Good Inside with Dr. Becky - When Depression Doesn't Look Like Depression

Episode Date: August 4, 2026

What does depression look like? It’s not always… sadness. It can be anger. Irritability. Picking fights. Checking out. Taking risks that don't make sense. It can look, to everyone around you — including you — like a character problem, not a medical condition. Christopher Choukalas is an ICU physician at UCSF. Six months after his twin daughters were born, he had every symptom on the paternal postpartum depression list. He had no idea. In this episode, Dr. Becky and Dr. Choukalas go through the symptom list live — and talk about why this form of depression is so easy to miss, what it costs the whole family when it goes unnamed, and what getting help actually looked like for one father who needed it badly. Christopher G. Choukalas, MD, MS is the author of Even the Darkest Night: A Father's Journey of Hope and Healing from Paternal Depression. * Thank you to our partners for making this episode possible: SmartyPants: Shop SmartyPants Vitamins at Target, Walmart, or Amazon today LMNT: Get a free gift with your purchase at drinkLMNT.com/goodinside Girl Scouts: If you have a daughter in kindergarten through 12th grade, visit girlscouts.org to learn more Little Spoon: Get 50% off your first order at littlespoon.com/rattled with code RATTLED Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

After 10, 12 hours of work, I would start to think, okay, well, what's going on at home? There's it going to be chaos when I get home. And inevitably, I would have to take the long way home. And that would involve twisty, curvy roads. I have a old manual transmission car that can go fast and do dangerous things. And man, I was in it. And so for those four or five seconds where you were going so fast and turning so hard that you couldn't help it be immersed in that, there was this like release.

But inevitably, the curve straightens and your focus turns back to what you're going to find at home. So on the surface, this is an episode about a dad who experienced depression in the months after his daughters arrived. But honestly, I want you to hear this in such a broader context. The more we understand about how our minds work, the more we understand about what's actually going on underneath behavior, whether it's for us, or a partner or someone in our life we really care about, the more behavior starts to make sense and not make sense like it's okay, but make sense in that we actually understand what's going on and then we can actually intervene in a way to make things better. And I just know by the end of today's conversation, you're going to have that new framework. It's like you're going to have

a new set of glasses. You're going to see things differently. And you're going to feel so much more empowered. Today I'm talking to Chris Jukalas. He's a physician. He treats patients at an ICU at UCSF and he's a dad who experienced this form of depression. Now, this form of depression doesn't just happen in men. It can happen in women as well. And it is eye-opening to hear him talk about all the different things that actually were part of his depressive cycle that were massively impacting his partnership and his relationship or his struggle to really form a strong relationship with his daughters. And I have a feeling it's going to help you just to understand that this exists, that it's real, and that it can get helped. I'm Dr. Becky. This is good inside. So it's six months

after your daughters are born. What's life like in your house? Well, six months with twins, you can imagine there's a lot of chaos. But the truth of The matter is the chaos started even before that point. When the girls were born, you know, we're in the middle of COVID pre-vaccine. I'm an intensive care physician at the University of California, and so I'm seeing some horrific things every day at work. And then on top of that, there are wildfires making the sky gray and orange and black and even the scent infiltrating the hospital as the girls were born. Lindsay is recovering from her emergency surgery, her harrowing near-death bleeding event, and I'm just kind of holding on.

I don't think I know at the time what's happening. I'm just trying to be there and be present as much as I can. Just show up, survive function, keep the day moving forward, or how would you term it? Well, you know, I'm an earnest Midwestern Scandinavian, and our job is to keep the train moving. And so, and again, as you can imagine, there's a lot to do. So I am shuttling the girls back and forth between the nursery and the ICU where Lindsay's being cared for, trying to help with the feeding. They even have me carry these little swabs of colostrum from the ICU down to down to the babies to pretend that I'm doing something that's helpful. And give a little bit more color about, you know, about Lindsay's birth.

