01:56:52.160 their healthcare professionals for any such conditions. Finally, I take conflicts of interest very

01:56:58.000 seriously. For all of my disclosures and the companies I invest in or advise, please visit peteratiamd.com

01:57:05.760 forward slash about where I keep an up-to-date and active list of such companies.

01:57:22.160 Thank you.

The Peter Attia Drive - January 25, 2021

#146 - Guy Winch, Ph.D.： Emotional first aid and how to treat psychological injuries

Episode Stats

Length

Words per Minute

Word Count

Sentence Count

Misogynist Sentences

Hate Speech Sentences

Summary

Transcript