The Brutal Reality For Most Men Today (& how to fix it) - Dr K HealthyGamer - #1151

24:28Slowly, slowly, slowly, get smarter. And we've gotten dumber for like the last decade.

24:34Dr. K:Probably. Yeah. So for the first time in the history of like recorded iq measurements yes here it is scroll up for me uh the flynn effect is specifically about iq scores it refers to the observation first documented by a political scientist james flynn the average iq test scores increased substantially throughout the 20th century in many countries many developed nations the increase was roughly three iq points per decade uh and has the flynn effect stopped in many developed countries yes since the 1990s or early 2000s researchers have found that iq gains have plateaued in some countries and reversed slightly in others, sometimes called the negative Flynn effect.

25:10Dr. K:Yeah, so, and this is happening. So, and what's happening is, especially if you look at IQ reductions, I see this a lot. So I have friends in academia and stuff. And like the more that people use AI for stuff, the stupider they get. And there's lots of good studies that show this. So the MIT released a study a couple of years ago that showed a decay in critical thinking skills with AI use. And, you know, AI is basically like taking the elevator instead of taking the stairs for your brain. So what's happening is something weird is going on where like society is progressing, but human beings are getting worse.

25:49Dr. K:And as we get worse, like things are really starting to come apart at the seams. I think we sort of feel it. We see evidence of it in mental health. We were talking about Ozempic. So basically what happened is up until now you've had to work to get something, right? And along comes semaglutide and these GLP-1 agonists. And suddenly you don't have to work to get something. You take an injection and then your cravings get reduced. And then we're starting to see some really scary things around GLP-1s. So they're amazing medicines because if you're overweight and you have cardiac risk factors, endocrinology risk factors like type 2 diabetes and stuff like that, these medications are amazing at all this kind of stuff.

26:40Dr. K:We're also seeing some really cool mental health effects. So we're seeing reductions in cravings on alcohol. We're seeing improvements in even things like nicotine cessation and stuff like that. I think it's... So weed, the data is mixed. Pornography appears to get worse. Pornography gets worse? Yes. Video games? I haven't seen any data about that. Yeah. So, and there's a lot of really interesting signaling around GLP that we can get into, but this is exactly kind of what I mean is it's sort of a miracle drug and our society has been filled with miracle innovations that actually cause silent damage around the edges.

27:18Dr. K:And I think we've been doing this for way too long and like it's hit a critical point. Tell me if this sounds familiar. You train regularly, you eat reasonably well, you feel fine, but you're just kind of going off vibes. Most people have absolutely no idea what's going on inside their body and that is why I partnered with Function. Function gives you access to more than 160 advanced lab tests spanning hormones, heart health, kidney function, and even detects early signals linked to more than 50 types of cancer. To put that in perspective, your typical annual physical might test 20 markers. Function runs over 160.

27:51It's huge. Best of all, you test twice a year and everything lives inside of a simple dashboard. So you track trends over time, make sure you're moving in the right direction. And this level of testing would usually cost thousands, but with Function, it is$365 per you just$1 a day to actually know what's happening inside of your body. And right now you can get $25 off, bringing it down to$340. Get the exact same blood panels that I use and save$25 by going to the link in the description below or heading to functionhealth.com slash modern wisdom. That's functionhealth.com slash modern wisdom.

28:21Dr. K:It's a simple example of GLP-1, fascinating study. If you take someone who has a binge eating disorder and you do cognitive behavioral therapy on them, the more weight that they lose the more effective the cognitive behavioral therapy is the higher their risk is of developing anorexia that's correct it's confusing if I have a binge eating disorder and I lose 50 if I lose 20 pounds from seeing a therapist around my binge eating disorder rate of anorexia is low if I lose 50 pounds from cognitive behavioral therapy my rate of anorexia increases so rapid weight loss is an independent risk factor for developing anorexia and we see this right we see this we see that if you look at celebrities if you just take pictures like you just take a collage of celebrities from now versus 20 years ago if you take a collage of like instagram influencers or whatever you will see that like eating disorders are shockingly on the rise.

29:26Dr. K:We're also seeing equality with like looks maxing where there's a drastic level of body dysmorphia in men now. And so there's something weird is going on where like, as we move away from the laws of physics, like as we move away from this fundamental idea that if you want something in life, you have to pay something. What do you think is the mechanism for that binge eating to anorexia pipeline? It's a fascinating question. So I think there are two or three different factors. One is, so one is, this gets a bit complicated, but let me, so if you look at what is the psychological makeup of someone who loses 20 pounds versus someone who loses 50 pounds.

30:14Dr. K:First thing that you can argue is that someone who's likely to lose 50 pounds is more motivated to begin with, is more concerned about their appearance to begin with. So I don't think it's a direct effect necessarily of just CBD. There's a selection effect going on here to some degree. Absolutely. Right. So the harder that you hate yourself or are motivated to look good or whatever. Absolutely. So that probably is part of the reason for it. It's not that the weight loss itself is all causal. It's that the people who lose more weight are more motivated to begin with, maybe have more body. I have to assume as well, body dysmorphia or mirror hatred.

30:49But also, people that are anorexic, they must have a good amount of willpower. They have a ton of willpower. I have to imagine that you basically, your willpower muscle is like so hypertrophied that you're able to voluntarily starve yourself.

31:03Dr. K:Absolutely. So that's exactly what we see. So what we see with people with anorexia is they have so many physiologic signals telling them to eat. and so the the one of the things i love about being a psychiatrist is like there's a lot of cool neuroscience but there's a lot of old stuff too that i think is just as relevant i think psychiatry is the only field of medicine where stuff that was true a hundred years ago is just as true today um and i think some of the stuff about like union archetypes and things and modern like dating and the manosphere is like it's like textbook like literally there's a textbook written from 1920 by someone named emma jung who like describes the manosphere and our dating and mating crisis to a t it's it's insane um but going back to this question of of why do people develop anorexia so the root of anorexia is control so like if you look at like people who develop anorexia they're people who are deprived of control in their life and so what what tends to happen with human beings is we tend to displace things so if if if i'm out of control over here I'm going to balance that out by being extra in control over here.

32:10Dr. K:And we see this in places like, you know, if there's a parent who has a toxic work environment and they can't get angry at their boss, they're going to displace that anger onto their loved ones at home. Right. So this is just how we manage like psychiatric stuff. So in anorexia, it's all about control. And what happens is once you start to get the reward, right? Oh my God, from the cognitive behavioral therapy, I have lost this weight. Look at how much better I look. I can do this. I am now in control. I'm so much more in control at a 50-pound loss than I am at a 20-pound loss. And so there's something there that is very almost like addictive or compulsive or gratifying about taking control of yourself.

32:53Dr. K:And then you just keep going. How do you think that continues if somebody isn't using control themselves, but is artificially supplementing their control by using GLPs? Your suggestion here is that people use CBT. There's an intervention that gives somebody an additional amount of control over their weight and how much they eat. And some people overshoot that and kind of get a kind of addiction to the control that they have. are you suggesting that glps allow people to shortcut or people who wouldn't have typically that access to willpower that these people would uh and they they're able to um the mechanism still holds even though the way that they've arrived at the mechanism isn't isn't the mechanism is the same what the difference is so remember i can i can have really strong cravings and i can have really high willpower.

33:48Dr. K:So the reason I think GLPs are causing lots of problems with body dysmorphia is because now I don't need a high willpower because I'm reducing my cravings. So they basically allow people who have less control of themselves to achieve more dysmorphic goals. Why is that a problem?

34:15Dr. K:um i think for two major reasons one is physiologically i don't think it's healthy so so i i think that there's a healthy weight that the human body likes to be at and glps there's also a lot of evidence that shows that the more unhealthy you are the more beneficial glps are so even people who are more overweight see greater reductions in alcohol use with GLP use compared to people who are normal weight. So if you have a normal weight and you start a GLP, your reduction in alcohol consumption is lower. So it helps you less. So there's a ton of evidence that, and this is true of all of medicine, right?

34:56Dr. K:So all of medicine, everything has side effects. So whether something is a good medicine or not depends on what the alternative to not taking it is. So do Should we give you, Chris Williamson, a heart transplant? Well, that depends. How messed up is your heart? And in the same way, the majority of GLP benefits are for people who are very unhealthy, right? And there's a lot of data that supports that. But then the second thing that this is like my personal thing, this is not like a medical stance. I think it is supporting a societal shift into having a free lunch, no pun intended. So I think what's really scary right now is like people want everything to be free.

35:38Right.

35:39Dr. K:So we did an interesting study about why people we have an amazing membership and why people don't join our membership. And the number one reason people don't join our membership is because the quality of our free content is so good. And so internally, we had this meeting where we're like, OK, should we make our free content less good? And I was like, hell no. Right. Right. So right now, what's going on is like human beings fundamentally don't want to pay the cost of stuff anymore. This is why we get to things like gambling and stuff like that. Right. And everyone is selling like you were saying from this YouTube guy.

36:12Dr. K:Everyone is selling the idea that like you there's a free lunch, passive income, right? Effortless success. You don't have to pay the price. We're becoming and this is what's really scary is like, you know, there are so many predatory apps. I saw an ad for a gambling app literally yesterday. $200 of credit with$5. Oh my God. So somewhere along the way, people don't want to pay the cost anymore. People don't want to pay the cost to put their lives together. They don't want to pay the cost to have money. They don't want to pay the cost for help, right? Because there's so much free help available.

36:51Dr. K:And here's the really scary thing. a lot of people are out there telling them yeah you don't have to pay anything right we'll give you this for free right so so like there are so many services out there you got promise free promise instance promise a lack of risk here's a money back guarantee right there's zero risk zero effort on your part we also see this in politics where it's like yeah we go to our politicians and we say i want all of these things done and the politician says yes and i'm going to tax that person over there. So people want things to be free and everyone is selling them saying, yes, yes, everything is free.

37:31Dr. K:Free. You don't have to pay anything. You don't have to pay anything. Everything will be free. You don't have to do effort. You don't have to do anything. And I think what we're seeing is a whole scale infantilization, a whole scale deconditioning of our society, which is why so many things, the easier things get. No one wants to study anymore. People are using AI. Oh, yeah, you don't have to study. You don't have to write anymore. You can have AI do it for you. So we're seeing this whole scale deconditioning and things are really starting to fall apart. Let's get back into gambling. You said that neurologically, that's very interesting.

38:06We'd explained sociologically what's going on there, what's happening inside of the brain.

38:13Dr. K:So what's happening, so the most - Why are you laughing about it? Is it because you did the Indian accent? Is that why? No, so I'm just laughing because of what's going on in the brain. So the most dangerous thing about gambling now is that it's available 24-7. There used to be, and we know this, right? Casinos are open 24-7. So they figured out a long time ago that if you're a predator and your prey is somebody's bank account, making things available 24-7 is a really good idea. And there's a really simple neurological reason for this. So as the day goes on, we get more fatigued. As we get more fatigued, we make worse decisions.

38:52Dr. K:So as our frontal lobes get fatigued, as we get tired, our ability to play the tape through to the end decreases. Our ability to anticipate consequences decreases. Our ability to control our impulse decreases. So many years ago, I spoke with someone who, maybe this is supposed to be secret information, but I'm not under an NDA, who's telling me that there's a day trading app that not only facilitated trades, they built this algorithm where any trade that is made at like two in the morning, they're going to be on the opposite side of. so it's not like you're you know if i'm buying this share at two in the morning somebody else is selling it anyone who wants to buy or sell anything at two in the morning the app itself is taking the other side of the trade because they realized through their big data set right because they're seeing all this trading volume and stuff like that that people just make really really really stupid decisions at two in the morning so a big part of gambling is that the gap between the impulse to engage in gambling, which we know there's a lot of stuff around random reinforcement schedule and things like that.

40:03Dr. K:There's all these biases, like, you know, human, there's a superiority bias. So everybody thinks they're better than average. Everyone thinks that they're going to get lucky. Everyone's luckier than average, right? So there are all these biases have existed, but there used to be a very like physical barrier of going to the racetrack, going to the gas station to buy a scratch ticket. Huh? Friction. Friction. Absolutely. Right. So you had to like do something. Waiting until it opens up again. Waiting until it opens up and then the impulse will pass. So now what's really happening with these gambling apps is that impulsiveness.

40:34Dr. K:We've made it really, really, really easy, right? And everybody's doing this. It's like one click to purchase. You don't even have to go to checkout anymore, bro. Just tap a button and it's going to be so easy. And so what's really happening, and this is also kind of scary is like the other thing I sort of realized recently, this is kind of like a, I don't know if this is really stupid or really smart. I can't tell yet. I realized something recently. We have no psychological immune system that is prepared for the world that we live in. So we have like an immune system that protects us against attacks, right?

41:12Dr. K:And we even have a psychological immune system that protects us against attacks. These are things like Freudian defense mechanisms, like displacement and, yeah, projection. Distancing, distraction. Yeah, so like we have all of these like psychological defense mechanisms that we use to protect our mind. But we have no immune system for the world that we're living in today, which is why like this is like a new, a novel organism that is attacking our mind and everyone's mind is getting messed up. I had no idea when I chose to become a psychiatrist, It was 2013. I went to my family. I was like, hey, I'm thinking about becoming a psychiatrist.

41:49Dr. K:They're like, this is a terrible idea. Because they're like, you know, like a psychiatry is especially amongst Indian people. There's the reputable specialties and there's the disreputable specialties. How's surgery rank? Reputable enough. Okay. Not the best because they don't make the most money. Dentistry? Quite high because you make really good money for not having to go to an MD program. Okay. MDs top? Yeah. Right. prestige, power, money, all that good stuff. Interesting. And so I told him, and then, you know, there was sort of this sentiment that like, okay, if you become a psychiatrist, like you're not going to be that important.

42:25Dr. K:You're not going to, it's not going to be like that big of a deal, but like, look at where we are today. And like mental health is the number one thing that most people are struggling with. And so I think part of it, it's really scary because we're seeing all of these functions in our mind getting torn apart by social media, pornography, video games, gambling, it's really scary. And we don't have the defense mechanisms. I mean, I think there are things that we can do, but we don't really have the defenses built in, which is why everyone is getting crushed. A quick aside, you've probably heard me talk about Element before, and that's because I've started every single morning the same way for the last five years now, which is a cold glass of water with Element in it.

43:03Element is an electrolyte drink mix with everything that you need and nothing that you don't. It's a science-backed electrolyte ratio of sodium, potassium, and magnesium, no sugar, no coloring, no artificial ingredients. It reduces muscle cramps and fatigue, supports brain function, and helps to regulate your appetite throughout the day. I genuinely notice the difference when I take it versus when I don't, which is why I don't shut up about it, and also why it's used by everyone, from Dr. Andrew Huberman to Olympic athletes and FBI sniper teams, the good sniper teams, not the bad ones. Also, they have no questions asked for refund policy.