Well, you know, we spent five years trying to get pregnant. And for anybody who's been through IVF, you know it's a lot of poking and prodding and tests. And because the pregnancy was so medicalized or the conception was so medicalized, she felt very strongly that the pregnancy and the birth would not be. We're in Marin County. There's a lot of homebirth. There's a lot of sort of non-traditional medicine practices there. And yet here I am trying to make sure that everything, quote unquote, goes okay. So I want every time. test, every ultrasound, and Lindsay did not. So we got to 39 and plus weeks with twins, which is bar long. Bar long. Yeah. And so when we finally went into the hospital, hours of failed induction strategies, ultimately a C-section during which, as the babies are coming out, I'm realizing that Lindsay's blood pressure is dangerously low.

and the cognitive disconnect between being an anesthesiologist who does care like this routinely, holding two babies that I've never, I mean, I don't know that I've ever held a baby in my life before that moment. Yeah. And then simultaneously looking over my right shoulder at the monitor and realizing that something seems wrong, and yet they have not taken these babies from me and shuttled me out of the room, which is the first thing you do. when something is going wrong in a C-section. And so after what felt like hours of just living through that sort of bewildering confusion, I sort of looked up over the drapes and realized what was really going on,

that her uterus was bleeding from uteranatony, that the anesthesiologist and the surgeon were calling all of these plays to try to rescue her massive transfusion protocols, the machine that pumps and heats gallons of blood at a time to transfuse to her extra IVs. being put in. And that's when I kind of snap to and realize, I need to give them these babies and I need to get out of here because I cannot help. Yeah. That was, that's the start of your your fatherhood journey. The start of my fatherhood journey. Wow. And then, okay, so she gets out

of the hospital after how long? So we were there seven days. Okay. You're home. And then, I guess, give me what Lindsay's point of view would have been on your behavior kind of day to day? Well, growing up the way that I did, I felt as though I had to control everything. And when my anxiety and panic would creep in, I wouldn't necessarily have labeled it that at the time, but it caused me to have this overdeveloped need to control things. and nothing more singular than the sleep routine, which for parents of young children, you know, is an area that's just begging to have people try to control it.

So she would say, I would say, I was trying to keep the trains coming on time because if the girls weren't sleeping, I couldn't breathe. She would say that I was sapping every last bit of joy out of being a parent, which is really just all she ever wanted. And so it created this tension between the two of us that that just began to boil over month after month. And just to give it a flavor so someone here can, someone listening can recognize it. Like, the babies have to go down now or that nap wasn't long enough or we messed that up or

what would it sound like? Yes, yes, yes. And worse than that. I mean, imagine, again, and it's COVID. And so stores aren't really open and people aren't really going or people certainly aren't coming to visit us. Right. And so our only way to experience joy with these children is to go.

for a walk in the park, maybe get a bag of potato chips and a beer at the one place that has outdoor tables in the neighborhood. But you know that the babies have to go down at such and such a time. In order for that to happen, you have to feed them and change them at such and such a time. In order to do that, you have to get home at such and such a time. Well, then you have to leave this place at a certain time. I mean, it just goes on and on and on. And it never stopped. And so if the precision of sleep, you're saying kind of became like the operating focus, everything was about optimizing for that. Everything was about just building this stack of spinning plates around making that perfect. And what's interesting to me, because I see echoes of this in my own life.

I don't have babies anymore, right? But just tell me if this makes sense to you where each individual factor makes sense in a vacuum. Okay, yeah, sleep is good. A schedule is good. And so that's true. You have to feed them at a certain time. That's true. You have to kind of change their diapers at a certain time.

Like all of these things are individually logical, but it sounds like somehow the accumulation of all of them was kind of joyless and more stressful than it was stress reducing. Oh, absolutely. Okay. Absolutely for her. Yeah. And then I think the tension, the fact that she wouldn't sort of play ball on this stuff, made it very difficult to relate and to co-parent

because here I was trying to make everything better and when she would kind of refuse and no no we're going to stay out longer we're actually going to do another lap I would then become kind of a jerk yeah what um and we'll get to that you guys were you guys had different worldviews

I feel like you were optimizing for different things she was optimizing for I may have another lap this is enjoyable sleep will I don't know, figure itself out, we'll be off schedule, it'll be on schedule, but I'm kind of trying to enjoy a moment. You were optimizing for controlling it in this way. So that I could breathe, so that I could stave the sharp, jarring, electrical jolts of energy that would go through my chest and my belly when I would have these sensations. And again, I think for anyone listening, we all have a mindset that feels like it makes sense to us. It gives us relief sometimes.

