HealthyGamerGG - Dr. K Diagnoses Your Favorite Characters

Episode Date: May 16, 2026

In this episode, Dr. K explores the psychological profiles of iconic fictional characters like Eren Yeager and Joe Goldberg before sitting down with an expert for a deep dive into the reality of Obsessive-Compulsive Disorder (OCD). He examines how trauma, stunted development, and personality disorders manifest in media and what these portrayals can teach us about real-world mental health. What to expect in this episode: Eren Yeager and Moral Injury: An analysis of the trauma of being forced to commit "vile acts" and how dehumanizing others serves as a survival mechanism to avoid falling apart. Joe Goldberg’s Limerence: Why the star of You is a terrifying example of limerence (falling in love with a fantasy) combined with sociopathy, leading to a "morality of a pedestal" that ignores actual empathy. Michael Scott’s Stunted Development: How the Dunder Mifflin manager acts as an "alien trying to be human" because he lacks a healthy template for relationships despite being world-class at a specific skill like sales. Saul Goodman and the Gambling Brain: A look at why some brilliant individuals fail to learn from their mistakes due to a deficit in counterfactual thinking and a drive to prioritize a "flashy fantasy" of success over actual stability. Levi Ackerman and Clinical Thresholds: Why being obsessively clean does not necessarily mean someone has OCD if they lack impaired function and ritualistic compulsions. Expert Guest Dr. McGrath: Dr. K is joined by Dr. Patrick McGrath, a clinical psychologist with over 26 years of experience specializing in OCD and Exposure and Response Prevention (ERP) therapy. The Reality of NOCD: An introduction to NOCD, a specialized online platform for OCD treatment that has been vetted by the Healthy Gamer scientific advisory board to provide evidence-based care. The Doubting Disorder: Dr. McGrath explains how OCD attacks the things people value most—such as religion (scrupulosity) or children—by using "what if" scenarios to trap individuals in a loop of searching for answers that don't exist. Living with Uncertainty: Why the gold standard treatment, ERP, focuses on teaching the brain to accept doubt rather than providing logical answers that the "OCD monster" would otherwise "eat for breakfast". HG Guide and Research: A first look at the new Guide to Love, Sex, and Relationships and the introduction of "QI" surveys designed to measure real-world mental health outcomes for the community. Dr. K's NEW Guide to Love, Sex, & Relationships is here! Order now: https://bit.ly/4dO3x0VHG Coaching : https://bit.ly/46bIkdo Dr. K's Guide to Mental Health: https://bit.ly/44z3SztHG Memberships : https://bit.ly/3TNoMVf Products & Services : https://bit.ly/44kz7x0 HealthyGamer.GG: https://bit.ly/3ZOopgQ Learn more about your ad choices. Visit megaphone.fm/adchoices

This episode is brought to you by FedEx. These days, the Power Move isn't having a big metallic credit card to drop on the check at a corporate lunch. The real Power Move is leveling up your business with FedEx intelligence and accessing one of the biggest data networks powered by one of the biggest delivery networks. Level up your business with FedEx, the new Power Move. Hey, chat. Welcome to the Healthy Gamer Gigi podcast. I'm Dr. Al-Ocinoja, but you can call me Dr. K. I'm a psychiatrist, gamer, and co-founder of Healthy Gamer.

On this podcast, we explore mental health and life in the digital age, breaking down big ideas to help you better understand yourself and the world around you. So let's dive right in. All righty, chat. Let's get started. Welcome to another Healthy Gamer Gigi stream. My name is Dr. Aalo Kanoja. Just a reminder that everything we discussed on stream today is not intended

for medical advice. Everything is for educational and entertainment purposes only. If you all have a medical concern or question, please go see a licensed professional. Yeah. So, today we're going to be doing

some fictional character diagnosis. I know we're getting a little bit of a late start. And then we're going to have a guest coming in in just about 40 minutes. Apologies for the late start. You know, basically what happened is I'm a professional stream.

This is what I do for a living now, theoretically, not really, sort of, a little bit. And then one would expect, as a professional streamer with an amazing content team who makes these kinds of things happen. One, see, this thing is blurring, but I figured out, I figured out that I have to lean in, and then it'll resume. You would think that we would, we would fix these things, but literally what happened is, like, the headphone jack broke off. off. And so we had to fix that. But thankfully, I used to build my own PCs, so I know how to fix a couple of things. And then we've got an awesome team that helps. We're going to be hearing from our team a little bit later, but we're going to do some fictional character diagnosis. Before we do said fictional character diagnosis, we need Solid Snake in Dante Sparta,

diagnose a character that has a gambling addiction. You guys need to tell me who the character is. and then I need to watch said anime. I need to bill my boss, Gruthi, who is CEO of Healthy Gamer, for my time watching anime. And then I will, yeah, so we're going to do Walter White. Walter White's on the list. Let me show you guys the list real quick.

Okay? And then y'all start spamming. Not quite yet. I'm going to show you all the list. You guys think about it. Think about it. and then then

when we after we do announcements we'll decide okay so leaning in okay

no no okay Uzimaki Naruto Uchihasaske Ashaaske Aaron Yeager Levi Ackerman

Harry Potter Severus Snape Michael Scott Dwight Shrut Creed Angela Martin Batman Walter White

Skyler White, they were like, hey, we need to do Walter White. I was like, Braz, you got to have Skyler. Jesse Pinkman, Saul Goodman, and Joe Goldberg. My preference is going to be Joe. Joe is the only one that I want to do for sure. So these are our options for today. And then y'all let me know who else you want. Okay?

And then before we get into that, though, so y'all decide. And we're not going to do a poll or anything. gonna just, y'all are going to randomly spam chat. And when you randomly spam chat, we're going to decide based on that. Okay. Um, but don't spam chat yet. Let me do my announcements chat. Calm down. You guys are already any Jojo character. Okay. Jojo's bizarre, I, I, uh, Joe's bizarre, I, Jojo's bizarre adventure is so bizarre. I watched a few episodes of it and like, uh, yeah, we get, we did a squid game diagnosis. Yo. You guys know that? We did that. We did that. Like four years ago, we have that.

Okay, let me do, let me do, let me do my announcements. Okay, listen, we're going to speed run these. We made a guide to love sex and relationships because, hey, we can diagnose fictional anime characters all day long, but at some point we need a real relationship with a real human, okay? Speaking of real relationships with real humans, so we've got this counter here at the bottom. All right. We're trying to sell guides. So here's our thing.

I know other channels do sub-athons. Other channels will raise money, things like that, right? But like our thing, we don't do sub-athons and stuff. The reason we don't do sub-a-thons is because I don't know what y'all get to sub. I don't know what you get. So a big part of what we do here is we try to build stuff that we believe is helpful for you. And then if y'all are going to give us money, you should get something in return.

Right? So we may do donation drives and things like that down the road. I'm not saying we're never going to do that. But a big part of what we do is like, we're here to help you. And what you guys need help with is getting into a relationship, improving your relationship, getting laid, et cetera. So we hit our 4,000 goal. Thank you guys so much for all of your support.

If you guys know someone who's struggling with relationships and you've already bought one, send the guide to a friend. You guys can do that now because people ask for that, right? the most subtle form of help and or burn that you can do is to send them a copy of the guide. Hey, bro, I think you need this. So if we hit 5,000, we're going to have a V-Tuber stream. I don't understand what that means. I don't know what this is, chat.

I don't know what this is. But that's what has been decided by the powers that be. And then these other stretch goals are because we at H. want to do stuff. We've been, we've presented at the Canadian House of Commons. We've gone to the White House. We've done some work with the UN counterterrorism unit. We want to start publishing some of our research and academic journals.

We're going to talk about that at the end of the stream today. We want to grow the HG Institute. And I have a vision for an app finally. Everyone's like, why don't you build an app? Build an app. And I was like, why? Why? What does the app do?

Now we actually have stuff that we think that will be helpful. if delivered in an app form. And that is basically an evolution of some of the things that we already do like community events. So let's accept cookies. So the heart-to-heart community event we have going on,

you all can join on the Discord. We are going to start by writing a postcard to your future self, get honest with yourself, get brave. So set boundaries, be voluntary, be vulnerable, have the conversation, get closer. We're going to nurture connections and sharpen your social skills and then keep growing, right? So then at the end of the event, we don't want to just disappear into the ether.

We want you guys to actually like continue growing. And so these community events have been incredibly successful. Like we've done like the touchgrass campaign a while ago. We did a write in the fields campaign, which improved people. people's emotional awareness and reduce their elixothymie and things like that, name their emotions, sit with emotions, all that kind of good stuff. So there's like content that we do. We educate y'all, which is fun.

But we also want to build stuff that will help you. Okay. So now I'm going to turn to what do y'all want? So, okay, people who are saying Luffy. Okay, so I don't know how many episodes. episodes of One Piece do I have to watch to understand Luffy's psychology? Can you all tell me this? One?

Nice. Sounds like his character development arc is fantastic and full of depth. Okay, Ang from Avatar, the Last Airbender, okay. So Hunter X Hunter is on my list. So I want to watch that. Okay, they don't have to be, by the way, they can be fictional. They don't have to be anime bros. Okay, you guys want to do Aaron?

Let's do Aaron. Okay. Do the horse. Okay, I'm going to do Aaron. All right. Aaron Yeager. Okay, so here's the thing with Aaron. Okay.

So if we look at attack on Titan, so let's start by like doing a quick summary of Aaron, okay? So defined by, oh, I can do Ted Lasson. You guys want to do Ted Lasso? Oh, man. We can do Ted Lasso. Okay. So, Aaron is like... Okay, so let's just talk about Aaron for a second, okay?

All right. Erin Yeager. So is a part of this? Oh, I'm blurry again. My face is blurry. Okay. Let's talk about Aaron. So Aaron is a kid.

Okay, so there are going to be some spoilers. Okay, chat. So if you guys haven't watched Attack on Titan, there's some spoilers. So Aaron is injected with some stuff, right? And then Aaron grows up when he's a child, he experiences a lot of trauma, sees his mother, I think, being eaten by a Titan. And then they're in this ensconced little area, right? And then there are all these Titans and the world is a very scary place. There's a lot of trauma, okay?

And then what happens is as Aaron starts to become heroic, he's. starts to become more powerful. He has more power. He realizes that the Marlians are the bad guys. And so then he's going to inflict upon them the pain that has been inflicted upon him. Right. So he's kind of got this sense of vengeance. Okay. But it's not really vengeance. I don't think he wants vengeance. So we're going to, I'm going to show you guys. So there's, form of trauma. So Aaron has been traumatized. Okay.

But I think the most interesting thing about attack on Titan is how there's no way to get the train off the tracks. Okay. So if you listen to Aaron, he's like, you know, even when he's talking to what's that guy's name, the armored Titan, right? And he's like, look, you guys came here to try to destroy us and like you didn't have a choice. Like you were just doing what was supposed to be done because remember the LDians are like evil people, right? We're the bane of existence. So Marley was concerned because we've got a bazillion titans in our walls and we can release the rumbling. So you showed up here and you did really bad things for the right reason.

You didn't have a choice. Okay, Reiner. Okay? And so if we look at this, there's a lot of definiteness. There's a sense of powerlessness. There's a sense of lack of control. Like, we're not really responsible for our actions, right? We're not allowed to say no.

The world exists in a way where you're doing what you think is right. I'm doing what I think is right. What I think is really fascinating about this is how this has been explored psychiatrically. So there is a new form of PTSD that got basically like got sort of finalized in the DSM called moral injury. Okay? So these are individuals who are exposed to traumatic events that violate their moral values

may experience severe distress and functional impairments known as moral injuries. Over the last decade, moral injuries captured the attention of mental health providers. So, hold on. Okay, I'll just explain it. So basically there's a new form of trauma. I mean, this has always been there. But there's the trauma of having something done to you that is traumatic. And then there is human beings being forced into situations where they have to do bad things.

Right? So and when, so we see this a lot with like soldiers, right, who go to some of these war-torn places and you like shoot some of guns because, or you launch a missile or whatever, you're like bombing something with a drone, and it turns out that it was supposed to be a military target, not a military target, turned out to be civilians in there, and now you have become the bad guy. And this is traumatic. This is like really damaging for you to be forced into the role of bad guy. And now the interesting thing is, if we look at moral injury, it's a form of PTSD that is debilitating. Okay, so the really interesting thing about Aaron is that is he debilitated? Is he mentally ill? Is he non-functional

because of what has been happened done to him traumatically? And this is where like I remember I was in med school actually. And I also have a master's in public health. So I was in a dual degree program. And one of the most shocking things that I remember learning in, in my MPH in med school, was that everyone who goes through genocidal conflicts does not have PTSD. which is a weird thing. Right? So when I was in residency and stuff like that, in Boston, there was a large population of, I think, Cambodian refugees. And so, like, if we look at, like, refugee populations, not everyone has PTSD.

And the question is, why not? Right? The intervention, the thing that they experience is the same. Everyone is running away from genocide. Some people end up debilitated with PTSD. Some people do not. And I think what's actually really good about attack on Titan, I think it's actually a psychologically in-depth anime

because it shows what someone has to do to not fall apart from the trauma that they've been to. And one of the scariest things that I've seen for people who commit vile acts is the justification of, I don't have a choice. Right? So in order to not be hurt by his moral injury, because when you do something evil, because this is what's so confusing, you'd think that, oh my God, Aaron, his family, his friends got eaten by Titans. They were hapless victims of the aggression of somebody else. You would think that in that situation, and we see this in attack on Titan, right? We see that some people on Aaron's team have compassion for the Marlians. And they're like, hey, bro, they did this to us. Killing innocent people is bad.

How about we don't do that to them? And what's really interesting is, so that's one way. So this is what I think is fascinating about attack on Titan. It's like when you have a genocidal conflict, what are the different psychological ways that people respond to this genocidal conflict? And this is what's fascinating as a psychiatrist, right? When I work with people, something bad happens to you. How do you rise to that occasion? How do you adapt? How do you respond? I mean, literally, how do you adapt? So adaptation number one is,

hey, this is bad. This hurts. This is bad. Let's not do it to anyone else. Let's have compassion. Option number two is vengeance. Right? This is like, you hurt me, therefore I want to hurt you. The reason I'm hurting you is because you hurt me. There's no sense of like overarching moral stuff beyond, hey, eye for an eye. You deserve what you get. But that's vengeance. It's a very noticeable. It's a discreet motivation that some people have.

I'm going to do this because it's vengeance. But what we see with Aaron is something else. So when he's committing bad acts, right, so there's a moral injury diagnosis that could be made here, but he doesn't have because he's not impaired. He's not non-functional. He's the opposite. He's hyperfunctional.