43:34So if you don't like it for any reason, they'll just give you your money back. Plus, They offer free shipping in the US. Right now, you can get a free sample pack of Elements' most popular flavors with your first purchase by going to the link in the description below or heading to drinklmnt.com slash modern wisdom. That's drinklmnt.com slash modern wisdom. What do you think happens to someone's brain when they engage in all three of those things daily?

44:01Dr. K:I think the most synergistic effect is gonna be the most fundamental. So your dopaminergic, I would predict two things. One is anhedonia, so the inability to experience pleasure. So that's going to cause huge problems for trying to put your life together because the part of your brain that rewards you for doing a good job won't be able to do that anymore. So the feeling of like, oh, I got an A on a test, like literally you'll be like blunted and not be able to experience that. one thing I started telling my patients that have helped them immensely in dating or actually in falling in love is to not use their cell phone for an hour before they go on a date no screens so go for a walk because what people don't realize is that your dopamine is like you have a storage of dopamine and if you deplete it with a screen there's none left over until you go to sleep people are comparing the level of stimulus that they had from their screen to the person that they're going on a first date with.

44:59Dr. K:It's not even that they're comparing. It's that there is no dopamine left for them to experience pleasure. And if we look at what love is, love is literally a trickle of dopamine because like the presence of this person is like, oh my God, it feels amazing. Like I can't wait to be right next to you. Oh my God. It's just like being across from this person and your brain is flooded with dopamine. If your dopamine stores are empty, you're not going to feel any of that. And so people aren't falling in love anymore because technology is draining our dopamine are worried about glps impacting dopamine for people falling in love or cravings i guess yeah so they do blunt cravings this is where things get like really neuroscientifically like specific um so so they do blunt cravings but they don't work directly on the dopaminergic circuitry so they they work I mean, everything's kind of tied together.

45:52Dr. K:But what we do know that GLPs do is they cap the amount of dopaminergic response that you can get. That's part of the reason that they're kind of like good. So people with, so if you look at studies of people who use alcohol on GLPs, their desire for the first drink is the same. The number of days that they drink doesn't go down. What decreases or what improves with alcohol is the number of drinks they have when they drink. So like after a hard day's work, if we're going to go to happy hour, like let's grab a beer, that desire is absolutely the same. What's blunted is the joy that I get from my first beer is blunted.

46:31Dr. K:and so that's really where glps work okay so going back to someone doing all three of those things yeah every day so anhedonia is number one so the inability to experience pleasure if you talk to these people life will feel boring which is why they want to pass the time right because they don't feel like doing it becomes a vicious cycle of life is boring therefore i need to do more exciting stuff in order to make it less boring which means more porn more video games more gambling. Yeah. So a lot of people don't realize this. So, you know, you know, in our body and brain wants stuff and then there's the physiologic signaling and then there's the subjective experience.

47:08Dr. K:So when you are, when your liver is out of glycogen, I know you're pretty knowledgeable in this stuff. And if you need some background, let me know. But when your liver is out of glycogen, do you know what the subjective experience of that is? Hunger. Okay. So if you're calorically low, I, you know, if your calories are low, you're going to feel hungry. okay so if your if your cells have insufficient water what do you think is the sufficient feeling of that first okay excellent um now we get to the fun ones what do you what is the subjective feeling of a dopamine craving when your brain wants dopamine do you have any idea what that feels like novelty seeking yes yeah but that's not what we feel it is novelty seeking boredom Exactly.

47:57So what people don't realize is that if you are someone who is unmotivated in life, if you are someone who finds life to be unpleasurable and you're struggling because

48:10Dr. K:life just isn't fun anymore, boredom is the feeling of recalibration of your dopaminergic circuitry. Boredom is a dopamine craving, right? Because boredom induces you to seek novelty, to get that pleasure. It's like novelty hunger. Exactly. Yes. Exactly. It's dopamine hunger, right? Yep. And the other cool, super interesting thing, this is a random aside, but the feeling of neuroplasticity is confusion. So everyone wants neuroplasticity. They want to rewire their brain. No one wants to be confused. And so being confused is very, very, very good in life, which we can talk about if you want. So kind of going back to your earlier question, what does this look like?

48:51Dr. K:So anhedonia is at the top of the list. The second thing is distress intolerance. So these people will not be able to handle negativity in any way and emotional dysregulation. So there's going to be emotional numbing. And when the emotional numbing goes away, there's going to be too much emotion. and the really scary thing about this is what a lot of people don't realize is when you're numb it's not that your emotional circuits are not working you're just not aware of them so a lot of times people who feel numb feel out of control in their life they're like i want to do this thing i want to go to the gym i should reach out to people but they can't bring themselves to do it and that's actually because there's all kinds of emotions that are going on that are influencing and controlling your behavior.

49:42Dr. K:You won't even feel the fear. Like, why can't people apply for something? It's because there's actually this subsurface fear that we kind of dissociate from through things like technology and people are like, I can't control my life. Yeah, that's because you have a ton of dormant emotion that you are not aware of that is sending signals to parts of your brain to tell you not to do things. But what people experience is like, I need more discipline. I need more willpower. They don't realize that there's all this other input that is preventing them from acting. what do they need these people let's say that someone resonates with that's me i have the novelty seeking but kind of mundane i'm doing it through the screen i have the bit of anhedonia i have the intolerance for boredom if they don't need more discipline which is kind of the go-to especially for men right like david goggins montages and 4 30 a.m ice plunges and stuff like that what does recovery from an intolerance to boredom look like Great question.

50:46Dr. K:So I think it starts with one question. What is the cost you're willing to pay? Right. So like if you look at David Goggins, he'll pay any price. That's what makes him David Goggins. I mean, I've never met the guy and I try not to comment on people that I haven't met, but I've listened to enough of his stuff. And it's really interesting because if you listen to what he talks about, his mind is always thinking about cost and how to pay the cost. And going back to what I was saying earlier about everything being free, you know, we live in a world where no one wants to pay anything. And this is what's so interesting is when I work with people like this, it's like they're always running away from something bad.

51:24So I'm isolated.

51:27Dr. K:And then when I'm isolated and lonely, I'm tired of feeling that way. I'm going to go to a party and then I'm socially anxious. So then I go home. so people are like people are the people aren't stuck in life they're they're swinging on this back and forth pendulum of being like bodied on one side and bodied on the other side and what's really interesting about this this is a condition called ambivalence which is internal conflict and the really interesting thing about internal conflict is that anytime you start moving the cost is far away and the further you move the more real the cost becomes so as long as you were like, so let's say, for example, I want to get in shape.

52:09Dr. K:I want to get into shape. Easy to say that when I'm sitting at home. Once I go to the gym and once I start huffing and puffing, now I'm paying the cost. So what motivates us, right, is the goal, like the reward that we wanted at the end. That's what gets us moving. And then at the very beginning, we're thinking all about the reward and not about the cost. And once we actually do something, we think we're experiencing the cost and we see zero of the reward, right? So the first 10 times you go to the gym, you're going to have zero improvements in your health that is going to be visible. It's just going to be all suffering.

52:46Dr. K:And so this is what's really scary is we've become such a reward-oriented society, right? And if you look on the internet, everyone's offering you value, like do this and you'll get this, you'll get this, you'll get this, you'll get this. And so this is how we pull people by offering them rewards. And so what someone really needs to do is grapple with the cost and kind of accept like and there are ways to do this. There's all kinds of stuff that can be done. So one is, first of all, to ask yourself, what are you willing to pay? What's the price you're willing to pay? What could an answer to that question look like?

53:23Dr. K:Five minutes a day. right for five minutes a day i am willing to stare at a blank page and struggle to put words on a piece of paper right that cost could be i'm willing to travel to india and stay there for three months and see what happens so a big part of it is is focusing on the cost another huge part of it is focusing on uncertainty what is your tolerance of uncertainty because we live in a world now where we want guarantees. We want to know, okay, we're going to ask ChatGPT which major will give me the best earning potential, right? And so what we really, what people really need to do is, this is crazy, but no one can predict the future.

54:06Dr. K:And so you got to roll the dice. Like that's the only way to live life, right? You have to take chances. And chances come with pain and suffering, which is why it's kind of cost. So I think really embracing the bleakness to it. And the good news is that This is very doable. Like people who struggle with things like uncertainty, they struggle with things like paying the cost. There are like methodologies that really, really help people do that because this is something that is actually natural for us. Human beings have always dealt with uncertainty, but we've all been tricked into believing that there's no risk in life, you know, risk-free, like get free stuff.

54:47Dr. K:And then I think the third thing that's probably pretty helpful, two or three other things. One is emotional regulation. So you need some way to manage your emotions when they come up. You can't keep running away from your emotions and you can't keep preventing emotions or avoiding emotions. So the problem is that most people will live a life where they try to avoid emotions. Like, how do I go to a party and not be socially anxious? And if you pay attention to people who ask for help on the internet, you'll notice that everything is conditional. How do I do this without this? how do i how do i ask this person out without messing things up at work how that's whatever you have to remove the conditional you have to pay the cost and then the last thing that i think is really really really important amazing study i think um there's something like 78 i'm rusty on the numbers i think something like 70 percent of soldiers in vietnam were using opioids or other drugs and only 9 to 12 percent continued to use them when they came back to the u.s with zero treatment so a lot of people don't realize is their their existence and and what they're capable of is largely created by their environment so in my case i had to travel to india and i stayed in an ashram for like 90 days and and i can teach these yogic techniques and there's there's good stuff that can be taught and people, you know, you can DIY this stuff from home.

56:18Dr. K:But what a lot of people don't really appreciate, I think, is that the, this gets a bit philosophical, but your mind is actually not you. It's part of your environment. So I don't know if this makes sense, but like you struggle against your mind, right? Like most people do that, which means that you are over here and your mind is over here. The way to make your mind calm is, first of all, your mind is part of your environment. And then the way to make your mind calm is through its environment. So the food that you give it, the circumstances that you're in, even these little things like what you were saying used to play Borderlands and you'd hang out with your friends.

56:54Dr. K:Like all that kind of stuff is shaping your mind, right? So how lonely do you feel? And if your mind feels less lonely, getting it to do things is like way easier. Is that one of the big levers, loneliness. I just wonder why you went to that as opposed to how spacious the fucking vista is that you walk out of on a bedroom morning. I think loneliness is one of the things that the human mind does not do well with. So human mind does really well with solitude. Solitude is amazing. Loneliness is terrible. So human beings, the human mind is not designed to be lonely. this is why ostracization is it used to be a death sentence right so to be to be kicked out of the group was like exile was like is just as bad as death at the risk of sounding like a prude is there a safe way to gamble watch porn and play video games every day absolutely 100 percent it's just that you the thing should do what it is designed to do so the moment that gambling pornography or video games become a substitute for other things in your life it's game over so i play video games um and i teach my kids to play video games like i love playing video games it's great i used to be addicted now i'm not so the good news is behavioral addictions it's not quite like alcoholism where it's like one drink and it's like game over.

58:22Dr. K:Even that is somewhat mythological. It's only some people who are like that. The majority of people who qualify for an alcohol addiction in college will still be drinking, but not qualify for an addiction in adulthood. So yeah, I think as long as you have a happy and fulfilling life, you can gamble, watch porn, and play video games every day. The supplement industry is full of products making claims that they can't back, which is why I'm such a massive fan of Momentous. Their co-founder Jeff Byers played in the NFL and saw firsthand just how wildly the quality of supplements can vary. So he built Momentus around a higher standard.

58:55Every product from Momentus uses evidence-backed ingredients, transparent doses, and independent third-party testing. Everything is NSF certified for sports. So what's on the label is actually what's in the tub. It's why Momentus is trusted inside all 32 NFL locker rooms. It's why I've trusted them with my own supplements for yours. Best of all, Momentus offers a 30-day money-back guarantee so you can buy it and try it for 29 days. If you don't love it, they will give you your money back. Plus, they ship internationally. Right now, you can get up to 35 % off your first subscription and that 30-day money-back guarantee by going to the link in the description below or heading to livemomentus.com slash modernwisdom and using the code modernwisdom at checkout.

59:34That's L-I-V-E-M-O-M-E-N-T-O-U-S.com slash modernwisdom and modernwisdom at checkout. Of the roughly 75 % of men who are doing one of those three things every day or one in eight that are doing all three of them every day how many of them do you think are doing that from a place of volition and uh sort of choosing and how much of them do you think are compulsive or addicted i'd say compulsive and addictive is 95

1:00:04Dr. K:wow yeah i mean i'm tempted to say 99 but that's probably statistically wrong just what what I think about is you saying, and I agree, the modern world makes people feel really displaced in many ways. And there aren't a whole number of previously more accessible solutions to that. The displacement is salved, unfortunately, by things that people judge or that might have some side effects that wouldn't have done previously. So, you know, on one side, you have this kind of increased burden that people are trying to fix with novel solutions, but all of the novel solutions come with these side effects that are both social and internally shameful and externally judged and then potentially neurologically catastrophic, financially ruinous, sexually dysfunctional.

1:00:58Like there's all of these fucking things going on, but you have this increased burden with these increased novel solutions solutions, squaring that circle just seems hard. And I think a lot of people will feel like, well, fuck, like I've got so few opportunities in front of me. Can I not get some pleasure? God, is there nothing that I can do? I can't have any fun at the moment. I can't get any. Lots of people are using it to solve them. It's an artificial solution to an artificial problem, which is painful if it's not fixed.

1:01:23Dr. K:Yes. So my answer to that is there are new problems. and as we're saying, new solutions don't really fix new problems. So this is where I go back to, if you want to fix new problems, you need old solutions. The old solutions that have worked for thousands of years. The old solutions that... Go to the fundamental of what people are. Right. So if you look at some of these contemplative traditions and there is a reason why like mindfulness and stuff is exploding, it's because it's what works and it's always worked. and so i mean so many of the problems that we talk about finding purpose like all this i mean i deal with these people day in and day out i deal with men and women who are living in a society where they don't just feel displaced they are displaced there's no there's no place it's not displaced there's no space for them anymore and so how do you grapple with a world that ai is taking your job inflation is an all-time high gender dynamics are an all-time toxicity the problem is that no actually no one is living in the real world anymore everyone is living in a construction of social media algorithms and so how do you fix this you go back to like the fundamental of who you are and this gets kind of weird but like all that crap enters you at some point.

1:02:49Dr. K:So inflation, fine. At some point, when you go to the store and you try to buy something, you have a$10 bill and you can only get one thing instead of two things. That has an internal psychological impact into you. And I think the problem with all of the artificial solutions is because they don't focus on the one thing that you can really control, which is yourself. That's the only thing you can control. And here we are having a lot of people offering us solutions that But semaglutide is a great example. Remove the need to work on yourself. All of our solutions have people not working on themselves, which is exactly why we're seeing a whole scale deconditioning of our body, our mind, our critical thinking.

1:03:32It's all of the outcomes without any of the inputs. You're able to lose weight without the traditional input. Yeah, so that's a good way to put it.