Sometimes. Sometimes, right? Sometimes the relief becomes part of the cycle that makes the anxiety worse. Oh, of course it does. Right, you're a psychologist. Right. That's how anxiety works, unfortunately. Solutions sometimes become tomorrow's problem, but it works for today.

But I think the shift starts to happen, at least in the marriage, when you kind of realize, we have kind of these different worldviews. One's not inherently morally superior than the other, but we're probably not just talking about the sleep schedule. probably not just talking about the sitting on the couch. We're talking about how each of our bodies kind of process stress and uncertainty. Well, and if you go even farther back before the birth,

all of the conflict between the medicalization of the pregnancy created tension too. And you could argue that it was the same underlying principle, right? Like, I needed to have all of the tests and the ultrasounds and all of the things so that I could feel as though, A, I was doing everything that I could do to shepherd these babies into the world.

as a physician. And it was kind of that same irritation earlier as after the girls were born of this sort of faux casualness that she would exhibit. And it's, I haven't articulated this out loud before, so I may not get it just right, but I'm trying to put the puzzle together and she's not even willing to sit at the table

and look at the piece Yeah. And so I think the sleep issues, you know, after they were born, were just a stronger version of the stuff from before they were born. So coming back to your story, your wife comes home one day and she diagnoses you, kind of in some ways. Or maybe that's the wrong way of saying it, but she has a framework. Tell me, what happened?

Well, that was a very difficult day for me. Yeah. And it was a beautiful day for her. She had been out on this run with a friend of hers through a gorgeous valley just north of the Golden Gate Bridge and inevitably complaining to her friend about me about all the things that I was doing to make her life miserable. And her friend said, God, it sounds like he's got postpartum depression, but as a man. And my wife said to her, men can get that. And I think the way she responded, I was like, sure, why not? And so they get back to the parking lot, they finally get some cell reception, and she's Googling this.

And she comes up with this list of symptoms. And it's not the things that you think of with depression in general or maternal postpartum depression with the sadness and the guilt and the shame. It's anger and irritability and conflict, drug seeking, risk taking. And she thought to herself, he has got all of these. So she comes home ready to have a talk about this as if she is now saving me. runs up the stairs, I think I know what's wrong with you. And I'm thinking to myself,

why does there now have to be something wrong with me? Why can't this just be terrible? Why can it be that I'm right about the sleep and you just need to tow the line and get on board so that we can have a peaceful life? But I eventually came around to the idea that at the very least, if I go talk to a therapist, I will be able to unload that to them. And that will make me feel better.

And between this day and when I could finally get an appointment with someone, because again, this was COVID. And it was a mental health crisis in the making. And it was not necessarily easy to find someone that had time in their schedule. But I did. And during that time frame, I think I came to realize, and part of it was my physician mom. mind, like, if there is a name to this, if there is something that I have, then maybe it can get better.

Maybe I'm not just a terrible father. Maybe I'm not just a selfish spouse. Maybe I'm not just an out-of-control lunatic. Maybe I caught something. And if I caught something, maybe it can get better. Okay. You just said something, you know, that I always think when we're in a marital argument, we're kind of just saying, I'm right.

And if you just saw it my way, it would all be fine. If everybody thought like I did, what a place the world would be. Turns out, it doesn't help things get better. But it is, we all have that wish. So what I want to do with you right now, because I want to go through this list of symptoms. And I'd love for you to tell me with each one, like, check, did you have it? Or like, no, not that one. But then I wanted to tell me a little bit in your day-to-day how it actually looked.

Because I think sometimes there's a gap with what, we think something will look like and then what it actually looks like. Honestly, that's such a great exercise. Anxiety. Anxiety was thing number one. And I didn't, I wouldn't have labeled it as such. I would have just labeled it as I'm being a responsible parent. Yes.

