How Leaders Regulate Their Emotions in High-Stakes Moments — with Psychiatrist Dr. Tracey Marks

0:00How does an electrical engineering student with no interest in psychology become one of the world's leading experts in mental health with millions of followers across the globe? Dr. Tracey Marks discovered her love of psychology almost by accident during a psychiatry rotation in medical school. One that she had actually deferred because she had zero interest in it. But once she did it, something clicked. That was the start of a journey that wouldn't just change her life. It would change the lives of the millions of people who now follow her work. One of her core motivations has been destigmatizing mental health while also democratizing access to high-quality information.

0:40Information that is crucial for combating the misinformation that is often spread by psychology influencers online. Today, she's at the forefront of the most important conversations in that space. The role of AI in mental health, how to perform under pressure and manage stress, and way more. We aren't just learning from the best. We're learning how the best became the best. This is the story of Dr. Tracy Marks. Welcome to Big Swings Only. This episode is brought to you by Granola and Quint. If meetings are eating up your day, Granola is a no-brainer. You can try it totally free for three months.

1:17Just head to granola.ai slash Kwame. That's granola.ai slash Kwame to get your time back. Three months free at granola.ai slash Kwame. Find your next fall favorites at Quince. Download the Quince app for app-exclusive offers or go to quince.com. Get free shipping on your order and 365-day returns. Now available in Canada and the UK too. And when Quince asks you where you heard about them, let them know it was me. That's the best way to support the show. A fun place to start would be talking about your background in psychology as a psychology influencer now, because I'm assuming when you started off, that probably wasn't the goal.

2:01How did that part of what you do start? Yeah, so it's funny. It starts with me clarifying that I'm a psychiatrist and people say this all the time. Call me a psychologist. That's fine. I don't get caught up in that, but I'm an MD. So I'm a psychiatrist. I went to medical school. And psychologists are not MDs. They can either get a master's degree, but some level of graduate studies, usually PhD, PsyD. But there's a lot of overlap between the two of us. Okay, so enough about that. I but you know what I did not start out with an interest in psychology psychiatry I started out with an interest in engineering I was an electrical engineering major because I was good at math and science and I did not like to read or write papers so I went to Duke and at Duke as an engineering major you only had to take one semester of of English and you didn't have to take a language so that's my major.

3:09But it wasn't until I got out of school that I've always been someone who's very, who's been very sensitive and like to help people. And the work that I was doing just wasn't meeting that need for me. So I decided to go back to medical school. And I'd actually thought about medical school in undergraduate, but I was like a junior. And at that point, it was way too late for me to change my major. So I just decided to just push forward. In medical school, my intention was to be an internal medicine doctor. And it wasn't until, in fact, I deferred my psychiatry rotation because I had zero interest in that.

3:56I mean, I grew up in the South. And culturally, for me, seeing a psychiatrist or psychologist is, that's for other people. Like, you know, you don't talk to, you talk to people you know, you don't talk about your problems to strangers. So it was never on my radar until I did the rotation in medical school and saw how much more satisfaction and gratification I got out of helping people with their mental pain over their physical problems. Wow. This is so fascinating. It's definitely not the response that I expected. This is really interesting. So you kind of almost in a sense stumbled upon this passion for psychology within something that you were actively trying to avoid.

4:49Absolutely. Yeah. In fact, I went to, well, you know this since your wife is a doctor, but there's a whole match process, which is like the draft for medical students going into residency. And so I matched in internal medicine and I made the switch after the match. There was a psychiatry resident who couldn't come because of a medical issue. And so they just switched my name from one roster to the next at the New York hospital where I trained. So but when I was at my graduation dinner, you know, we had family there and everything. and I made this announcement, I'm actually going to be doing psychiatry instead of internal medicine.

5:33There was like, it was like mic drop. I mean, it was like, it was just silence because again, culturally that was just not seen as something that warranted, you know, anyone's attention. It's like, why would you do that? In fact, one of my attending, attending doctors on my internal medicine rotation when I told her that I'd switched to psychiatry, her response was, wow, what a waste. Like, what a waste of intelligence. And I just, I thought, what a shame that that is the sentiment, even within medicine. Now, I do think things have changed tremendously over the years in terms of respecting mental health.