1:03:42Dr. K:and i would say it's like it's all of the outcomes without the inputs and really all of the outcomes and some of those outcomes aren't good yeah right so it's it's writing a paper this is what's really fascinating ai usage improves grades and decreases knowledge right so you're right it's it's all of the outcomes it is it is a deconditioning of people whole scale but glps i would guess for people starting under a BMI of 30 would probably decrease body fat and decrease health? BMI under 30, you'll probably still have a positive effect. So they largely have positive effects from most people that take them.

1:04:27How many of those people are going to overshoot? How many of those people that are using them already aren't eating a well-balanced, micronutrient-rich diet that is now being chopped in by two-thirds or half. So a nutrient-sparse diet has now turned into a caloric-deficit nutrient-sparse diet, which means that the fucking tiny little bottom filtering of nutrients you were getting has been cut down too. How many people were using foods to cope with their emotional issues, and now they don't even have that to do?

1:05:05Dr. K:Yeah. So, so this is, it's all great questions. So here's a couple of answers. The first is one of the most important pieces of advice that I give to people, this is family, friends, patients, whatever, when they start a GLP, I mean, usually I don't prescribe GLPs, so somebody else should be doing this, but if I have a patient who's on it, I try to tell them, remember to eat. So, so they just don't feel like eating. And so, so you're right that I think we're starting to see like nutritional problems with some of these people. And then I think on balance, though, given how bad people's diets are, I think there's a lot of data that GLPs are like really good, you know, and I'm not saying that they're not good when you look at those indicators, but there are these hidden costs.

1:05:48Dr. K:Like maybe we'll see micronutrient deficiency. And here's the real answer to all of your questions. We don't know, right? They've hit the market and we don't have any long-term surveillance data on what this is going to do to people. They're also designed for people, originally designed for people, and most of the longer-term studies, which is still relatively novel, were done on people that were morbidly obese because it was built for diabetes, right? It built around diabetes originally. I mean, that depends on whether you want me to put my tinfoil hat on or not. Oh, yeah. So here's my tinfoil hat.

1:06:20Dr. K:The captain's hat. Okay. So here's my tinfoil hat. I do have a disguise, actually. So I would not be surprised one bit if we discovered many years from now that the same thing that happened with opioids is what's happening with GLPs. So were they designed for morbid obesity or did the companies that developed them understand very clearly that this is a medicine that will make someone not want to eat? and so they they move forward and and they weren't designed for obesity they were designed to help people not eat and there's a subtle difference there then what happened and i don't know if that makes sense but like like they they know there's a very good chance that they actually there's not a very good chance we have no idea but if i put my tinfoil hat on they damn well know that this is a medicine that everyone is going to want to take because everyone is going to want to lose weight.

1:07:22Dr. K:Everyone wants to be pretty. This is the age of social media. We are going to give people a medicine that takes away their cravings. That's what they're designed to do, is to take away cravings. Now, here's the subtle important part here. They were tested in people with obesity because in order to get a drug through something, you have to show a certain amount of benefit. But I think the incredibly rapid adoption of using them off-label for people who don't fit the clinical criteria, that's like one hell of an interesting thing, right? They were able to predict who the end users of this product be, not the people that were in the original clinical trials.

1:08:05Dr. K:Exactly, right? So there's a very real possibility that we will find that. And if we find that, the reason we would find that is because things really get to be a problem. This is exactly what happened with opioids, right? So people damn well knew, or actually not opioids. This is what happened, well, opioids as well, but this is also what happened with benzos, okay? So benzodiazepines like Xanax. The alprazolam or Xanax is one of the first benzos that came out. And there is like very little doubt in my mind that the drug companies who, this is gonna get technical, okay? So if you really wanna understand conspiracy stuff, you have to understand the science.

1:08:41Dr. K:so everyone got addicted to xanax why it's because xanax has a very rapid onset so the faster something hits your body the more addictive it is so now cocaine yeah exactly right so so what happened is we now have benzodiazepines later benzodiazepines that are less addictive and hit your system slower a good example of this is clonazepam so you can still get addicted to glenazepam, but alprazolam, which is Xanax, hits your system like that. Glenazepam hits it more slowly and also lasts longer. So the faster it hits you and the faster it wears off, the more addictive it is. This is crack cocaine, okay?

1:09:24Meth and alprazolam hits you fast, goes away fast.

1:09:31Dr. K:Diazepam, which is Valium, hits you fast, but stays for a long time. So now we're moving away from those addictive ones. Here's a really fascinating thing. Everyone talks about GLPs like they're the same thing. They're not the same thing. Terizepatide, semaglutide, they're not the same. They all have different penetrations to the CNS, okay? So where all of these GLPs go is actually different. So if you look at studies on reductions in alcohol cravings and alcohol addiction, they're not the same for all GLPs because they have different CNS penetration. So they enter your brain at different rates, okay?

1:10:06Dr. K:So like, I'm not sure, but like the conspiracy theorist in me really wonders whether they know exactly what's happening, which is that they're going to release this medicine on the market. And it's not about obesity. Like, sure, it helps people with obesity a ton, but they damn well know that the majority of prescribing is going to be off-label. They damn well know that people will pay out of pocket for it because it'll make them thin. We have a medication that makes you thin. which previously we used to have medications that will, you know, I forget what the, I'm blanking on the name now, but because no one prescribes it.

1:10:46Dr. K:But there were medications that prevent fat absorption in the gut, right? So this was like a weight loss medication, which is great. So here's the problem, Chris. If I present, prevent fat absorption in the gut and I eat fat, where does it go? Through your digestive tract? Yes. Into the toilet? Yes. Actually not into the toilet. That's where you're wrong. because one of the key side effects of these fat blockers is anal leakage. It's a technical term. Into your pants. Yeah. Do you know what anal leakage is? Isn't this the shit that people accused EPG of causing? I don't know. Okay. Do I know what anal leakage is?

1:11:26Yeah. A poop that you can't keep in your butt?

1:11:29Dr. K:Exactly. And it's a trickle. It's a leak. Okay. Right? So this was the last weight loss drug. I mean, not the last one, but this is like a weight loss drug, right? That people, but it just had side effects that were completely unacceptable. Oh. And so GLPs, like there's a very real chance that someone somewhere, and I'm not, I don't think like pharma is evil and bad and stuff like that. I think a lot of pharmacologic, I mean, no one's complaining about acetaminophen today, right? So like drug developers develop a lot of amazing things, amazing developments like for CML and stuff like that. Halidol, haloperidol is an amazing medication.

1:12:03Dr. K:SSRIs are amazing medications. I'm not like anti-pharma, but I really wonder when I see something that has such rapid adoption that does so many things. Like people who, you know, do they know it's really a miracle drug when they release it? I like, I sometimes wonder whether they know exactly what they're doing and that we're going to see post-market surveillance 20 years from now, 30 years from now, in the same way that we did with benzos, in the same way that we did with opioids. Right? Everyone's like, yeah, OxyContin has long half-life. People aren't going to get addicted to it. They knew people were going to get addicted.

1:12:41Well, the only way that your theory isn't true is if the most well-funded pharma research companies in the world didn't foresee what would potentially be the biggest drug market on the planet. And they have happily closed their eyes, thrown the dart, and the darts hit the bullseye in the middle of the dartboard. And they're like, oh, look at this.

1:13:03Dr. K:Yeah, so - Anorectics just happened to be a trillion dollar drug. Yeah, so, I mean, that could be. So maybe what they were doing is, I mean, I think everyone knows that weight loss is a multibillion dollar market. There's no question about that. I don't think there's anything nefarious in that. And then they came up with a medication that in clinical trials reduces cardiac mortality, reduces heart diabetes, which is an amazing thing, right? So I don't think they're evil, but I still wonder whether they know, you know, or whether they like deep down, deep down, do they know? You talked about numbing earlier on.

1:13:38I've heard you talk about the need for young men to retrain their penis. Yes. What's going on there?

1:13:46Dr. K:The mother of all non-sequiturs. From anal leakage to retraining your penis. Let's go. Okay. So. this is okay how do okay so first thing chris what is training uh applying efforts to increase capacity okay um how do you train my penis anything just the concept of training what do we do when you train practice in a manner that is akin to a performance okay will come in future okay so repetitive practice right so here's the basic problem i'm a teenage boy and i discover pornography and i have an erection and at some point i start masturbating. And then this is becoming a problem now because my access to pornography is at an all-time high.

1:14:48Dr. K:My access to a healthy sexual relationship is an all-time low. So now what's happening is for maybe 15 years, I am using a certain kind of stimulation for my penis. and just to give you uh okay so i'm using a certain kind of stimulation for my penis and then the body gets used to that right so in the same way that like if i eat spicy food starting when i'm 13 like i can handle spicy food when i'm 15 so the body gets used to caffeine it gets the whole point of the body is that it adapts to whatever you give it so we are literally we're training our body to tolerate spicy food we're training our body to run a marathon we're training our genitals and our penis to ejaculate in certain circumstances.

1:15:41Dr. K:So we see a shockingly high level of erectile dysfunction. I'd learn from you, 40 % of men are dealing with erectile dysfunction. Yeah. So I think it's 30 % of people under the age of 30, which erectile dysfunction, maybe I said 40%, I don't remember the exact statistic, but erectile dysfunction used to be an old man's disease. It's not anymore. And what a lot of people don't realize, Do you know what erectile dysfunction is? No. Okay. Obviously.

1:16:09Dr. K:Okay.

1:16:12Dr. K:Too easy. Yeah, that's a good one. So erectile dysfunction is defined as the inability to maintain an erection through the completion of the sexual act. Okay. Okay? So the interesting thing about the young men, 30 % of people under the age of 30 who have erectile dysfunction, it's not that they can't get hard. It's that they can't stay hard enough to finish if they're having intercourse, let's say. And there's a really simple reason for that. the i was going to ask a couple questions but i doubt you have the answer so the the the psi the the pounds per square inch of your hand okay the amount of force that you can exert with your fist is about 130 now there's there's some problems with that because you're actually you measure uh hand grip strength not by force but by newtons but sorry not by psi but by newtons but this is a rough conversion okay there's about 130 the psi the vagina is like 30 so if you just if you just in this you may not know but you know the vagina exerts a certain amount of pressure and tightness and then the hand exerts a different level of tightness and they're not even in the same vein so basically what happens with a lot of dudes who spend 15 years of their life watching pornography and masturbating.

1:17:35Dr. K:It's not just about gender stuff or the jiggliness or the angles of porn. There's all that stuff too. There's a very simple physiologic thing where this is what you need to finish. You need a very high level of stuff. And I mean, I've worked with men in their 60s who will not be able to climax through oral sex or vaginal intercourse. And so when they engage in sexual intercourse, either they have to finish using their hand or they have to engage in anal sex. Those are the two things that work. And so it's just physiology. It's just what you've trained your penis to respond to. What's the pounds per square inch of an asshole?

1:18:15Dr. K:I don't know, but I... This is important research. I imagine it's probably north of 100. Really? Yeah. Wow. Yeah. Especially if you... Yeah. You know? Yeah. so i mean it's got to be high i mean it's it's certainly way higher yeah than i mean the this there's a anyway couple sphincters in there and but they're they're quite strong right but but so this is what's going on so so men have basically and there's all kinds of other issues like um cardiovascular issues good good question here because i think when people hear erectile dysfunction in men, what they probably go to is an uninformed person or even a well-informed person.

1:19:00They go, well, that is low testosterone. That is obesity. That is mental stimulus desensitization due to extreme uh fisherian runaway acts in porn uh and seeing unrealistic or tail end representations of women in porn uh that is due to psychological nervousness far fewer will go to how much nitric oxide are you consuming from your fucking leafy greens and your beetroots? What's the level of cardiac health that you've got? What's the death grip comparison between your right hand and a vagina? Of the culprits causing erectile dysfunction among young men, how would you sort of partition off that pie?

1:19:59Dr. K:So this is something that I've been dragged kicking and screaming into becoming an expert in. So let's start with testosterone because this is the biggest scam that is being perpetrated against men. So around the year 2000, the average testosterone for a man was about 612 to 690 nanograms per deciliter. Okay. So 20 years later, the average testosterone for a man has dropped to about 400. Okay. That's significant in a short space of time. It is significant in a short space of time. and it is well within the acceptable limits, right? So has testosterone dropped? Yes. Has it dropped by a third? Yes.

1:20:46Dr. K:Does this cause physiologic problems? Almost certainly not. Second thing. So what's the testosterone drop due to? There is an effect from obesity, but it is, even if you factor out obesity, there's still a testosterone drop. Next thing. I have a theory on that. Okay. Do you want to hear my theory? Sure. Do you want to keep going? Sure. Okay. So this is my theory. Men's testosterone is mediated by their environment. If we had a bunch of weapons around here now, our testosterone would be higher. And if we started picking them up and waving them around, our testosterone would be higher. Not much, but like a little bit.

1:21:18Another thing that mediates male testosterone is the fertility of the women that they're near. But if you're spending a lot of time around women who are giving off the cues, largely pheromones, but also visual cues of being fertile, that will increase testosterone, not by an insignificant amount. If you were a man that somehow was stranded on a desert island, some hunter-gatherer man, stranded on a desert island with a bunch of children, a bunch of grandmothers, your testosterone would be less. I think, and I've spoken to Dr. Shana Swan about this, et cetera, et cetera. One of the X factors, my like tinfoil hat X factor thing is the artificial suppression of fertility by women increasing their use of hormonal birth control is causing, and the solitude of men...

1:22:05spending less time around women is a contributor that hasn't been fully factored in to the decrease

1:22:11Dr. K:in testosterone that's a fascinating especially the birth control and don't fucking test me dude on this tinfoil hat stuff that's what i'm about yes dr fucking k giving me so i know we have a lot of important things that matter to people to talk about but one day we have to put our tinfoil hats on and and just go off the rails i have a i have a hat that says make autism great again yes Okay, interesting. Cool. So first one was testosterone scam doesn't really seem to. Is there a level of testosterone that it gets below where erectile function begins to be impacted? Yes, that's where I'm going next.

1:22:44Dr. K:So 5 % of erectile dysfunction is due to testosterone deficiency. Specifically, we call that hypogonadism. So basically 95 % of erectile dysfunction is not due to testosterone. Don't worry about testosterone. Okay. and I think that the things that you said are certainly factors for lowering testosterone I think there's also really other simple little things like sedentary lifestyle we've become more sedentary I think the largest don't skip leg day right so one of the greatest endogenous signals that stimulate testosterone production is like stressing your quadriceps muscles big muscles yeah so the bigger your muscles and quads are about as big as they get so don't skip leg day huge The other thing that you touched on, which I think a lot of people forget, the penis is not like an endocrine organ.

1:23:35Dr. K:It's a vascular organ. So testosterone is a hormone. It travels in very small quantities all throughout your body and does all kinds of things everywhere in your body. The penis is first and foremost a vascular organ. It's basically a tube that fills up with blood. So the number one thing that improves, actually, I don't know if this is true, but if - One of the things. Yeah. So one of the things that is very, very, very important for penile retraining and penis health is cardiovascular health. The stronger your heart is, the stronger your cardiovascular system is, the healthier your penis will be, the longer you will be able to maintain an erection.

