HealthyGamerGG - Why You're so Avoidant ft. Dr. Kirk Honda @PsychologyInSeattle

Episode Date: November 11, 2024

Do you find yourself avoiding conflict in your relationships? Do you perhaps find yourself avoiding relationships altogether? In today's video, Dr. K talks with Dr. Kirk Honda, as they discuss what avoidance is, and how to deal with it in every day life! Check out more mental health resources here! https://bit.ly/3xsk6fE Learn more about your ad choices. Visit megaphone.fm/adchoices

Hey, chat, welcome to the Healthy Gamer Gigi podcast. I'm Dr. Alokinoja, 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. I just did our intro, just a reminder to everyone that Dr. Honda is also a medical professional, but nothing he is going to say today qualifies as medical advice.

anything that you all have a medical concern or question about, please go see a licensed professional. Sound appropriate, Dr. Honda? Absolutely. So I was just telling people that you're an expert in personality disorders. But do you want to start by just telling us a little bit? And I think today we're going to be talking mostly about avoidant personality disorder. Okay. I love how he says, okay.

So if there are other things that are available, cool. Yeah. Well, we had brainstormed lots of things. So I sort of mini-prepped a lot of things this morning, but yeah. Yeah, do you want to tell us a couple of the other things that you kind of thought about or talked about? I know we prepped, as you said, for a lot of things. Well, yeah, we talked about schizoid personality disorder as well and maybe just about loneliness in general and what can cause isolation. Yeah, awesome.

So that sounds great. I'm personally curious because I've worked with very few schizoid people in my clinical career. They don't usually come to therapy. Right. Yeah. So I think I would love to hear about that. But do you want to tell us a little bit about kind of who you are, where people can find you on the Internet? Yeah.

I have had a podcast and YouTube channel called Psychology in Seattle since 2008. And we do all sorts of things, you know, podcasts. and reaction videos and deep dives and lots of things. Yeah. But I've been a therapist and a professor since the late 90s. Wow. So you were doing podcasting before it was cool. Yeah.

I don't know why, but I was. Yeah. No one was listening, but I was doing it anyway. And what kind of stuff can people expect on your podcast? Yeah, you know, I have a hard time elevator speaking it, because on one hand, we'll do a deep dive on a personality shorter, for example, and I'll talk, I'll research for six months and talk for 12 hours, and it'll be from several different angles, and I will feel like it is a mini dissertation. Or I will react to Love is blind and just go,

what was that? And I'm never diagnosing from afar, but I am using it as a launching pad to talk about relationships and attachments and conflict resolution and fidelity, that kind of stuff. Or I'm talking with one of my co-hosts who are all really good friends of mine and sometimes we're reacting or we're responding to emails or we're talking about a movie we saw. You know, when you create 20 episodes a week, you know, you got to keep the needle moving. And so you make 20 episodes a week? I mean, it depends on the week, but, but yeah. That's insane.

Well, yeah, but my understanding is you work a lot as well. So, you know, you know the drive to like keep going. Sure, but I mean, I didn't miss hear you. You said per week, not per month. Yeah, like right now, Love is Blind Season 7 is on. And so I always will react to that. Okay. Because it's my favorite reality TV show.

And so I will put out two episodes a day just for that. Then there's also the audio. Okay. Okay. About podcasts and stuff. So, you know. That's so cool. I think,

so here's, I think your channel is phenomenal. And I think part of what I really like about it. Here's by the way, but I am quite honored. I never thought that you would even know who I was and give me the time of day, let alone have me on one of your videos. So I'm quite honored by this.

Well, we can, you're very welcome. I am equally honored because, you know, you've been a professor since the 90s. I was like in elementary school in the 90s. So to have someone of your experience and just breadth of stuff is super cool. And I think strongly recommend everybody check out your channel. And I think it's a really good fit for people in our audience, because like you said, I think, so I think a lot of people come here because they want mental health in different ways, right? So like sometimes it's a conversation, sometimes it's like a deep dive or like dissertation. Sometimes it's like, and I think you do react content incredibly well. Yeah. And so I think you do a fantastic job of taking things that are entertaining and already people that are like watching or into. And then you sort of make like learning about psychology, psychiatry and mental health like fun. and in a more packageable way.

So strongly recommend everybody check out Dr. Honda's channel. Yeah, I kind of fell into it. At the beginning of the pandemic, I was bored like everyone else during the initial days of the lockdown. And I had heard of this show that everyone was talking about called Love's Bine. And I never watched reality TV.

But I'm sitting there with my wife and I'm like, well, we have less time to kill. So I started watching it. And I found myself actually liking the show and bothering my wife. wife with like, no, no, no, they shouldn't be doing that. They should try this thing, you know. And I was, and I was like, maybe I should stop bothering my wife and I should just bother the internet with this. And then I didn't think anyone would watch, but it sort of blew up and then, you know, here I am. Yeah, that's cool. But yeah, it is along those lines of like finding things that people are already interested in. Because, you know, I've been podcasting since 2008 trying to break through the SEO on some level. And whenever people would find me, they would say, I can't. You know, you need a better SEO or something because I just, you know, I finally found your content and you've been doing this for so long. Well, the trick is, is if you sort of jump into the stream of content that people are already Googling, then you have a greater chance of actually coming across people's feeds.