6:18And when I started on YouTube with mental health education, that was one of the things that I wanted. That was one of the reasons I wanted to see that change. I wanted mental health to be something that can be ordinary conversation at the dinner table without anyone feeling shame about it, because we all have brains and minds and it affects everyone. Yes, absolutely. And when it comes to this, I 100 % agree. We needed to de-stigmatize these mental health conversations. But in addition to that, we need to have real leaders within the field who are the people driving these conversations, because that's one of the things that drew me to your content.

7:03It was always so scientifically sound. Everything was scientifically sound, not sensationalized. And I'm wondering your perspective as somebody who has worked tangibly within this field, but also has inspired and educated millions online through this. What are your thoughts on the different types of social media conversations that are happening around mental health? and because I want to say social media because I feel like that permeates into everybody's everyday vernacular so when you're thinking about the different types of influencers talking about this topic what are some of the good things and what are some of the things you would rather not see oh boy okay so uh do I tiptoe through the two lips on this or do I just say it okay so So it was a struggle for me at first to not be drawn toward sensationalism.

8:02That is a draw on social media because, you know, if no one is interested in what, if I can't get a click and no one watches, then it goes nowhere. And so it's very tempting to want to make the content sexy for people, for then just the broad public to want to watch it. But I didn't want to go down that road because the original reason I started kind of going back to, you know, Simon Sinek's knowing your why thing was it started with me treating patients. I mean, I still have a practice today, but seeing how here I'm doing all of this explaining and things in sessions. And I thought, how many people don't get this because they don't see a doctor?

8:50And so here we've got this information that's just kind of locked behind the doors of an office practice. And if you don't have, if you aren't seeing a doctor who's talking to you this way, then you're just kind of out of luck. So I thought, how many more people could benefit from just learning these things? Because the more you understand your mind, the better you know how to equip yourself with tools and strategies to get through life, to have better relationships, etc. and just improve the quality of her life just from knowledge alone. So I think that, you know, online there's been, now that there's so many more people, influencers, I kind of don't like to think of myself as an influencer, but people online with presenting mental health content, there is what we call just pure education.

9:48Then there's edutainment. So there is, you know, doctor reacts and, you know, maybe commenting on television shows and speculating about people's personalities within the television shows like that would be kind of more edutainment. It's a mixture of it's entertaining, but at the same time educational and then just pure entertainment. entertainment. It's hard to make mental health purely entertaining, but still there's, you know, there's the draw to want to kind of go more in the entertainment realm because it, you know, gets more views, more views, gets you more attention, potentially more money, et cetera.

10:29But one other thing, though, is there's also more of a concern these days now with the proliferation of misinformation. And so sometimes it's not, there's a lot of mental health content that's not coming from a clinician. And so, but, you know, if someone's not really making any kind of distinction or even trying to see if the person is grounded, they can just take in this information and think that's the way it's supposed to be. And unfortunately, you know, that backfires when people get misinformation. Yep. I agree 100%. And I think you are an example of somebody who exemplifies the distinction between a thought leader and an influencer, right?

11:16An influencer is somebody who could just, you can influence anybody in anything. It's easier to influence people negatively, right? Oh, absolutely. But be a thought leader who has garnered a following in a psychologically and scientifically sound way. I think it's just, it is incredibly encouraging because we need more of this so we can have higher level conversations. Because when it comes to communication, I think that this is one of the fundamental elements of humanity is how we transfer information. But if we are basing the communication on misinformation, then how good can the quality of the conversation even be?

11:53And so I really appreciate the work that you're doing to kind of lead the way when it comes to addressing this in a meaningful way that is no educational. I find it entertaining. I still do. I still find it entertaining, but it is educational and sound. So I just appreciate the work. Absolutely. Thanks so much. I guess a different way to think of it is engaging. So I try to make my content engaging. And if that ends up being entertaining, good. But yeah, the idea is not to clickbait, rage bait you into watching my content. Right. Right. That's good. And I want to talk to you about the ability for people to perform under pressure, because I know based on what I've seen about you, a lot of the folks that you work with are high performers.

12:46And then for me, when I see people who are having tough conversations, whether it's a high stakes negotiation or just a difficult conversation with a loved one. One of the problems is that they cannot access their skills because they can't manage their emotions. And I'd love to see from your perspective, when it comes to performing in these tough conversations, what are some of the biggest barriers that can hold us back? Sure. I think one of the biggest barriers that can hold us back is letting the emotions at the moment just take over. And we all are prone to this or susceptible to this because that's how our brain is wired.