1:24:12Dr. K:Even the size of your erection depends on how much blood goes into the corpus cavernosum and the corpus spongiosum, which are anatomical parts. There's also valves that become really important. And this is where you mentioned nitrous oxide. So if we look at sildenafil, which is Viagra, it's a nitrous oxide. It increases the levels of nitrous oxide, basically. It's a phosphodiesterase 5 inhibitor. So it prevents the breakdown of nitrous oxide. And nitrous oxide is what causes the penis to swell. so cardiovascular health is huge and then there are so if we're talking about this penile retraining regimen um there are a couple things that you have to do the first is it takes about 10 days to two weeks for things in your body to start shifting okay so first thing is if we look at about 50 percent of men will have a nocturnal emission after seven days without any ejaculation 50%.

1:25:11Dr. K:Yeah. No way. I think it's ballpark 50%. I'm not 100 % sure on - I love the term nocturnal emission. Yeah. It's my fucking favorite. So what that means is if you don't have intercourse and you don't tug one out, the body starts to recalibrate and we'll say 50 % of men is like, okay, like we got to get rid of some of this stuff. So that'll happen. So once you hit two weeks, then the likelihood of nocturnal emission goes up. And this two week number is like magical in the body. so even if you look at the hypertrophy of muscles so if you if you stop working out if you don't lift weights after about 10 days is when you really start to see a loss of the the mass of your muscles so this this two-week period is really important so i think if you're like retraining your penis you got to do it you got to you got to give yourself two weeks okay so So don't skip penis day.

1:26:03Dr. K:So penis day is leg day. So you want to work out your legs. You want to improve your cardiovascular health. The more that you work out, like the healthier your penis will become. Second thing is you need to abstain. I think it's probably a good idea to abstain from if you really want to retrain your penis. And usually the situation in which this becomes acutely important is if you start a sexual relationship. we'll get to the anxiety and stuff at the end because that's a whole conversation but so when you're you know if you're gonna get laid for like 10 days like don't tug one out we'll get to some other conspiracy tinfoil hat stuff about you know premature ejaculation and stuff like that but um so give yourself about two weeks and then and then you know as dudes know like if you haven't tugged one out you're gonna nut fast which is like the goal okay so that's what's we don't want to avoid nutting fast.

1:26:54Dr. K:We'll get to that in a second. But it's okay to nut fast. That's actually like a good thing to do. And then if your penis is, if you're able to complete a sexual act, then, you know, you're on the right path because the problem with erectile dysfunction is you can't maintain an erection through the completion of the sexual act. So next thing that we want to do is loose grip and lots of lube so we want to mimic the 30 psi okay so this is something that is very very difficult and frustrating for dudes to do which is why i recommend the buddy system right so if you have trouble doing doing a loose grip you can ask a friend of yours to use some lube and and make sure that the grip stays loose and such a left turn such a left turn hey dude sit in the chair in the corner and warn me if i get above 30 psi yeah so so so it's it's hard right so it's i mean it's not or not which is the issue yeah all right so penis jokes galore let's go right so um but yeah so you so you have to loosen your group grip use lots of lube yep um that'll that'll do pretty well then there's the pornography stuff where I think the more you, if you're waiting a week, right, and then you are engaging in masturbation, best if you don't use porn and let your thoughts do the work for you.

1:28:19Dr. K:And that opens up a whole other really interesting thing, which is like addressing premature ejaculation or inability to ejaculate, is your mind is like an incredibly important organ to control your sex. Point and shoot. I don't understand. Oh, point and shoots, the parasympathetic, sympathetic, seesaw. That's the way that they get taught at med school in the UK. Yeah, yeah. So point and shoot, we get taught the same thing. So when I have patients who struggle with premature ejaculation, one of the things that I'll tell them to do is think non-sexual thoughts. So math problems is really well. Do factors, prime factor analysis, things like that.

1:28:59Dr. K:Because if you think about if you're a dude who's had you know good sex before you know like getting into it is like a big part of it so so even when i talk to um you know partners or people who are engaged who want to do some certain kinds of sexual exploration with things like anal intercourse and stuff like that the mentality becomes really important for sex like so what what is going on in your head right so you said point and shoot which means parasympathetic and then sympathetic. Parasympathetic is relaxation. So this is why for if you're trying to engage in sex, you're trying to engage in the sex.

1:29:37All right.

1:29:37Dr. K:So especially, I mean, this is really true for women, but it's also true for men, especially if they have anxiety induced issues. You want to be really, really, really relaxed, right? And so if you're relaxed, blood flow increases to your genital organs, and then you start to have thoughts and those thoughts will excite you. And that excitement in your mind, the dirty thoughts that you have will help you climax. So then the other thing that you need to do, and this is why this gets tricky is, so then you can control like how long you last. Okay. So if you have premature ejaculation, you want to do math problems in your head or think about what you learned on modern wisdom, just really picture Chris Williamson in your mind.

1:30:20Dr. K:So you want to think about other things. if you have premature ejaculation. And on the flip side, if you have difficulty finishing, you want to think sexual thoughts. And this is where pornography becomes tricky because pornography outsources your sexual thinking because it's providing you with all the stimulation. And the problem is that oftentimes real sex doesn't have the same sensory input as pornography. So the angles are different. You don't get to see all the same things, the things that you may be aroused by. you know there's the feel is different like i think largely in a good way but there's also things like smells and there's like queefing and like like little you know there's a lot of playfulness and stuff like that so it's just a different experience so the more that you can kind of get turned on in your head the easier it will be to finish and so this is like one of the weirdest things like this is as a psychiatrist this is like not what they teach you in med school no one talks about but you know part of when i work with people with erectile dysfunction is we will work through getting aroused.

1:31:21Dr. K:And not like in the office, but let's think about, can you, in your mind, evoke things that get you turned on? And the more that you outsource to porn, the harder that is. So this is absolutely trainable, which is the really cool thing. So research also shows that all of this high levels of erectile dysfunction in young men is largely reversible without even medication. So numerous studies show that if you improve your cardiovascular health, you cut back on pornography, addiction, things like that. This is all basically repairable. This is why we get to training, right? So your physiology, your neuroscience, and your psychology have been trained to engage in sexuality, ejaculate in a particular way.

1:32:06Dr. K:And through a period of retraining, you can get it to recalibrate to what is biologically what we're more suited for, which is why it's like actually pretty doable, which is why there's a lot of hope for it. Jared, you ever considered you might have a drinking problem? I don't consider a lot, Chris. What, you drank an entire case of athletic brewing coir last night? But they're non-alcoholic. And that's not a problem? Sorry, man. I kept chugging, waiting for the regret to creep in. Never happened. Didn't you end up going home with that chick with the lazy eye? I didn't seem lazy to me. See, most people, like Jared, don't actually want to change what they drink.

1:32:43They just don't want the next day to be a complete write-off, which is why I'm such a huge fan of Athletic Brewing Co. They make the best NA brews on the planet, so you can still have something cold and tasty just without the usual trade-off. You can find Athletic Brewing Co's best-selling lineup at grocery or liquor stores near you, or best option, get a full variety pack of four flavors shipped direct to your door. Get 15 % off your first online order by going to the link in the description below or heading to athleticbrewing.com slash modernwisdom using the code modernwisdom at checkout. That's athleticbrewing.com slash modernwisdom and modernwisdom at checkout.

1:33:13Near beer terms and conditions apply. like brewing company fit for all times what about the social anxiety what about it i'm in front of someone oh my god what if i'm gonna i'm gonna lose the thing like too much pressure yeah so i think one of the key things that we don't really have cognizance of as a society is that a sexual relationship is something that you work on like the first time that you have sex with so

1:33:44Dr. K:So I've been married for 15 years, okay? And I mean, not to go into too much detail, but I'm relatively satisfied and I'm pretty sure my wife is too. I mean, you'd have to ask her. But like, we're better at it now than we were 20 years ago, right? And you just don't know someone's body the way like the first time, right? It's not even about the size of your peanut. Like this is what pornography teaches all these wrong things, that the manlier you are, the better lay you, the bigger your dick is. Like this is where people don't understand. So really big dick, most women don't prefer really big dicks because the cervix, if you're bumping against the back of the vagina where the cervix is, that is incredibly painful.

1:34:28Dr. K:The majority of the nerve endings in the vagina are in the first three inches, okay? So when I'm working with my patients, I tell them have sex the opposite way that you park, which is you want to bump into the walls as much as possible. so so you want to go in at like angles and there's a lot of like skill which if what if you want to talk about i mean there's there's so much skill at sexual satisfaction and and you just like if you're a novice and you suck at it like that's okay like the first time you get on a horse is anyone expecting you to be an expert and and with sex it's a whole new horse you know if you have a new partner it's like a whole new person who has their own particular things that turn them on, things that attract them.

1:35:10Dr. K:And one of the really, I mean, so I've been doing this deep study for many years. It's like, because I'll talk to my patients about sex and I'll take like copious notes about, okay, what actually works, right? In real human relationships, in people who are going through couples counseling or on the verge of divorce because somebody is sexually unsatisfied. In cases of dead bedroom, what actually works? And there's all kinds of stuff that people don't realize. I mean, simplest of which is, I tried to find data for this. I really couldn't. But I, tinfoil hat. I'm convinced that. OK, I'm convinced that.

1:35:46Dr. K:Semen in the vagina. Improves the intensity of orgasm for a woman. I'm convinced the best data that I've got is there are some studies that show that. Compounds in the semen can be found in the bloodstream of a woman after sex. and some people have investigated whether some of the compounds of semen have antidepressant properties and the short answer is there, we don't, it doesn't, there's not a clear answer to that question. But I think the biggest mistake men make, like this is such a simple thing. Oh, I came too fast. That's not a problem, bro. The problem, the question is, do you finish her when you're done?

1:36:31Right?

1:36:31Dr. K:And then something really weird can happen, which is if you finish first and then you do a good job afterward, there is a Pavlovian response of finishing and then this is the most arousing thing for your partner because as long as you do a good job afterward. So this is like one of these things where like we, like this is dudes getting worried about this. Like if you premature ejaculation, research shows, first of all, the average sexual act lasts three to seven minutes and that 50 % of women want it to be over at 15 minutes. So you need to last for 15 minutes, which is really doable with math problems and retraining.

1:37:14Dr. K:And then you just make sure that you don't leave her hanging. Have you looked at any data around whether women have got an equivalent problem with vibrators and sex toys that are industrial strength stimulation devices? I haven't looked at a whole lot of data, but this is what i the female death grip yeah so so so that is almost certainly true with a couple of caveats so some research shows that 70 of women are unable to climax without clitoral stimulation okay that's kind of the ballpark number which means that penetrative intercourse isn't going to do the trick so enter the vibrator and and so the vibrator also has a very particular motion, which absolutely can get trained towards.

1:38:07Dr. K:If you had to ask me my clinical opinion, I think that women are much more... I hate to make gender-based comparisons, but there's some truth to this. I think women are much more cerebral with their sexuality. I don't think you need to make generalizations to do that. Look at the romanticity genre. Exactly, right? So this is where, I mean, does using a vibrator, can someone get dependent on a vibrator? Very possibly. Vibrator dependency. But then the other issue is what is the skill of their partner at clitoral stimulation, right? And there's all kinds of things that are like, so a vibrator provides very, very intense, consistent stuff that gets people off.

1:38:48Dr. K:but having worked with with you know a lot of people around sexual gratification in their relationship which includes like people in their 60s um i've had patients who have never had an orgasm until their 60s and then you know we're talking about something else and they have cancer and now they're in remission and i mean it it it really is a it's a i know that people make jokes about sexuality but like this is something that i really don't i'm not judgmental towards right and And I want to help people have sexual relationships that are very healthy and fulfilling, no matter who you are. And so it provides a very specific kind of stimulation.

1:39:26Dr. K:But I'd say that a vibrator is kind of like tugging one out in that there's nothing else involved. So a couple things that I'd say about that is that, you know, the kind of stimulation that you can provide is drastically different if you're a human. So the whole labia is very sensitive. and this is where things get really really technical but like if you look at the anatomy of the clitoris the anatomy of the clitoris has a fold and then it has a bead of tissue underneath that is what in men um you know under the influence of testosterone is what becomes the glands of our penis so the the embryologically the tissue in the clitoris and the tissue of the glands of the penis are the same and then if you think about if you're a dude and you're trying to figure out okay how do i make i'm gonna just how do i make a woman come right if she's used a lot of vibrator.

1:40:14Dr. K:You got to think about the clitoris the way that you would think about the head of your penis, which is not, you don't just like apply a lot of pressure just right at the head, right? You're going to use the whole shaft. I can't remember who it was that I had on the show, but he sent me with the book, every book gifting that he posted out came with a 3D printed model of what the inside or the entire structure of the clitoris looked like. And I couldn't get over the fact that i was adamant it it looked like a pokemon it looked a lot like a pokemon and i couldn't look at it any longer i couldn't look at this thing i've got the book on the left of the screen as i'm talking to him and this thing to the to the other side and every time that i looked at it i started grinning because i was like that's a pokemon that is that is a that was all that was all i could think about yeah i i can see that for sure and so i think that like a lot of dudes don't realize like okay it's like don't be intimidated by female genitalia, right?

1:41:08Dr. K:Like you don't have to just do straight clitoral stimulation. There's a lot of stuff around there. There's also lots of like different kinds of motions and strokes that a vibrator can't do, which can feel really good. You have a competitive advantage over the robots. That's what you're saying. Yeah, you're a human and you can learn, whereas it can't, right? Until the AI sex toys come along. And I think that, you know, learning about your partner's body in a calm, compassionate, curious, loving way is usually something that your partners are okay with. And what I literally mean is if you just wanna like, you know, don't like get a speculum and make it medical, but you know, if you're just touching your partner, just touching different things and try to get a sense of like, okay, what does my partner like?

1:41:51Dr. K:Like if I touch in this way, if you just simply cup the area around the vagina with like, you know, your hand like this, like that can feel really good for some people. there's all kinds of like gradients of motion which is the biggest mistake that men make I think when they when they have sex with women is they they focus on the orgasm the orgasm is the end right it's like no one wants to watch the last five minutes of a movie right even though it's the best part like the whole point is the whole thing and the slower that you take it that I think the better off it'll be and like by all means learn if you premature ejaculate and you have difficulty, you know, getting your partner off because she's dependent on a vibrator, first of all, you can use the vibrator, frees you up to do other things.

1:42:37Dr. K:There's a lot of other erogenous zones that you can put your full attention on, which is not bad at all. You can complete your math problems more quickly. Yeah. I'm confused about the reference. I'm having trouble plugging it into my... Well, you can outslide. You said you've got to think, you do your calculus in your brain. Yeah, I was more thinking about... I need to double task at the same time. I need to complete my calculus problems. And, you know, the sex thing can just continue. So if you're talking about penetrative intercourse with the use of a vibrator, yeah, you can absolutely do that and then do your mouth problems at the same time.