So I think we have some people on our team who I think understand that stuff really well and they're super awesome. And so let's dig into personality disorder. So can you start by just telling us what is a personality disorder? Yeah. Well, it's complicated. And even when I explain this to students, I will tell them and hope that they believe me that me describing a personality disorder and even having gone through a few courses, studying personality disorders and other disorders, they're not really going to get it until you actually know the academic disorder. side, the research, DSM criteria, and hear it from an expert and hear all the vignettes, but also experiencing the individual. If you out there have had someone in your life close

to you, or you are someone that has a personizer or things that you do, then you have a much greater chance of understanding. But if you don't have someone to reference or you have an experience it yourself, it'll, even if you think you get it, you know, I'm just speaking for my own personal experience. It's hard to grasp, but the easiest way I can describe it is that it is a disorder in perception. And I don't usually hear it described this way, but I find, which makes me wonder if I'm off base in some way, but I find that all personality disorders, aside from antisocial, which is kind of an anomaly, depending on how you look at it. But all the other personality disorders have pathologically distorted perceptions,

you know, like a common personality disorder that people might know about is borderline. And so with this personality disorder, the distorted perception is that people are about to ban and be at any given moment, even when they're not. So it's not delusional. It's not hallucinating. It's not psychotic, but it's borderline psychotic, which is, why it has that name in that the individual is convinced of abandonment and reacts accordingly, even when there's no evidence of that or extremely limited evidence,

like someone doesn't text you back right away and you are triggered and you become convinced. With other personality disorders, it's a different core pathological perceptual distortion related to the relational traumas that were chronic in. early childhood. Okay. That's the shortest way I can describe personality stories. Sure. So, what, what is the, what happens in avoiding personality disorder? Yeah. So I always find that with any personality disorder, just for my own sake, I will understand it through its hypothesized and frequently found early relational trauma. And then once you understand that, then to me, it all kind of fits together because like again with like borderline if you just read the criteria

it looks kind of like a jumble of behavioral observations but when you understand that it all generates from an abandonment trauma then it's like oh okay so with avoidant personality disorder the childhood trauma is that on you know baseline is and really this is true for all personality disorders is there's general abuse and neglect that is present and lack of attunement. So the child, because, you know, all children go through bad things and have bad moments, but if they don't have someone to turn to that is safe, that can listen to them, attune to them, and help them, then they're left to their own devices to come up with

their own defenses against that fear and danger and threat. So, so as, and that's similar, and that's the same with avoiding personality disorder, is that there's some sort of neglect and abuse. Often it's neglect. But the second feature of the childhood ongoing relational trauma is that the child is made to feel excessively afraid of social situations, which of course makes sense, right? But this can look a lot of different ways, right? It can look some obvious ways where you have a child who is, you know, and it can be subtle.

You can have parents who, you know, maybe there's conflict, there's divorce, Maybe the parents aren't the best parents in the world, but you don't characterize your parents as the worst. But they're not really there for you. And when you were two years old and you had a pain or a fear or a boredom or a joy, your parents just weren't there. Maybe they were avoidant themselves. Maybe they were depressed. Maybe they were working too much. Maybe your family was experiencing war trauma or something.

But anyway, so there's some sort of neglect. And then the parents are trying to get you to go to daycare or to preschool and they push you into it and they don't have a good approach to it and your experience in that preschool or in that daycare was not pleasant. And when you get, and that's very common, but then when the child comes home or gets picked up by the parents, the parents, again, don't attune. and they don't listen and they don't notice. And so the child learns that they're alone in the world and they cannot turn to other people and that there's a constant threat of being humiliated and rejected.

And it develops into this perceptual distortion, which brings it to a higher degree than social anxiety because we have regular social anxiety. Jump in for a second. Yes. Yeah. So this is all. Awesome. Oh, thanks. Love it. So I want it because you're covering a ton of good stuff. So I wanted to, first of all, make sure that I really understood this because I have never heard personality disorders described in this way before.

Okay. And I struggled a lot with learning about personality and personality disorders during residency training. So I'm going to just repeat back. So you said, so I think it's really interesting because when we look at like some person. personality disorders when I look at something like, let's say, BPD or something like that. There's more frank or overt abuse, right? So there's like a very high history of physical abuse or sexual abuse for people who develop borderline personality disorder. And the way that I think about personality disorders, I think about non-personality, or maybe we'll

get to this in a little bit, but I think about personality disorders is very similar to what you're saying in terms of it shapes the way that your brain, your psychology, your mind, your mind, mind and your physiology develop. So when we're young, right, the concrete is still wet. And if we draw in it, it'll kind of solidify in that way. So based on your upbringing, kind of the way that you're shaped is the way that I think about a personality disorder. And perception is absolutely a huge part of that.

And I think it's a beautiful way to just launch into everything. And so what we're talking about in avoidant personality disorder is not so much frank abuse, but more neglect. Right. typically. And this is also why I think it's hard for people to recognize that, right, because it feels normal to them. And we hear stories of things like physical abuse or sexual abuse. And some people will be thinking about their childhood and they were like, none of that happened. So they think that they don't even realize that there is a developmental trauma or neglect or something that could have shaped you in a certain way. It just feels really normal to them because the red flags that they have heard. about don't apply to them. Exactly. And then I thought it was super cool how you described this like made to feel afraid of social situations because then the question in my mind was what does that look like? But I loved your kind of one-to punch forced into daycare. And then when they, daycare is bad.

You get bullied, whatever. And then when they pick you up, that forced into a social situation plus the neglect or absent parent is really what I like clicked for me. Yeah. Right. So when you come home and you tell your parents, hey, I don't like daycare. And then they're like not paying attention. And it's really interesting because I can think about the patients that I've worked with. And it's the ones that are okay are the ones that only have one of those two things. So if you get forced into daycare, but you have supportive parents when you come home, you'll be okay. And presumably. And then if you go to daycare and it's not traumatic, then you'll be okay. But when you have those two things, that's really what is the birth of avoidant personality disorder.

Yeah, yeah, right. And you rinse and repeat that because you're anxious and then you're awkward, and then you get shunned, and then it gets worse and worse and worse, right? And then you develop this idea that you're inherently ridiculous for some reason, and there's no point in even trying because everyone knows that you're ridiculous. There's something deep down in your soul that makes you inherently rejectable in social situations that everyone can see. That's the perceptual distortion is that everyone knows how ridiculous that I am, you know? There's no hiding it. So there's no point in

even trying to hide it. And maybe no point in leaving my house. So how does that cycle, can you tell us a little bit about how someone goes from not having fun at daycare? And then you kind of alluded to the cycle that results in such a concrete belief about, inherent rejectability that is impossible to hide, which I think also is just a brilliant way of describing it. Yeah. Well, it's chronic and even in the, you know, well-meaning parents, they might even bring their kids to therapy. But if there isn't enough, so the cure, if you will, the treatment involves the correct, so there are, I summarize in my mind all therapy and two prongs, which is awareness, so you have cognitive therapy and other kinds of, you know,