13:27So our brain is wired to always be looking for threats. And back in the day, way back in the day, you know, a threat could be a saber tooth tiger right outside your cave. but um and that was you know 20 years ago but um i'm just kidding but you know ancient times that's what a threat was but today's modern times a threat is can just be uh someone's tone or um having a an upcoming deadline or just too much online information you know on our phones and things so there's lots of things that get that get interpreted in our brain the same way as a threat. So therefore, let's divert all of our energy toward defending you.

14:19When that happens, and again, the threat trigger could be someone using a very negative tone with you or accusing you of something or criticizing you, let's just say that. The thinking part of your brain kind of takes a step back, goes offline sort of, and that's the prefrontal cortex, which is responsible for rational thinking and emotional regulation. In fact, that takes a back seat while the rest of your body is, you know, your heart rate increases, you know, your senses get sharper, but you're not able to think and rationalize as much. You're just kind of acting on autopilot. So one of the ways to break that cycle or one of the things that can get in the way of that is not recognizing that this is a natural thing that happens.

15:16And how can I intercept that so that my thinking brain can come back in and allow me to be able to be able to interact with this person in a calm way and in a rational way instead of just mimicking, you know, their response or their emotions. Yep. It makes so much sense. And I think one of the things that's important for people to just accept about this is that it's a very natural response. In fact, it would almost be more shocking if you did not respond in this type of way because it's very human. But what we then have to recognize is that, yes, it's natural, but there is a way to level up and improve because at the end of the day, this is a skill.

16:02But I think it's oftentimes people just say, this is who I am. This is how I react. This is my personality. And to a certain extent, it might be. But that doesn't mean that you cannot utilize the skill of emotional intelligence and learn to manage your emotions. That's right. That's right. And the better you can get at that, the better you're able to manage your emotions. So what do I mean by that? I think kind of the first step toward even being able to recognize how you're feeling about something is to recognize the early signs that you're starting to get triggered. So that would be things like, and it can be different for different people.

16:45So I mentioned the heart racing. Sometimes you could I can start for me, I could start feeling heat in my chest, kind of like a fire breathing dragon or or starting to sweat. You know, whatever your signs of you're starting to get amped up or worked up is being able to recognize, oh, it's coming. Then in order to keep things from escalating to a point where you don't have much control over what you're saying or you can't really think straight. you could take a micro pause just take a second a couple of seconds to breathe in and then exhale slowly and then acknowledge or just think about how is the situation making me feel like putting a name on the emotion that you're experiencing at the moment that whole process can take 15, 30 seconds, it's enough time to just put in, just to create space between the trigger and your reaction to it so that you can then formulate a better reaction than the one you would have had you just, had you not done that and just let things flow.

18:02Yes. Oh, this is great. And this is exactly why I wanted you to have you on because a lot of times people will talk about the power of the pause. Just take a moment. And that's a great start. But it doesn't help if you don't know what you're doing and why in that time. So you can still take like 30 seconds and still be supremely pissed off at the end of the 30 seconds if you don't know what to do. So I appreciate you breaking this down. So let's recap and tell me what you think about some additions here too. Because we're taking this micro pause. And so we're breathing and exhaling slowly, intentionally to trigger the parasympathetic nervous system.

18:37Because if we are being threatened by that hypothetical saber-toothed tiger, taking a deep breath isn't our natural first response. So we're kind of coaching our body to say, this is not a threat in that way. I can take the time to breathe slowly, introducing more oxygen into the brain, and then labeling the emotion. Because we know in psychology, you have to name it to tame it. And labeling it using affect labeling, It helps us to be able to not just get an understanding of ourselves, but it also triggers frontal lobe activation, which lowers the limbic response. So there's a lot that's happening beneath the surface.

19:12We're not just taking a pause for the sake of stopping. Right. Or just doing some silly exercise of, well, OK, let me, well, how do I actually feel? Well, because you described it perfectly, that engaging your prefrontal cortex with that exercise, which is a cognitive exercise of how of affective labeling or affect labeling. What do I feel at this moment? It brings your brain back into it. And then you have more control over what you're saying and how you're behaving. If you don't reengage it like that, then you can just be acting on autopilot. pilot, because another concept here, since you like nerding out on psychology stuff, is the concept of mirror neurons.