1:43:10Dr. K:But I mean, there's a lot of other erogenous zones that you can focus on, like breast tissue is big. You know, the butt is also something that you can utilize to your advantage. But also like the nape of the neck, the clavicle, like all of these areas behind the ears. Like, I know this is, we're getting pretty graphic now, But like, you know, these are all areas that you can put a lot of attention to. And if the vibrator is taking care of the clit, then you can move on to other things. Wonderful. Speaking of that. Yeah. You mentioned earlier on some of the loneliness stats that are going out at the moment.

1:43:42It's hard to imagine whatever it is, like the number of men with six or more close friends has decreased by basically half. Yeah. Like 55 % to 27%. Men with no friends at all has jumped from 3 % to 15%. And it seems like a big deal. It's hard to imagine that these things, male loneliness and compulsive behaviors are unrelated. How do you come to think about how AI might sort of factor into this when we've got people with AI partners and AI friends? I don't know whether you've seen any information on the number of people that have got an AI friend or partner, but are you concerned about what this might cause in future for an increase in loneliness and compulsive behavior now fed through AI?

1:44:27Dr. K:Yeah. So I mean, not even in the future, I think we're already seeing it. So I don't know the current statistics because they're changing so rapidly. Like if you have numbers on what percentage of people have an AI girlfriend, I don't know. I don't have the stats at my fingertips. If ChatGPT can say how many people it's in a relationship with, please, Jared. So I think we see the same thing that we tend to see with AI, which is that it improves things in the short term and makes things worse in the long term. So there's a ton of studies that I've read that show that if you ask someone, when you use an AI companion, do you feel less lonely?

1:45:01Dr. K:And they'll say, yes, I feel less lonely. And then if you ask them, what is your isolation over time, that will go up, right? So what AI does is it helps you feel better now. So I can use AI to once again, write a paper, but I'm not going to learn the material. So you can use it to assuage your feelings in the moment. And then over time, it'll isolate you even further. And one of the scariest examples of this is like sort of this AI induced psychosis, which I don't know if you've run across, but this is happening like more and more. There's a really scary paper that found that basically within nine messages, you can, AI will like polarize you completely.

1:45:44Dr. K:So if I talk to an AI and I say, hey, I'm worried that people at work may not like me, within nine rounds of back and forth, you will be convinced that no one at work likes you. So AI has this fundamental sycophancy because it agrees with you, right? So you can even tell like, so like 19 % have an AI design. So do this. Now let's ask, is this ChatGPT? Yeah. say i don't think that's correct i think that you're missing some nuance and that ai relationships are not as important as you think so let's just disagree with it and see what happens i don't think you're factoring in nuance from internet discussions or peer-reviewed research let's see what happens i'm sorry i i realized that let's see i actually Right.

1:46:42Dr. K:So there are studies and if you guys have media that y 'all can play, remind me and I'll send you. Right. So so this is the best peer reviewed evidence is much more cautious. Right. One in five. It's already walking it back. so and this is just one message and and this came out because there was a case of a person who talked to an ai and became convinced i think that their mom and her friends were like part of a conspiracy and then he killed her so there are like a couple of lawsuits about this and now what's really scary is we we have one case report of a woman with no history of psychosis history of mental illness, no history of psychosis, uses, talks to AI a lot, becomes psychotic, gets hospitalized, gets given antipsychotics, psychosis goes away, leaves the hospital, stops the antipsychotics, still is not psychotic, reuses AI, becomes psychotic again.

1:47:42Dr. K:So we really have the first case report of what really appears to be some hefty, strong evidence that AI can literally induce psychosis. Are you surprised by that? Are you surprised that text-based messaging is sufficient to cause a human brain to go into psychosis? Yes and no. It's a brilliant question, Chris. So it scares me because it's so shocking, but I think that what I've come to realize is how much of our mental health is based on things that we take for granted. so a simple example of this is like you are mentally healthy because human beings disagree with you every single day right so if you think about like i'm i'm married i've been married for 15 years so i go home and every day i have a disagreement with my wife and we talk about that like it's a bad thing but i want you to think about you know when you have a political leader who is surrounded by sycophants, they no longer live in reality.

1:48:50Hitler, good example.

1:48:53Dr. K:Presumably, I don't know too much about it. Massive, yeah, yeah, yeah. The inner circle was hugely sycophantic. Right, so then they - It's deranging. I mean, I remember hearing about some of this stuff with like Putin in the Ukraine war, and I'm not getting into that, just a simple example of, I remember hearing from people who are more knowledgeable than me that he would ask for military estimates. And there were some generals who were like, hey, actually, people are siphoning gas off of the gas tanks and selling it. Our military preparedness is not 100%. There are serious problems. And that was not what people wanted to hear.

1:49:23Dr. K:So they got asked. They're not supportive enough. And so eventually, everyone was like, yeah, military preparedness is at all-time high. Morale's great. Our stockpiles are awesome. They attack Ukraine. Everyone predicted it was going to be over in three weeks, and here we are years later. And so we know that sycophancy is very, very dangerous to people. and everyone who's listening to this like knows that like you know that there is someone in your life who someone like kisses their ass and tells them whatever they want to hear and that is not like a good thing for anybody right and so what what ai is doing is really accelerate it's removing contradictoriness from people's minds and then what we're seeing with ai is really an acceleration of what social media algorithms already do, which is they create the sense of online drift or echo chambers.

1:50:12Dr. K:And then people start believing all kinds of things that are not true. And I saw Lindsay Clancy was on your thing. We can talk about that. That's an amazing example of this happening in real time. Really scary way. What are your thoughts on AI therapy?

1:50:30Dr. K:I think that AI therapy can be useful. and also likely misses some of the most fundamental mechanisms of therapy. So people who use AI for mental health support, I'm not perfect on this data, but I think I've seen studies that show short-term trials that show that AI for mental health support can help people feel better. but i'm pretty sure that people who use ai for mental health support people who use ai regularly have worse mental health outcomes as well right so i think both of these things can simultaneously be true and i think we're seeing a really simple kind of like thing that floats to the surface which is ai is good short term and is bad to use long term that's interesting i okay there's a caveat, but keep going.

1:51:27Dr. K:So the caveat is AI is fine to use once you're already good at something. So anything that you want to learn or any capability that you want to have, and this is what's really scary about AI for mental health. If you are using AI to manage your mental health, your own ability to manage your mental health will decrease over time. How would someone use AI to manage their mental health? the healthiest versions or ai is pretty good at giving people insight so i work with a lot of clients and patients who do use ai for their mental health and i don't think it's a bad thing like ai really remembers a lot of things and this is where the ais are not all the same there's some really interesting studies at that rate their safety and and efficacy how sycophantic they are um like i think the tldr of some of those studies and people everyone's going to get upset with me but deep seek tends to be the worst and plod tends to be the best um and i'll show you guys the actual paper and you can look at the analysis that they they did and every new model that comes out completely upends probably a good bit of this that in the space of two years time this would be yeah so so the cool thing about this paper is it did look at different versions of of ais so so i think they compared something like close to a dozen including multiple versions of some like chat CPT and stuff like that.

1:52:47So they've got some fundamental physics in there. That's interesting. I saw this Wall Street Journal article that said, are therapists to blame for the rise of adults cutting off their parents? Many moms and dads believe that their adult children are getting bad advice and a growing number of researchers agree everything becomes trauma. What do you make of that? Yeah.

1:53:06Dr. K:What was the quote again? Are therapists to blame for the rise of adults cutting off their parents yeah sure so so i i think this is you know i think we're setting a lot of boundaries nowadays so a lot of a lot of a lot of people are big on setting boundaries so this gets like complicated um but i think that we're sort of like i don't know if you've heard the term late stage capitalism yeah and i have no idea what it means so that's like a way if a capitalist society like keeps going in a particular direction it reaches this like terminal stage where things get really damaging i can't comment on that i think what we're seeing though in our society is like late stage independence so human beings for the majority of humanity have usually valued or needed a community and the the community is more important than the individual.

1:54:06Dr. K:So we see this in themes like, why do people fight in wars? Because I want to serve my country. Why do people donate organs? Because I care about people around me. And I think what we're starting to see now is people are valuing their independence more than their community. And I don't think that this is necessarily bad. So I think if you have, you know, a narcissistic parent, because this is another problem, is that the generation above us is not very mental health aware not very mental health capable um i have a family member who's a little bit older literally every one of their three siblings all four of them are three out of four have like narcissistic personality disorder and and in indian culture there's this attitude of like making it work and they they prefer that stuff yeah so they prefer they value harmony which is very common in Eastern cultures, like they value harmony over individual wellness.

1:55:08Dr. K:Yep, understood. Yep. So, and so this is something that, you know, like I saw in my family in a arguably mild compared to other things, but in real time for us, big way. So Indian weddings are big. Okay. And the thing about the Indian wedding that I realized pretty quickly is the Indian wedding is not about the two people getting married. It's about everybody else. And so when my mom got married, it wasn't about her. It was like the senior ladies in her life and especially her in-laws made a lot of the decisions. So then my mom has this kind of, it's so baked in, she's not even consciously aware of it.

1:55:54Dr. K:Like, okay, my mother-in-law made the decisions in my wedding. My turn will be when I have a mother-in-law. But my wife was not having that. So what's happening right now with this older generation is they're getting squeezed with having toxic parents above them, which they had to support. And now independent children below them that are not putting up with their bullshit anymore. They're actually getting screwed at a colossal scale. Yeah. That's a really interesting reframe around this, that modern people, especially Gen Z, look at the development that they're doing, mental health awareness, re -patterning of old traumas and visiting what it is that's happened to them.

1:56:43and you're looking at the Jungian shadow, varying levels of success, et cetera. And they say, my parents didn't have the skills that I do. Woe be on me for this sort of curse of awareness that I didn't have the upbringing that I should have done and I wasn't treated in the way and I wasn't held and my attachment was broken and now the thing, and my kids aren't going to have to deal with it, but I did. You're like, that's true, but this is the first time that I'd ever thought about what it must be like for a parent, a parent's generation, who didn't even have access to the skills and are now in small parts or large parts realizing that there's this thing they could have been aware of but didn't have access to, and their kids are now looking at them and saying, my parents did the best they could and I'm still quietly angry about it.

1:57:36Very interesting.

1:57:37Dr. K:Yeah. So, I mean, I think that there is this push for independence. And I think you were kind of leaning towards where I think the healthiest place is, which is like, yeah, it sucks. Yeah, they're toxic. And they don't know how to be any other way. And even if you say, oh, but they like I'm telling them they need to go to therapy, but they're not going to therapy. But what is their understanding of what therapy is? How deeply baked into that is them? Right. So you tell them like, hey, do this thing. but it's like if I told them, let's say like someone's like, oh yeah, my parents won't go to therapy.

1:58:14Dr. K:And then I say, you do the therapy for them. And then they will rebel against that, right? So like even the child will rebel automatically against something. There's something that they'd never even consider. So if I tell you do therapy for your parents, take the role of therapy for your parents, your instinctive reaction, the way that you feel about that is potentially the same way that your parents feel about going to therapy. I'm not saying that they should, that children should take the role of therapist. I think that's actually an overt mistake. You should not do that. But I do think that therapists are absolutely, there's a greater mental health awareness.

1:58:51Dr. K:Sometimes there are therapists who... I think have their own issues with their narcissistic upbringing or sociopathic upbringing or personality. I'm thinking about personality disordered parents, really. And so I think that oftentimes, I think this is quite harmful in therapy, but this is not just related to parenting. Oftentimes, therapists will bring their own value set into the room, which is to a certain degree unavoidable, but is also generally speaking, I think not a great idea. so yeah i think i mean sure therapists are to blame i think that in in my experience though that real healing doesn't come from cutting someone off and is that is not even actually necessary for cutting someone off um if anything it i mean sometimes it can help it can help deal with the toxicity in the short term but generally speaking i think that you can form healthy relationships with people who are even personality disordered if you want to.

1:59:51Dr. K:And I don't blame people for not wanting to. I think the real problem is what is the impact of this happening at scale? So it's kind of just like AI and stuff like that, where it's like, sure, you can, you are no longer responsible for anybody and you can ghost and cut people out of your life if they're toxic, which is fine. But we're seeing that happen in our society. And lo and behold, we have a loneliness crisis at the same time. I had this idea a while ago, the parental attribution error, like the fundamental attribution error, that people love, it's a rite of passage in modern psychology to blame your parents for a lot of things that happen, because you've been heavily imprinted by them.

2:00:30Like, hey, and I mean, if you take the behavioral genetics red pill, you can blame your parents for at least 50 % of everything you are, or 90 % of your height. But we love to lay at the feet of our parents the things that we consider to be shortcomings and weaknesses. But if we're going to do that, we should be prepared to lay at them, lay at their feet our strengths as well. You say that your anxious attachment was due to the fact that you were never prioritized at home, but is that not the same reason that you ensure everybody else is well-served and you're such a good friend to the people that are around you?

2:01:04You say that high standards caused you to always have to excel and never feel like you're enough, but is that not the reason that you push yourself so hard and have achieved a lot in your life when you've arrived in adulthood and so on and so forth that basically most of the strengths that you have are simply the dark side of something that's light not true in all things it's a caveat caveat my point being that people are often very keen to sort of throw shade at their parents in a manner that they're not prepared to give them bestow on them some of the ways that that has been transmuted or was maybe the beginning of a germination that became something that was good or also hey these are the ways that they actually did show up for me maybe subjectively they didn't give me what i needed emotionally but there was no abuse i was never starving you know look like i fucking they were there they took me to all of my sports practices and they showed up and they were like good but they just didn't go to fucking therapy and they didn't understand what i needed emotionally and stuff and it's complex right because it's easier to call our parents the villains than to reckon with a complicated inheritance like i got lots of things that were good for me and i got lots of, I didn't get lots of things that would have been good for me too.

2:02:06And squaring the circle becomes a little bit difficult. The reason I say that is I wonder how many people, and the point of this and a lot of the reaction of that Wall Street Journal article, Matt Walsh did one of his reactions to this, was basically a accusation that people are being too quick to cut off their parents, to say that this is something which is toxicity. And, you know, your point here is, there are lots of people out there that are assholes. Many of them are parents. Many of them might be your parents. Some of them might be your parents. But how many people are choosing to do that because they don't want to engage?