And how does he attain that hyper functionality by dehumanizing? Hey, Reiner, you didn't have a choice. I don't even blame you. There's no desire for revengeance, right? Reiner did all these bad things. Is he angry with a Reiner? Not at all. He does not walk the path of Uchihazasake.

He's like, no. Actually, I don't blame you. And here's the beautiful thing. Here's the really scary psychological thing. If I don't blame you for doing bad things, guess who else? I don't have to blame. Not my fault. I'm about to do some terrible things.

And this is just the way of the world. This is just what happens. Nothing can be done. Okay, I haven't seen the end of the anime, so I need to watch it, but into season four. I'm like episode 12, season four. So this is what's going on with Aaron, right? So I think we're seeing a moral injury kind of picture. But the way that he responds to this evilness, right, is by saying, hey, like, I'm not

responsible, you're not responsible. No one's responsible. And that is a really, really powerful way. I've seen this. And it's like, you know, I saw, you know, I don't even know what the right word is. A heavy episode of South Park with where I think it was Jimmy starts using steroids. And then he starts becoming abusive. And then he's like, why do you make me do this to you?

Right. So what's really scary about abuse is that what people who commit abuse, which is, I think, what we see in Aaron, what they will do is they will depersonify, depersonalize themselves and the other person in the relationship. Why do you make me do this to you? You know, I don't want to do it. You're making me do it. I understand this is wrong.

I can't control myself. It's really, really scary. Like, sitting with these people is one of the creepiest experiences I've had as a psychiatrist. Because what really scares me when I sit with these people and it's kind of like sociopathic, okay, which is another thing that we can talk about with Aaron in the second, is that, like, you kind of get the sense that once this person makes a calculation, if I'm on the wrong side of that calculation, there's nothing I can do to change their mind. I have no protection from their empathy. Like they won't think that this is wrong. Or even if they know that's wrong, they, wrongness will not

affect them, which is where we get to another really interesting aspect of when people get traumatized, why do they respond in different ways? So if we look at sociopathy or psychopathy, this is a scale. Okay? So we'll say like, okay, this person is a sociopath. The reason they're a sociopath is because they're high up on the scale of sociopathy. So they're in the top fifth percentile. Okay?

So if you look at human beings and if you look at the features of sociopathy, one of the features of sociopathy is a lack of empathy. The inability to feel what other people are feeling. So I think what we see in Aaron is someone who has some degree of sociopathy. which, by the way, is like somewhat genetically inherited, which we see from his dad, right? Imagine how sociopathic you have to be to inject your child with Titan serum, right? There's like a streak of some real madness sociopathic kind of stuff in there somewhere. So when you have a certain personality makeup and you get exposed to a genocidal experience,

depending on how that cookie crumbles and the decisions that you may, make in your mind, you will end up with Aaron Yeager. Right. And this is the work that I do. And this is why some people like, is why I'm actually hopeful being a psychiatrist. Because there's a decent chance that you have a personality makeup. Maybe you're a little bit more prone to rejection sensitivity. Maybe you're a little bit more sociopathic.

Right? Maybe you're a little bit more narcissistic. You have a personality temperament. And then as experiences happen to you, we make automatic. interpretations. We arrive at conclusions, but the whole point of psychiatry is that those conclusions are not actually set in stone, that you can reevaluate and reinterpret. The conclusions that you come to, Aaron comes to the conclusion that bad stuff happens, there's nothing we can do about it. We are all lifeless people who are basically on this train. We have no agency. And yet look at what he does.

Look at how much agency he exercises and look at how much agency he believes he has. And this is what's really scary when it comes to things like relationships, right? Is we actually have a ton of agency. But if we don't believe we have agency, then there is no controlling our destiny. Right? So I think it was Carl Jung who said, until we make the unconscious conscious. I forget exactly. Let me figure out what the quote is.

Hold on. What's the quote? You know this one? Until you make the unconscious conscious, it will direct your life and you will call it fate. So this is what's really scary when I work with stuff. And we cover this kind of stuff in the guide. Right? There's a lecture on like anima and animus and some of these Jungian perspectives because sometimes in relationships you can talk about, you know, the dopamine and the oxytocin and stuff. But sometimes like we have to talk about this deeper stuff.

And what's happening with Aaron is he's got a lot of stuff going on in his unconscious, but he's faded. Because he's not aware that he's actually making choices. He's making huge choices. He's making catastrophic choices, but he's not consciously, it feels like he doesn't, he feels out of control. And this is what's really scary about trauma is when we experience trauma, we learn that we have no agency.

You'll get that? So when Aaron is watching his mom be gobbled by a smiling, Titan, right? When he sees person after person after person that he knows and loves, he learns that he has no agency. And this is what's scary about trauma. Once you have that conclusion, you carry it forward. So when he was a 12-year-old boy, he had no agency. When he's the founding Titan who consumes other Titans, he has a ton of agency.

But in his head, he still believes he was that thing. He's a 12-year-old boy trapped inside the founding Titan. And he doesn't grapple with the fact that he actually has immense power now. And so he calls it fate. This is the tragedy of trauma, is that you actually have way more power than you even realize because you're not the person who got bullied in school. You're not the person who is financially dependent.

You may still be financially dependent, but financially dependent at 14. and financial dependence at 24, when you actually have a lot more agency than you realize, right? You are a different person. And just like Aaron, and this is why I like attack on time,

because I've worked with like literally dozens, if not hundreds of patients, who my job is to teach them that they are not the person that they used to be and that they have more control over their life than they realize. And we'll see. I need to watch the end of attack.

on Titan, so maybe I'll have a different answer. But, like, we'll see, you know, if he discovers this in some way. But so that's what's going on in there. I think it's a beautiful case of trauma, moral injury. So there's one, so I want to talk about Joe Goldberg for a second. So I think Joel Goldberg is a good example of a principle that we talked about with Aaron. So if you guys haven't seen you, I think it's a great show. So spoilers for the show, okay?

Not like two big spoilers, but you sort of figure this out early. So Joe Goldberg is someone who's a stalker, right? And he falls in love with people. So I think Joe Goldberg is a really good example of when we diagnose a person, the shortcomings of using a single diagnosis. So there's something called limerence. Okay, we have a whole video about limerence. Limerance is super scary.

Limerance is when you develop this idea of a person. And that idea is so encapsulating. It's so beautiful. This person becomes a fantasy. They're a fantasy embodied on the earth, on the planet. They're an angel who has come down from heaven. And if you look at people who are stalkers, we'll get to stalking in a second. If you look at limerence, the idea behind limerence is someone has this vision of someone

who is perfect in so many ways. And the really frustrating thing about limerance is you look at this person and your brain tells you, oh my God, this person is amazing, they're beautiful, they're the person that I need. We fall in love with this idea of a person. We fall in love with a fantasy of a person. in a big feature of limerence is that we actually don't oftentimes interact with them in a how can I say we don't interact with them much so in some cases of limerance that I've seen you'll literally meet someone once and then for the next like eight years you'll be fantasizing about

how this person is amazing okay and then you start to build this fantasy in in your head about who this person is the other really scary thing about limerance is as you engage in a relationship with them, they become a real person. And the limerence disappears and can actually transfer to another person. This is common. So limerence shifts. The research suggests that limerence shifts every like eight to ten years. Within eight to ten years, your limerence will move on to a different person.

So it's really scary if you've got limerance is you may actually succeed in stalking them, dating them. They enter into a relationship with you. But then as they become a real person, that fantasy shifts to somebody else. So here's the cool thing I think about Joe Goldberg, is that limerence is something that happens to you. It is not who you are. But depending on your personality makeup,

if you have limerence happen to someone who is sociopathic, you get Joe Goldberg. He's not just a sociopath. He's not just limerent. And this is what's kind of like fun and exciting about psychiatry is like it's not just one thing. It is like if you develop limerence, if you stick limerence in a sociopath, it looks one way. If you stick limerence in someone with dependent personality disorder, it looks another way, right? That's a much more classic picture of someone who feels or avoidant personality disorder.

Or narcissistic personality disorder. Or limerance in a borderline personality disorder. Joe Goldberg is limerance in a sociopath. So when he has that limerence, his personality, I don't know if this makes sense, he feels attracted to them. He has a fantasy about this person that anyone can have. Anyone can fantasize and have limerance about a particular person. But then his personality organization, how does he organize around the limerence? That's the sociopathy.

He starts following them around. He has no empathy for them, right? And this is what's really scary. Like, it's kind of scary. like a lot of dudes and women that I've worked with will be deeply in love with someone. Like, oh my God, this person is amazing. But what they're in love with is the idea of a person. They're in love with a vision of a person, not a real person.

And so this is what confuses these people is because they're like, I do everything right. I'm so kind. I get them flowers. I'm there for them. I'm there to pick up. I have, I express a lot of positive affection. I express love. I express patience.

I express compassion. I do everything right. I honor them. I worship them. I sacrifice for them. And why don't they love me back? I'm doing everything. All of these stories that we have about love. Sacrifice, love, this, that, right? This is what someone, if you really love someone, this is what you do. You give him a kidney. You pick them up from the airport. You answer the phone at midnight, 10 in the morning. Oh, blurt. There we go. This is what you do. I'm doing everything right. Why don't they love me back? What's wrong? I don't know what else I can do, right? What you're doing wrong is there's no empathy. How does the other person feel? How are they responding to what you're saying?

Is there space for another person in your head that is full of fantasy? Does another real human being exist? He has no empathy for them. He has a cognitive empathy. he can predict what they're going to do. He knows how his actions are going to make someone feel, which is why he engineers these scenarios that make people feel a certain way, right? And then they get a flash because they have empathy.

So then at some point the scariest thing happens is since they have empathy, they see him. And when they connect to him, it's empty. They begin to realize, oh my God, this person doesn't, like literally when he looks at me, he doesn't see me. He sees a vision of me. Right? And Joe Goldberg is a great example if you guys see the later seasons, right?

So he ends up in a relationship with kids. And then his limerence immediately transfers to somebody else. Show has to be written by someone who's either experienced limerence or work with people who have limerence. Really good. But Joe Goldberg is when you have limerence in a sociopath. So then he's willing to do anything for the sake of preserving his fantasy. He has no moral compass at all.

He thinks, he feels, if you ask him, do you have a moral compass? And he's like, yes, absolutely. I will do anything for this person. I will kill. I will bury. I will stalk. I will ignore their desire to, I will chase them all over the world. Right?

So he feels like he's got a, it's like a weird kind of morality. It's like a morality of a pedestal. But it's not like real morality. He's not real empathy. He doesn't actually, he's like, even when people are like, get the hell away from me, he's like, oh, I don't want to hurt you. He sort of fantasizes everything gets twisted by his, like, obsessional thing, right? So even if he, he doesn't genuinely understand that somebody wants distance for him, he's willing to make that sacrifice for the person he loves. He's willing to deprive himself of his own joy and passion as a sacrifice for the one that he loves.

So this is real narcissistic parent level stuff. Oh, yes. Oh, my God, it's not that I'm toxic. It's that you're so distorted in your thinking, but as a mother, I have to sacrifice for my baby no matter what, even when they're wrong. So if you need to cut me off, I will bear that cross. And I won't, oh, my God, I'm a victim,

but I will bear, I will be put on the cross of sacrifice for you. I'm going to be, they're telling you, hey, you're violating my boundaries all the time. Please respect my boundaries. And they're like, no. Instead of respecting your boundaries, what I'm going to do is twist your boundaries into an astronomic sacrifice on my part. So I become the good guy and you become the ignorant, pathetic bad guy.

Which, remember, if you guys know, this is kind of an older system of diagnosis, but there's a system of a personality diagnosis that involves something called Cluster B. And sociopathy and narcissism share certain features. So we see that in Joe as well, but he's more sociopathic than narcissistic. Make sense? Oh, wow. We've got a raid of 1,916 people, Bose. Thanks for the raid.

Welcome, everybody. Appreciate it. We are doing fictional character diagnosis. And we're going to have a guest in about nine minutes. So, and it's going to be an expert on OCD. So if you guys are interested in that, stick around. It's actually a sponsored portion of the stream. So, and we're doing fictional character diagnosis for now.

And we just did Joe Goldberg. Give me a second. Hello? Oh, no, it's on Bluetooth. Hello? Okay. Okay, does that work? Are you sure that works?

Okay, great. Okay, gotcha. Okay, all right, bye. So we're going to continue doing fictional characters for a little while, okay? So for those of y'all that have just come, let me show you guys what the options are, and then we'll do whatever. Raiders get to choose, okay? Fictional character diagnosis, we're, so we've got Naruto, Saske,

we just did Aaron Yeager. That's moral injury, and that was a great one. Levi Akraman, Harry Potter, Severus Snape. Michael Scott, Dwight Shrewt, Creed Bratton, Angela Martin, Batman, Walter White, Skyler White, Jesse Pinkman, Saul Goodman, Joe Goldberg. So we did Joe. Okay. Raiders. So we're going to prioritize Raiders, okay?

So Hal Wilkerson. Joe's diagnosis, I'll explain to you all, because y'all are here. Raiders, Levi. Okay, we're going to do Levi. and Saul. Okay. Okay. We're going to summarize Joe, though.

So Joe has limerence. Okay. But he, so remember, limerence is something that happens to you, but he's a sociopath. So he's a sociopath with limerance, which is like the recipe for the worst stalker on the planet, the scariest stalker on the planet. And so this is where, you know, a lot of times when people talk about fictional character diagnosis, they'll be like, oh, this person has this. We will think of their diagnosis as unidimensional. But one of the things that I love about this is some of these characters are written really well, and it's not just one diagnosis.

This is a really great example of limerence in a sociopath. So he has features of sociopathy. He can kill and dismember people. He can people that he loves. He can keep them in a cage for days on end so that they can be together the way that they're supposed to be. So there's love of a sort, but it's not generally. genuine love, it is limerent love. And the other key thing about Joe is that when he finally ends up with the person that he has

limerance with and doesn't have to butcher them, then his limerence transfers to somebody else, which is a really common feature of limerance. Okay? All right. So you guys, okay, Saul Levi. Let's do. Okay. Oh, my God.

Okay, we can do, man, I don't know who to do. Okay, just I'm going to, Michael, it looks like people are saying Michael. Okay, we can do Michael Scott. Okay, so Michael Scott's diagnosis is going to be a little bit strange. So I think he's actually a really good example of someone who is developmentally deprived. Okay. So his core problem, so,

So we can look at Michael Scott, right? So he seeks validation. He's hypersensitive. He's hyper sensitive to the opinions of others. He wants to be everybody's friend. He wants to be a cool kid. But what's his problem, right? Does he have social anxiety?

Not really. Does he have borderline personality disorder? Not really. Does he have anxious attachment style, sort of. But his real problem is developmentally. stunted. That's Michael's problem. So if we look at Michael, one of the core features of Michael, so he loves relationships. He's all about relationships. He's all about connecting with someone, being someone's best friend. I love inside jokes. I'd love to be a part of one one day.