19:55Yes. So mirror neurons are kind of like our, well, they're specialized nerve cells that work to imitate or match is probably a better word, someone else's emotions and presence. so if someone is like hey blah blah blah blah blah blah blah and you're just sitting there reading peacefully and they start talking to you like that you can automatically click in and respond in that same attitude and that that they have of anger and you you know what do you got to be angry about you're just reading something peaceful and this person's coming saying this kind of stuff. So all that to say, just as it's kind of like, you know, catching people's emotions or emotional contagion, if, if, if someone, so just as you can pick up on someone's negative energy, they can pick up on your positive energy.

20:59And therefore, it brings it deescalates the situation. So if you go back to the whole micro pausing thing, like, so somebody comes over, hey, blah, blah, blah, blah with some bad attitude, instead of me just snapping back with something, if I take that 30 seconds to create the micropause and like register how, okay, I'm feeling attacked, I don't know why, I don't even know if it's justified, but this is how I feel at the moment, it then gives me the ability to respond more calmly. And then that can calm that person down. so they can catch my calm just as I could catch their irritation. Yes, this is so powerful.

21:41And I want the person listening to fully appreciate this because we're seeing how the very beginnings of these conversations, especially when emotionality is introduced, this could be the micro fork in the road that dictates the direction of the entire conversation. Depending on how emotional the conversation begins, And we might be set upon a course that was doomed for failure from the jump. It's wild. And it's determined by these first seconds of how you handle this important part of the conversation. And here's the thing, too, because I remember that there was a time when I was less mature than I am.

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24:40I use Quince and so should you. Find your next fall favorites at Quince. Download the Quince app for app-exclusive offers or go to quince.com. Get free shipping on your order and 365-day returns. Now available in Canada and the UK, too. And when Quince asks you where you heard about them, let them know it was me. That's the best way to support the show. Now, and I used to think I could just kind of muscle my way through emotion management. Like a weaker person would feel this, but I don't feel this, so I'm going to keep on acting like I don't feel this. And I remember that with my wife, she told me, she's like, the way I know that you're mad is because you say you're not mad.

25:20And denying the reality doesn't allow you to do the very thing that's required to actually manage your emotions effectively. And I see a lot of folks in the business world, they try to convince themselves and others that they don't feel anything. And as a result, they don't have any mechanism to control their emotions. And they're making these decisions thinking that they're strategic when they're really emotional. That's right. And you can lie to yourself consciously, but your mind still knows how you're really feeling about this and how you're processing it, even if you can't fully relate to how you really feel.

25:57So let's say, and what I mean by that is, let's say you're not that emotionally intelligent. You just know that made me feel some type of way. That's what people will say. Well, some type of what way? But anyway, that made me feel some type of way. But really what you feel is resentment or you feel disrespected, you know, disrespect or resentment. You know, those are different kinds of anger and negative emotions than just simply I feel attacked or, you know, there's, there's lots of different ways that you can experience something negative. So the better you can get at recognizing how it is you actually feel, the better you can get at processing that emotion.

26:45So yeah, if I just say, well, you know, that made me feel some type of way, but, or I'm not going to let these people get to me. I'm just going to keep moving because I got work to do. That still doesn't address the fact that I still don't feel very respected. So how will that manifest? I can start doing other stuff, sabotaging, I could, you know, act passive aggressively toward people who I think aren't respecting me, where is it without, and that can all happen on autopilot as well. Like I'm doing these things because I'm still mad, but I'm trying to act like I'm not mad because that's the professional way to act.

27:26And it's like you can run, but you can't hide. These things will come out some kind of way. That's so powerful. And I think as well, and this is kind of a step to another direction, but in some cases, this helps me to recognize how some people can end up being unintentionally toxic. You know? Right. Yes. Because I can't imagine, because one of the things that I talk about so much is that I'm a recovering people pleaser. And so I like to create a lot of content for people who struggle in these tough conversations. What often happens in these conversations with people pleasers is that they sacrifice their own wants and needs.

28:03They don't articulate those to other people. They don't set boundaries. And they just hope that other people will adjust or self-correct. But then they say, you know what, I'm a good person. I want to be easygoing. I don't want to make a ruckus or anything like that. So I'm just not going to say anything. I'm not going to do anything. But I will just sit here seething in perpetuity. And like you said, it leaks out in different ways. And now you're trying to be nice for other people. But that exact act is what's making you mean and unintentionally toxic. That's right. That is so right. I love that term, unintentionally toxic.