But I would be up at night. I described those physical jolts of electricity. I was even having palpitations and had to see a cardiologist. Like, why do I have this a regular heartbeat? Yeah. And so anxiety, absolutely. And just to go further on that, I mean, anxiety gets such a bad reputation, right? Like, anxiety is trying to be helpful, just to say, you know, to everyone here.

Anxiety is trying to be helpful. Anxiety increases our alertness because our body thinks there's something in our environment that requires extra attention, which, by the way, when you have a baby, this is true. Okay? So if someone said my anxiety level before I had twins and my anxiety level, after I had twins, straight line. I'd be, that's a little concerning. Like, you know.

But, you know, every time I would be confronted with something that I didn't like in this process, that burning and that pang of, of, of, of, of sensation, that's not normal. Well, I think that's, that this is exactly kind of some of the nuance. So do I wake up sometimes thinking, oh, have I fed my baby recently? That's, yeah, you want to wonder that. You don't want to sleep through the night and miss setting your alarm

or responding to their cries, right? But what you're differentiating also is things felt like a 10 alarm fire. Every time. Every time. And then your body just kind of probably gets short-circuited into that more and more often.

And the more tired you get, the more often it happens. And then it generalizes to lots of other things that are not threats if you want to think of it that way. right. Okay, panic attacks. I have those and they would manifest in the form of the rapid fire cycling of if this, then that, then this, then that. And if not this, then not that. And to the point where I just couldn't even stand up. Was a big feature of it how rapidly things, the spinning.

And the connecting one thing to the other, the certainty that this was going to happen and then that was going to cause this other thing. Mm-hmm. And an endless parade of problems borrowed from the future. Yep. Okay. Inability to bond. I think so. I definitely spent time alone with the girls.

And I would have thought that I was loving them. My wife will send me videos occasionally. And there's this one with Pia who still at six just can't not sit in my lap. And there's this great video of her climbing. I'm sitting on the floor. I've got my arms behind me and she's climbing. She just cannot help herself, even at whatever she was, six months, eight months, ten months. And she's looking at me.

And I don't even move my hands. I'm like leaning back on my hands and kind of looking around and we're having a conversation. And she's just like right there, you know, just looking up at me. So I clearly wasn't. And what do you think now she was looking for? I think probably to mirror back to her like what she was giving me. Yeah. And your mind was elsewhere?

I guess it was. Yeah. And I just want to name, I think this again is if your body is in hypervigilance mode all the time, you really think about if I'm in the forest and there are enemies all around me trying to potentially hurt my child, it would make sense that bonding with your child wouldn't be top of your list. You'd be like, I'm sorry, I'm protecting my child from threats.

I'm not like playing peek-a-boo, which would be smart. Like if you're playing peek-a-boo and there's bears coming at you, someone would be like, dude, stop. A very real threat in Northern California. Right, exactly. And so, again, that makes sense.

What probably, quote, doesn't make sense is there weren't bears. There were no bow and arrows at the time. But it explains why like bonding comes after assurance of safety of the most vulnerable, you know. That makes perfect sense now. Right. And so a protector is constantly scanning out to protect. Right.

Right. And so I just, I think it's so easy for all of us. We're so hard on ourselves. And that's not to say it's an excuse. It's not about excuse. It's an explanation that helps us understand something, which to me usually unlocks change. you were in hypervigilant scanning mode. All the time.

All the time. Anger. Absolutely. Absolutely. So it was mostly at Lindsay, at my wife. And it was over the disconnect between what I thought was important and what she thought was important. And it all comes back to we need to have a regimented orderly situation so that they can sleep so that I can breathe. The only time I was free of those physical feelings

was when they would be asleep. And I had to know they were asleep. And by the way, she also would not let us get a baby monitor. So I often didn't know if they were really asleep or not. I'd have to tiptoe around and kind of peek through the cracks in the door. Yeah. You guys were pretty far apart. And these kind of, you were like,

I would like to know they're asleep at all times. She's like, ah, monitor, shmonitor, right? And so. Well, and it's funny because we later spent some time at a friend's home that had, she had young grandchildren, and so she had a few rooms set up for them to sleep, and we were all enjoying time of the pool. And they had a baby monitor that was in use

in the room where our girls were napping. And the way that you stare at one of these things is insane. I mean, even Lindsay was like, see, this is why I didn't want one of these things. And by then, I was far enough along. I could be like, yeah, I kind of get it. Like, you cannot stop looking at this thing. You know what?