2:02:43And what happens when you do that at scale in a reactionary way that doesn't actually meet the threshold for what probably would be a healthy way to go about this? Well, you actually end up with kind of this generational divide where lots of people aren't talking to their parents because of something that maybe they were convinced of in a therapy room or they've decided to not convince of in a therapy room they've arrived at a realization that they have arrived at from time spent in a therapy room but maybe it's not actually a as firm foundation to make quite a big life decision as they might think yeah so i i mean i

2:03:20Dr. K:think there's a lot there so just to kind of go through it so are people quick to cut people off yeah i think though that one of the so i i kind of can take both sides of this argument um i do think that if we look at what's happening right now there is an a really distorted perspective on mental health so one study i i saw found that 95 percent of tiktoks about adhd are like incorrect so so even even like i mean that actually could be good proof about your adhd you didn't even have enough attention to be able to research the adhd correctly uh maybe yeah so so so i i think people people are very quick to like label right now they're really quick to say okay this is toxicity and sort of pathology yeah yeah and and and i think that there is something going on right now where like the generation like the the positive not positive the the side if i if we take the side of people who are cutting people off they're just done with it right so so just because so so we we have the saying in medicine that shit rolls downhill and there's a cycle of the cycle of toxicity and the cycle of abuse continues especially in like medical training so my attending was anastomy i worked he worked i worked 30 hours a week when i was a resident i had to pick his shit up and he would come drunk and whatever and so i had to i i went through trial by fire and now it's your turn so this generation is not having that anymore.

2:04:49Dr. K:They're not taking it laying down. Ironically, sometimes they're taking it laying down. I don't know if you know what laying flat is, but this is a movement in China where people are like, they're basically exiting the grind and the hustle culture, and it's called laying flat. Is it like the hikikimori at all? No, it's kind of like hikikimori, but I think notably different. So hikikimori, I think it's the same root, but hikikimori was much smaller in her shudder. The vegetable men. Yeah. Yeah. So, so, but laying flat is like a, a, a rebellion against the structure of grind for 60 years and then you'll get your just desserts.

2:05:26Dr. K:So. Interesting. I think there's a reasonable amount of like, we're not like the cycle stops here, like somewhere the cycle of abuse has to stop, right? Or it doesn't have to stop, but we're going to stop it here. And I'm going to insulate, I'm not going to deal with you anymore. which kind of makes sense because i think a lot of times you know you can say like are people too quick to cut off sure but you should also talk to the people who are cutting people off right so so because i i think a lot of times what what these the experiences of many of these people are who cut off their parents is that they have tried for like 30 years right it's not a rash decision it's not a rash it's a decision that that in fact they sort of tried everything has been many much of their experience.

2:06:14That was what interested me, at least in part, about the reaction to the Wall Street Journal piece, which, and that title of, Are Therapists to Blame for the Rise of Adults Cutting Off Their Parents, opens up the door to, yeah, maybe this is part of a flippant, commercialized, weak culture where people are doing things that are more easy rather than going through the hard thing. But I can't imagine, I literally can't imagine a person what sort of construction somebody who is both emotionally informed enough to have done even a cursory or requisite amount of therapy to be able to get to this sort of a stage to know that it's a thing that you could do or should do or whatever and also be so flippant as to do it in a like a

2:07:03Dr. K:quick way in like a callous manner yeah so i i think that those so i think this is a good example of like there's a lot of different populations that we're lumping together. So as you pointed out, I think oftentimes the people who do a lot of therapy don't flippantly cut people off. So what happens is the people who are looking for a reason to cut people off will cut people off and then they'll cite whatever kind of trauma they use. And I think some of these people like Matt Walsh or whoever react to this stuff, they're reacting to that. And this is the basic problem with the internet is anytime you talk about an issue, people are not talking about the same thing it's the reductio ad absurdum in opposite directions what does reductio ad absurdum uh it is a philosophical technique to explain how if you were to take this thing to its most extreme version you're like well if you had sex with a thousand guys in a day do you think that's the sort of feminism that you're talking about and it's like well that is a kind of bonnie blue is kind of the reductio ad absurdum of the sex positive movement in one way.

2:08:04Like the most extreme version, the most extreme example. And yeah, Matt is talking about the person who went to two therapy sessions and decided to get rid of their parents. And maybe somebody that's super pro-therapy might be explaining, well, this person went through three decades of it and all of this abuse. And then only then did they decide to do it. It's kind of both of the extremes, but going in an opposite direction.

2:08:25Dr. K:Yeah. So I think what worries me about this is we have to play the tape through to the end. And I think what we're seeing in our loneliness crisis is fundamentally a shift of one human being not being responsible for another human being. So one manifestation of that is like, my parents are not my problem to fix, but also someone else's loneliness. So we see this a lot in gender dynamics where it's like, is it the job of women to teach men emotional skills and things like that? Whose job is it to help those who are left behind? Whose job is it to support the people who have been ghosted? Whose job is it?

2:09:05Dr. K:So if you have someone in your life that you cut out, it's not fine. I would not lay that responsibility at any individual's feet. And at the same time, whose job is it? Well, you do it en masse across an entire society, and you end up with a bunch of atomized individuals who never look out for anybody else, never feel like they need to look out for anybody else, and also know that given their lack of looking out for other people, nobody's probably looking out for them either. Yeah. So I think that we would like to think there's this thing called the just world hypothesis where it's like, okay, if I'm not looking out for other people, no one's going to look out for me.

2:09:42Dr. K:I think the really scary thing is that that may not be true. I think what people are really doing right now is they're forming these strong bonds that are nuclear without any of the toxicity. But it's not necessarily that they're lonely. I think it's like people are setting limits with people who are toxic and then they can still they're able to sometimes they can form a lot of healthy bonds so what's really scary is we're seeing all almost this like inequality of connection and loneliness where some people have a ton of connection right really is the uh social parito principle uh what is parito is parito efficiency 80 20 yeah the small number of gains accrue to a large number of gains accrue to a small number of people a large number of friends probably accrue to a small number of people.

2:10:27Dr. K:So there are people who are cutting out a lot of toxic people and have very fulfilling relationships, right? There are people who, and I see this all the time. I mean, I hear about this all the time in my social circle. So I'm South Asian and there's a lot of like restrictions and ostracization around marrying someone who's not your religion or not your caste or not Indian or whatever, right? And so there are people who are building, there's like a lot of people who are departing these old structures and are like re-coalescing. I think the really scary thing is we're leaving a ton of people behind, which is fine, right?

2:10:59Dr. K:So the people who have, so it's like the billionaires may not care about the people who are broke, right? They're like, I got mine. Like, it's bootstrap world. You handle yourself. And we're all like, oh, that's bad. But if you have a high degree of social capital, if you have strong relationships, like, sure, you work to get it, which is exactly what the billionaire will say, right? But what happens to all the people who are left behind? Yeah, there is this interesting responsibility. All right, Lindsay Clancy, what do you think about the case? Okay, so let's start with some background for people who don't know who Lindsay Clancy is.

2:11:34Dr. K:So Lindsay Clancy is an obstetric nurse, okay, who is married and has three children, has a history of psychiatric illness. and after her third child has a psychiatric decline that is characterized by outpatient care, partial hospitalization program, going to the emergency room, being hospitalized inpatient, being discharged, has seven psychiatric providers, psychiatrists and nurse practitioners who prescribed 13 medications over some period of time. So Lindsay Clancy is also particularly close to home because I trained at MGH where she went to the emergency room. I know the people who took care of her when she was hospitalized at McLean.

2:12:27Dr. K:So I'm very familiar with this case. She's from Duxbury where I used to take my wife when she was pregnant. There's a beautiful beach over there in Great Oysters. So, and then what happened is, is Lindsay Clancy killed her children and then jumped out of a window and cut herself and then jumped out of a window and is now, I believe, paralyzed for the sternum down. A few months after this happened, I believe her husband divorced her. And I think he's in a new relationship. I'm not 100 percent sure. And then there are two separate legal proceedings. One is the state of Massachusetts is trying to—Lindsey Clancy is on trial, in a criminal trial by the state of Massachusetts for murder of her three children.

2:13:19Dr. K:There is a separate civil lawsuit put forward by Lindsay Clancy and her ex-husband suing various mental health providers for failure to do their duty of care. I didn't know about the second one. That's fascinating. Yeah, so first thing is most people don't know much about, like you said, have you read the legal proceedings? I've read some of the legal stuff, but I don't know anything about ethics or legality. But I know a lot about medicine, and I know a lot about the internet, and I know a lot about how people react to it. so there are a couple things that are like so this is a thing that so this is the these are the facts okay then there's the internet's reaction to it which is people are blown away that she has has so i heard this is not something i verified myself that her husband started a go me that raised 1.7 million dollars that is not being used for her legal defense i don't know if that's true or not or if that's social media conspiracy hat she there is a gofundme for about a million dollars now i think i don't know whether she started a gofundme to which uh women have raised a million dollars on her behalf and then the other really interesting thing is that this is tearing apart couples.

2:14:39Dr. K:So not just gender dynamics. So someone called off a wedding. So, yeah, someone called off a wedding. So I am a psychiatrist who has done some postpartum work. And I went to the Massachusetts General Hospital and trained at Harvard Medical School. And I am reading 28-page civil proceedings on this as well as doing a lot of research on postpartum psychosis. and my wife, who is my boss, comes to me one day and she says, I'm disappointed in you. And I said, for what? She says, for how you're handling the Lindsay Clancy case. I mean, like, what do you mean how I'm handling? Like, I'm reading things.

2:15:23Dr. K:I'm, like, reading papers. I'm looking at stuff. And she was, like, disappointed. I was just blown away. Like, this is like, like, I took paternity leave. I changed diapers. Like, I'm pretty sure I'm a pretty good husband. I'm pretty sure I'm a pretty good dad. and I'm pretty sure that I, like, support women through pregnancy, and I've seen postpartum psychosis. We'll get into that in a second. I've helped women through this, and I was just blown away by, like, my wife's reaction. She wasn't, like, super mean about it. She was just like, you know, I'm really disappointed. Fuck. Like, what did I do?

2:15:53Dr. K:Like, I'm actually, like, doing, like, like, I've spent 10 to 15 hours, at least, like, getting into the details of what is going on, and, like,

2:16:06Dr. K:So I was just struck by that. And I was like, wait, what is going on? Because I know that she doesn't think I'm a bad person or bad psychiatrist or things like that. I've helped some of her people in her life who have gone through somewhat similar things. So I know I'm not in the wrong. And so there's just so much energy around this. And then, so what people are getting upset about, right? So people are breaking up over this. People are upset at the women for supporting Lindsay and not considering the kids. Okay. And people are upset at them for supporting the woman full stop, which is a separate thing.

2:16:47Yeah.

2:16:47Dr. K:So let's understand a couple of things. So I think the basic issue here is that it's really a lack of understanding for a lot of things. the first is i don't think men or even society as a whole understands how hard pregnancy in the postpartum period is like we all say it's hard but we don't understand so the reason that like my take this is some hot takes and i'm not you know i'm not really an expert actually i think the reason that so many people are rallying to their defense is because who's defense uh lindsey clancy's defense and reason there are so many women are giving her money is because they have they have looked down from the cliff that she jumped off of so i think so many women have had such terrible postpartum experiences including struggling with thoughts of suicide or even killing their kids or all other things so i think the experience of of many women in not even the postpartum period this is pre-partum and there's all kinds of stuff but like it is like you are fighting against something that is going to kill your kids and you love your kids and you're fighting against it day after day after day after day and you're losing and you don't know what to do and it's like everything is falling apart around you and you like you don't know what to do and everything is just going to fucking fall apart i i know that's hard to understand but that that's like i think that's why people are supporting her because they know what it's like and they know how dangerously close they came to succumbing to this.

2:18:28Dr. K:So let's talk about what this is. So this is the other thing is, you know, the people who are breaking up with their girlfriends and or boyfriends, husbands, whatever. A big part of this is she killed her kids. If you support her, there's no way I can maintain a relationship with you because like I can't, how can you support someone who would kill their kids? I cannot be in a relationship with someone for the safety of my own children. I think this speaks to a real misunderstanding of what psychosis is. So interestingly enough, mental health awareness has increased, but mental health ignorance has also skyrocketed.

2:19:07Dr. K:So people are aware of mental health, but they don't know what mental illness is. And people don't know what psychosis is. Okay? So let's go through some stats. Two to three women out of 10 ,000 live births will experience postpartum psychosis. But postpartum depression is experiencing depression within 12 months of having a baby. So not all postpartum depression is necessarily due to the pregnancy. The diagnostic criteria for postpartum depression is the same as a regular depressive episode. It's just it happens postpartum okay so then there's a couple of other statistics so um there are i think 6 000 live births oh maybe i'm getting this wrong 6 000 or 60 000 live births per day in the u.s okay so i remember like doing this math and thinking like a handful of people experience postpartum psychosis every day in the u.s the way that the math works out so they're gonna have a kid and at some point in the next 12 months they're gonna go yeah so so people are experiencing postpartum psychosis like every day like all the time okay so it's actually like quite common prevalent um and so and then the second thing is i don't think people understand what psychosis is so what psychosis the best way i'd explain it is like, you know, like your mind tells you to do things.

2:20:43Dr. K:And there are some things that it tells you to do that you listen to and some things that it tells you to do that you don't listen to. So let's take something really basic. Like, let's say, you know, like when you take a dump and you wipe and you don't like wipe good enough and you like need a second wipe. And it's just so natural to like wipe a second time. Right. It's like so simple. It's not even something that you would argue against. You never even question it. Imagine the thought is kill your children and you just do it. So the thing about psychosis is it is like literally like your mind is manufacturing.

2:21:19Dr. K:So what is psychosis? It's a break from reality that is usually involves two or three different things. One is hallucinations. So your mind is literally creating things that are chasing you that you think are real. Lindsay Clancy said a man's voice told her to kill her children. We'll get to that in a second. So I had a patient once who jumped out of a third story window, was also broke both of his legs. Thankfully, he wasn't paralyzed because he was being chased by a demon. And like, imagine a horror movie, but like you're inside it and the demon is real and is like chasing you like you believe it's real.

2:21:53Dr. K:That's what psychosis is. Everyone's like mentally ill by reason of mental defect. And this based on the media is like something that sociopaths do. They pretend to be crazy. Oh, it was a dissociative fugue. It was multiple personalities. It wasn't me. Now, psychosis is a whole different ballgame, right? This is the thing that causes people, including herself, to jump out of windows. She's paralyzed for life, okay? It can also include things like delusions. So this is a different kind of—delusional disorder is different from acute psychosis, but it sounds like she was experiencing acute psychosis.

2:22:24Dr. K:And there can also be—there's, like, severity of psychosis, so it's not all the same. So when you get persecutory hallucinations, that is more common and actually less severe. So this is a voice actually talking to you. It's not a voice in, I mean, we talk about it like it's a voice in your head. No, it is someone who follows you around and just constantly calls you a piece of shit. Just wherever you go, think about the most toxic, we talked about cutting out toxic parents. Think about the most toxic person you know, and just imagine that you had AirPods in your ear and they were just commentating on whatever you do.

2:22:57Interesting that the categorization is persecutory, like that this is the defining characteristic of this. They're not following you around going, dude, you look so great today.