discoveries about the self so you can discover your triggers, you can manage things better in the moment. But the other prong is corrective experiences. And for people with avoidant personized disorder, awareness is important and can definitely help, but it won't take away the intense fear and the propensity to distort reality to fit the way things. feel. So the corrective experience is to have social situations that go relatively well, and the individual habituates to that while they are being loved and attuned to. So that, commonly in my world, can look like someone who has a spouse and a therapist with me, who cares about them and is loyal to them and understands them and attunes to them and doesn't

reject them and doesn't buy into their or doesn't a slot into their their perceptual distortion that they're going to be rejected and that they're ridiculous and they're ridiculous and they venture off into what they believe to be risky social situations and you know do their deep breathing and reassure themselves and it's a graduated exposure and then they come back to me, they come back to their spouse, and they're welcomed back, you know, sort of like the opposite of what happened when they came back from daycare, that kind of thing. And you rinse and repeat that enough times, and, you know, the neurology eventually habituates and a new story and a new reality and a new perception, a new feeling is generated. Okay, so that's cool.

I'm wondering about, so there are a couple of assumptions that really worry me about that. So the first is that there's a spouse. Yeah. The second is that there's a therapist. Yeah. Because I imagine a lot of people with avoidant personality disorder have trouble engaging in romantic relationships. Yeah. Well, yes.

They have trouble with the beginning because it's risky. But once they actually feel they can trust someone, which is a big leap, I mean, there's a lot of things you have to do to get there. Then they're actually, you know, they revel in that, right? And they're just, because it's not close. I mean, not all, but frequently people avoid a personized order. If they have a family member or they manage to get, you know, through awkwardness, maybe they find someone who's also kind of awkward and they go down the road and bumble together, then there's not as much complications as there are with other, like with borderline,

it's sort of the opposite. The closer you get to someone with borderline, like a spouse relationship, the more you're going to be distorted and transferred to. But yeah, I hate to say that treatment and change and alleviation of symptoms involves things that, for some, they don't have access to or will have a great difficulty overcoming the anxiety to get there. But that's the way that I see it, and that's how I've experienced things. you know, it's a select, you know, sample size because I happen to have clients who are in that category, right? I don't treat people that I don't treat. So, uh, but it's the way that I see how we operate as human beings. We're, you know, perhaps the most social creature that's

ever lived in the universe. And if we're going to develop these things socially, then we're going to get out of them socially. Okay. So when you're working with someone who has avoidant personality disorder, you said that the beginning is hard, but then later on it becomes a little bit easier once you establish that trust and safety. Can you tell us a little bit about what that process looks like? Well, you know, everyone's so different. And I, as I'm talking, I'm referencing like a dozen people and every one of them is different. And when I think about this, this course, you know, the course of them, either in the past before I met them or during or after, how they manage to cultivate.

You know, for some people, they just kind of, they don't really associate spousal or romantic or sexual relationships with the risky social. Interesting. Yeah, they don't. It's like they might be okay with, but they're terrified of small talk with the grocery store clerk or introducing themselves at work when you know over zoom and there's like okay everyone go around the room and introduce but to even just walk up to someone on the street and introduce them you know everyone's different is a thing so um it it can kind of depend plus with romantic relationships if someone pursues you then you can kind of get over it plus Plus, you have this urge, you know, from several angles in your body that might say, I don't care if this freaks me out. I'm going to do it anyway.

So there's that. But, you know, then I also will know people with avoidant personality disorder who have never had any romantic relationships and have given up on that ever happening and are absolutely terrified of things like Tinder. That would be worse than talking. So, you know, everyone has their own journey. associations and it to me has to do with where their traumas came from you know if you're if your social traumas came from acquaintances or you know sometimes it's a waitress like you're forced to order for yourself um and it's a spike in distress and you know so uh for some people it's it's

those kinds of interactions others it would be like on the playground when you're flirting or or some other people come over on the playground and start wanting to talk with you. And that's more emulative of what a peer-to-peer romantic relationship. So, you know, everyone, everyone has a different. And usually what I find is that people, there's some, there's some in, you know, like there's some oasis of comfort. And so, and finding that is important, you know, to capitalize on it, kind of pour all there. And, you know, for some people, it's younger people. They, they like to be a, a day care worker and they they they don't have any nervousness around kids that that kind of thing yeah so i it's interesting because it sounds like what what i'm hearing you kind of say is that so we have this

experience early in childhood where or not experience several experiences right it's chronic for it to be a personality disorder so there there's this pattern of forced social interaction followed by a lack of support yeah and then well it'll feel forced to them it it it can be forced obviously, but they will feel pushed into it. Like, no, no, no. And then it would go horrible for them. Yeah. Okay.

Right. So, so, and then they develop a perception, a perceptual distortion. Yeah. But that perceptual distortion circuitry doesn't necessarily translate to things like romantic relationships, right? There are some situations or age differences. So like our, our brain is basically figured out. what triggers this kind of cycle.

Yeah. Exactly. Yeah. For some, those traumas will be triggered. Those circuits will be triggered with the beginning of a romantic relationship, but for others, it won't be. Okay. And they won't be triggered.

And if they have an established relationship with like a sibling or even a parent, those relationships won't trigger them at all. And those people will say, if only the rest of the world knew you, the way that I knew you, because I see you around other people and you're a completely different person. And when I'm with you, you're this, you know, easygoing, funny, spontaneous individual, which isn't a common, which is common for people with a personality store. they they often will have one person. Now,

sometimes they keep that person at arm's length, but I am optimistic, more optimistic when I have a client who says, oh, yeah, I feel comfortable around my dad, and we're really close, and we see each other every other day, and he's my guy,

you know what I mean? And so that's, that we can capitalize on that, you know? Yeah, so I'm curious, can you give us, So a couple of these examples are awesome. So like this sort of getting feedback of, oh, you're a completely different person around me. I see this version of you.