Any screen with endless information is an addicting thing for the human brain. I guess that's right. Right? And I think one of the things in the anger cycle that can happen is when we're in that hypervigilant mode and we think we have to do all these things just to assure safety, even someone you love. Like, think about you operating as if your baby is behind you, your six-year-old, whoever is behind you, and you think there's an army coming.

And she's letting the bears in. And worse, Lindsay's like blocking your view like, hey, honey. And you're like, get out of my way, you know? And someone would say like, geez, you're white. is like really, you know, like being annoying there, right? And obviously, there's no army. There's no bears, but I think... Instead, everybody loves her.

She's like the life of the party. She sounds very likable. She's not worried about the puzzle. Not worried about the puzzle. Or the bears or the army. But I think, again, that anger, when we are solely focused as if everything is a threat, anybody who we experience is getting in our way of having the full view of all the threats, we experience them as a threat.

Absolutely. anger kind of comes out. You know that time in summer when it's about 4 p.m. You've been with your kids all day. You're drained because you're driving them everywhere. You've made snacks 15 times and honestly you want something around them that just feels like yours. Now this is the part that gets a little serious, but stay with me. That's often a moment when a lot of parents reach for a glass of wine. And this is not a referendum on wine, but so many parents I know tell me I don't even want to have it. I don't like the way it makes me feel in the moment or the next day. But I think what the real need is, is that we are looking for something adult. We are looking to hold something that tells us,

I am not just a caregiver setting up a slip and slide and making my 19th meal of the day. And honestly, that's one of my favorite reasons for Element. See, you can use Element as your adult summer drink. It can be just yours, not for the kids. And then it's 4 p.m. And what you might be looking for isn't necessarily alcohol. You might be looking for something that just reminds you of you, that you're an adult, you're not only a caregiver, and you're allowed to have something of your own. Plus the fact that it's healthy, no sugar, and actually hydrates you is going to take you through the rest of the day and help you stay calmer while it still meets that need. You can check out Element at drinkelement.com slash good inside. That's drinklmn'tt.com

inside. Okay. Drug use. Well, you know, it was COVID and everybody was drinking more. And we would have wine with dinner. That's how I would say it, right? Yeah. But were people having wine with dinner every night?

We were. I was. Were people having a half a bottle, sometimes more? Were people out on the back stoop, huffing cigarettes? What's your understanding now of what? first, what was that doing for you? What was your understanding of, what's your understanding of that now? Well, the alcohol absolutely softened the feelings I was having.

Because, I mean, let's face it, you get a little bit drunk and you care about stuff less. And so in the short term, I think that was great. And I like wine. And we would have these meals. You know, Lindsay's sister at this point was living with us. And so we had enough bandwidth to have nice dinners after the girls. else would go to sleep. And so it was lovely, but I would drink too much every night. Yeah. And I think the cigarettes were just a woman. I mean, everyone knows tobacco and nicotine aren't a depressed. I mean,

they don't relax you, not really, but I think it's just the artifice, the ritual. Yeah. Yeah. Something I could control, something that could get me out of the house. Yeah. Yeah. Okay. Iridability. Constant. At constant. Yeah. Because of the conflict. Yes. And because of the threat and the threat mode. I think so. I think yeah. I mean, when you're in constant hypervigilant threat mode, again, I just think about someone who's saying,

I'm going to stand guard Becky and guard you 24 hours a day and I've been doing this for five weeks. I feel like they'd be pretty irritable, you know? Okay. And then risk taking an impulsivity. Tell me about that one. So for me, that was related to driving. So I would go to work.