So what happens with Michael is he does not have an actual template for what a relationship looks like. he doesn't know what a friendship really is. He doesn't know what a healthy relationship is supposed to be. So if you look at Michael, his big thing is he tries to live his life based on the idea of what a life is supposed to be. So if you look at like, you know, he's like, oh yeah, I got a flat screen TV and it's like tiny. And he's like, oh yeah, people, humans like flat screen TVs. Flat screen TV, good. Let me check that box.

Inside joke is something that humans do. Let me have an inside joke. Check that box. And the really interesting thing about that is that, you know, he has this idea of what a relationship is. Relationship is loyalty. Relationship is togetherness. And Dwight is there offering it to him. Let's be best buddies.

Let's be together. And he rejects him time and time assistant to the regional manager. Right? So this is a case, this is what happens when kids grow up without the appropriate upbringing. They don't know, they don't have a template for what a real friendship looks like. We don't know too much about Michael's upbringing, but it seems to me like he's severely deprived. Probably didn't go to birthday parties.

Probably wasn't socialized properly. This is like kind of Romanian orphanage stuff where many years ago there were a bunch of Romanian orphans that got basically like they didn't have sufficient caregivers so that while they were fed and stuff like that no one could play with them no one could interact with them and they were just developmentally stunted he doesn't know how to be friends he's like an alien trying to be human that's his biggest thing right so if you look at the way that he relates to people why does he put up with who's that guy packer why does he put up with jan right these are people who are abusive to him and he craves their attention.

So people will say this is low self-esteem. Sure, low self-esteem is a part of it, but it runs deeper than that. What is the origin of the low self-esteem? The origin of the low self-esteem is that he never had connections to begin with. He doesn't know what a real connection even looks like. So he has this idea, okay, Jan's got big tits.

So I want a relationship with this person. Todd Packer gets laid a lot, is misogynistic. That's a real bro. Right? Whereas he has loyalty chasing after him in the face of Dwight. But Dwight doesn't fit his image. So he lives his life,

trying to live up to images of what relationships look like. And he chases those things. And that's what becomes so hard for him when he's in this like basically toxic relationship with Jan, it takes a bunch of women to kind of tell him time and time and time again,

like, hey, this is not normal, this is not healthy. Right? And she like sells his car and starts a candle company and like the dinner party thing, which is one of the scariest episodes on the planet, really hard to watch, really shows what he's looking for. He's looking to be something great. He's looking to be respected, looking to be admired. That's why he does Scott's Tots.

Right. So this is a good example of he doesn't know what a relationship even looks like, really, because when he has the opportunity for them, he kind of messes it up. And when he has the relationships he engages with are based on his idea. of a relationship. And this is something that's like really challenging because like, you know, we talk about the sum in the guide to love sex and relationships where, you know, we all, like one of the biggest problems with like dating and mating and making friends today is that we are all trying to live up to our idea.

What do you want? I want six feet, six figures, six inches. I want 32, 15, 32 or whatever. 36, 14. I don't even know what they are, right? This is what I'm looking for in a woman. She needs to be subservient. She needs to be this.

We don't, we, we have this idea. It's like Michael Scott is a, is a profit of what the world will become. And now we're there. We have these ideas of what friendship are. We have these ideas of what relationships are. We don't even know how to form genuine relationships anymore. So instead of what we do is we have criteria instead of connection, right? It's really scary.

Like this is just one of the interesting things that when I was doing research for the guide, right, where we explain all of this stuff, like how does an actual relationship form? So staggering, mind-blowing statistics. And I'm not talking about percentage of people who are virgins. Here's mind-blowing statistic. I'm going to ask you all a question. How many hours of contact does it take to make a friend? What do you all think?

Welcome, chat. Right? So some of you all have been maybe paying attention, right? Some people are saying one, two, three, five. So the average amount of human contact to become friends, according to research, is 50 to 200 hours of contact. Now, there are absolutely situations where you meet someone at an anime convention. And you're like, oh my God, brother from another mother, sister from another mister. We're like instant kindred spirits, and I felt those connections too.

But if you look at the research, this is why everyone's like, oh, go to like join a hobby group. And like, I joined a hobby group two months ago. I go once a week for two hours. I still don't have any friends. And it's like, yeah, if you go for two hours once a week, that's eight hours a month, that's 16 hours and two months, you're not even at the minimum. It takes 50 to 200 hours of contact. contact. That's the other thing is you don't have to have some sort of interaction. You need to be around each other. So if you look at like making friends at work, you make a friend at work after you go

at the end of the month. You're at work for 40 hours a week. About six weeks into work, you make a friend. That's completely normal, right? We don't make friends like within the first week. Sometimes we do. But sometimes, oh, like, yeah, we've been working together for about three months. That's when we started hanging out. And it turns out that we're like actually really, then over the next year, we became BFFs. So a lot of stuff around dating relationships, how this stuff forms, it's like, we don't know the science behind it. So like once you understand what really creates relationship formation, that's what we're trying to help people with. And Michael Scott would benefit from the guide for sure, right? Because we would teach him the fundamentals of how do you make friends?

What is an inside joke? How do you flirt? Right? Michael doesn't know how to flirt. Like what is the, we've got a stream coming up science of flirting. Now we're going to teach people like how to flirt. He needs to be, he's actually the quintessential. He's the one who needs to watch it. We could have helped Michael a lot. But that's his, that's his diagnosis. I think he's developmentally stunted. So his sense of self-esteem, his, he's not like he's like a 40-something year old dude, right? But he's not a 40, he doesn't act like a 40-year-old dude. He's developmentally like 19 or 20 or 21. He's like a freshman in college.

That's what Michael is developmentally psychologically. Developmentally stunted is his diagnosis. And the cool thing about Michael Scott is that you can be developmentally stunted in one direction and still be amazing in a different dimension. So he's been a salesperson for 20 years and he's grinded sales and he's leveled up sales. Sales is a specific skill that he's really good at, right? which is why he can close deals like nobody else, has one of the best.

How can someone so incompetent have such a successful branch? It's because he's a beast at selling. He knows how to sell. And even what's really interesting in the show is when they show him selling things, he is a different human being. He's not the same Michael Scott. He's like a completely different human being.

That is also really common in people who are developmentally stunted. Just because y'all are 30-year-old virgins doesn't mean that you aren't amazing at something else. You can be incredibly competent and proficient at League of Legends at Minecraft, at Dota 2, and suck at something else. Okay? All right. Who do you all want to do next? Levi?

Okay, let's do Levi. Okay. we're going to do Levi and Saul let's see give me a second let me just see how long we have you guys want to do Levi or Saul

yeah there's a guest coming but I think we're since we haven't gotten through enough we're going to start a little bit later okay Saul we can do Saul it feels like people want to do Saul okay Saul is interesting okay oh man

so I haven't seen I'm maybe on season three or four a better call Saul so I think Saul is the quintessential survivor. So first thing about Saul is that he grows up in a situation where there's a golden boy and a black sheep. Right. So he develops a sense of identity of, and this isn't just him. This is his older brother too, right? There's the person who's really, really good. And then there's Saul. There's the high-powered attorney, and there's the guy who's this Jimmy, who's only good at

delivering mail. Right. So Saul, first thing to understand is that from like an IQ perspective and capabilities perspective, Saul is just as good as his brother. Right. He's got the gumption, he's got the intelligence, he's actually brilliant. But he's been told that he's not. So Saul is a really good example of what, like maybe he's got ADHD, I don't know, but I think like I've seen this a lot with like ADHD, right? Where it's like, the scary thing if you have ADHD is you can have normal IQ, you can have high IQ and you can even recognize that you're just as smart as everybody else. But you've got a deficit. You've got in the case of ADHD an attentional deficit. I don't think Saul necessarily has ADHD. His frontal

developed more slowly. That's absolutely something that he's got, right? So we look at Saul, what happened early is that he's impulsive. He takes risks. He doesn't think through things. He gets enamored with how things could go instead of really gauging the risk of how things could go. Right? So he's like, he sees the glass is not half full.

He sees the potential of the glass being completely full when it's only 10%. full. He bets on the long odds. So if anything, like, he's probably got some combination of frontal lobe developing slowly, right? So he makes poor decisions. He may be almost like a little bit of a gambling addict, right, where his, like, risk threshold is really low. Like, he'll take big risks and hope that things work out well. And this, too, can be related to his upbringing. Because when a child is not given love, support, and respect. Sometimes what they can do is fall into dreaming. And this is Saul's biggest problem.

He has dreams. He has dreams and a poor ability to assess risk. So he's always like he's a big dreamer. I'm going to be with my brother working at the law firm. I'm going to go to night school. I'm going to be the good. I'm going to be the golden boy. He has an image of the golden boy.

And if I work hard and if I do this, I can fulfill my dreams. My dreams is going to be the respect of my brother. I'm going to no longer be the black sheep. I'm going to be a somebody. I don't want to be a nobody anymore. And so when you combine this golden boy black sheep, right, this creates the idea of a dream. I want to be, I don't want to be this. I'm going to bridge that gap.

And then what you do is you take that idea and then you add his like basically gambling addict kind of brain, frontal lobe impaired brain. Ability to assess risk is impaired. Ability to see upside is also impaired. He only sees the upside. So then he makes a lot of bad decisions. But he's smart. He's adaptive.

He's capable. He's scrappy. Another feature of ADHD, people with ADHD thrive in cable. So I don't think he's got ADHD, but he's got, he's like subclinical ADHD, maybe. Where once things get chaotic, right, normal human beings are overwhelmed by chaos. But Saul is resilient. He finds a way. He'll slither to where he needs to go. Okay?

So, and this is what's really cool about Saul, right, is he is capable, he's brilliant. And so even though he kind of like create, like his story is one of creating these situations for himself and then he squeezes out of them. And then he creates them again and he squeezes out of them. Saul is a really good example of someone who doesn't learn from his mistakes. His capacity for, this is a really interesting, he probably has this deficit too, counterfactual thinking. There are two features that we're going to talk about, counterfactual thinking and something called error, error-reward processing,

a reward-processing errors. Okay? So our brain has a capability where when we make a mistake, it goes back in time and hypothesizes an alternative future. Okay, so a really good example of this is, you know, when you get a meal from your waiter, a waitress and they're like, enjoy your meal and you say you too, or when I do this, I'm boarding my flight and the gate agent is have a good flight and I say you too, they're not going anywhere.

They're not eating anything. So I make a mistake. And when I make a mistake, my brain tortures me that night. Oh my God, you're so stupid. Why did you say that? They're not going anywhere. That's not bad. That's good.

That's how we learn not to do it again because we feel stupid about it. So there's this capacity in our brain that when we make a mistake, we thought something was going to happen, and it turned out something else was going to happen. So our reward prediction error. We predicted a certain reward. We didn't get that reward. So then our brain is like, wait, hold on a second. We miscalculated. We need to adjust our calculation.

And people who struggle with addictions, this part of the brain doesn't work well. Which is why, like, when they lose a bunch of money gambling, like they just wake up the next day. and they do it again. Right? So he's kind of like this closeted, gambling addiction kind of person. So his ability to learn from his mistakes is not great. He learns some things, but he doesn't learn some of the fundamentals,

which is like, hey, Jimmy, just do things slowly. If Jimmy learned patience, his life would be so much better. And then we see another thing with Jimmy, which is that he doesn't want to be patient. Right? And this is the real scary thing. There is what makes us successful, and there is our vision of success. And Jimmy is attached to his vision of success more than he is to actual success, right?

He wants to do it flashy. He wants to do it impressive. He wants to do it. He has this opportunity to be a partner at a law firm, and they recognize, they recognize, oh, my God, this guy is brilliant. We're going to make you partner. You brought in this huge case. This is really amazing work. Here it is.

Everything that you wanted. Respect, support, money. Here it is. On a silver platter. We recognize your ability. And what does Jimmy do? Sabotages. And so this is where I'm going to try to explain this.

It's really important to understand because this happens all the time. See, we have certain psychological needs. And what happens is we think about solving those psychological needs through external behaviors. So what does Jimmy want? Jimmy wants the respect of his brother. That's what he wants. Right? And right now in the manosphere, because we're talking about dating and relationships and sexy.

Right? This is a sexy me. I see this all the time in terms of relationships because we, you know, when I work with some people and they'll be like, okay, you know, I'm a virgin, therefore I'm a loser. and if I get laid, that means that I'm a winner. I want to be an alpha. I don't want to be a beta. So what starts to happen is we have a psychological need. I feel like a loser.

And we equate it to an external performance. Okay? So if I get laid, that means I am a good person. That means I have value. A man's value is his body count. Right? So we have some of these attitudes. But do you guys see how the basic issue here is that there's the action up here and we are associating that action with a psychological need down here?

This is what Jimmy does. And then what happens is even if you get that thing, it doesn't solve the psychological problem. And then you end up sabotaging up here. See this all the time in relationships. You are looking for the relationships. So there's a video that we have about, you know, what basically, what are the real problem? are the, not red flags. What are the risk factors for an unhealthy relationship? And one of the key risk factors is the moment that we use a relationship to satisfy needs that are outside

of the relationship. So relationships can be a great form of self-esteem. They can be a great form of like financial support. Right. But the moment that we start dating someone because we need them, for self-esteem. Because in order to feel like a successful person, I need another human being. Now there is a pressure on the relationship that transcends the relationship itself. You are bringing something to the equation. And if you all have been, if you all have dated someone who's done this, you felt the emotional baggage, the pressure.

You're like, hold on a second. You are wanting me to be all of, like, you're trying to turn this relationship into some vision of your dreams. We're like, that's not what this is. I'm a human. You're a human. We have something beautiful here, but you can't turn this thing into some dream. Like, it's not working. Like, you have some fantasy that you're trying to play out. This is what I'm trying to say. You have a fantasy that you're trying to play out in this relationship. And Saul has a fantasy. He's trying to play out in this job. And so the really cool thing is we

feel trapped in these situations, right? Because nothing makes me happy. This is where the cool thing, this is a great thing. This is a psychiatrist. What do I do? I help people with psychological needs. we actually solve the psychological needs without the surface level actions. Right? So I help people develop a sense of self-esteem and confidence without getting them laid. And then the really cool thing

is once we solve those psychological needs, then the stuff up here starts to work out because we're not putting that extra pressure. We're not self-sabotaging in terms of behaviors. because we feel fulfilled in here. There's a beautiful quote that I saw today. I was reading a book about trauma and the soul. And it's written by this guy named Kalshed.