What are some other things that you've seen are kind of common experiences, almost from a qualitative research or subjective experience? You know, if someone has avoidant personality disorder, what is their experience of life? What does it look like or feel like? well um it can look a lot so one angle that i've alluded to or described briefly is that they're convinced that everyone knows that they're ridiculous that there's a very common whether they they wouldn't necessarily frame it that way but they you know they might have a very common social anxiety that is you know even that is extremely excessive like they have to plan for several hours before there's a meeting at work in which they might be asked to

introduce themselves, you know? And they like are worrying about it and thinking about it. And at best, honestly, they're practicing in the mirror. This is what I'm going to say, you know, but often people get so bogged down in the anxiety that they can't even do that because imagining it and planning for it actually exposes them to the anxiety, which is, you know, overwhelming to them. So there's that. They will often choose jobs that don't require those kinds of random social interacting. But other people, you know, I had a client once that was convinced that everyone knew that they dressed and walked weird.

That as soon as they walked out of the house, that everyone would notice that they were incredibly unfashionable, like ridiculously, laughably goofy when they dressed. And also the way that they walked, just their gait, you know, the way their arms would swing, they just would have, so they would do everything they could to, you know, try to make sure that they were as unrediculous as possible, even though they knew that they were. But that would make them look a little weird because when they're trying, when they're thinking about every muscle movement as they're walking, you know. It just kind of looks a little.

Yeah, awkward. People probably don't care. You know what I mean? If they do notice, they're just like, oh, that guy, you know, has a limp or whatever. But they're convinced. And then they see people kind of react occasionally because they are acting a little strange. They're like, see, you know, everyone knows. And I should just go home.

And, and, you know, the foundation of this, which might differentiate it from social anxiety itself, is that the individual believes deep down that there's something inherently ridiculous and rejectable about them. There's a defect deep down that they only have, honestly. You know, if they hear other people that will say some of our things, you're like, well, yeah, but, you know, I really have that T-Fine, you know, and I'm, they just, because of the way they were treated, right, they were shunned and they went through these social anxieties. they developed an almost magical thought that there's something inherently defective about them

and then they find something in society to latch onto like fashion, like the way their faces or like the way they swing their arms or like the way that they talk or whatever or how good looking they are. And that helps them to feel like, well, at least there's some concrete reason and why I feel the way I do. But if we strip away and we combat that, you know, in therapy, cognitive therapy and narrative therapy and stuff, and we strip away that and we're like, no, you know, empirically, all these people are saying,

that's not how they see you. They're still left with the knowledge. They know that they're defective and rejectable. There's something wrong with them. Maybe it's not what I originally thought it was like my fashion. but I still know. And so that's where the corrective experiences come in, where they can actually go through enough experiences

to create new neurology, new circuits that show them otherwise. Yeah. So it's so interesting. It almost reminds me of when I was learning about schizophrenia. And understanding that the basic problem there is a hyperactive pattern recognition in the brain. So what happens is people will have this, feeling that they are being watched.

And then what happens is once they have the feeling that they're being watched, then they start to interpret the world around them. And this is why people who are like paranoid or delusional will believe that the FBI or mafia is following them. It's really interesting. It's not that they have direct data. It's that they, first of all, I feel like I'm being watched. And then they notice this person is sitting in a car across the street.

they notice that when they go into a gas station, there's someone who has a blue hat on. And then the next time they go to a gas station, there's someone else with a blue hat. Is this some kind of uniform? So the part of our brain that generates patterns is hyperactive. And then what happens is their intelligence, their analytical capability kicks in

and asks themselves the question, who is it that has the resources to deploy all of these people and follow me around? it must be the FBI. It must be the mafia. It has to be some sort of, you know, worldwide organization Illuminati kind of thing, because who else could pull this off? Right. Yeah. And we all do this, right? Our feelings are first, and then we fit reality to our feelings. None of us are not like that, if that's a sentence. Yeah, absolutely. Can you tell us a little bit more about that? Because I don't think many people understand that.

Well, you know, a common experience is if you are dealing with the other side of the aisle politically and you're thinking, how did you come to that conclusion that's divorced from the facts? And they're looking at you in a similar way, depending. And that's, I think a lot of people will conclude, well, it's motivated reasoning, it's confirmation bias. And that's all just manifestations of this is the way it feels. And so I'm conforming reality or I'm cherry-picking reality to justify the way that it feels. This feels scary or I've been convinced of that. And research shows that, you know, that if you've been through trauma, then you're more likely to believe in a conspiracy theory, right?

You're more likely going to believe that there's a powerful force that is conspiring against you because that was actually true when you were three. There was a powerful force conspiring against you. And we all, you know, and I do this all day long. And it's probably helpful in a lot of ways, right? Like if I believe that my two dogs love me, but I can't confirm that. I'm going to look for, oh, you know, the dog comes to me when she's scared of fireworks. That means she loves me. You know, it helps me to sleep better.

at night. Yeah. So it's, I think it's interesting because you're mentioning a couple of things that I kind of want to highlight. So the first is when we're talking about avoidant PD, one thing that I thought was really cool was your people seem to do a lot of mind reading, right? So people are, so if you were convinced that you know what is in someone else's mind when they look at you. I'm sure that this person thinks that I look like an idiot. That's one really like powerful feature of it, right? when you, like, because you don't know what's in someone else's mind, but something is telling, like, you believe that you know what's in other people's heads. The other thing is the uniqueness of it that one person potentially with avoidant personality disorder can look at someone else and say, you are ridiculous for believing that. But I am, I'm sure that I'm fundamentally flawed. And so the third thing that I thought was really interesting is that the way that you almost described how they latch on to a particular. defect, but the defect is deep rooted. And then they try to find some reasoning for it because honestly, and that's almost seems a little bit protective to me, because at least if I have an explanation, oh, like, I feel, if I feel horribly broken and I can blame my awkward fashion

sense for it, that almost is protective because then I know why I'm broken. And it's not this raw feeling of unbrokenness. It gives you some sense that, okay, if I could fix this one day. And I I know they don't try to because they feel like nothing ever works. Or maybe they try and they just feel like it never works because that's not actually the problem. But I think it's really interesting how, so when you're working with people, do you kind of, as you strip away those distortions, what happens to that raw feeling underneath? Yeah. And by the way, it's brilliant of you to make that connection. I actually had never thought about that before that it would be almost like a defense.

it's almost better to think it is fashion than it is something deep to my core. So at least in the conscious mind, it's a temporary reprieve from what they believe to be true because of the mistreatment they went through growing up. But, yeah, when people have those defenses or, you know, surface level conclusions stripped away, it can actually be worse for them. It can feel raw and hopeless. As you're saying, at least with fashion, there's a chance, right? But if it's just you, then there is no chance, right?