So after, I don't know, four or five months of leave, I was back to work. And I was taking care of patients in the operating room. and the intensive care units. And that at first was like a break for me. Like that was, I knew I have six, eight, ten, twelve hours ahead of me where I just couldn't be responsible for anything. After two, three, four hours of work,

I would start to think, okay, well, what's going on at home? Is she getting them down for their naps? Is it going to be chaos when I get home? And inevitably, I would have to take the long way home. And that would involve twisty, curvy roads. And that sounds trite. I have a old manual transmission car that can go fast and do dangerous things. And man, I was in it.

And so for those four or five seconds where you were going so fast and turning so hard that you couldn't help it be immersed in that, there was this like release. But inevitably, the curve straightens and your focus turns back to what you're going to find at home. But those moments, those seconds were so addictive that I couldn't not keep doing it. And the drives got longer and longer. So I'm just thinking everything you've, I mean, you've, so many of those, you know, if I go back to my list, right? So anxiety, panic, inability to bond, anger, conflict, drug, use, irritability, risk-taking,

impulsivity, a lot of check marks and a picture on the surface that's very different from the person who just can't get out of bit. Yeah, absolutely. Right? And I just think it's so important that, you know, postpartum depression, anxiety, it can look like this very, you think about someone who's on threat alert all the time. They are high activation all the time, which also isn't doing good things. That's your body. Tell me a little, and I don't know if you've heard this, women go through so, your wife is going through so much.

Am I supposed to be sympathetic to you? You know, how am I supposed to process? that. It's almost like you're reading social media. Almost. Right. Well, it's true that, I mean, first of all, I'll be the first one to say, the time for a man to not have needs is right after their wife gave birth.

I will say that from the highest hill. And I'll really believe it. But what if you do? And I did. And my own belief is that. And again, as a solid, stoic midwesterner, that my job in that moment is to push it down as hard as I can and not create an issue for my spouse. But as a psychologist, you know that you can only do that for so long and it's eventually going to come out. I think there are a lot of people out there who feel like calling what men go through after their kids are born postpartum anything.

takes away from a woman's experience. And I don't know that I disagree. I mean, look, men have taken plenty from women and continue to do so in ways that are disgusting. But I keep coming back to the fact that by denying that something is happening, we're keeping people from getting the help that they need. And first of all, it should be obvious

to anybody looking at a family unit that if one person's impaired, they're all impaired. But the fact of the matter is there is scientific research showing that dads who have untreated depression and anxiety have kids that do worse across a range of academic and emotional spectra. And so we simply have to treat everybody. Yeah. Look, I'm a big believer, you know, to me, multiple things can be true. I think we've kind of lost the ability to hold on to that in a million ways in our country and our life. And so there's a lot of people who struggle before having a baby after having a baby, people who don't have babies, right? And so, and I think you're right that at the end of the day, it's about the health of the family unit.

That's right. For everyone. And so it's all about trying to optimize for the health of that unit. So you end up finding a therapist. I do. And yeah, tell me about how does that all go? Well, I had had some exposure to different models of therapy as a grad student. psychology, so I kind of knew what type of therapist I was looking for, like what sort of model,

right? I knew I couldn't have like a cognitive behavioral therapist because I'm just, I'm already too up in my head. I need to have somebody that was going to take my words and turn them into feelings and basically spit them back in my face and make me feel these things. But that isn't on the website. I mean, they don't say like, that's what I'm going to do. So we, you know, and when I say we, I mean, it was a family affair.

It was Lindsay. It was Lindsay's sister. It was me. We were online, like, finding websites. And Lindsay's sister, who actually, she has a great sense of people. She was one that introduced us and set us up. She found this guy. And you'd ask her now, she'd say, well, you know, his face looked really warm on the website.

But, you know, people have these senses of things. There had to be more truth than that. And we had our, you know, introductory phone call, like on a Tuesday. And I'm sitting on the stew. in front of our house or in front of our flat. And I'm just like, in about five seconds of talking to the sky, I'm just unleashing, just sobs of like, this is terrible.