I don't know. K-L-S-C-H-E-D. It's K-A-L-S-C-H-E-D. And one of the things that he's a psychoanalyst, and one of the things that he talks about is that relational problems must have relational solutions. emotional problems must have emotional solutions. If a right brain has a problem, right brain has to fix the problem.

You can't fix a right brain problem with a left brain solution. There's no amount of intellectualization that will substitute for feeling loved. Core thing. And so for y'all out there, this is what's so scary about relationships is if you've got a psychological hunger, if you've got a psychological need, if you have a need for self-esteem, build that. thing on your own. Relationships can be a very important part of it. I'm not denying that. That's one of the most important places that we get self-esteem is from our relationships.

But his biggest problem is that he's got psychological hungers that need to be addressed. And then he's got some constellation of poor risk assessment, poor ability for counterfactual thinking. He doesn't really learn from his mistakes. thrives in chaos. That's Saul Goodman. Questions. Okay.

Yeah, so your girlfriend is 10 years older than she's making you a better, smarter man? Great. Right. So I think there are romantic partners are oftentimes amazing sources of self-development. Like, I certainly know that my wife made me a better man. Right? So what happened with my wife, like my story is really simple. She had her stuff together, and I did not.

She started working at the age of 16. Her first job was Pizza Hut. And she has been working since she was 16. She took one year off. Maybe she took a year in college off, but otherwise she had internships and things like that. She was like doing PR for authors and things like that when she was like a sophomore in college. And she took one year off from her job when we had our second kid. But she's worked since she was six.

16 years old, earning paycheck. Like, was supporting me financially when I was, like, 25 years old. Like, not, like, paying my bills and stuff, but, like, when we went somewhere, like, she would pay most of the time. Right? And then, like, she, like, didn't dump me, and I was, like, I wasn't doing anything. I was just failing to get into medical school. That's what I was doing.

And I was starting to become a monk and all that kind of stuff. So I was, like, doing stuff, but I was, like, not a functional adult man. And so then my whole thing was like, okay, she deserves better. And so I started like working my ass off, you know? And it's like, so she helped me become the man that I am today, for sure. I don't know if she, I'd say that she made me the man I am today, but she certainly helped. Really supportive. And the other thing that really blows my mind, I was thinking about this.

She never gave me a timeline, which is insane, dude. Can you guys imagine? She was never like, hey, look, if you don't figure your stuff out in the next two years, I'm out. Never. Not once. Was she like, you have to figure it out? Otherwise, I'm moving on to something better. She kind of like went all in really early.

And it was insane when I think about it. Yeah. So, and I think that's where, like, you know, when I think about some of these things and I think, about love and relationships and stuff like that. You know, I made this YouTube video a while ago about how red flags are actually like not the worst things in relationships. It's so interesting because working with my patients, one of the most interesting observations I've had is how many healthy relationships I've seen that have a red flag.

Like, fentanyl addiction. Right? And so a lot of times, like, and this is what's really cool about some of these relationships. is like we think about relationships as sort of a calculation. Right? So if red flag, I'm going to bail. Whereas I think what makes relationships really successful is not the presence or absence of red flags.

I think there's a lot of research that supports this. Right? And I'm kind of one of these people that like believes in love. And so what we try to do in the guide is we try to show y'all, okay, like how does all this stuff work from a scientific perspective? I'm not saying that it's 100% guaranteed or things like that. But there's a lot of good science about what makes, what creates love in a relationship. We just talked yesterday about, you know, friend zone and stuff like that. And like a lot of people don't realize that a lot of the stuff that you do in a friend zone, actually, a lot of the ways that people behave in friend zones where they think that someone is going to develop feelings actually is not biologically how people end up falling in love with you.

And a TLDR for that is falling in love is about. shared emotional experience. And oftentimes in the friend zone, we don't have a shared emotional experience. Right. So your friend who you're in love with is going through a breakup. They're feeling really sad and you're feeling really supportive and deeply in love. But you're not feeling sad for, you're not feeling the same sadness they are, right? You guys don't share emotions. You are supportive and they are hurt. Or you were resentful and they are content. Right. So there's a fundamental emotional mismatch. And the people who transition from friend zone to relationship zone are people who end up creating shared emotional experiences. And the example that I talked about yesterday is husband and wife are married. Let's say wife passes away. Wife's sister and husband are both grieving and they fall in love. Really common. So shared emotional experience is what creates love.

And when I sort of think about my wife and I, like, you know, we had a lot of shared emotional experience. That was a huge part. We still do. And that's what really sustains love. So anyway. All right. So we're going to talk about Levi. And then we're going to hop in with Dr. McGrath.

Okay? Yeah. Fentanyl addiction is a red flag. I want to be clear. You're correct. It is a red flag. But I think there are some red flags that are not deal breakers. If I observe healthy, successful, long-term relationships, many of them had a red flag very early on, including mine.

Mine had two. I'm going to what they are. Well, one was me, which I've talked about, which is like, This guy is 25 years old, makes no money, is applying to medical school. Where's the green? This red flag has no career. That's a red flag for a 25-year-old, right? No?

Okay. Trauma bonding. Yes. That's what helps people fall in love. Okay, let's talk about Levi. Okay, so everyone says Levi has OCD because he's very obsessed with cleaning. Right? And I think Levi is a really, really, really good example.

of clinical thresholds. So Levi will get bent out of shit. No, actually, he gets upset. Like there's this, you know, image of him where he's got his, his sword or whatever, his blade. And it's like covered in blood. And he's like, this is disgusting. And when he, when he, you know, has this house, he or this fortress or whatever, right? So he has all of his pupils, like basically obsessively clean it.

So he's obsessively clean. Okay. Does Levi have OCD? And we'll ask Dr. McGrath if he's familiar with Levi. But, you know, my take is that sometimes we forget that a diagnosis involves impairment of function. So everyone has some degree of anxiety. That doesn't make it an anxiety disorder.

Everyone has fluctuations and mood. That doesn't make us bipolar. So the first question that we have to ask ourselves if Levi has OCD. So is he clean? Yes. Is he obsessively clean? Yes. Can he put himself in dirty situations?

Also yes. Does he regularly put himself in dirty situations? Also yes. Does being in dirty situations impair his functions? Absolutely. not. He is grossed out by Titan blood on his sword hilt, but he will chop Titans right, left, and center all day. Right? So I think he's a really good example of sort of like subclinical OCD tendencies. Is he somewhat of a germaphobe? We don't actually know.

So this is where I think there are like other features of OCD, right? Is he willing to share food with someone. Like maybe. It's not super clear that like, you know, he's clean and he's obsessively clean, but he doesn't seem to have an impaired function. Right. So he can, he can get dirty without a problem. Whereas some of the people, you know, I once worked with a patient with OCD or not worked with a patient, but I was learning about OCD from an OCD expert in residency. And they were telling me about a patient that they had worked with where like this person was so scared of insects that they started to like dig a moat around their bed. And then they filled the moat with like toxic stuff so that insects could not physically

crawl across. So Levi, I think is a really good example of someone that when people say sees OCD, I don't think he is. I mean, is he obsessively clean? Sure. But I don't get the sense of compulsions, right? So this is where a lot of people don't realize that a compulsion is. some kind of ritual you either do in your head or in the outside world that alleviates the

thinking in his head. I don't think we see that with Levi. So I don't know if he meets criteria for OCD. What we're going to do is hop in with Dr. McGrath and we'll see, we'll learn a little bit about OCD from him. So let me just hop into this call. Welcome, Dr. McGrath. So Dr. McGrath is here from OCD.

This is a sponsored section of our stream. I just want to tell y'all a little bit about our experience with NOCD, and then I'd love to hear Dr. McGrath talk a little bit about it. So, you know, we don't take sponsors often, y'all, but, you know, we'll sometimes get approached by people. And NOCD was actually reviewed by our scientific advisory board, which is full of psychiatrists, therapists, academic people from, we've got awesome people on our scientific advisory board.

and they were very impressed with OCD. So part of the reason that no CD, part of the reason that we accepted the sponsorship is because we really do believe that no CD is offering specifically OCD treatment and that there is the number of clinicians who are well trained in specifically OCD treatment is pretty small.

And so no CD seems to really be filling that gap. And we're happy to have sponsors on the stream that I think fulfill our mission of like making mental health better on the planet. So thank you very much, Dr. McGrath for being here. I know we've got like a set of questions, but can you just tell us a little bit about yourself and no CD? I'm a clinical psychologist. This is year 26 for me of treating obsessive compulsive disorder with exposure and response

prevention therapy. I've done it in various settings from hospitals, intensive outpatient, partial hospital, residential treatment centers and I came over to NOCD six years ago to help jump start their teletherapy network because of exactly what you said there is a problem out there which isn't that there aren't enough therapists it's that there aren't enough therapists with specialized treatment for certain conditions and obsessive compulsive disorder being one of them so that's really what we do at NOCD is we offer a specialized care called exposure and response prevention therapy for people with OCD and related conditions because you see other things come with OCD

like anxiety, depression. You'll see body focused repetitive behaviors like trichotillomania, which is hair pulling or skin picking, even ticks and hoarding too. Okay. Thank you so much. So I know we just did this like fictional character diagnosis thing. I know you have some thoughts about how OCD is portrayed in the media. Can you tell us a little bit about that?

It is more than washing your hands, I would like to say, first of all. That is not the only way that OCD comes about. And it also isn't just straightening things. But I think in almost any movie where there's a suspenseful character who's about to go kill a bunch of people, they walk past something and it looks a little out of line and they pause and they put it back where it needs to be. Right. And you see that a lot. And I think that it's trying to say that OCD is related to some of these things.

So I'm happy to talk about what it really is for sure. Yeah, I just wanted to double check. So we're getting a little bit of microphone issues. Do you know if you're on the right microphone? Yeah, I was the one that we tested yesterday. Yeah, this sounds fine now. It just seems to be like kind of coming in and out. But so no, no, no problem.

I just want to make sure that people can hear your awesome answers. So, you know, you were saying that there's, you know, people talk about washing hands. What does OCD look like? The way that OCD comes about is it attacks something that's really important to you. So if, let's say you love children, it could say, well, maybe that's because you want to molest children. And that's something we call pedophilic OCD. Maybe you are a very religious person. And OCD will say, and maybe that prayer you just said wasn't quite right.

And therefore, you're probably going to an afterlife that you don't want because you don't. just goofed it up, right? OCD always attacks important things. Maybe that was a speed bump, but it might have been someone walking and maybe you just ran somebody over. It might be best if you drive around the block and look for the dead body to see if you just killed somebody, right? These are the types of ways OCD very commonly attacks people. I'm going to just double check with chat because I'm still getting a little bit of mic problems. Can y'all hear okay? Or? Are we getting...

I hear him fine. Okay, great. Chat audio is good. Okay, so then it's just my headphones, so we're perfect. Okay. Okay. So you said that OCD specifically seems to focus on things that people care about. Absolutely.

You wouldn't have OCD about something that didn't bother you. That just wouldn't happen. Yeah. So, you know, I've had a lot of... I've had some experience with some pretty severe OCD. And I think one of the things that I've seen with my patients is that they're very perplexed. And they make almost like moral judgments about themselves based on the thoughts that they have. So I had a patient who had very inappropriate sexual thoughts.

And so he was really plagued by like, not just why this is happening to him, but he almost seemed to be making or theorizing conclusive. about himself? He's like, what is wrong with me that I'm like thinking these kinds of things? Sure. Who hasn't had an intrusive thought or image or urge at some point in our lives? And when you don't have OCD, you're very good at going, well, that was weird and letting it go.

When you do have OCD, you're very good at reading into it, wondering why you had it, what it meant about you. Maybe you're a terrible person. You better do something to undo it. if you don't and that thing happens, then you're a terrible awful person because you could have done something and chose not to do it. So wouldn't it be best just to try to neutralize these things? And the more that we try to do neutralizations through safety behaviors like compulsions, the worst people start to feel because you get stuck in this just loop where you're chasing,

a dog chasing its tail, right? You can never do enough compulsions to satisfy OCD, and OCD will always raise the bar to get you to do more compulsions. Yeah, so can you explain to us how does, why do people do compulsions, right? So I get that if you start doing compulsions, the obsessions actually increase. And then you're kind of stuck like washing your hands a second time, third time, fourth time, right? But can you tell us a little bit about how a compulsion helps? Right? So the idea is that it reduces the obsessional stuff, right?

But how does that work? In the moment, it's a behavior or a mental act that we do to try to bring about some relief from whatever that obsession was. It might only last for a millisecond or two, and then we feel the terribleness again, so then we do it again. But the whole purpose of the compulsion is to try to neutralize whatever that obsession might have been and allow a person to feel as if, okay, I purposely did something to try to make. sure that thing didn't happen because if I didn't do it and that thing did happen, how terrible would I have been that I didn't take a moment to try to undo that thing? Yeah. So how, I mean, do you have a sense of how that works?

How do people kind of get into that cycle? Like, what's the mechanism of, you know, almost like the magical thinking of like, unless I pray this way, the plane is going to crash? It could be so many things, right? There are people who, I can give you one example of someone I know personally. personally, was in New York a couple of days before 9-11 and thought, wow, imagine if a plane hit one of these buildings. That was just a random thought that they had, right? And then a few days later, boom, it happens. And now, you know what they wondered? Did I manifest that? Did I bring

that about? Was that my fault that that thing happened, right? So you can have coincidences like that. And when you have it, you think, huh, maybe I have powers or magical thing. you know, my thoughts are magical, right? They can do things. We call that thought action fusion, thinking something is as bad as doing something or can influence the occurrence of something. And because of that and the powerful thoughts that I have,

maybe I better make sure that they don't have that power. And so I'll do something to take the power away. And there's the compulsion. And are there particular things that you find that people don't, so I'm sort of thinking about the subjective experience of OCD, and some of the patients that I've had with OCD will be like, they'll describe it as anxiety, right? Because the subjective experience will be like they're worried that this thing is going to happen. How does, what are some of the common signs that someone has OCD that oftentimes

patients aren't aware of? Well, they'll spend so much time in their head trying to think their way out of something. So, and this is important to talk about because most people don't realize compulsions can be mental. Because TV often portrays them as washing your hands or locking the door, people only think in terms of physical compulsions. But there are people who are just stuck in their head for hours trying to figure something out. I for once went out of the office late at night and someone I had seen that morning was sitting in their car still. And I thought that that was very strange. And I went over and it turned out they were reviewing our session for the last six hours and they were wondering had they said this, then I would have said that or had they told me

enough about it because maybe now I'm treating them for something that's not quite right. So you can spend hours just trying to figure something out. But of course, because OCD's nickname is the doubting disorder, you're never going to get it to a point that it won't doubt it because the nature of OCD is to doubt it. So you'll see people stuck in their head. You'll see people who will be doing things that look to you like it's ridiculous. There are people that I've been in a parking lot with back when I was doing more live work who are laying on the ground looking under their car and they're trying to find the dead body. And they want me to get down on my knees and look under the car too. And there's no dead body under the car.