And that's where, you know, depth therapy actually helps, you know, a deep relationship with the therapist. so that the thing because it'd be tempting if you're a friend or a family member to just say don't do that to yourself, you're a good person and to try to reassure the person, right? But, and maybe that would temporarily help, but that's not going to take it away. You know, a trained specialist would understand, okay, we've arrived at something that will take potentially a few years of corrective experiences and hard work to actually chip away at. And here we are. and it's okay.

And, you know, I'm thinking of a few moments in my mind. And it can be scary for me too. You know, I'm a human being and I don't want someone to feel that way about themselves. And it'll break my heart. And I'll absorb their anxiety about having to look into the abyss. But when I'm at my best, I'm like, it feels like an abyss, but it's not an abyss. And it feels like an emergency, but it's not an emergency. In fact, the fact that it feels like an emergency means we've worked hard

to get to this place, which is a very necessary place. And this is the same with all personality disorders. There's a moment of looking into the abyss and having that fear. It can happen in the first session, but it can also happen in like the 100th. But the trick is that you, at the very least, as a therapist, have to believe that it's not an abyss, that there are things down there. There is a self there. There is safety in the unknown. And we just have to, you know, search around in the dark or start turning up the dimmer switch to see it.

I don't know if I'm making any sense. But when it comes to avoid a person eye shorter, that looking into the defect, the inherent defective self, and for me to say, I'm glad that we're here, I'm sorry that you feel this way. but the fact that we're here means that we have gotten to a certain phase and it sucks and it hurts and it's scary and it's the worst and you know i'm in it with you and we'll you know we'll go through this together but know that i know that you're not defective know that i know that there's nothing wrong with you and know that i know that you were told that and treated in a way that was like that to convince your two-year-old self that that was true, but know that I know that that was not true. Yeah, it's so interesting. And I think you made a lot of sense for people who have been there. I love this concept of looking into the abyss.

Because when I work with, it's so interesting, because he said, you know, antisocial personality disorder is a little bit different. And my, so I work primarily with Cluster B personality disorders. Yeah. And I just think they're more fun. They're more likely to come into therapy, that's for sure. And so the interesting thing is what I work with people who are sociopaths, we look into the abyss. And I love the way you describe it because I think every patient that I've worked with has this experience of looking into the abyss.

So there's one moment where we look into that. Interesting. It was with people who are sociopaths, we say, we don't, I say, there is an abyss there. I see it. You see it. And it's okay. What are we going to do about it? Right?

So I think they're important. emotional architecture is also a little bit different to where that's not quite as scary to them. And, and, um, but it's, it's so I, I think you described it well. And I think this is the hard part for a lot of people is that, you know, the deeper we get into describing what happens in therapy, the less words work. Yeah. Right. So, so you just have this moment where everything is kind of laid bare and it is super scary. And I think what you're really describing is, that's really healing about that is that in that moment, they're not alone. Right? So when you look into and see the worst parts of yourself, there's someone there who doesn't reject you. And even if you say, hey, I think it's just feelings. And they're like, no, it's reality.

I think the beautiful thing, and this is what little clinical experience I have, is that in that moment, you know, what they believe or don't believe is not nearly as powerful is you being there with them. And then also, so what time next week? Yeah. Right? Yeah.

Yeah. And that's, you know, that's the magic, right? That's the formula is consistency and being with someone and the client puts their hope in you

because you have hope. Because it's too much to expect a client to have hope about that. It's too overwhelming. convincing to them in the specifics of avoided personality that the individual is defective and ridiculous, but they are convinced enough that you're convinced and you are an expert. So maybe there is hope. My therapist has hope. I'm choosing to go along with that. I'm taking the leap, and that's hard to do, you know, because you can just say, as a therapist, I have hope,

But you have to be, you know, connected on a deep level with the client. And the client has to be convinced of that. You can't just do this from the sideline. You've got to get in to the scrum of it, you know? So I think when you say take the leap, I think that's where the neuroplasticity happens. Right. So before you take the leap, you know everything. Your logical mind is fixed.

you have all of the answers. So if you really think about it, that confidence in your beliefs is what, that's not neuroplasticity. When you take the belief, when you take a leap into the unknown, that creates a question mark from a psychological perspective.

And what I've kind of seen is that's what really triggers the change is being able to take that leap. And then that's the moment that like you're saying, you start to question. And when you start to question your beliefs, that's when the brain starts to change, the mind starts to change.

I'm kind of curious. I mean, you would know more than I would, but isn't that one of the theories as to why SSRI's work is that it doesn't make you happy, but it makes your brain more plastic. It makes your brain more flexible to change in those moments. It is absolutely one of the theories. But I think that the tricky thing about SSRIs

is that for most psychiatric medication, we're not too clear how it works. Right. So I think there's absolutely some evidence of neuroplasticity induced through SSRIs, but the mechanism of that is also like questionable. So, you know, people who are very anti-SSRI basically will even acknowledge that the one thing that an SSRI does is emotional numbing. So, and it doesn't make you happy.

It just potentially makes you less sad. And what I would say is the mechanism that I would. kind of lean into there is if you look at emotional numbing, then I feel less sad. And what are we talking about? We're talking about when an emotion is very, very strong, you are more convinced, right? So when you're, when I'm super, super depressed, it's not depression, it's reality. Right. And so if we quiet the emotion, then it opens the door for more cognitive flexibility. And, And that's evolutionary, right? So if we think about why have emotions evolved,

they've evolved to short-circuit analysis. If I slap you across the face, your analytical mind is not going to be like, hmm, I wonder what he's going through today. The ethics of slapping people across the face. I wonder what Plato would say. You need to just react, yeah. Maybe if I, yeah.