28:39Because yeah, it just that brooding and the seething takes its toll eventually. And it will start to affect the way you relate to people. It will even affect how you speak, your tone. It's hard to express genuine emotions that don't exist. You know, if you're quietly and secretly pissed, you're not going to be able to really come across genuinely as this, you know, happy or satisfied or joyful person. You just can't. Yeah. No, that's fascinating because it's what oftentimes the folks who are conflict avoidant, they don't have these conversations because they don't want to damage the relationship.

29:30And in doing so, they ultimately damage the relationship. And it's a guaranteed loss too, because they're saying to themselves, okay, I want to sacrifice myself in order for this person to feel good in the relationship to be okay. But what ends up happening is even if they do successfully please the other side, they are guaranteeing that they themselves will not be pleased and they're an equal part of the relationship. So still, there's going to be a person within the relationship that is unhappy with the relationship, which makes it kind of fundamentally untenable for the relationship to be successful at that point.

30:04Absolutely. Because on a more subtle level, there's the connection issue. And I can relate to the people pleasing person because I'm one of those two. It pains me to like say no to someone who really wants something. They need this. But, you know, I can't take on everything. But at any rate, what can happen is you can feel like you can just not really be connected to the other person. Let's just say this is a dual thing, you and someone else. And you're just kind of yesing them and letting and yielding to whatever their needs are to the expense of your own. you're not really being emotionally honest with them because you have to be disappointed that your needs aren't being met at some level and so you can you can get to where you're just kind of out there on your own not really feeling like anybody understands you or really cares about you because no one's really like meeting your needs whereas you're allowing everyone to not meet your needs because you don't want to speak up and admit that you have needs.

31:19This is getting deep. I can feel people getting really uncomfortable training. This is really good. And I think that's what people need. And this actually gives us a good opportunity for us to segue because I want to talk about the magical power of journaling. And I recognize that a lot of times people describe things as magical when they don't understand the science behind it. Right. And so in your practice, when you've worked with high performers, people who have been struggling in different ways, how have you seen journaling be part of their pathway to recovery? So there's so many different ways that you can journal.

32:00And I'll just name a few. So one is I like to call it a worry journal or setting aside worry time. So if you're someone who tends to anticipate negative scenarios, maybe even catastrophize or have a lot of what-ifs floating around in your head and they particularly get worse at bedtime when you're trying to go to sleep and now you've got time to yourself and your mind's just running, set aside worry time. You pull out a journal and you write these things out of, okay, well, what if this scenario happens? What if this scenario happens? What if this scenario happens? And you could either just write out the scenario, so you're just kind of offloading all of this information, or you could even put down, you know, potential solutions to these, which also serves the purpose of offloading all of this information from your working memory onto paper.

33:01that's part of what's going on here as well because it's taxing for your mind or your brain to kind of try and keep everything fresh and and you know if you're worried about problems to keep all this information top of mind for you as you go through your day you know you need to be you need to focus on if you're working you know you need to focus on this project and then you need to think about what you're going to have for dinner and so on and so forth there's like a million decisions that we need to make throughout the day, if I'm still having to like keep reminding, keep, keep refreshing, oh yeah, I got this.

33:37And what if this happens? And all, you know, all these things that are also running in the background, that's one of the ways people can get cognitively and or emotionally overwhelmed and overloaded from just too much information. So too much information that they're trying to keep current and fresh for themselves. so another benefit to journaling is just even if it's not necessarily about worries is just offloading information like a data dump so i know i've done this where i could be like getting toward the end of my evening thinking oh yeah i can't i can't i can't forget that i need to do blah blah so i'll go and i have this little book and i'll write down all these things that i want to make sure I do tomorrow.

34:23And once I write them down, then I don't have to hold myself responsible for keeping it fresh so that tomorrow I won't forget. You know, another thing for journaling, some of it could be freestyling where you just kind of, well, you want to process some difficult emotions you had during the day, or they don't even necessarily have to be difficult. If you're trying to improve your emotional intelligence, the affect labeling thing, you can use a journal to document those situations. So let's say, you know, something happened at work or wherever that made me, that created or triggered a strong emotion.