But they'll spend an hour or two just trying to make sure because they don't even trust their own senses well enough to believe that there isn't something there. OCD is really driven by two words. And those two words are what if, followed by the worst case scenario. you can possibly feel. So I consider OCD to be a what if disorder. And one other thing on what you said, the DSM kind of got it wrong on OCD because it talks about anxiety or discomfort, but it's also driven by shame, disgust, guilt. Any emotion that is so uncomfortable OCD will use in order to drive you to do a compulsion. So, so I mean, you're using a really interesting language. You're saying OCD will use.

So you're almost like personifying it, right, as if it's its own entity. Can you say a little bit more about that? Yeah, I mean, it's outside of the logic that you and I use. When you and I are having a conversation, we're using a certain level of logic. OCD uses a different logic, which always has one more, yeah, but what if, then we can give an answer to. So we can't have a conversation with OCD where we'll come to a conclusion because OCD will always want more. So I talk about it like that, that it's this other thing that says, no matter what you give me, it's not enough. No matter what you tell me, it's not good enough.

I still need more. It's like filling a bucket without a bottom. You'll never get it to the top. Wow. It kind of reminds me. I have two kids, and they've recently gotten into this why thing. I don't know if you've seen that before, but you know, what did they ask you a question, you give them an answer? And they're like, why, why, why?

And so how does someone know, I'm trying to really wrap my head around this, right? So it makes perfect sense that there's always an additional what if, which is why you will spend hours thinking about something. And no amount of thinking will ever do the trick. How does someone know which, whether OCD is in the driver's seat of their mind or they are in the driver's seat of their mind? That's a question that people with OCD want to know, but it's not actually the most important question because I will never give you an answer that will satisfy that question. It's so self-referential. It's like kind of reminds me of an MC Escher painting where there's no answer. So how do you address that with patience?

We talk about teaching people to learn to live with doubt and uncertainty, which frankly all of us do in our life. You know, I have no guarantee when I go down the stairs after this interview that I won't fall down the stairs. I will make it to the bottom. It might not be in the most painless way. It's a possibility that something could happen. So I accept that doubt and uncertainty. And OCD says, yeah, that's fine because OCD isn't concerned about that. So we're just going to help you learn to live with the question. So one thing I've said recently everybody is, my job is to help you live with questions not to give you answers. Interesting. And so I imagine people are quite reluctant to engage with that solution, right? Because it feels somewhat unsatisfying. Yeah.

And how do you navigate that with people? Well, we talk about all of the things that OCD has done to their life so far and how much time they've spent searching for answers and how they've never actually achieved it. And the idea is maybe the search for answers and the lack of achieving it is a sign that there isn't an answer to give you, but there is another way out of it. So you can choose to fight OCD two ways. You can go up against it and lose every time. Or you can choose just to say, yeah, okay, whatever, and move on and live your life. And that's what we want people to do is learn how to do that. It's not that you won't have an obsession ever again in your life, just like if you have an addiction you've been treated. It's not that you won't ever have urges or cravings

in your life. You'll just learn to live with them and to live your life even though they're there. And so what does treatment look like? So it sounds like you do exposure response prevention? Yeah. Yeah. So it's two parts. Purposely people to their obsessions, which is the exposure. And the response prevention is teaching people how to not engage in what OCD wants you to do and all the safety behaviors and compulsions that it wants you to do. And that's the difficult part, but that's the curative part, right? You can expose people all day to things, but that's not curative. OCD is constantly exposing you to obsessions. If that cured people, they wouldn't need therapy, right? They were just always being exposed. You have to teach people that once the obsession

occurs, you have a choice. And the choice is do the safety behavior or compulsion or do the response prevention. And we want to take you down the road of response prevention so that you learn how to live life with OCD instead of trying to satisfy OCD. And can you share with us like what does what is the subjective experience of successful treatment look like, right? How does what and you may not be able to say because you can't see into your patient's minds but I'm wondering if you have kind of an idea of you know what is being in their head look like after they after treatment starts working Sometimes they're shocked because they're amazed to learn that not everybody is thinking 24-7 about all of these things.

That blows their mind that people aren't always trying to figure something out or answer a question and go down these rabbit holes. So sometimes the quiet is actually really weird for people when they stop engaging in what OCD wants. and they start to recognize, unfortunately, and it can be kind of sad, how much they've lost of their lives trying to satisfy the unsatisfiable. So it's not uncommon to also see some depression with OCD. Why? If you think about what's the definition of depression, one, I feel depressed or two, I've lost interest or pleasure in things I once enjoyed. If OCD attacks things that are important to you, it attacks the things you love and enjoy.

Well, what if you stop doing those things now because of OCD? now you're going to feel pretty down because you don't have those things in your life anymore because OCDs attack them. So we're often also helping people deal with the depression that can come with this and help them start to do behavioral activation. Go back outside, live your life, do things that you used to do that you haven't been doing anymore because now hopefully the influence of OCD on those things is decreased significantly. Yeah. So I mean, I'm really appreciating. I see this a lot. I have, I mean, I've treated a fair amount of OCD, but, you know, I think patient population-wise, I'd say less than 5% of my patients have had OCD.

And, or at least that have been a major part of my active treatment. So one of the things that I, it's really interesting to hear, because I see this a lot with, like, ADHD, where, you know, it comes with a comorbid depression. It's like the illness itself, the constant, there's the illness itself, and then there's the consequences of the illness on your life, which are almost a separate thing that has to be addressed. Yes, for sure. And there's also with that sometimes a frustration with the entire mental health system. You know, we have people come in and say, well, I was on Zoom and I was told I couldn't have OCD because my house is messy. Well, you can have OCD and have a messy house. So unfortunately,

many people are often misled into thinking it's something else that's going on or they're misdiagnosed, and they're giving more of a talk therapy treatment, which OCD eats for breakfast. I mean, it's just like, oh, can we talk about this more? Yeah, that would be amazing. Let's do more talking about this. OCD would love to talk about OCD. It's its favorite topic is to talk about OCD. So we're also trying to get the trust of people, and it's why we spend so much time in our sessions at

OCD trying to just build report with people because we know that there have been people that have been misdiagnosed. I mean, our CEO, Stephen Smith, went through five therapists misdiagnosing him before he met a therapist who did ERP. He spent thousands of dollars and hundreds of hours of time doing things like snapping a rubber band on his wrist every time he had a thought that he didn't want to have. Or he moved away from his family because one therapist said, your family's such a trigger for you.

you should just not be at home with your family. So he moved a thousand miles away from them. Or people said, well, when you have a thought you don't like, replace it with one that you do. Well, that's a compulsion, actually. Wow. Yeah, I mean, that's scary. I mean, because I'm hearing that, you know, a lot of things.

And I've seen this before. I don't know if you're familiar with mesophonia. Oh, yeah. But, you know, I had a patient who had mesophonia where it seems like half of what we were dealing with was the. trauma of mesophonia treatment, right? Someone tried an almost like ERP kind of approach with her, and it seemed like it just hurt her way more than it helped.

What's your sense of why so many therapists do get the diagnosis wrong? Well, it takes a lot of training for OCD because, again, a lot of people just think of it as what they see on television. The other thing that I think is really disturbing is there are several, I won't disparage anything, but there are several publications.

out there where therapists can list themselves. How many of them have you seen have checked off that they specialize in 30 different things? Yeah. There's mood disorders, eating disorders, sexual dysfunctions, you know, fictitious disorders, schizophrenia, personality disorders. Can you actually specialize in all those things? No, I don't think so. So people go to their insurance or they look up a therapist. The therapist has clicked off everything. And so they go to someone because it says you know how to treat OCD. And that person is likely doing a general talk. therapy for OCD, which does not help OCD. Interesting.

So I'm kind of curious. So I know that there are like psychodynamic or psychoanalytic perspectives on OCD. Do you have any thoughts about those? Like I'm not so familiar with what, you know, what it is. But I know there's psychodynamic perspective. There are. Haven't seen them better than the wait list controls in terms of outcomes. that they've had because, again, they can spend a lot of time talking about OCD or trying to

figure out where OCD came from. Well, if your OCD is like, yes, let's figure out where we came from. But I doubt if that was really where it came from. Could we do this some more just to see if there's another place where it came from, right? Yeah. That's a problem. So that's a bit scary because it almost sounds like, you know, people with OCD are happy to indulge in thinking of.

about it, talking about it, and maybe a psychoanalyst will also be happy to indulge that. Correct. And so that's just curious because, you know, it seems like you're very like ERP focused. So I was curious about that perspective. And one of the things that we're focusing on this month is actually relationships. So one of the things that I've kind of learned the hard way as a psychiatrist is there is so much work that I can try to do with a patient that is basically almost trying to substitute for, you know, we call it like a corrective emotional experience and there's transference dynamics and things like that.

But like so many of my patients, as I started to help them just get into relationships, I noticed that there was just such a profound impact on their mental health. and I understand that OCD can show up in relationships in a very specific and profound way. Can you tell us a little bit about that? Sure. If OCD is, as we talk about it, being doubt and uncertainty, and being in a relationship is a very important thing to you, OCD is going to say, is this the right relationship? How do you know for sure? Is this really a soulmate for you?

Could there be somebody that's better? Oh, they laughed at your joke last week a little bit more than they did this week. Maybe they're mad at you. Why don't we spend several hours discussing that? It seems the neighbors hold hands more than we do. Do they love each other more than we love each other? Let's also talk about that, right? OCD will find anything to compare your relationship against and you'll lose.

And so then you can even see in relationships testing. Well, I'm going to test my partner to see how they react to this. And then the partner could get frustrated and it's like, oh, no, now. they're frustrated at me. Oh, you know, OCD will grab one. Oh, now they're mad at you. This might not be the right thing for you. That shouldn't be happening. So if you can throw doubt into a relationship, that's what OCD will do. And people will come in and they'll want to know that this is 100% the right relationship and the best relationship. And of course, nobody can give you that guarantee that the relationship you're in is the right or the best one. Yeah. So how do you tell

the difference between, you know, and because, like you said, everybody has doubts, right? And some of the things that you said are really scary because I see that a lot in social media, like people are testing their partners all the time. People are also making comparisons all the time. I think social media has really amplified the comparisons that we make. So what I'm kind of trying to tease apart is where do you draw, like how do you know, whether you're someone who's got OCD that has not been diagnosed, or whether you're just someone who's indoctrinated by social media?

Yeah. Very often, the people who might be indoctrinated by social media could get an answer to something or feel some level of satisfaction with an answer, but I don't see that in OCD, that that level of satisfaction rises to the challenge, where now I don't have to go down that road anymore. Right. And so that's one of the ways that I will take a look at it. The other will be that, you know, maybe something can pass, right? OCD, though, doesn't really let things pass.

OCD likes to hold on to things for a very long time. You know, I've treated people who didn't even get into relationships out of a fear that they might do something that would ruin a relationship. And somebody I treated, it was in their 90s before they had their first date, actually. out of a fear around how they would approach relationships. So, I mean, I was thrilled. Someone in their 90s finally having a date. Wow.

It seems like it's never too late. It's never too late. It's never too late. But to OCD, it's never the right time either. There's always maybe tomorrow. Maybe tomorrow will be better than today. Yeah, I think some of the stuff that you're sharing the way that you're putting like words to this, I think is incredibly helpful.

so things are not maybe tomorrow, right? So then that gets me thinking a little bit about like procrastination. Oh, yeah, sure. So can you say, can you tell us a little bit about how OCD and procrastination intersect? Procrastination can be a big safety behavior, especially for people who are perfectionistic. If I get something done early, I'm going to go back over it and I'm going to keep evaluating it and wonder if it's right. Or I could wait till the very last minute and do it and then have to turn it in because if I don't, I'm going to fail it. So procrastination can be a safety behavior that people

use to avoid having to review and review and review things. Yeah. So can you, and you mentioned perfectionism. Does that connect with OCD in some way? A hundred percent. There's one theme of OCD is called the just right theme of OCD. So that can also go with relationships, right? Is this the perfect relationship? Is this the just right relationship for me? How do I know for sure if it is or isn't? And since we can't know something like that, OCD says, well, we need to keep finding it. There's this notion that I see with my patients, we call members at OCD, with the members that I work with, where even though they wouldn't expect anybody else to get the answer and they wouldn't give the advice to any of their friends who had a similar problem to do what they're doing, there's something in them that says, but I need to know, right? So people often live with two different

sets of rules. It's fine not to know about all these things, but in this area, I have to know. And that sets you up for failure very often. And so if you have to know if your relationship is the perfect relationship, but you're never going to get an answer to that, it's very hard then to be in the relationship because, and I don't mean this in a negative way, but people with OCD will use their partners for reassurance. I want you to confirm for me that this is the right relationship. I can't trust my own judgment of this relationship. You're my external conscience. You need to prove to me that we're in the right space. And thank you for that. Oh, and now that just wore off. Now let's do it again because now I'm feeling like it might not be the right thing again.

And couples get in a real rut in this kind of situation where they feel like they're, without knowing it, serving the OCD instead of serving each other as partners. And what does that rut look like? Like, how would someone know, you know, I'm just trying to imagine someone's listening to this and they're trying to figure out, okay, like, how do I know if I fit this criteria? Yeah. I can give it as a homework that I give. One of the homeworks I give to couples is I'll say to the partner, I want you to get a

notebook and put it on the dining room table. And if they ask you a question they've asked already, I want you to run. write the question down and then I want you to write down the answer. And if they ever ask you the question again, I want you to say that's in the notebook, right? Because these are the kinds of things that happen. I hear couples constantly report to me. We have the same conversations over and over and over and they go a little bit longer every time because reassurance is kind of like a drug. You build up a tolerance to it. So today I'm going to need a little bit more than I got yesterday. and I still have a lingering doubt about the conversation yesterday, even though it went on for hours,

I'd like to revisit it, but today we're going to have to take it one notch up from where we did yesterday. Interesting. So, you know, I'm thinking about a patient of mine that I'd love to get your thoughts on. So this is a patient that basically was engaged and she learned that her fiancé was basically living a lie. And so fabricated a career, would pretend to leave the house, would leave the house every day, but would actually go to his parents' place. And I'm changing, this is somewhat of a chimerical patient presentation, but would go to his parents' place.

From his fictitious job, parents would deposit money into their account. So, like, he was really maintaining, you know, this, illusion and then one day basically what happened is she got lucky she stopped by her perspective in-law's place and saw him playing video games on the couch and she was like oh like what what's what's happened you know what are you doing here I thought you were supposed to be at work so things kind of unraveled and so then she almost had you know what I would kind of call it so my my understanding of her was like a trauma based anxiety where she was sort of paranoid about this

in her future relationships she would demand a very high level of transparency and, you know, location tracking and things like that from her future partners. Sure. Thinking about it now, you know, I assessed her during the intake for like OCD, but didn't really see anything like that. And then also, you know, quickly discovered that the things that she would do for reassurance were only amplifying the problem.