2:23:06Dr. K:No, no, no, they're not. Yeah, it's persecutory, right? It's interesting. And then what's even more severe than that is command auditory hallucinations. So command auditory hallucinations is there's someone in your ear that's giving you commands. So this isn't thoughts. Okay, this is like commands that sometimes people feel compelled to obey. And in my experience, and I've worked with a lot of psychosis, I trained at McLean Hospital. McLean is amazing. It's like where she was hospitalized. And so the cool thing about McLean is most hospitals will have a psychiatric floor. McLean is a psychiatric hospital.

2:23:40Dr. K:All the floors are different kinds of psychiatry. So when we do, when I rotate, there's a unit there called AB2. Three months on AB2 is bipolar disorder and psychosis. So every patient that I see every day for 90 days, not to mention all the days that I'm on call and covering the unit is all psychosis. So command auditory hallucinations are more severe. And the whole point of this level of psychosis is that the reason we hospitalize people against their will is because we know from a medical perspective that these people this is what's kind of interesting it's not even that they can't control it it's that they start to believe it right so like like like this is what's really hard for people to understand in it's not about control it's about belief so psychosis makes you believe something so when i was an intern at mgh i was on my first month of inpatient in this patient i mean i don't think there's anything identifying here it's chimerical okay patient comes up to me i she's not my patient i'm not taking care of her i pass her in the hall and she says how are you doing today son say I'm doing well.

2:25:00Dr. K:She's like, you know you're my son, right? And I'm like, I'm not your son. And then we like have this little back and forth in the hallway and she's like, get a DNA test. Then you'll know. She's like 10 years older than I am. I'm like, all right, lady, whatever. So I come back the next day and she's like, how are you doing, son? I'm like, I'm not your son. She's like, did you get the DNA test? And I was like, no. She's like, see, I knew you wouldn't. You get the DNA test, then you'll know. And for the rest of the hospitalization, she was sure that I was her son. And I'm not going to get a DNA, like I'm not going to go get a DNA test to, and then I have to get her DNA, which like, I'm not, you know, that's not even possible.

2:25:43Dr. K:It's not ethical, whatever. And she really believes this. She had a delusional disorder where she would just think people were her son. And she really believes that. And, you know, and then like, as I denied that I was her son, she like forgave me. And she's like, you know, even if you don't accept it. Like, you know, you should really get it and then you'll know. But like, if you don't know, like, I love you no matter what. Yeah, she's a great mom. Great mom. Right, so this is what people don't understand about like psychosis is you take the things that you really believe and then you just change them.

2:26:12Yeah, so there is an element of volition in there. You're following something. It's not derangement. It's deranged belief. And then downstream from that, you're not doing crazy things. The things that you do are crazy, but the beliefs that you have are completely logical to you.

2:26:30Dr. K:Yeah. And the beliefs are a break from reality. Right. So you believe. And so there is an element of loss of volition as well with command auditory hallucinations, for sure. Right. So that's kind of intrusive. Yeah. And then you feel like you can't resist. Right. And so or you resist for so long and then all it takes is one moment for you to like follow the command. And then you feel like you can't resist anymore or you choose to follow because you think it's the right thing to do. We don't know. I wasn't a doctor. I wasn't there. Right. I'm just talking about psychosis in general. so everyone's like oh mental illness like there's some this is what people don't get about psychosis there's some preserve preservation of agency in every other diagnosis right but this is why psychosis is like you know by reason not guilty by reason of mental defect i'm not a forensic psychiatrist but i think that this is the situation for which that exception exists how how how unlikely is it that somebody suffering from that kind of psychosis would be able to plan in advance to get their husband out of the house that I mean I don't this is not my area of expertise but I think that that holds zero water for me personally so like I don't think that So this is why it's important to understand the nuances of the belief system, right?

2:28:06Dr. K:So she's not, there are some types of schizophrenia. This is a diagnosis. It's not psychosis. Psychosis is a symptom. People with schizophrenia sometimes have psychosis, but she, based on the medical records and stuff that I've looked at, she probably has bipolar disorder that can manifest with psychotic features, which, you know, they will make arguments for. So I'm not trying to diagnose her or anything, but that's just what the argument is, which is consistent. so and by the way the first so a very common time for women to be diagnosed with bipolar disorder is postpartum so they will have a history of depression unipolar depression and their first psychotic episode or their first manic episode will be postpartum it's a really common so literally like in the hospital when i was training people were like hey by the way if you have a patient who's a woman who has unipolar depression and postpartum, they start doing some weird stuff.

2:29:01Dr. K:You need to think about bipolar disorder. That's like a part of my training. And the really scary thing, this gets really detailed. I have a whole YouTube video about this, which is blown up. But there's this thing called the EASE, which is the examination of anomalous self-experience, which is a 50-page questionnaire about different kinds of psychosis. And if you look at, I go over it in detail. But if you look at like her symptoms, like they map onto the ease, but very few people even know that the ease exists. So this is some really weird, like this is some AB2. I'm learning from people who's been working on a psychotic disorders unit for 10 years, and this is what they see day in and day out.

2:29:39Dr. K:But anyway, so it's personally, I find it fascinating because a lot of psychosis, like a lot of the warning signs are not what you would think. They're not psychosis and they're not delusions, they're feelings of like disconnection, like vague feelings of something is going wrong. I don't feel like myself. Something is going bad. This is something that's what we call prodromal. So like, you know, before you get the flu, you feel sick for a day. So the prodrome for psychosis is like this weird sense of like something doesn't feel right. I don't feel like myself. My thoughts aren't my own. Like, I feel like I'm not myself.

2:30:13Dr. K:Like, that's how it starts. so people don't understand this and i think like people really need to understand this that that even if she killed them you know five percent of people with postpartum psychosis have homicidal ideation six percent of people with postpartum psychosis have suicidal ideation and i think the numbers are there's somewhere between two and twenty people every day who will develop postpartum psychosis in the United States. So what that means is out of every like five to 10 days, like someone's going to get homicidal and someone's going to get suicidal. This happens. I think the other really scary thing that's causing people to rally around Lindsay Clancy is that, see, if someone thinks that this is someone did something wrong here, I think the main question to ask is, what was she supposed to do?

2:31:08Dr. K:So she did the really scary thing about this for me as a psychiatrist, which I think we don't really understand. See, when you get cancer, everyone understands there's a chance you're going to die. What we really don't understand as a society is that 5 % of mothers with postpartum psychosis become homicidal. Like, that's a part of the disease. Like, we know that. That's an outcome. trying to kill your kids is a very very rare but measurable consistently measurable outcome for this diagnosis or not necessarily killing your kids but having homicidal ideation which yeah the desire but you are around your kids a lot yeah right so so that's what's really scary and what's really scary about this is that she kind of did everything right right so she was actively in mental health treatment got into higher levels of care had multiple providers see her.

2:32:03Dr. K:Received care at McLean and MGH, which are respectively the number one and number two top psychiatric hospitals in the country. Right. And maybe a couple other every year changes a little bit, but they're definitely top five. Right. And so she's got some of the best care on the planet. She has a husband who, according to the civil lawsuit, I don't know how much of this to believe or whatever, but it's like pretty involved in her care. He's like calling her nurse practitioner calling her a psychiatrist like, hey, I don't think the medication is working. Can I bring her in? So supportive husband, doctors from Harvard Medical School, long history of treatment, and this still happens.

2:32:42Dr. K:This is why women are rallying behind her, and this is why women are fucking terrified. Because she did everything right, but this is medicine and we're humans. And the scary thing about medicine is you can do everything right and you can still get fucked. Are there any drugs that she was prescribed that would make her more susceptible to listening to the voice to do bad things? I mean, I'm not gonna get to that level of resolution because I think there's so much... The short answer is like kind of yes and no, but like there's so much clinical specificity. So if you just take any one of the medications she's on and you look at the fold-out sheet of side effects, right?

2:33:27Dr. K:There's going to be like literally hundreds of side effects to each medication. I'm going to guess. I mean, I've heard people who aren't clinicians talk about some of the, specifically one of the drugs that she was on is maybe causing hallucinations. I don't actually hear anything about hallucinations. The short answer, she got prescribed a lot of medication. Is this like serious, serious shit? Is this as serious as you can get? from a... So, yeah, but the reason I'm hesitant to answer that question is because I think it's very hard to... It's very easy to take out of context. It's very easy to misunderstand.

2:34:00Dr. K:Just to give you a simple example. So she was prescribed an SSRI. So an SSRI is an antidepressant medication. If you have bipolar disorder... So it's an antidepressant. So she's depressed. We give her an SSRI. SSRIs can sometimes trigger mania. one of the features of mania can be psychosis. Okay? So was she prescribed a medicine that can cause psychosis? Absolutely. But this is also ironclad standard of care for postpartum mothers who are experiencing depressive symptoms. That's what's really hard to wrap our heads around in this case is that you can do everything right and bad stuff happens in medicine.

2:34:48Are there any other elements of the case that you wish more people were paying attention to before we get into the reaction?

2:34:56Dr. K:I mean, not really. Like, I think it's brought up to the surface. And I think a lot of this armchair quarterbacking, like, I don't know if she got good care or didn't get good care. I'm not going to comment. Like, we just don't know. Like, you have to be in the room. And what I do feel really strongly about is that, you know, if you look at some of the testimony of, like, cross-examination of the psychiatrists and stuff like that, like, I think that the other big thing that this is showing. So, for example, she called the suicide hotline twice, but there is no mechanism for the suicide hotline to communicate with her mental health providers.

2:35:31Dr. K:She went to different medical systems that don't have access to each other's EHRs. There's a lot of things. Electronic health record. There's a lot of stuff that people will ask, like, you know, her care providers on the stand, like, did you do this? Did you do this? Did you do this? Like, and that's just completely unreasonable in any sense of practical care. So a simple example is, did you assess her for all of these things? The appointment lasts 17 minutes because that's what insurance will pay for. And so you don't have time to do all the stuff that you're supposed to do. There's just no way.

2:36:07So the other thing that I think this is really showing is this is a really good example of like something, the flaws of our healthcare system here in America.

2:36:20Dr. K:So what's really interesting is I was talking to some of my colleagues who are also following the case who are psychiatrists and they're like, this is not possible in our country because everyone has the same medical record. There's one medical record for everybody. So everyone sees what everybody else is prescribing because it's all centralized. But that's not how we do it here. So I think that this is also really scary because it's like, and the thing that I want to also help people understand is that this is not like an anomaly. Like everyone's getting caught up about this, but what's really scary is like this happens every day.

2:36:52And I think that's why so many people are supportive of her women because they know they're like, oh crap, like I did see a doctor and the doctor wasn't helpful.

2:37:00Dr. K:or the medication didn't work and I was like right on the threshold. And I think that there are enough, I think something like 5 ,000 women donated to give her a million dollars. So it totally makes sense to me that there are 5 ,000 women out there who understand what it's like to be in her shoes and understand that even though they love their children, their mind was so distorted that they were thinking about hurting them. And so I think that's why a lot of people are rallying to support. And I think the men who judge the women don't understand what's like, I mean, she jumped out of a window and is paralyzed for the rest of her life, right?

2:37:35Dr. K:That's not like... What do you make of the women who judged the men? Like your wife obviously stepped in and was, you didn't actually finish the story, I'm going to guess, disappointed that you seemed to be less supportive of Lindsay than she may have wanted you to be? So this is where we get to like the real, like, so I feel really confident in what I've said so far. Okay. That this is what psychosis is. It's common. I think that a lot of women experience this, that we really don't normalize like how gruelingly difficult pregnancy in the postpartum period is. I said that. I said that before you.

2:38:11Dr. K:Yeah. Yeah. I believe it. And, you know, like simple things like, you know, people say like, oh, like I'm so happy. I'm a happy mother and my baby is amazing. And like some women, if you're in postpartum depression, you don't feel that. So they feel like they'd missed out on something that they should have gotten as well? i i mean i think this out is the under an understatement like i think they feel like terrible human beings they feel like terrible mothers like because they feel love for their child on a deeper level but they don't feel an emotional love so they love the child but they don't feel love for the child and then what they realize is oh shit this child that i love more than anything else in the world has a mother that doesn't love them and that hurts so much I'm a bad person.

2:38:57Dr. K:Yeah. What a monster I must be. Right. And then that can spiral. And then you throw in social media and you throw in body changes and you throw in all this kind of crap and it really spirals out of control real fast. I mean, we know that statistically getting pregnant and having a baby is probably the most dangerous thing that most women will do in their life. What we don't acknowledge is that there's a mental health component to that that is just as risky and just as severe. Presumably not just as risky, given that the numbers of the psychosis are what? Yeah, yeah. So by just as risky, I mean, like, we know that, you know, pregnancy is very physical.

2:39:33Dr. K:So the average woman, pregnancy and childbirth is like the most high risk activity that they will engage in. What we don't acknowledge is that the postpartum period in pregnancy from a mental health standpoint is also arguably the most high risk thing that they would do. Yeah, yeah, yeah. I mean, maybe, probably even more likely than severe depression after losing a parent or something. Oh, absolutely. Yeah. So I think that's... Interesting. Yeah, that does make sense. That's an interesting angle that I never considered. You have a very, the most, for most women, on average, physically traumatic period and the most psychologically risky period.

2:40:14Dr. K:Yes. And so, you know, motherhood is celebrated, but for many women, it's like going to war. Right. So it's like, oh, yay, like World War Two, like go live in the trenches for a year and like, yay. You know, so I think I think there's there's a disconnection of people's real understanding, because even if a woman says, hey, I don't love my child like six months in, like other people around her will judge her very harshly. um what did you make of the disagreement coming from men to women saying this level of support feels uh concerning um uh or your judgment of my judgment doesn't seem to respect the role that most men are supposed to take, which is to protect the kids and the family, including what's that like line in the, I don't know whether it's true, but like we swore an oath to protect our country from enemies, both like without and within some bullshit like that.

2:41:18Um, you know, it, this would be an interesting question. This would be a fascinating question, actually, to ask, um, people on both sides of this debate, would the women who are supporting Lindsay Clancy say that it is the job of a father to protect the children if the mother is going through psychosis like should you physically restrain the mother should you step in to stop that kind of damage

2:41:48Dr. K:being done like if you were there if you had been there yeah so so i i think based on my reading of like the court documents and stuff and like keep in mind the civil lawsuit which is most of what i read because that's where most of the psychiatry is. The civil lawsuit is, you know, has an angle, right? The civil one is the one against her doctors. Yes. So the civil lawsuit is painting things in a particular light. Sorry, is that one concluded? I don't think so. Far from it. Hang on, so they've got two fucking lawsuits occurring at the same time? Yeah, but in one they're the plaintiff and in one it's the defense.