So I think it's interesting. So I think that's one mechanism of potentially neuroplasticity. The really interesting thing is if we look at, I think there are more robust studies on maybe not more robust, but if we look at the mechanism of action of a lot of these like pilot studies on psychedelics, neuroplasticity is a huge part of it. A lot of the meditation literature is about neuroplasticity. And so I think we absolutely see that as a goal. The really interesting thing is that even if we look at psychedelics and meditation, we just did a stream about this recently.

and what's interesting is it just induces neuroplasticity. What you do with the neuroplasticity is up to you. So one of the really scary things that I've seen is when people hear psychedelics are healing, they'll be suicidal and depressed, and they'll take psychedelics with the hope that it heals them. But all it does is induces change in the brain. And if you're in a negative environment, you can actually end up way worse. So I've seen a ton of patients who have anxiety disorders, PTSD from bad trips.

And if you look at psychedelic-assisted psychotherapy or the religious traditions, what you tend to find is that when they use these neuroplasticity-inducing agents, you have a guide like a shaman or a guru or a therapist who helps you then integrate that experience and make sense of it in a much more positive way. That's probably what's responsible for the healing. And like what we're describing is, you know, when you're in that moment of staring into the abyss and they take the leap of faith, you're in. in the room with them. And if they do it on their own, it can be way too scary. Yeah. Yeah. Yeah. Hmm. I feel like I just took psychedelics. My mind is blown. That's interesting how all those connections. Yeah. I'm going to have to chew on that for a while, but I like it. Yeah. So maybe a conversation for a different day after you've had a chance to chew. And I was wondering if we can kind of switch gear. a little bit for a second. So tell us, tell me a little bit about the difference between social

anxiety and avoidant personality disorder. Yeah, well, I'll tell you that if it's fairly severe social anxiety, but not beyond the fuzzy threshold into a personality disorder, you present that case and give each clinician a good amount of time to assess, you know, maybe five sessions. You're going to get varying diagnoses, some saying it's just high level of social anxiety and some saying it's low level, avoidant personality disorder. But a common differentiating factor with a heavy asterisk is that people with social anxiety tend to know that they have excessive anxiety without treatment. They tend to understand, yeah, I have this phobia of meetings or of social situations and it's all in my head. I get up in my head and I'm convinced

everyone and I know that they're not but in the moment I get stressed out. So when they're relaxed they often, but that's the thing. This is a heavy asterisk because some people with what we would call social anxiety don't have insight into it or have pockets of lack of insight meaning that they are convinced that people are thinking negative things about them when they're not, or that they're inherently ridiculous when they're not. But that's generally the demarcation line is, for me anyway, it's the pre-treatment, pre-awareness, the extent to the semi-delusional perceptual distortion. You know, how convinced are they of the fear when they are calm and how severe is it?

And sometimes it's very obvious, right? if someone is absolutely convinced that they are the most disgustingly ugly person on the planet. And as one human in the culture, I'm looking at them and saying, I mean, maybe you're a six out of ten. I don't know, but you're definitely. And even if you were a one, I can't imagine, you know, what are we talking about here? Like you're just this HP Lovecraft, like unnamed.

Getty monster face or something. I don't even know. Like, what do you, like, that's the image. So that would definitely differentiate it from social anxiety, right? But, you know, not everyone has that kind of obvious perceptual distortion that they latch on to. So I, in practice, don't really differentiate between the two. The treatment is essentially the same. If someone's in the middle zone, you know, it doesn't really matter what.

label we put to it. It's similar with borderline if someone is, you know, on the moderate end of the scale and or moderate middle of the scale. And another clinician might say that they are subthreshold and just have traits or have severe preoccupied attachment or something. It doesn't really matter. The treatment's the same. Okay. Interesting. So, so a couple of things that I'm taking away. One is that, so how do you know you have avoidant personality disorder? If you look into the abyss and there is a Cthulhu-esque monster there that makes you not human, fundamentally not human, right? You are a Cthulhu-esque monster wrapped in a human form. Yeah.

And everyone sees it. And everyone's going to see it, which is why you have to avoid them and you have to go out to a cabin in Massachusetts, which is, you know, what happened with H.P. Lovecraft. And so it's such a great characterization. And I also really like this kind of, in fair point that, these diagnoses are essentially artificial distinctions that we make, right? And that the underlying pathology is along a continuum. Yeah. Because people with social anxiety often have a similar background, a similar trauma, a similar path. Yeah.

So, so, and I'd say what I kind of heard there, which is sort of squeezing it through my understanding of the difference between the two, is actually kind of the, the degree of pervasiveness to it, right? So if you have a psychological architecture that develops at least somewhat in a healthy manner, and then social anxiety happens to you later. So I think that, you know, diagnosis really starts to spike around puberty, for example. So you can have a relatively normal childhood, but also heavy asterisk there that you probably had some of these experiences, which make you somewhat vulnerable. And then so, so since you have that normal personality architecture develop, then social anxiety sets in, which is what allows you to see

and have some degree of insight when you are calm. Because you know, like, hold on a second, like I wasn't that way when I was eight. Some things changed. Like now I recognize that I'm not, you know, I have friends. I'm able to see that at times. And then depending on the physiology stress level, depending on what's going on in your amygdala and things like that, you can lose that insight. But it's essentially the way that I kind of conceptualize it or the way I teach it as, you know, personality disorders are about the way that you're shaped. And then usually what we used to call kind of Axis 1 diagnoses back in the day, right? These are things that happen to you. So you developed relatively normal and normally and then something happens. But I completely

make sense that there's a shared experience and there's a fuzzy line in the middle. And that from a clinical perspective, you know, the treatment is the same. Right. And so. Yeah. Right. That's all, yeah, that's just another way of saying the way that, that I see it. Absolutely.

The pervasiveness and the structure of personality that for people without a precise order, with, you know, with just social anxiety. And just social anxiety can be crippling, by the way. It can be really, really debilitating. That the individual, baseline has, you know, what some literature will call an intact personality or their, you know, their reality checks are stronger. Their ego strength is stronger, that kind of stuff. But, but, but yeah, but I will say that you can have what we would call social anxiety and feel

pretty confident as a diagnosis and also have a personality disorder. You probably wouldn't see someone diagnosing someone with social anxiety and avoidant personality disorder, but you could have social anxiety and say borderline personality disorder or some other personality disorder. So it gets a little weird. But yeah, what you're saying in the beginning is, you know, these are constructs. These are things that we in psychology and psychiatry construct as a way of conceptualizing behavioral clumps and experiences so that we can research and guide treatment. And it tends to pan out. These labels have been around for over 100 years, or at least the concepts have.