And so she ended up getting engaged a couple of years. later, and the fears started to creep in. She started to invade her partner's privacy, would be checking his cell phone without his knowledge. And then, you know, so he's kind of figured that out, and that's why she presented for treatment. And so we were able to work through that. I kind of had conceptualized it as a trauma-based anxiety kind of thing. also worked in, I'm not sure how familiar you are with, like, trans-diagnostic factors, yeah, a little bit. Yeah, so there's actually a trans-diagnostic factor called intolerance to uncertainty.

And the idea behind some of these trans-diagnostic factors is that they're kind of, they're not quite as phenomenological. They're almost like more biological. They're like the way that our brain tolerates uncertain. or doesn't tolerate uncertainty. And intolerance to uncertainty with these various transdiagnostic factors, is your score on these transdiagnostic factors

increases your risk for a diagnosis that could be OCD, could be anxiety, also increases if that kind of makes sense. And I haven't seen this with OCD, but perfectionism is another transdiagnostic factor. Okay. And studies will show that if you do like CBT around perfectionism, you will see a comparable reduction in anxiety symptoms, if that kind of makes sense.

Absolutely. And so I had sort of conceptualized her that way, and we worked heavily on intolerance to uncertainty. But I'm kind of curious about, you know, so I had conceptualized it as traumatic experience followed by anxiety, followed by repetitive behaviors that reduced her anxiety. And so as we worked on intolerance to uncertainty, that seemed to work. work well and she got clinically way better. But I'm kind of curious about, you know, your take on this. Do you think this was like basically OCD that was missed or how do you how do you tease apart trauma-induced paranoia versus something like OCD? Yeah. And it's interesting you say that because OCD is kind of a

glom on disorder. So if somebody's had a traumatic experience, OCD, again, to personify it a little bit, but OCD will say, hey, I can prevent that from happening again with these compulsions, just so. you know, I'll keep you safe forever. So do these things and then you'll never have to worry about that thing happening again. So in the end, was it OCD maybe? Was it also a lot of reassurance seeking? Because I talk about five safety behaviors. So I like your transdiagnostic and I talk about five safety behaviors.

So there's avoidance. There's reassurance seeking, which I think a lot of that checking was for sure to satisfy I heard doubt and uncertainties about if this was person was lying during like the previous one. There's distraction where and you know we all have a phone and within a foot of us right there's the greatest distractor ever created in the history of the world there's substance use and then there's compulsions. So I always look at anybody from a series of what safety behaviors are being employed in this situation and my go-to for anybody who's employing safety behaviors is going to be exposure and response prevention. So I think of ERP as transdiagnostic also because I use it for all anxiety

disorders and trauma. We can do prolonged exposure for trauma. We can do an interoceptive exposure for panic, which is things like running in place, hyperventilating, breathing through straws, creating symptoms of panic one at a time to teach people that they can handle those symptoms without jumping into a panic attack. So to me, ERP is really transdiagnostic. So that presentation that you said, I may not be as concerned of what the actual diagnosis is as making sure we do the absolutely right therapy. And to me, that would be ERP. Yeah, that's very similar to what we ended up doing, you know, which is, we just notice that, you know, you have, and when we got to a point where it was even, she was able to vocalize her anxiety and her fiancee would, you know,

she would share it with him. She's like, hey, I'm, I'm like feeling distrustful. And he's like, do you need to look at my phone? And then she would tolerate that. And so, you know, sometimes she would say, yes, I do. And then we'd kind of work on that. So that's interesting. Can you, so I'm curious. I mean, you mentioned that, you know, we have cell phones,

which are like the ultimate distraction tool. Can, so have you noticed a correlation between cell phone access or technology access and worsening? symptoms or increased prevalence of OCD? I've seen it. I can't give you a research study on it yet, but I can definitely anecdotally see that when you have at your fingertips the ability to answer your health anxiety questions and look things up constantly, or you can now go to chat GTP and said, hey, do you think

this could have been this? And it can give you an answer. What OCD loves an immediate answer, right? And so absolutely people want to diagnose themselves. I'm sure you've seen this too. I mean, how many people come into an office now and say, I think I have this because I looked it up on WebMD or ChatGPT and it told me that I did? When I do lectures in other countries, they say, you Americans are kind of nuts with your drug ads on television because they don't have them. But they're like, you know, they've heard that people come into doctor's office and say, I want this drug because I have this thing because this commercial told me that I have it.

And they don't have that in their country and doesn't exist, right? So these immediate gratifiers that we have available to us, I think can definitely do good, but they can definitely do not so good too. And when you're anxious and you're using these, I see them do more not good than good. Yeah, that's kind of scary because, I mean, you know, you mentioned chat GPT and I'm, just the way that you framed OCD is, you know, almost a personified thing that then I can totally see people spending a lot of time with their chat bot getting reassurance over and over again. Because in relationships, I think the challenge is that your partner eventually will become

exhausted with your need for reassurance. And what's kind of scary listening to you is there are so many terms or situations where people will not necessarily clinically diagnosed, but they'll say, okay, my partner has really low self-esteem, right? And so that's why they need so much reassurance. they lack self-confidence. That's why they need so much reassurance. What's actually really scary listening to your examples

is how many of those things could be OCD? They could, yeah. Absolutely. And so it's just interesting. I'm kind of curious about, I have sort of two directions that I'd love to hear more about. One is it seems like you've got a couple of frameworks, so like this is the classification of five safety behaviors.

Do you have other frameworks that you utilize on a regular basis that you could kind of share with us to give us some insight into either diagnostics or, you know, coping mechanisms, maladaptive coping mechanisms. Just what other frameworks do you have? I love stories. Okay. I love to tell stories. So here's analogies. So I will describe OCD to people in ways that hopefully they understand it. So one way is OCD is Lucy holding the football and you're Charlie Brown hoping this will be the time that you kick it. And I saw an amazing interview with Charles Schultz one time where he said, people ask me all the time that Charlie Brown will kick the football. And the answer is no, because it is in the nature of Lucy to always pick the football up

every time Charlie Brown goes to kick it. And it is in the nature of OCD to doubt whatever you give it, no matter what you give it. So you could be Charlie Brown hoping this will be the time that you give it the thing that you need to do to kick the football. You ain't kicking the football, right? It just isn't going to happen. So I love stories. And I like how you even look at some characters because I like to look at characters like that too and use that to show people your attempt to satisfy OCD is like Charlie Brown trying to kick the football. Wow. Okay. Yeah, I love that imagery. I'm kind of other frameworks or stories that you want to share? I think that the other thing is there's a lot of therapists out there who teach coping

strategies right away to somebody in a session when they're anxious. They teach Diaphimatic breathing and muscle relaxation. And when I do lectures to therapists, I say the most common question that I get is what if my patient has a panic attack during a session? That seems to be the number one fear that therapists have, that a patient will have a panic attack in a session. And so they do these things like diaphetic and muscle relation, I believe, not only for the therapist's benefit, but for their own benefit because they're scared to have somebody be scared in their session. I don't teach diaphomatic breathing or muscle relaxation. We don't do, five, four, three, two, one. We live in the anxiety and the doubt and the uncertainty. We allow it to be there

and we let people learn. You can handle it. So another story I'll tell us, how much diaphragmatic breathing, muscle relaxation and closed eye visualization did you do when you learned how to drive? None. Probably none. Right. What did you do and said, you created a hierarchy. You started with getting in the driver's seat and turning the car on, and then you put your foot on the brake, and then you shifted it into gear, and then you slowly left your foot off the brake. Well, if you could do all that without any safety behaviors whatsoever, maybe a parent saying you're doing well or something just to give you some kudos, but it's not that you needed that. If you can do driving like that, you can approach anything you're afraid of in a very similar

matter and not have to do all these other things in order to be able to do them. So this is one of the hardest things for therapists, and this is my framework now for therapists. One of the hardest things for therapists is to give up teaching safety behaviors out of their own fear of being with somebody who feels anxious. Yeah, that's, I think that's something I've experienced front and center and have worked through in supervision, which is, you know, how much much of my anxiety am I managing through therapeutic interventions, right? Whether it's increasing medication dosage or things like that, especially when I have patients who have chronically elevated risk of things like overdose and stuff like that, like managing your own anxiety becomes a real

challenge. So I kind of have sort of two other questions or two other directions. So I'm still sort of struck by this personification of OCD. I really like that. I really like that. The other question's the framing. And I'm almost like waxing a little bit philosophical. So can you tell me like, what is OCD? Because you make it out to be an entity. Yeah. To me, OCD is the unanswerable question that you keep trying to answer. So I think that's just one very simple way to describe it. And there's a drive in you to try to answer it, even though logically, you, you know, you know, you know that you're not going to get the answer, but emotionally, you feel so compelled to do so that you do it.

So one thing that I'll say to people, and this is very crude, and I know you're on the psychiatry side, so forgive my crudeness here, but I'll talk about when you talk to OCD, I'll go back to Charlie Brown. It's like Charlie Brown's teacher talking to you. It's just blah, blah, blah, blah, blah, blah,

right? OCD loves to hear it, but it gives it nothing really. it still wants more. If you think about a talk therapy response to OCD, where does talk therapy occur in the cortex, right? In that part of the brain where there's language and everything. Where does OCD occur though? More in the midbrain, that emotion center of the brain.

And guess what the midbrain doesn't have, a language center, which means the midbrain hears blah, blah, blah, blah, blah, blah, and why do we do an exposure and response prevention therapy? Because it targets the emotions instead of targeting logic. And if you want to fail at treating OCD, just take a logic approach toward it. But if you want to win at treating OCD, take a behavioral approach toward it. Yeah, you seem very behaviorally grounded to me. Because I would push back a little bit that talk therapy works at the cortex.

Because I think if you look at, I'm not saying that people have failed epically at treating OCD through talk therapy. But I think if you look at, you know, most mechanisms of talk therapy, affective activation is critical, right? And so I think the purpose of using talk therapy is to get to that limbic response and then managing those. But I don't know if the pathophysiology of talk therapy really applies to OCD, right?

And that's kind of where I'm really curious, like, what do you think, what is your understanding of what causes OCD? So there's a lot of ideas around this. There's overvalued ideation on certain aspects of things that we think about. There's friends of mine like Fugendezaruglu who's done some work in that area. You have notions about ideas. I thought this was interesting that I heard in a lecture once.

We have indirect pathways or direct pathways in the way that we look at things. So on my indirect pathway now is like the birds in the background or noise that, but, And then on the direct pathway might be a siren going by that suddenly I'm paying more attention to. And maybe some things get slipped into the more direct pathway off of the indirect pathway. And so therefore, we think we have to pay attention to them. There's these interesting ideas about that. There's pans or pandas, which is these ideas of pediatric autoimmune neuropsychological syndromes that as a reaction to maybe Lyme disease or strep, people could go to bed and then wake up in the morning with, OCD or ticks or Tourette's or something like that.

Yeah, so I think I've seen papers about this about kind of a sudden onset OCD following viral infections, right? There's some inflammatory hypothesis. And my sense is, just as a clinician, is like some psychiatric diagnoses are more psychological and some are more neurological. And OCD definitely feels more neurological to me. Like there's something going on with the way that the brain generates thoughts. There's something going on in the way that the brain is unable to regulate itself, right, where you have some kind of amygdala activation where your frontal lobes just aren't able to work on it. So I was kind of curious if you have, I mean, but what I'm really getting from you, I think you sort of

already answered it, is that, you know, when it, when it comes down to it, where OCD comes from, it's certainly, it's almost like one of these illnesses where our solutions to it is what sustains the problem, right? Where our reactions to it, the way that, and that's what I think is kind of interesting about OCD is it's one of the illnesses where I feel like patients feel the most powerless, but that good treatment can really revolutionize the way. way that they live life? 100%. 100%.

So I want to just... Go ahead. I was just going to add one more thing about... Just to go back in the moment about technology, in the past, I've had patients who have heard there was a hit and run on the radio or television, so they call the police on themselves to come to their house to see if it was them. Now, with the technology that we have, they're going online and they're watching video to see

if their car was the one that went through. Even if they didn't drive that day, they're still checking to see if it might have been that. Interesting. Yeah, that's so scary. So I was wondering, so, yeah, so some people in chatter, you know, surprised by this idea of OCD from infection.

But yeah, there are some papers that actually show specifically pediatric papers like new onset OCD. So I guess, are you comfortable? I just want to turn things over to chat for a second and see if they have any questions, just because you're here and we have a very engaged community. Wonderful. Yeah, so one person, so, man, there's so many questions. So one question is, do you have, so people are asking about meditation and OCD?

Sure. What's your understanding of the connection between the two? Can one be used as a treatment? How does it work? There's not necessarily that meditation is a treatment for OCD, but in the terms of mindfulness work, we want people to be mindful of whatever their obsessions are and allow them to be there without having to try to push them away. So the more you try to get rid of a thought, what happens? It intensifies you.

It's the pink elephant effect. Yeah, yeah. And I liken this to if you have a song stuck in your head that you don't want to hear anymore, the best thing to do is listen to it about 20 times. and you'll just get bored with it instead of trying to make the song go away. And that's exactly how we would approach it with ERP. Let's dive into that thought and keep saying it over and over and repeating it instead of trying to run away from it. Yeah. And so your take is that meditation is a way to embrace and accept those things as opposed to running away from them?

Absolutely. And sometimes people will use meditation in treatment. I'll say, I don't mind if people do meditation, but in the midst of, ERP, we're really working on allowing something to be there without going into mantras or things of that nature that people might use during meditation. Okay, so thank you. We've got a couple other questions. One is one person is sort of saying, I've always claimed atheism cured my OCD.

Do you think that's possible? So if somebody had more of a scrupulous nature to their OCD, scrupulosity is OCD about morals or ethics or religion. there is a chance that with now not believing in something, you can walk away from having the doubts or uncertainties about if you've done a religious practice correct. However, just keep in mind, I've treated atheists who have religious scrupulosity, who have said to me, I know there's not a God, but in case I'm wrong, I'm going to say a bunch of prayers anyway, and they still do hours of prayers just in case. Yeah, that sounds like Pascal's wager, is it?

Where I'm going to be. Exactly. And yeah, so I'm glad you mentioned scrupulosity. So I was prepping for, you know, in our stream today, we were doing like fictional character diagnosis. And, you know, some people have suggested that Batman has a form of basically like moral OCD, that he's very kind of justice focused, quite obsessional, intolerant of certain people.