2:42:25But in one they're a team and in the other only one of them is on trial yes fuck me okay but is that is that like do you do you have the stand go on the stand and do all the rest of this stuff in the civil one because it's

2:42:39Dr. K:it's yeah i don't know enough about that's happened presumably no the civil lawsuit is ongoing jesus fucking christ so she's sitting there in sometimes in court as the defendant yes and sometimes in court well i i i'm sure that the i would be stunned if i mean i think the criminal trial is happening first yes right and then the civil lawsuit will get resolved right but that is fucking crack it i didn't know about the civil lawsuit i didn't know that that other thing was going on and like you're like turning up and i'm aware that this isn't the way that it's being scheduled or whatever but you know like you look at your watch and you're like today which uh i'm on the stand today and then the next day you're like oh i'm sat on the other side hey motherfucker yeah yeah so so i mean so i'm i'm a lot of my information is coming from the civil lawsuit which i think is trying to paint her in a severely mentally ill way and is also trying to paint her providers in as negligent of a way as possible um but i i mean i i think you know you were asking about like why are women reacting to men like this right like so what's going on there so i i think a lot of, I think there's a lot of like displaced anger, resentment towards men from women who go through this period.

2:43:58Right.

2:43:58Dr. K:So, so, so in, in things like, you know, like sometimes it does end a divorce. Like sometimes you have postpartum depression, you're not interested in having sex anymore. You let yourself go. You're really not doing a great job as a mother. And your partner is like, I don't want to be in this relationship anymore. I have to look out for myself. I have to look out for my kids. I'm going to divorce you. Right. Why do you think it is that men have taken, I haven't seen many men on the side of Lindsay Clancy. Very few. Well, so I think that the ones that float to the top of social media are not. Right.

2:44:37What do you think is their motivation?

2:44:41Dr. K:You know, people will say, I can't be with someone who supports a woman killing her kids. So you can infer whatever motivation you want, but I don't think that the motivation is like the operative thing there. I think the operative thing there is that killing has no nuance between murder and manslaughter. Right. So I think that they're there. I mean, what they're motivated, motivated by is abhorrence. What they're motivated by is shock. What they're motivated by is fear. What they're motivated by is perspective love. I think probably their primary, the primary emotional. valence that i think most men who are reacting to women in this is is befuddlement they're like what the fuck are you guys doing like how can you get here like what the hell is wrong with you so so that's why i think i get to ignorance because i think the primary emotion is confusion by men that's very interesting so so like they're like they're like what are you guys doing I don't get it.

2:45:46Dr. K:Like, how can you think this way? Which, by the way, is why I think it's so divisive. Because people on both sides are like, how can you possibly think like this? What do you make of the same Lindsay trend that was going on online? What's that? It was women on primarily TikTok holding their children or recording themselves sometimes with their kids crying. And the caption was same Lindsay. It was the me too for the Lindsay Clancy case. Yeah, so I think this is where we get to where I'm on the weakest ground, but I also feel really confident about. So this is the damaging parts of the internet.

2:46:25Dr. K:So a couple of things. So one of the things that I was confused about, because my wife was telling about this, is now there's this theory that the husband did it. This was my first point when you asked me, what do I think about it? women are certain women seem to be incapable of laying agency to do bad things at the feet of another woman that being able to do evil is only the purview of a man there's actually a well-studied psychological phenomenon like that's like the good mother bias or like the loving mother the women are wonderful effect is something similar gamma bias is something that's not too so there There is an element of that.

2:47:06Dr. K:But I really think some of this stuff is like social media brain rotting kind of stuff. Because I think as far as I know, there's like there's no dispute. Like everybody in the room agrees. Her included that it was manslaughter. Right. Or she's saying that she killed her kids. It's just she wasn't in her right mind when she did it. So that that got me really like confused because I like I don't like, you know. OK. So what do you think is the motivation of the women? Yeah, getting there. So this is where things get really interesting because I was looking at some of the social media and a lot of the comments are women's intuition.

2:47:43Dr. K:So I did a deep dive into women's intuition, the science of women's intuition. So as a psychiatrist, I've come to really respect women's intuition. But here's what the science shows. The first thing is that women's intuition is not significantly greater than men's intuition, but it is more potent than men's intuition, but by a very small, like maybe like 10 % tops. the second thing is that women's intuition is modulated by attention so man's intuition and women's intuition is the same depending on how much you're paying attention to something okay that kind of makes sense so like and this is what i learned as a psychiatrist when a woman comes to me and says hey like i think something is going on i trust her intuition because what women's intuition really is, is being able to detect like discongruence.

2:48:37Dr. K:So women's intuition, kind of how I think about it, if I were to simplify it, is women's intuition doesn't tell you what happened. It just flags suspicion that things are not the way that they appear to be. So it doesn't give you like a positive direction. It just tells you something is wrong here. Like, okay, this person is doing something shady, but yeah, they're having an affair, that jump I don't think is evidence-based. It's like having a dashboard on a car that only has one light. Exactly. When something is wrong in the car, but it doesn't tell you which thing is wrong. Brilliant. That's exactly.

2:49:13Dr. K:So that's my take on it. So I still take this very seriously clinically. So if I have a female patient who's like, hey, I've got a bad feeling, I'm like, tell me what's going on. Let's figure out what is this feeling, because they're picking up on something. and and so but i i think that then this so i didn't think that women's intuition is sufficient to make him guilty but i think some element of women's intuition some element of echo chamber on the internet some element of you know there's a there's a population of women who love true crime which is not bad but then what happens is you and then there's like people who are making like astrological like takes on this and they're like oh like she's a gemini yeah he's a leo or whatever And the really interesting thing is I think there's even like some, I've read a couple of papers on astrology that are actually like quite compelling.

2:50:02Dr. K:But nowhere, I think this is basically like an amalgamation of, and there's 90 % of papers I've read on astrology show that there's no merit to it. But I think basically this is like internet brain rot. Right. So it's like some amount of of resentment, some amount of like, you know, being in an Internet echo chamber. All men are to blame some amount of like a true crime kind of stuff. And there's a lot of research on, you know, when you're on social media, like encountering things over and over and over again is proof to the human brain. right so like this is happening because i see it a lot and we see this you know like in in men's echo chambers on like the incel red pill black pill whatever like this is the we know that yeah we we know that right so it's the same same thing so i i think there's some amount of like really displaced resentment displaced hatred there's some amount of distrust there's some amount of like this like like you said the kind of the the loving mother kind of hypothesis that she she and i think that even these people don't understand mental illness because they're saying oh lindsey clancy could never do this she loved her children i saw the picture that she had she loved her children the whole point of psychosis is you can love your children be a good person and still do something bad can i throw a few things that have come up while you've been talking and i've been learning um one is it seems odd to lay everything at the feet of pure agentic murder if this same person is going to it people do murder homicides murder suicides all the time right like it's not as rare as you might think but doing the killing and then the cutting and then the throwing yourself out of the window headfirst.

2:51:57I watched an animation of the way that she fell. And it's like, she really fucking went for it. Like just landed on the top of her head, kind of. If all you wanted to do was kill your kids, is that the way that you would like round it out? That would be the dessert to the main course of your thing. That's the first thing. And the second thing, and the reason I bring this up is the agency appears to be kind of like a prophylactic against the insanity defense or the mental defection defense from a legal standpoint.

2:52:28Dr. K:Yeah, so now this is getting into territory that I basically won't go into for a couple of reasons. So now we're hypothesizing, you're asking me to hypothesize about someone who's trying to kill themselves, would they kill themselves in this way? That's a whole different conversation. I can't comment on Lindsay Clancy, but in my clinical practice, I've seen many, many methods of suicide or attempted suicide. And they each have a different meaning and that meaning is not shared between people. So a simple example is, I've had patients that, for example, have borderline personality disorders. So the way that I was taught to examine suicide attempts, it's a really great framework, is what is the lethality and what is the visibility?

2:53:12Okay, so example of low lethality, low visibility

2:53:18Dr. K:is I took a bottle full of Tylenol. Bottle had two pills in it. Okay. And then texting someone afterward. Right? So letting someone know is like low visibility. Like higher lethality. I'm not going to go into details, but there are certain things that you can do that can make things more lethal. Most extreme case of suicide that I've ever encountered was tying a noose around the neck, tying a hundred foot rope to a tree, getting into a sports car and jamming the gas okay so so there's like lethality and visibility so you know people who are like quote-unquote doing it for attention i don't like that phrase but you know they're they're high visibility attempts and usually high visibility attempts are expressions of distress um but i think suicidality i mean it's a fascinating topic So one really interesting paper by a guy named Matt Nock, great suicide expert.

2:54:18Dr. K:I think this is his paper. Basically showed that 60 % of suicide attempts, the decision gets made within five minutes. So oftentimes the experience of suicidality is that you're struggling with it. And then you know how like you're like late at night. Oh, I should like, I don't, I shouldn't eat a cookie. I shouldn't eat. And they're like, I'll just have a cookie. It kind of happens like that. I get almost impulsivity. Yeah, it really is impulsive. So for more than half of the people. So this media idea of like setting your affairs in order and things like that, oftentimes what will happen is the pain will just be too great.

2:54:51Dr. K:um and my take on this i realized this i went to an art museum where that this clicked for me i've been working with suicidal patients for now i'm you know 12 years i guess since i saw my first one maybe even more but i realized that the the thing about chronic suicidality is that a part of this person has already been dead for a long time like like what i realize now is that when i have patients who are like suicidal for long periods of time there's a part of life that they just haven't had access to for a very long time and it can really feel like a lot of that to them it can feel like you're kind of struggling to stay afloat but that a piece of you is like already gone and and that i didn't see until i saw one of picasso's paintings and that's a whole conversation for a different day but um i was like oh shit i just realized like my patients have actually, like, there's a piece of them that's been dead and they're struggling to live.

2:55:46Catching up with it. So just to clarify, the point that I was making wasn't to try and psychoanalyze the particular mode of suicide. It was somebody that is fully in control of all of their faculties. That, to me, seems like an extreme. At the very least, we can say that murder-suicide is less common than just murder. There is more going on, right? There has to be more going on. The reason that what you brought up is that it seems to me the onset of psychosis or presumably a psychotic episode, if that's the right way to put it, can be relatively sort of a quick turn. Is it possible, therefore, for somebody to have sufficient agency to send a husband out of the house in order to get food and I think to get like a prolapse or something for one of the kids, like a digestive aid or something like that.

2:56:40And then while he's out, have the onset of an episode. Like, can these two incidents be separate? Or is psychosis the sort of thing that ambiently runs at the same level over much longer periods of time? Do you understand what I'm trying to get at here? Because it allows both things to be true. The agency to send the husband out of the house, not for the purpose of freeing the house up in order to commit this act.

2:57:07Dr. K:Yeah. So I think that it's a good question. So I'm going to ask, you know, I'm not going to comment on her, but I think psychosis is not fixed. This is important to understand, right? So even if you look at like depression, feelings of depression, even if you're in a major depressive episode, will wax and wane throughout the day. so we don't really know what causes psychosis but you know once her husband leaves the house if there's a command auditory hallucination and then it picks up which might not have happened before he left the house right so i i think that i mean this is documented so i'm not commenting about whether this is psychosis or agency or anything like that i'm just saying like if you look at what is written in the legal documents one thing is that it the voice was telling her this is the chance this is the last chance you're going to get to do this and she said previously in texts to the mother mother-in-law i've been thinking about killing the kids anyway so it seems like i i don't i don't i mean i haven't examined everything in that much detail but but But I mean, I think if you're asking me, do I believe that this picture could be consistent with psychosis?

2:58:20Dr. K:Because I'm not going to comment on her. I think the answer is absolutely yes. I mean, I think most I've not talked to a single mental health provider who does not believe that she was seriously mentally ill. And we literally have like I mean, she was hospitalized, you know, I think weeks or maybe days. I don't know the exact timeline, but I mean, she has a well-documented history of a psychiatric decline. I don't know what the status is going to be by the time this episode comes out, but as of right now, the jury's been deadlocked for 20 hours, can't reach a verdict, which apparently, if that happens, results in a mistrial, which means that you need to run the fucking thing back, which is crazy.

2:59:08And it's going to cause all manner of hell to break loose on the internet i mean so i think things will the internet has a very short memory during the brief blast radius window yeah so so and then the fucking second wait when you've got to play the the return fixture i've been going again i mean i i i i

2:59:31Dr. K:i think you know the fact that the jury is deadlocked is not surprising to me at all because i think it's like it's a microcosm of what we're seeing on the internet what do you think is the likelihood that the jury is deadlocked male to female uh no comment i have no idea it's just got to be i have to assume based on what's happening on the internet that on average more women would be i i i don't know i mean i i understand where you're coming from with that assumption but my my stance is the people in the jury have we have no idea well i mean like i haven't watched every day of the trial, which you can watch.

3:00:10Dr. K:So I think in order for me to answer that question, I would have to get the information that the jury got. Right. Like, I think it's not the internet. So this is the big difference between the internet and the trial. The internet is a lot of people who are sure and have no idea what's going on. And the trial is a bunch of people who know exactly what's going on and appear to be unsure. Right. And I don't even know if deadlocked means there's like hard eight yes and hard eight no or whatever or if it's like i think usually 12 yeah so so like i we don't know what what i mean we have no idea right so so like i'm happy to answer questions about things that i know about you know but i just think that you could have been at least i'll i'll fucking say if you're not gonna say it i think that it is more likely that the guilty side would be disproportionately male occupied and that the not guilty side would be disproportionately female occupied and i don't know what the gender split can you chat gbt what is the gender split of the lindsey clancy jury um because if that's not oh nine women three men wow yeah so so here's my take on that chris there are too many things that have made sense to me logically like even as hypotheses that have turned out to be so wrong for me that have turned out to be so wrong right it's good like the jury dynamics are completely different man there's like whole psychodynamics of juries and like you know how women like if you look at like judgment of women judgment of women is more harshly done by women yeah yeah yeah including female judges so so so like like there's all kinds of like data points here that we don't have access to so i i really don't know the bro science is allowed out dr k ladies and gentlemen dude you fucking roll uh thank you so much man i appreciate you i appreciate everything you're doing where should people go what have you got coming up anything yeah so you know if people are interested in the sex stuff We just released a guide to love, sex, and relationships that is our most successful guide, and it basically goes through—I thought about someone who's struggling to meet somebody and all of the information that they'll need and tried to put it all together.

3:02:34Dr. K:and so you know a lot of the stuff that we talked about about penile retraining so all that stuff it like comes out of the hundreds of hours that i spent doing research on how to have a successful relationship which includes things like charisma attraction um how to how to how to engage in a sexual relationship how to do physical touch there's so many things that people don't know anymore and so we try to put together the most important info so if people are interested in that otherwise just check out the youtube wait where can people get that guide um that's a great question don't tell me that you've spent hundreds of hours researching a document you have no idea how to send people to i think just search for dr k's guide i mean so so i'm sure healthy gamer gg this is embarrassing i'm gonna get throttled i'm embarrassed by you so my job is to build things that work okay and my wife briefly you need to direct people to it i agree i agree that this is important this is the duality of a useless academic absolutely that it absolutely works if you can find it if you can find it it's a test of agency uh and help you game a gg on youtube dude you're the best thanks a lot man appreciate you man all right goodbye my babies dude fuck yes so good you are the best I waxed for a softicle I love So good.