And I need to not feel this way. I'm just thinking about how activated were and angry and in threat mode. But then how much pain, there was a lot of, you realized in that moment, I'm actually like, I'm in a lot of pain. You realize that? I think that it was so close to the surface that like one probing question, one,

in a setting that felt safe somehow, just let it all burst out. I mean, you think of this stuff, and there's so many analogies of pushing it down or the pressure cooker and the steam, but as soon as you open that cap, it comes out. And what is opening the cap look like?

And I think it's important to talk about this because part of the whole point of the book is like to get guys into therapy. Yeah. And a lot of men, I think, are afraid of what it's going to be like because they don't know and they don't want to share feelings with a stranger. All these different tropes about like what it would be like to go. And for me, there was just something about the way that he provided an environment that made me feel on some subconscious level that I could share these horrible, dark, awful things

in the presence of another man without losing my masculinity. Yeah. And that I could cry in front of this person, that I could be held metaphorically because again, it's virtual, right? By this other man and not feel like less of a man somehow.

Yeah. And that's what opening the pressure cooker felt like. And it just came out. Can you give that a little more detail? Because for example, like I know, I don't know again, I think maybe we'll get back to this. There are so many different types of therapy that sometimes such a disservice in the psychology department because I think about if the medical department was someone to say, you need to go to a

doctor and you like go to a dermatologist when you actually needed an oncologist. You'd be like, that doctor was awful. Like no, you just don't. Oh, that's super interesting. Of course they were awful. They were an oncologist. They're not an oncologist, but we have like really specific names and seeing someone who is a more dynamic therapist or more CBT therapist or a more internal family system or more somatic, you're going to get very different. And it's not, it's just a fit thing. But instead, people just find out they go to a therapist and there's like a black box around it. Well, that's super interesting. And I think the average person probably wouldn't. I mean, the average person knows if they have cancer, they go to an oncologist. Because we talk about

and there's less shame. And there's words around. And I'm sure that you're right, that the fact that it's quote unquote physical health and not mental health makes it easier for people to talk about in a way that they're now informed, right? But it's true. There are lots of different schools of psychotherapy and one would never know. And I only knew because I had been a graduate student in it and I knew what I thought I would respond to. I think once we were out of triage mode, once we were out of crisis mode, we could talk about what my upbringing was like. And there's some of it in the book, but look, I spent decades in denial about the impact that my father's abandonment had on me. And again, when you grow up the way that I did in that environment where stoicism and hard work

and I want to say a lack of emotionality is rewarded, that's what you do. And look, he was a yeller. He wasn't very fun to be around. And so it was really easy to say, look, we were, we were better off without him. I'm better off that he left. And I could say that for decades. It wasn't until this in the throes of my own fatherhood, fathering crisis that I, and as a part of therapy that I could finally admit that it impacted me, that it hurt me and that I hadn't gotten over it. Yeah.

Was that the whole story? Certainly not the whole story. Right. But it, I mean, imagine being abandoned at 10 or 12. or whatever it was when he really took off and being 46 or 47 when you could finally say, yeah, that was a big problem and that impacted me. That had an impact, right.

I think, you know, one of the things, if I were a therapist I'd be interested in, is certain events have high impact potential. A parent leaving a house has high impact potential. But to be honest, I'm always more interested in how an event gets processed in someone's childhood, than just the event itself. Because to me, it's an event plus how it gets processed.

That's the thing that lives in our body. There's this cruel irony. We name things as symptoms in adulthood that were adaptations in childhood. Like, oh, I learned that was an adaptation. Now it works against me. Well, you know, like anxiety is only the perfect solution to a number of problems, right? Yeah. And that's a great point, and that it's something that is an adaptation, something that's a strength.

A hundred percent becomes a weakness. And then I think, you know, to me, good therapy starts, in some ways the understanding comes with massive appreciation for that part of you, for that part worked really hard and was really crafty. It happens not to be useful in 2026, but I think we can all understand that kind of the parts of us that helped us survive in the early years are a little hesitant to. give themselves up, you know? It got me pretty far and it got me as far as it could. And now as a father, all I can think of is, how the fuck did this guy do that? Yeah. Like I look at my kids and people have as, well, why didn't you and why didn't you leave?