Maybe the exact wording of the label has changed over time, but the construct of avoidant personality disorder and other personality disorders have been around for a long time because there's just been a lot of observation of humans that seem to fit into this category. Yeah. So speaking of kind of long time and changes over time, so what's been, what's your take on the rise and technology? and how that affects social anxiety or avoidant personality disorder. Well, on one hand, it has been helpful because subredits will provide these extremely quick SEO found forums and communities where people are generally speaking healthy and speaking openly and I as a clinician will sometimes read these subredits just to remind me of the variance within a particular personality disorder. I, you know, have to filter. I can't, I am always a little skeptical of people self-diagnosing, of course. So I'm always reading a post and

thinking, okay, where's, where's the marker so that I can be assured that this person actually does have this disorder and and I would say half the time I'm not satisfied in that way and you know makes sense because the landscape would be hard for people to discover but but the very least I think the internet has has really helped you and I are in the internet right now talking to people that who might have never even heard of a personality disorder prior and you know we see the evidence of that you know the problematic tip of the iceberg is that people are labeling everyone a narcissist these days and gas lighting and stuff and we can lament that but that's the result of having worked for decades in our field to raise awareness about abuse and about personality disorders and moving away

from just in like you know the idea of inherent spiritual badness you know so uh we see some ill effects which you know uh i i don't i didn't predict but well how was i supposed to know but overall you have a lot more people going to therapy and you know people tuning into this live stream who 30 years ago would have thought well that's for crazy people why would they want to watch uh to clinicians talk you know so um so there's a lot of good things um the bad thing is that it uh can inadvertently create a platform upon which individuals lack the exposure that typically will occur naturally when you have nothing to do at home. You know, like when I was a kid in the 70s, I, uh, there wasn't anything to do.

Uh, that, you know, there was three TV channels and none of the programming was geared towards kids. So aside from like before school and maybe an hour after school. And, um, I, you know, you just were bored out of your mind and toys weren't as prevalent, you know, there weren't as many cheaply made. readily available things to play with, certainly also video games. And so you either had to read, draw, or climb trees with your friends. And that's what I did.

And so with the Internet and with media, you have a lot of young people and old people, you know, adults who, you know, there's several whys in the road. And if there was no Internet, there was no technology, there were no video games, they would say like, oh, okay, fine, I'll go knock on the door of my neighbor and see if they want to play or something like that. And then you just, you know, you go through the normal exposure and habituation and trials and tribulations and, you know, hopefully, not always, but you progress through that experience, learning that things are going to work out in the end and bad things will happen, but, you know, overall you'll get through it and be. Because the other people depend on you because they don't have video games either, you know? So they don't want to shun you because they don't want to be alone. They don't want to be without.

So, you know, I'm not saying anything mind-blowing right now. But, you know, I think that we see that. And that seems to be the consensus is that there's a lot of things conspiring for isolation. Helicopter parenting is another factor, I think, that people identify. Yeah, so, so it, I mean, it sounds like you're kind of, and that's been my experience, too, that I, I think when I was growing up in the 80s and 90s, you know, when you got bullied, when things were socially difficult, you kind of didn't have a choice, right? So you were kind of tossed into the deep end and it's like, sink or swim. And, and so it was, it was a really brutal, I had a really rough period of time between probably fifth grade and eighth grade. And, and it was like, you know, you just had to learn there's no retreating to anywhere. What happened? I was bullied very heavily.

Oh, really? Yeah. Oh. Ouch. Yeah, it made me who I am today. Have you found them? Have you looked him up and given him the finger and said, look at me now? Am I first?

Not really. Yeah. Do you want to? I used to want to. I want to. I want to. I want to find these guys and tell him, look at him you find the people that believe me yeah why uh i can see you as a fifth grader i don't know

what happened but i can visualize it and to think that people would mistreat anyone but you know treat you, which I imagine if your demeanor is similar in the fifth grade as it is now, that it's, you know, curious, smart, active, a talker, but not harmful and not, you know, problematic, not worthy of being targeted, you know. And to think that there would be people that would habitually, you know, target you and harm you is upsetting to me. It makes me angry. You make you want to go to those people and say, I don't know.

I don't know what I would do, but it just, I guess I want a time machine and go back and like alert adults when you were in the fifth grade to tell them to protect you or something. I don't know. I just have that urge. Yeah. So I appreciate. the, this is great, dude. I'm loving this because, you know, oftentimes what we do on stream is, is I do what you're doing. Yeah. And it's, it's, um, it's fun. This is the first time I've been on

the receiving end and it's quite the experience. So thank you so much. Um, and, and, apologize if it's like invasive or, no, I, I, I, I, I, maybe I was caught off guard because I wasn't expecting it. Um, but I, my first, you know, the thought that had popped into my head is, like, well, I do this shit to people all the time. So like, you know, so and, and I, I think it's, it's, it's important to do, right? So I think it's important to acknowledge. I think for me personally, like, I think a lot of that, I used to sort of feel that way. And I remember I had one experience where I went back to my hometown.

And I ran into one of my bullies at a bar, actually. and it was sort of at first I felt a little bit triumphant and then I sort of like realized so like I have I have a history of kind of spiritual practice and I think a lot of that stuff has to do with the ego so like you know wanting vengeance on people is like a gratification of the ego is it is it sad was that kid hurt sure yes absolutely and at the same time part of my post traumatic growth and part of my narrative and part of the work that I've done is is like to really stop and think about that right so just because it was sad for that kid that this is part of the experience of life that negative things happen to us I happen to believe that that's my karma so did I do anything to deserve it maybe not in this life but that all things there's an order to things and that also those experiences make me part of who I am today.

And this is pretty post-traumatic growth kind of, you know, narrative rebuilding and all that good stuff. But like, I really do believe that. And so now I, I try really hard to not hold ill will towards them because they too were just kids, right? Like, I mean, a fifth grader, they don't know what they're doing. They're, you know, and so it's like, what's the point of, you know, going back and telling them.