35:12It would be best in the moment, so you could use your phone, the notes app on your phone or something, to identify how it made you feel and write it down real quick at that time. And then later when you've got more time, open up your journal and just kind of work through it again. So this happened and I felt slighted or overlooked. I could be thinking of, well, what else did it make me feel? Or go a step further and this is processing the emotion. This is what this exercise is for this journal entry. Okay, so I felt slighted when this project was given to someone else and I had already been working on it.

35:57But actually, why is that such a big deal? Like, what's the bigger problem here? This is just a one-time incident, but why is this bothering me still? So it's because I always feel like this is a dead end job for me that they don't really think that I meet their expectations. So maybe I need to address that or look for another job, you know, that kind of thing that that would be processing. Or I could conclude from that processing that I just don't feel secure in my own skills. And so I'm misinterpreting what people are saying. You know, maybe maybe it's me. Maybe if I improve my skills, I won't feel so insecure at work, that kind of thing.

36:42I mean, there's lots of things that you could write in a journal, but really, I guess, the high-level strategy or one of the high-level benefits here is offloading a bunch of thoughts in your head onto paper to give your brain and working memory more space. Yes. Oh, Tracy, there's so much to explore here. So first of all, I think it's important when we think about this as related to difficult conversations of any kind, one of the questions that I get frequently is, what are the best ways for me to manage my emotions in these tough conversations? And one of the things I always say is the best way overall is to do a better job of managing your baseline level of emotionality.

37:31It's not just what happened in the conversation itself. It's everything that led up to that and then how you process this. And so you could see how this could be an integral part of the preparation for tough conversations if you're feeling, for whatever reason, fearful or avoidant. Because now you can work to process this in a meaningful way before the conversation happens so it's easier for you to maintain your cool. I see that people often prepare strategically for conversations but not prepare emotionally for the conversation. And then they go in the conversation and trip over a landmine and they're freaking out right there in front of the person.

38:05You should have handled that freak out before. this was predictable. That's right. Absolutely. If you feel fragile, emotionally fragile, then it is going to be harder for you to feel confident that you could have a difficult conversation with someone or even when I keep saying difficult conversations, not like everything has to be these we need to talk conversations. But let's say, you know, you need to ask for something and you have a feeling you're going to get some pushback and you already, you fear that at the least bit of pushback, you are going to lose it. And if you do that, you may lose your job.

38:49So how do you hold yourself together? Well, to your point is if, if, you know, it isn't to how do I make this one situation go perfectly? The bigger question that precedes this is how do I make myself less fragile or less explode, less labile, we call it when, you know, I could just easily explode. How do I, yeah, how do I make things just kind of less sensitive that way. And that's more of a, you know, that that's more than, you know, a what's what's the cognitive exercise you can do or behavioral exercise you can do for that. That's a lifestyle adjustment that that touches on multiple aspects of your life, your sleep, because a sleep deprived person, no matter how good they are at emotional control is going to lose that emotional control if you are sleep deprived.

39:53That's just the way it is. Yep. You know, it just strips all your defenses. You know, diet, exercise, like everything that builds a healthy mind helps you have more margin and cushion to be able to absorb these insults. Yes. Yes. No, you're spot on. And when it comes to this, I know you've done a lot of work, not just as a clinician with telling people to journal. You actually created a guided journal, right? I did. It's called the Shine Guided Transformation Journal. And I love it because it's 12 weeks. And each week, there's different things you can do. So there's people who, and I say guided journal, because there are people who want just a journal that has just blank pages and they're good at knowing exactly what they're going to do with their journal.

40:50There's others who just aren't used to journaling and they don't really know what to do. So this is perfect for that person. And so that's the guiding part. So there's, you know, each week there's a challenge exercise for the theme for that week. There's affirming statements that you can read and then reflect on. There's also open space for just general journaling, and then there's mindfulness exercises. So I think it's a great tool for the person who would like to feel like they're trying to improve different aspects of their life. Like for example, one of the months is self-awareness, helping you improve your self-awareness by focusing on certain aspects of it with a little bit more guidance than just kind of freestyle, just journal about whatever is on your mind at the time.