Can you tell us a little bit more about what is, what does that scrupulous form of OCD look like? Yeah, that moral OCD. If we were doing Dungeons and Dragons, I would say Batman might be chaotic good if we were going to give them a class. Yeah. Yeah, we can do D&D, by the way. If you want to use D&D to teach OCD, I think we've got, we're well grounded in that. You and I are good. We could get our magic cards out.

We could do some D&D. Fantastic. We've been taking the wrong direction. Why didn't you tell us you were a nerd at the get-go, bro? We're suddenly best friends. What happened? Anyway, so with moral OCD, you're dealing with people who are afraid that they might have somehow been offensive to somebody, that you might have not done enough for somebody. I've had people who have waited outside of grocery stores for six months looking for the person that they're afraid that six months ago they held the door open for them.

But what if they let it go too soon and it hit the back of their foot? And it might have caused them to be in pain somehow. So now they just, whenever they're off, they're hanging out at that grocery store, hoping that person will come back through. And then six months later, they do. And they go up them and say, hey, just so you know, six months ago, I held the door for you. I don't know if it hit your foot. I just wanted to make sure you're okay. And of course, the person looks at them like, who the hell are you?

What are you talking about? Right? Just kind of go away. You can see a moral aspect, too, where I've seen people with those pedophilic OCD concerns who, if a family's walking down the street, they start saying, don't come near me. I don't want to harm your children. Well, guess what happens when somebody screams that to a family? Oh, my God. From the family, right?

They're trying to be as moral as possible and helpful and everything, and it's a backfire when it happens. So people with moral scrupulous issues won't even throw out something that could be recycled into a regular garbage, because what if they're contributing to the destruction of the earth? Even if they have to carry that thing for four miles on a trail until they get back to the trailhead where there's something that they can recycle. there's other garbage cans along the way. You know, these notions of extreme responsibility toward the welfare of other people, it goes above and beyond. I hope we're all about the good welfare of everybody else. OCD takes it to a level that it's unattainable, though.

So, I mean, it sounds like what you're saying is, and this kind of fits with my understanding of it, but that they're concerned about their own moral shortcomings. Is there a form of OECD? that is concerned, like, obsessional about the moral shortcomings of others? Or is that not something you've seen so much of? Not so much. That might go more into OCPD, right?

Obsessive-compulsive personality disorder, where you're always finding the moral shortcomings of other people because you're doing things better than they are. And I think this would be a great time to, you know, just highlight for a moment, OCD versus OCP, can you just give us a pretend, pretend I'm a psychology intern? Yeah. OCD is obsessions, you know, these intrusive or unwanted thoughts, images, or urges that people

have that are neutralized by compulsions, which are mental or physical acts. Obsessive-compulsive personality disorder is more of a way of living in the world that doesn't have to have obsessions or compulsions. So it's kind of an odd name in, first of all, it probably should have been called anal retentive personality. If we're going to go back to our psychoanal retentive personality is sort of might have better better. But I heard it described once by a patient I had that I treated who said, my concept of the world is, I'll do it. You sit in the corner in color because you can't do it as good as I can do it. And even if you do it the way I do it and follow my directions, it's still not good enough. So I need to be the one to

do it. And so they hold things to such a standard that it's difficult for anybody to ever attain that standard. And there can be a resentment against people for not attaining that standard, even though like an OCD, it's an unattainable standard for anybody else to achieve. Yeah. So, so I think so one of the things that I'll, you know, when I do some public education, oftentimes what I'll tell people is that, you know, when you think somebody is OCD, what they are is OCP, right? And that oftentimes OCD looks very different from the way that media portrays it. OCPD is like control freaks, I think exactly kind of what you're alluding to. And so I think it's a very important distinction that like, you know, if someone's like anal retentive, I think is a really good term.

You know, if they're just really just control freaks about it needs to be done this way. even some of like the organizational kind of stuff where it's like this pen goes in this place this pencil goes in this place these notebooks go here one thing that i'm i'm a bit curious about um and we can maybe make this our last question but uh is um so what's been your experience of children who have or i children who have parents who have untreated oCD what what does that look like Yeah, that could be difficult. I actually have a friend John Herschfield's writing a book about this right now. John is a therapist. He has OCD. He's writing about being a parent. His has been treated, though, but he's writing about being a parent with OCD and raising children and how you do that. So I think it could be a very difficult experience for the children, especially if it is around the safety of the children, because OCD, I'm going to personify it a little again here, maybe has the best intentions for protecting the children, and in doing so, bars the children from really living the life that they want to live, and they're only living the life that OCD allows the family to live. And that could be a very isolated life, right? You can't go to the neighbor's house,

because what if they serve peanut butter and you suddenly develop a peanut allergy, and then you'll die. So you can only have your friends come over here, but they have to take their shoes off, and they can only be on the wooden floor, not of the carpet, and they can't use the bathroom here. they have to go back home because they could leave a German or, you know, just these are the kinds of things that you're not allowed to live your life. And I've seen it's the reverse too, where untreated OCD and kids runs a household. You know, I've gotten calls where the family has to take their clothes off in the garage and put on a robe and then go to the bathroom and take a shower and then put a new robe on and then can go to their room so they don't bring germs into the home.

So OCD will, if it can, take over everything. Yeah, so I mean, it's so sad, but I've seen that time and time again, actually, how, how it, the whole family, you know, the person with OCD, their emotional experience is so profound that they'll rope everyone around them. And I've certainly seen kind of like more in like, almost like trauma work, what, what you're kind of talking about, which is kind of why I asked is like, you know, I've seen, you know, I've seen. children who grew up with parents who I suspect have untreated OCD. And just how deprived, I think that's the right word. Like they were just really deprived of a normal life because there was just this like monster that was completely like, you know, this is the way that things have to be. Right.

A lot of really interesting psychotherapy around actually anger at the non-ill parent for. Yes. Right? Yeah. Oh, yeah. For allowing that to even. Exactly. How did you let dad or mom do that?

Exactly, right? So one of my supervisors once told me, it's the parent that they don't complain about. That's really the problem. That's where you have to go. And sort of just because you can need to a certain degree, okay, like this parent had OCD, this parent was drinking, this parent had an addiction. But it's this other parent that was my loving parent that I feel really conflicted towards because they were the positive parent, but I also blame them.

So. Yeah. Thank you so much for coming today. Can you tell us a little bit more about where people can learn more and what no CD is offering? Yeah. So no CD offers exposure response prevention therapy for OCD and related conditions. And we are an online platform for this. We work in the United States, the UK, Canada, and Australia.

And we take most insurances. So we're always working on getting more because we want this to be an affordable experience for people. We believe that people deserve to have evidence-based care, and we want to be the best providers in the world for that. So if you're looking for help for OCD, you can go to nocd.com, or you can even download our free app. It's the no-cd app. And you can engage the largest community of people with OCD in the world on the no-CD app and

find just thousands upon thousands of people who are there to support each other and help each other through their OCD. Awesome. Thank you so much, Dr. McGrath. And next time Last Next time we're going to have to launch into D&D earlier, bro.

Oh, yeah, I'll roll for Paladin. We'll see how it goes. Speaking of scrupulousness, I'm sure a Paladin would be at the top of the list. Thanks a lot, Dr. McGrath, take care. Good to see it. All right. All right, team.

That was great. So, yeah, I think, you know, I think Dr. McGrath is right. I think like this is one of these things where scariest thing about listening to him is like how many things, you know, I don't think if you're in a relationship and your partner tests you, you know, that doesn't mean that they have OCD. But what really scares me about this is like, I think this is we didn't really, maybe I'm just connecting these dots now, but, you know, we have a media portrayal of OCD.

But procrastination, tests and relationships, all this kind of stuff, this all could be OCD. Right. And one of the, I'd say OCD is probably at the top of the list of diagnoses that I misunderstood when I came into psychiatry training. It is the thing that is the most different from what people think it is. And then I think that's kind of scary, but that's also why I think we see some of these things like inappropriate OCD treatment, even though you're in therapy, right? Because it's easy to conceptualize it as anxiety, even for a therapist.

And so I was kind of thinking about that case that, you know, I've shared on stream before about, you know, the person who was like anxious after this traumatic experience. And for me, that was pretty clear because I, you know, and I think it's really interesting to see that we sort of ended up in the same place, which is intolerance to uncertainty, is the goal. But a huge shout out to NoCD for sponsoring, you know, our stream today. And shout out to Dr. McGrath and the work that they do. Like I said, y'all, we don't take sponsors often.

And so NoCD was vetted by our scientific advisory board. They do evidence-based treatment. And I would imagine that their outcomes are pretty good. So, and I think we've got, I think they've got a quick. that you all can take, right? So a big question is, you know, do I have OCD or not? Is it procrastination? Does my partner have OCD? And so they've got a quiz that y'all can take. I think we're linking it in the chat right now. So if y'all are curious, check it out. Okay? I think the last thing that we're going to do today is we have a team member who's just going to showcase something. So let me just hop in because I, I think, think we want to show y'all what we've been doing. So I don't know if you guys remember. Hold on a second. Let me pop this out. Hello. Hello.

Let me mute streams. I'm not hearing you twice. All right, cool. But I want you to listen to me twice, Brandon. I think I get enough of that. Okay. So for those of y'all that don't. So Brandon's going to show us some stuff. So as you guys know, we have, we built a new guide, Dr. Kay's guide to love sex and relationships. And am I driving, Brandon? And am I screen sharing with you? Yeah, you screen share with me and then you can share on stream to. I'm going to screen share with you.

And then, so I'm going to give you all just a little bit of background before we go into this. Okay. So many years ago. Oh, we're lagging. Dude, what's going on with this lag? I'm going to shut down some stuff. Your PC, you need an update? You know, I honestly wonder if it's because I installed Star Citizen.

This stuff started when I... Okay. The game that will never end, it's crowdfunding. Yeah, dude, speaking of projects that never end exactly. Oh, this is laggy AF. So I think it's some... Because I think I use a lot. Maybe you're working with this, sure.

Let's see. Okay, let's do this. I'm going to call you, I'm going to set up a different... I'm going to be a different link, okay? I'm not used to score. Still lagging. Still lagging. It's getting better.

Okay, so I think it is... Okay. Okay, let me do... Give me a second chat. Let me do this. Let me do this. Let me do this. Um...

And then... Okay. No, still lagging. What is the deal? Okay, almost. I got to fix one or two other things, but I think we're getting there. Okay, count to five for me. I said count to five for me. Okay, they can't hear you, so I'm going to fix that real quick. Say something? I'm saying something. One, two, three. Perfect, perfect, perfect. Okay, okay, okay. I think we finally got this. Okay, so I'm going to go over here. I want you to count to five one last time. All right. One, two. Okay, we got it. We got it, chat. Okay.

Nice, nice. So we're going to give you all a quick background. Okay, so look, many years ago, I was, I made the fateful decision to, I got done with work early, a couple of patients canceled. I remember, I think it was like 2.30 p.m. on a weekday. And I opened up Reddit, and I posted an AMA, and I said, hi, my name is Allo Kanoja. I'm a psychiatrist or training to become a psychiatrist focused in video game addiction. And the AMA hit the front page of Reddit. And there was a group of people who were like, hey, can you like teach us some stuff?

And so this is where HG was born. It was actually born out of an AMA. And Brandon, who's here with us today, is one of the original people. We had a Discord. So I started a Discord server. And we used to meet once a week. and we would just like talk about stuff. So I'd like teach stuff basically like what I do on stream.

I'd offer like a little bit of a lecture, teach some meditation. We'd learn about how our mind works. And Brandon's been with us from the beginning. And so Brandon is is good at technology things. So Brandon's going to walk us through some stuff. So Brandon, what do we need to understand, bro?

Yeah. So can you a quick refresh for the page? Okay. I'm going to refresh in a second. But I want you all, because this could be gone, okay? So hold on a second, opt in. Okay.

Opt in to QI. Yeah, sure. We'll start with that then. No, it's not gone. Yeah, we saved it. Okay, cool. Yeah, so one of the big things we're doing at HG is we're working for improving our research and expanding our research division.

And one of the parts of that involves, you know, you guys, chat, people who use our products, people who engage with HG every day. And we've gotten the really awesome research team now, and we are actively wanting to assess how people are improving when they're using our products, especially with guide and memberships. So whether or not you're a new guide purchaser or veteran guide user, this feature where you can opt into getting just occasional surveys. Yeah, opt in to get occasional surveys and stuff will show up on the live coaching platform,

or just our platform in general. And it allows you to just receive occasional surveys that will pop up, to get a check-in on where you're at. And most of this information, if not all of it, is just used to improve our products, see how people are doing, see how people are improving over time, and things like that.

So yeah, once you opt in, you see that research, tell us a little bit more about yourself for science. And there's just some surveys there that you can take, it'll come back periodically, like once or be four weeks. And they're not very long, but they're really, really informative for us to get a good baseline and really get a lot of research backing behind our products and services.

Is there other stuff that you want to share, Brandon? Nothing about that QI stuff, but yeah, we just want to give a preview of the LSR module. So this is currently our devs are working hard to put this up and get this ready for live release on Monday. But this is just our staging environment gets you a good overview of like what you're going to be seeing, what you can expect once you kind of purchased and unlock this module. So here on the home page, as usual, just like the other modules, there are seven different playlists that span different topics

all from starting the beginning of why dating feels so hard today all the way through to building and actually maintaining relationships and breakups and recovery. So a lot of the stuff that Dr. Kay has already talked about on stream yesterday if you guys were there. I guess Dr. Kay, do you have any insight into why these seven topics, what you decided to go through? Yeah, so go through.

So I want to talk about QI for a second first. Okay. Oh, yeah, sure. So we're going to ask you all to take surveys. And I'm personally asking you guys if and when you get, use our stuff. Okay? I want you all to take surveys. Here's why.

We have this idea. Okay, so in terms of how we built this. So I think we showed you all a PowerPoint yesterday where it's like people, ask us questions about relationships all the time, all the time. Should I go to a prostitute to lose my virginity? How do I get people? I'm an in-cell. I'm short. How do I do this? How do I do this? How do I've been through a terrible breakup? How do I let myself go back into the dating world without being burnt out? How do I let go of resentment? How do I grieve? How do I let go? I'm becoming an in cell? How do I stop? Right? So people need help in relationships. I have a dead bed

room situation. How do I, my partner says that there's no spark anymore and they want to break up. I suggested couples counseling. They said there's not really a point because there isn't a spark. So people ask, like, you guys are hammering us with these questions. So then what we try to do, and now I have a bunch of help, right? So like, it used to be just me, but I'm not a relationship expert, which I know sounds weird because I'm telling you guys to get this guide. I think you all should get this guy. But like, I have to learn this stuff because this is what y'all are asking me for help with. So we have people like Clark and we've got a research team and stuff that we're building out quite robustly. We showed you guys some of the questions and stuff from the research,

right? So what makes a successful relationship? How do you successfully? What's the healthiest way to break up? How do you stay resilient from breakups? How do you let go of emotional baggage? So we built this stuff. And the topics that we picked are the most important topic. So it's like My idea is, it doesn't matter whether you've never been in a relationship or never been on a date or you've been married for 20 years. This is the stuff that you need to know. Okay? So we trim down the topic list quite a bit and we want basically everyone to get through it all. And this will equip you with the most basic and advanced skill set to succeed in relationships.