Why didn't you flee this anxiety? This source of something that's causing you so much pain. You could have left. And I'm sure, but like relive this generational sin for lack of a better word. And the guilt of doing to them what was done to me, I just, I couldn't. Yeah. It just, it never, it never sat with me. It never fit.

And then I'm just thinking about how easy it is then postpartum. Like, yeah, maybe, maybe some things feel a little extra activated or this, you know. But if part of what you had to do to cope with hard things in your childhood was develop a little bit of a, oh, but this is fine. Maybe it's not a big deal, right? we're a little late to the game to notice our own changes because in a way being a little late to the game was something we learned and was kind of adaptive to not put it all together back then. Absolutely.

I'm learning a lot. This is great. No, I just think it's really interesting to me. And I think, and you do such a good job kind of saying, you know, being an advocate for self-reflection and therapy for a group of people who haven't always sought it out. But it's really the process of trying to figure out why where you are. today actually makes sense. And make sense never means permit. It doesn't mean allow to continue, but you have to understand why things are the way they are. Like very basically, if I'm going to be a

good basketball coach, I have to understand why my player is missing all their layups before I help them make layups. Like if I don't understand why they're missing it, for all I know for a year, I'm going to be teaching them something they already know and isn't the problem. Which is why the therapist gets around to question number 20 and comes back your mom comes back to mom and dad 100% it is back to that um okay so take me to today take me to your relationship with your girls now what's changed well i mean can you say everything it's so first of all i'm calmer and i'm calm enough day in and day out to be able to attend to the way in which i need to behave around them and by that i mean you know my parents were yellers. And I think part of how I ended up was was the response to that terror that comes

from a parent who's sort of out of control. And so I can, I have enough wherewithal now to be that parent for them, to be the one who can respond in a way that's calmer and more loving and more more protective and productive. It's fun now. I can, I mean, I was on, I, I, I, I, I, I, I, I, I, The rest of my family is on a vacation right now that I'm joining them on in a week or so. They're in Spain with another family. And I'm FaceTiming with them. And they're doing things that if this had happened before, I couldn't even be on the phone. Like they're off an island and they're doing the waterboarding is the right where the paddleboard.

You should be worried if it's waterboarding. Get that. Get that worried part back. And the snorkeling and the late dinners and all the stuff. And it's like it's so it's so fun to watch that and to actually wish that I could go earlier and be part of it. And so I would sum it up like that. Like I actually want to be in their lives. I miss them.

And I want to be part of those spontaneous otherwise anxiety provoking events like being in the ocean and things that I could have never done before. Here's the thing I want to emphasize right at the end of this conversation. The part of our conversation we were talking about the difference between therapy and seeking medical help really, really is staying with me. Because this is actually something I've said to friends for a while. Imagine you have some type of medical issue that you really need an oncologist for, and you just look up great doctors and you end up in a dermatologist appointment.

Well, that dermatologist could be the best. dermatologist in the world, but it's not going to help you if you have an issue that dermatology isn't equipped to help you with. Therapy is often confusing for people because it feels like a black box. And there are people trained in very, very different ways. And most of the time, we don't even know that. You might have just heard that for the first time. There are so many ways to get educated about this. Like I said in the conversation, there are probably good questions you can ask to the internet to get more information. But also, when a friend says to you, I had a great therapist, you can ask that friend, hey, do you know what kind of therapy that therapist practices?

I'm trying to learn more about this. Or if you're referred to a therapist, feel free on the phone to say, hey, I'm just learning that there's many different type of therapies out there. Could you tell me a little bit about how you were trained and how you tend to work? I'm trying to make sense of the right modality. You are definitely allowed to be an informed consumer. I would say you should be an informed consumer. You're about to share a lot of your life with someone and be vulnerable enough and brave enough to get help. And so please do ask those questions. All right, let's end the way we always do. Place your feet on the ground. Place a hand on your heart. And let's remind ourselves, even as we struggle on the outside, we remain good inside.

I'll see you soon.