41:47Right. Oh, that's powerful. And this is, is this in the mental wellness store that you have online? It is. So I've created a, my brand is the mental wellness space. And so I created an online store, mentalwellnessspace.store, that is designed to have different tools to help people with various aspects of mental wellness. So this is one of those tools, a guided journal. Nice. Brilliant. This is great. And before we bring Simone in for his question, which I'm excited for, I want to ask you one question, which will probably open up Pandora's box and require a completely different episode. But I just I'm interested to see your thoughts on this.

42:31And I'm also interested to see whether or not you've shared your thoughts on this publicly before. OK. What are your thoughts on A.I. therapists and people using generative A.I. for mental health?

42:49so um i have mixed thoughts um this is coming from observing even like my child heavily using ai uh to now gotten to the point where um she asked for just about everything you know well i'm gonna see what chat says about this probably so i don't know i think it's it can be great it can be great for general information. I still think it's too, it's dangerous to rely heavily on it as a substitute for a real clinician because it's just, it just, it makes mistakes. It doesn't always take other things into context. And so it's, it's, I don't know. I don't know. I've got mixed feelings. In some ways, it's very helpful, but it's a double-edged sword, really.

43:48Agreed. Yeah, I'm with you on that because we see the pros, we see the cons, we see the stories of both. And I think a big part of it comes down to sophistication as well. Because I think, for instance, if you hypothetically were to use this as an AI therapist for yourself, you would have the sophistication to know, hey, that what you just said was BS and nonsensical. So I'm going to Ignore that. Right. And, but the problem is a lot of people don't have, not a lot, the majority of people do not have your level of sophistication on the topic. And as a result, they don't know enough to protect themselves.

44:24And it's also designed to be very validating. And even when you're wrong, just for everybody, just try, just try this, put in like a statement that you believe is incorrect, you know, to be incorrect, not even factually, maybe philosophically, and then say, tell me why I'm right. And it will validate the hell out of you inappropriately. So I think it requires a lot of self-awareness. But again, from your work, we talk about the fact that self-awareness is the foundational step when it comes to emotional intelligence and so many other things in life. But we also recognize that self-awareness is the step that most people lack because it's a skill.

45:05So it's tough. And I think especially when you consider the discrepancies of sophistication on specific topics that people are asking about. It could be very dangerous. Sorry. I live my life with alarms, Tracy. I get into a flow state really easy, and if I don't have these alarms, something will get missed. So sorry about that. That's okay. Yeah, what I was saying is, if you don't have that level of sophistication to know what's right and what's wrong, or what could potentially be wrong and double check it, then it could be very dangerous in the wrong hands. Absolutely. You know, I forget that aspect of it because of the fact that I have the knowledge.

45:45So I feel like it's a little safer for me because I can tell when this isn't correct and, you know, that sort of thing. But and even be able to see the nuanced things that are just not quite right, but maybe sort of right, whatnot. So that makes it all the more scary to think about the person who is just blindly trusting it because they don't know any better. That's usually the more impressionable person, the younger, younger minds. And so. So, yeah, it really is a double edged sword. I do know that medicine is trying to utilize it more for delivering, not really care, because you can't call it that, but information and things to make up for the fact that not everyone has access to health care and, you know, all the information that we want.

46:42So what do we do about this? Here's this tool. But, you know, tool in the wrong hands can still be harmful. So we have a ways to go to put some protections in place. Agreed. Agreed. Great. Well, perfect. Let's bring in Simone before we wrap up. He's always listening and always comes up with fantastic questions. So, Simone, what do you have for us? Tracy, you have more than 2 million followers on YouTube, so you should receive lots of questions and comments. What are the most frequent questions you receive on social media and what are the answers? Wow, I probably get a thousand comments a week.

47:26So I don't see as many as I used to. When I first started my channel, probably the first two years, I was answering or responding to every single comment until I just couldn't do it anymore. um but i will say so right now i get it's more people commenting that this has been helpful or they may use an example of how they plan to use whatever i suggested um but if i kind of pull back a little bit and just look at the people who actually do have questions i would say probably the most frequent, let me say it this way. The most frequently requested topic for me to talk about would be ADHD. Everybody thinks they have ADHD.