That's how these were picked. So we need to first of all understand what's different. everyone is struggling to meet. Why is that? Okay? What has changed? Right? What's the meta right now?

Second thing is finding partners is hard. All the good ones are taken, Brandon. They're all taken. Why? What's going on there? All I'm getting is people wanting to send me dickpicks, right? And then a lot of people like screw this up. So there's like a group of people that's like, okay, I can, I get one date and then I get ghosted.

Two dates, then go. ghosted, three dates and ghosted. I've been on six dates. I've been on this app for 18 months. Talk to hundreds of people. Only six people went on a date and I can't get a second date, can't get a third date. Why? How do you fix that? Then choosing the right partner. How do you know who's actually right for you, right? Because we all want right partners. How do you build and maintain a healthy relationship? Then we're talking about sex and intimacy. Right. So some of the stuff that we talk about here. I don't know if this is like against TOS on some of these platforms,

but we talk about things in a very like, you know, straight kind of medical way. And sometimes that's hard to do on some of these platforms like YouTube and Twitch. And then breakups and recovery because things are not always easy. Now, the reason that I want you all to opt in and take these surveys is it is our hypothesis, hypothesis, that this will help y'all. and I know that I'm an influencer on the internet and my job is an influencer on the internet is to sell you things, right?

Because that's what we do. No, but really, this is designed to help y'all. And we don't know whether it's going to help you or not. This is my best attempt at putting together something that I think will help you all substantially. But we don't know that. Okay, so one thing that we're very, different about here at HG is we try to collect outcomes on the things that we offer y'all.

We don't do sabathons. We try to sell you things. I'm going to be super transparent about that. Why? Because we want to help you. You should pay us money. We should provide some value for that. Second thing is we want to do things that work.

We're a part of our mission and ethos is to do things in an evidence-based way. But in order to do that, we have to collect data. And that requires you to fill out surveys. The one thing that I can't talk about, I'm going to ask you, Brandon, actually, do you know, so I know, you know, this project that I've been working on for two years, you know what I'm talking about? Yes. Do you know if the surveys that people are taking will be a part of that project? Is there any overlap there? I think it will go into informing that project, yes. Informing that project, but what about user data for the connection dimension?

Is that over? Okay. Short answer, yes. Okay. So this will populate a user's connection dimension if they take these surveys? When we visualize it, yes. It'll be visualized. Okay.

So it is the same. Backend data is the same. Correct. It's just forming the foundations. So I get into trouble, chat, because I sometimes will make promises that our team then has to fulfill. I will leak products when they're not. ready to be leaked. So I'm not going to say more than that, except I can say with confidence,

we're working on something. The other thing about this survey is that all of the, not all, a portion, a large portion of the surveys that y'all take are not just going to be used by us. They will actually, we will give you back that data. Okay. So we're designing something. I'm not going to go into a whole lot of detail. But the surveys that you take are information about you that you will then get access to, which will give you an insight. So we're trying to measure. So I'm going to take my headset off. Go for it.

Are you done, Brandon? Are you, are you, is anything? I mean, there's a few more things to show, but really, I think you can. No, no, go ahead. So share what you want to share and then I'll rant. Okay. I want you to click into the first playlist. Okay.

And let's go directly to the second video because that's one that has additional things to show off. I think it's just the second video. The why it's part to fall in love. Yeah. Okay. I think this just goes to show also like to strengthen your points about just like how research back we are and how we want this guide to be like super evidence based. In the references and resources we're having like almost every single video will have two or three references. And I think this guide I've been working through all of the guides.

And I think this guy is probably one of the most heavily researched ones or at least has some most heavily research articles and references. So it really is like one of the ones that I think is the most HG direction in terms of like the research. And then the other thing is that I do think that this guide I think is the most information dense and also probably the most applicable to like the most people's daily lives because all the other ones are kind of niche with the exception of meditation to specific issues. but the LSR module is really universal to a lot of people. Okay, cool. Yeah. And the last thing I wanted to stay is on release at least, this module doesn't have a map view.

I know a lot of people are very endeared and like really enjoy using the map view. Yeah, but the problem with the map view is that it's overwhelming. Yes, right? That's one thing. And the other thing is that the LSRs, our module itself doesn't really have a strong connection point, like the other modules kind of tie together with each other. And if we were to originally put it on the module onto the graph, it would kind of like surround the whole map because it's like something that forms as like a baseline

for everything else. Yeah. So basically, like we started this off and I was like, okay, we're going to make an FF10 sphere grid that basically people can skill up in all of these dimensions. Uh, huh? You show it if you want. Go to like the Dr. Kay's Guide menu. Yeah. So this is like the map, right? Yeah.

The problem, oh, I have to purchase this. Okay, Gigi. Unlock now. Okay. Internal server. Gigi, get wrecked. Okay. That's fine.

Yeah. So what we're, other stuff that you want to show, Brandon? No, I think that's it. Sorry, it's, I think my headphones are dying. What's up? Say it again? That's, no, that's it. No, okay.

Okay. Thanks, Brandon. So, guys, I want to just emphasize, well, I'm going to go and drop the call, okay? Mm-hmm. Okay, so I want to emphasize, like, we're a whole team now. Okay? So Brandon's been with us basically from the beginning. And we make changes.

So, you know, we used to have this sphere grade kind of thing, but I think it's too hard to get the LSR, like Brandon was saying, it's too hard to, like, fit it into this map. And it's, like, more universal. It's also way more linear. So it, you know, it's like this is the chunk. It's like the tutorial for relationships is what the LSR module is. And tutorial makes it sound basic, but it's like advanced stuff as well, right? So I would kind of say it's not the tutorial.

It's almost like, you know, if you send someone to boot camp or like when they finish their like military training, they come out as trained soldiers. So there's like advanced skills in there, which is, what the LSR module is, love sex and relationships. The other thing that I want to tell you all is I want you all to take the surveys. This is basically me telling you, I want you to take the survey. I'm going to be transparent about that, because the surveys are cool. They're very cool.

That we put a lot of work into them. This is not just rate things from one to five. So the surveys are, I'll tell you guys what we're trying to do. Okay, but don't hold me to this because we're trying to pull it off. We're trying to figure out, does this actually help you? Okay. Now, in order to figure out if this helps you, we'll ask you, do you think it helps you? What's your satisfaction with this?

That's one type of survey. That's not the only thing we're asking. We are actually asking you questions about your relationship status, about your rejection sensitivity status, about your self-esteem. And as you watch these videos, as you engage with our various services like coaching or whatever or do community events, can we actually move the needle on outcomes? Right?

That's what we're trying to figure out. And we can't know that unless you all fill out the surveys. And the other thing is I've been working on this project for about two years. And I think we'll hopefully it'll come out later this year. But then the stuff that you guys fill out in the survey, you will be able to see. And we'll show you all different dimensions. You guys will see what the survey... Let me see if I can just...

Okay, great. I'm going to just show you all this, okay? So, I feel like I'm free to decide for myself how to live my life. I really like the people I interact with. Often I do not feel very competent. I feel pressured in my life. Okay, so let's just do this. I get along with people I come into contact with.

I generally feel free to express my ideas and opinions. I consider the people I regularly interact with to be my friends. I've been able to learn interesting new skills recently. So these are the kinds of statements. These are the kinds of questions that we're asking y'all. In my daily life, I frequently have to do what I'm told. People in my life care about me. Most days, I feel a sense of accomplishment from what I do.

And y'all may be like asking yourself, what on earth does this have to do with a relationship? Right? This is not just, are you willing to date someone who's over six feet tall? Okay? Or under six feet tall. People I interact with on a daily basis tend to take my feelings into consideration. Right? So these surveys, I don't know if you guys can tell.

These surveys are about certain attributes, okay? Character sheet like, almost, as if we could use scientifically validated instruments to develop a character sheet of sorts. And then we need to see because this is the stuff that's important. So a lot of this stuff has nothing to do with relationships on the surface, but that's not what we believe, right? Why are we making a guide to love sex and relationships? Why have we done so much research and invested all this time and energy and scripting and

stuff like that? Why? Because your mental health, okay? This is the thing. Your mental health, so many people on the planet will try to tell you that your mental health doesn't have to depend on relationships. And the basic reason for that is because if I'm like a psychiatrist, I can't get you late. Right. So as the field of psychiatry, we've like moved away from that outcome.

Instead, what we're going to do is we're going to measure your satisfaction. We're going to measure your depression. We're going to measure your anxiety. but we as human beings, a basic part of our mental health, arguably the most basic part of our mental health, has to do with our connections with other human beings. Takatsubo cardiomyopathy is inflammation of the heart muscle that happens to men after a divorce. Okay, men are inflammatorily different from women. one of the greatest risks of heart attack or myocardial infarction is the 24 hours after a breakup.

So at some point, direction in life, how fulfilled you feel, the people that you interact with, how they treat you, whether you consider them friends, these things will be shaped by your relationships. And our hope is that as we equip you, as best as we know how, this is not like a pickup artist kind of thing where it's like, and this is the basic problem with most of the dating advice. People will say, you should do this. This is how to succeed in dating. Do this. Do this.

Do this with your hair. Do this. Do this. These are the things that you have to do. That's not what the guide is. The guide is not telling you this is what you. What? Flurring. Okay. is not telling you do this, then do this, do this, and then it'll work. That's not what we're doing.

What we're trying to do is teach you guys how it works. So I'm not saying, okay, first you have to jump, then you have to hit a, then you hit X, up, up, down, down, left, right, left, right, A, B, A, A, B, start. That's what a lot of dating advice kind of stuff is. They're like, do this, do this, if they do this, that means this, and then you should do this. That's not what we're doing. We're teaching you guys the tutorial. This is the jump button. This is the light attack button. This is the heavy attack button.

Some monsters require heavy attacks to beat. Some monsters require light attacks to beat. This is how you tell the difference between a monster that requires a heavy attack to beat, a monster that requires a light attack to beat. Here are the principles. Here's what formulae. Here are the components of charisma. Here are the elements based on our best available research.

Here is how people fall in love. We're going to equip you with all the tools, the systems. We're going to teach you the rules of chess. Right? This is how a pawn moves. This is how a knight moves. Hey, there's this thing called a fork. It's when you move your night and you have these kinds of pieces.

When do you fork? Well, you have to look at the board. Communication skills. Dealing with resentment. Emotional processing after a breakup. So that you are not carrying emotional. baggage into your next date. Right?

One of the biggest problems that people have with dating right now is we're also fucking burnt out that when we go on a date, we're not emotionally like in our best frame of mind. Right? We're another burnt out person dating another burnt out person going through a job interview that is basically over drinks where we see if we're a match. I don't know if this makes sense. Falling in love is not about a match. Falling love is the opposite of a match.

match. Romeo and Juliet. Right? And that's like, we're going to try to equip you with this. Because generally speaking, like, genuinely speaking, not generally, genuinely. I'm here to help y'all with y'all's mental health. That's what I'm here for. And sometimes that involves, hey, we're going to do prana should be. And I'm going to teach you guys Agne Chakra meditation. And sometimes that means like, hey, let's do fictional character diagnosis and see if we can learn something about ourselves. And Sometimes it means like, okay, Dr. Kay, like, I'm lonely, right? Which is like we had to, we had to restrict dating posts on our subreddit to one day. Because if not, it would flood everything.

So this is our genuine attempt to help you guys with this. It's our, it's our opening salvo. It's not, we're not accepting defeat. It's not the only thing that we're ever going to do. This is our opening salvo. And it's a strong opening, right? It's something that has been well researched in chess. we're going to do this, and we've built some really cool stuff with it.

And the most important thing that we've built, not the most important thing, I say that way too much, way too hyperbolic. I'm excited about it. The big thing that we built is surveys. And these are surveys to assess various aspects of you. And then whether using the guide will actually move the needle or not. Okay? And then we hope to share that with you, right, to where you will.

like we're learning certain things about you, and right now we're learning it to see if you get better, but then we want to share it with you too at some point. But that requires a lot of dev time, basically. And if you guys want to know, like, where does our money go? So we're sitting at 4,134 sales, which is awesome, by the way. So 3,000 is what it costs to make the guide. So we've broken even. Okay. Now, this is where you may say, okay, if you've broken even, does that mean that everything beyond that is profit? Absolutely not. Everything beyond that is investments into other kinds of things that we want to build, which costs money. Right? So we have to pay, we have, we've had, I think, a handful of devs on staff for years that are building things like these platforms. And people

like, I want the ability to pause. And so our devs work on that for 30 days. They're like, okay, we can now pause. We have researchers. We want to do more research. We launched HG So like the more that we make, the more stuff we want to do, and we're super transparent with that. Like we're like 5,000 is going to be V-tuber stream, whatever. That's a reward for y'all. 6,000 allows us to do more research. 7,000 allows us to do stuff, more stuff at HGI. 8,000 allows us to develop Dr. K's next crazy brain child idea, okay, which I think we're getting there.

We built enough, we've piloted enough stuff. We've got some cool stuff going on in memberships. We've got quests that we give you guys every week. We've got now surveys that are going to assess certain aspects of you. We want to put all that together. But that costs hundreds of thousands, if not millions of dollars. So in order to, we're not going to Andreas and Horowitz to raise capital. We're coming to y'all, which is what we believed in from day one.

So if you guys can, please support us. Get the guide. It's there to help. have already gotten the guide, give it to a friend, and insult them by getting them a guide. Okay? And I'm super excited about this. And thank you guys for being here. This is a crazy journey.

I had no idea that we would be here six years later. Like, we're still doing this. Six years later. We've grown immensely. Okay? We don't view bot on Twitch, so our numbers are not where they could be. but we have over 3 million subscribers on YouTube, 10 to 15 million people watch us every month, unique people, right? And that number is growing. So this is the next dragon that we're trying

to slay. We started out with depression, anxiety, meditation, people have gotten better, people are improving their lives. Now we're going to help you find love. Like, that's what we're really trying to do. Okay? So check it out. Thank you guys very much. And we'll see you all next. Thanks for joining us today. We're here to help you understand your mind and live a better life. If you enjoy the conversation, be sure to subscribe. Until next time, take care of yourselves and each other.