48:20But, and a lot of people do who don't, who were never diagnosed. So, you know, that is a reality that deficits in attention, whether you actually have the disorder or not. Deficits in attention are very common and it can be on a spectrum. But understanding that, recognizing signs and things like that, those are the most frequent questions that I get. There are some trending topics. That seems to be one that comes up very frequently. Okay. Yeah. Well, let's stick with this because we talked about emotional contagion before. We talked about mirror neurons as well. I'm wondering, because I think, like you said, especially with ADHD, there are documented incidents of people not being diagnosed when they're younger.

49:08They're diagnosed when they're older and they say, oh my gosh, if I had this diagnosis, life would have been so much better for me had I known. So not denying that this exists. But I also want to think about, could there be a little bit of, what is the term, psychosomatic impact here where we learn about something and then we have it because I remember my wife, like I mentioned, is a doctor. And when she was in med school, it's like the more diseases she learned about, the more of them she thought she had. And she ended up having none of them, you know. So what do you think this balance is? Yeah, it's tricky because there are lots of things that can impair our attention that's not necessarily the disorder, the clinical disorder of attention deficit hyperactivity disorder.

49:58So going back to the sleep, if I don't sleep enough, if I've got some projects that I'm trying to stay up late working on and I get, you know, instead of my usual seven or eight, I'm only getting five or six hours of sleep a night for a couple of weeks, my attention is going to be compromised. So I may not be as sharp as I usually am. I may forget stuff a lot and all that. Does that mean I have ADHD? No, it means I have compromised attention because of something else affecting that, in this case, sleep. So anxiety can also affect your ability to pay attention and retain information. So if you can't encode information because you didn't pay enough attention at first, then you're not going to be able to recall it.

50:46Anxiety can affect that. Depression can also affect your thinking ability and problem solving ability and ability to remember things and hold things in working memory. So all of those are things that can impact your attention that's not easily talked about, you know, in a quick TikTok video that are clinical nuances that someone with more training would be able to tell the difference because those differences determine, well, what do you do about it? People who have significant executive dysfunction, that's a whole nother animal. I mean, it goes along with ADHD, but in terms of like, you know, our prefrontal cortex and whatnot, The executive functions are things like working memory, planning, time management, organization, and emotional regulation.

51:45There are different things that can affect our ability, our executive functions that aren't necessarily ADHD, but ADHD definitely impacts those. Again, I have a love of psychology. I love that we're talking more about it. I love that I'm seeing more videos on it. And then I'm also seeing people who are like self-diagnosing that see in ways that seem inappropriate. And then people going in the comments and saying, yes, I think I have it now, too. I'm like, I don't know if this is what the vision was for psychology based education. Because I remember day one of psychology when I was in psychology 101.

52:26one. Our professor said, okay, rule number one, you cannot diagnose your friends. Yes. They were very explicit. And now on social media, TikTok's like, diagnose everybody. And you probably have it too. So I don't know. It seems like it's kind of muddied the water when it comes to these conversations. It has. And again, another double-edged sword in terms of information has been wonderful to open our eyes, have some people get help that they wouldn't have gotten, but then also just over calling it and having everyone feel like this is their problem, or even pointing fingers at people and diagnosing people.

53:18But I still, despite all that, I still favor the proliferation of good and accurate information because we still need to know like this, this because of this double edged sword feature, that's not a reason to shut it down. And let's not talk about this anymore. Agreed. I think the solution is talking about it more in a better way, which is why I was so excited to have you on the podcast today. Tracy, this has been fantastic. And before you go, I want to give you an opportunity again to shout out the work that you're doing and how people can get in touch and work with you. Sure. So I probably the best place to find me, the hub is my website, Mark's Psychiatry, and that's M-A-R-K-S and then psychiatry.com.

54:07That's where I kind of where everything is. But as far as online or on social media, my main place is YouTube. And my handle is my name, Dr. Tracy Marks. And that's T-R-A-C-E-Y. Same thing on Instagram and TikTok. Of course, those are short form. And then the YouTube is where my most, my long form explanations and things is. So, you know, I'm all about helping people. So here's my kind of parting words is I think the most advanced, sophisticated piece of software that we own is our brain. And it is something that could be understood, updated and optimized. And if we can do that, you can do that through repeated behaviors and habits, little changes over time.

55:07And that is the way to have better relationships, feel better about yourself, and just have an overall better quality of life. Tracy, if my mic was not so expensive, I would have dropped it on your behalf. Thank you for this. Thanks for coming on the show. We really appreciate it. Thank you for inviting me. I enjoyed this.