I mean, there can be some gratification. There can be a sense of justice. There can be a giving. into anger. But I generally have the attitude of, like, what's the point? Like, I'm on this earth for who knows how many more years? Like, do I want to spend any iota of energy going back and feeling triumphant? Like, there's more, there's, like, more important things to do. Yeah. So I, I, well, the litmus test would be, and I, you know, I will ask this as generally, as possible, but you and I are on the internet and will experience occasional groups of people

that are coming after us, you know? And the litmus test, I guess, would be that as you and I go through this, are we having understandable and within normal limits reactivity to that? It's hard to deal with regardless, but if we are unresolved or still, you know, processing these feelings of past bullying, then I guess we would see symptoms of overreactivity. Or underreactivity? Yeah. Right.

I disagree with me. But it's interesting. I have a very similar experience. I wasn't bullied, generally speaking. I was a big kid. I actually was one of those kids that would walk around trying to act like I was shorter because I felt so awkward because I was so tall, you know, and so big. But, and, you know, it was the 70s and 80s, and because I'm Asian, everyone assumed I knew karate and I could kill them, you know, or something.

Because I grew up in a mainly white community. And so there was that, that worked for me, which kind of meant that I never really learned how to fight well because no one had ever fight me. But anyway, I was in like a suburb. grade and I'm walking home and it's, you know, the Pacific Northwest in Seattle and it's kind of cold in the winter. And as was the fashion of the time you didn't wear socks. So my shoe, my feet were basically numb. And this bully, this older guy, I had no idea who he was. Him and his friend are walking right towards me as I'm walking home from school. And he walks up to me and he just stomps on my foot as hard as he can and pushes me down. And oh my God.

I'm just like, flabber guys. I'm like, what is happening? Did I do something? did he mistake? And he just continued walking. You know, looking back, it's obviously, you know, likely that this guy had something going on in his life, maybe some whole life problems, who knows? But I got home and I just peeled my big toe nail off my foot. It still isn't quite attached to my body because, you know, once that comes detached, it doesn't really

reattached very well. So if I want to, I can like trim that. Anyway, it's gross. But I ran into him in my adult life in a bar as well. And he was with all of his friends that I recognize, you know, older, older people from my school. And I had a, you know, a couple of beers and I'm just like, I'm going to go confront this guy. You know, I'm going to go get him because he took me by surprise. I'm, we're the same size now where I'm bigger than him. And so this is going to happen. So I go up to him and, you know, I kind of get in his face and I'm just like, do you remember me? And he's like, at least he's saying he doesn't remember me.

And I say, well, you know, I tell him what he did. And he just sort of looked down at his feet. And all of his friends looked to him and said, did you do that? Did you do that to him? why would you do that to him? And he just looked ashamed. And it took all the wind out of my sails. And I just said,

oh, well, yeah, maybe you don't do that or something. And then I just walked away. But it was similar to you. I was just like, oh, you know, you're not this big monster. You're just a regular struggling human like anyone else. And it's not. the same like it was back then. And it just completely, you know, before, that was a time when I wasn't a therapist and wasn't trained.

And so I didn't have the perspective that I do now. So, you know, planted this seed that would later grow to this idea of just like people who we might look up to as monsters or as, you know, these evil creatures are more likely they are struggling and ashamed. and it manifests in this hostile, harmful, possibly bullying behavior, you know. So I don't know. I think we're off the topic, but. No, I think, I think this is great. So if I can respond? Yeah, please.

So the first thing is, like, it's super scary how senseless and random that is. Yeah. Right? So, like, I'm kind of thinking about just, because I think in some ways, not to get too comparative here, but I, I'm sort of it, I'm thinking about my own experiences and how sort of reassuring the certainty of the bullying was, right? So it was like every day, but like I knew what I was getting. And it's, and let me.

So like, I kind of knew where the danger zones were. So there was like safety and there was danger. But that was at least clear if that kind of makes sense, right? So there are like some people. Rules you wouldn't get bullied? No, no, I mean, but I know that, well, so not, not like the rules at school, but like I knew how to get become invisible. I knew that PE was going to be rough. I knew that if we played dodge ball, like, that was good because my only job is to dodge things,

which when people throw things at you a lot, like you get pretty good at, right? Okay. So, and when I'm hearing your story, it almost like seems kind of like more frightening to me because it's like random and senseless, right? So you're like walking down the street and you're living your life in the world is like a safe place. I was actually walking my girlfriend home, which is another detail. Right. So, so, and now there's like this aspect of like humiliation involved, right? So you're, you're made to feel so much less than and there you are with your sockless shoes in order to be fashionable and cool and your feet are numb, right?

And then also like the, the, I mean, it's like, I don't know how to say this. The, the deepness of the lingering physical representation, right? Like that wound, like you literally carry. it with you. Yeah. And it's by your words, gross. So, like, there's something, like, about that, that, and now it also makes a lot more sense, right?

So, like, your angry reaction is like, okay, so you, you're like, this kid doesn't deserve this. I want to go back and, like, protect him. And I felt very cared for in that moment. I felt really emotional. My palms became sweaty, right? And it's like, I just met you. And your ability to see into that and care for me in such a profound.

way. And now what I'm in understanding is like it's not just me, right? It's also protecting you. And sort of the sense of injustice and how, and that's probably also why both of us are on the internet, because we also recognize that there are a lot of people out there who don't have people advocating for them, right? People with avoidant personality disorder who get shoved into situations and then no one is there to attune them. And so even our whole, whole, this whole exercise and this moment in this conversation is all a very, very distal manifestation of trauma and, and the work that we now do and how it gets shaped into people and all that other good stuff. So I don't think it's off topic at all. I think it's, I mean,

it's off topic, but it's not, I mean, I think this is what we're here to do. Yeah. Yeah. I mean, it's two hours of live streaming. You've got to keep the need to moving somehow. so I might as well just talk about ourselves narcissistically. But yeah, no, I feel really cared for too. You have that ability to hear and reflect and make, you know, I feel seen, I feel understood. I feel like you care and that you were absorbing, you know? Yeah. You know, I didn't expect that to happen during today's live stream.

Me either. And I think that's what blew my mind about this. And I'm really grateful is like how, you know, you can do this. Like we do this every day. Yeah. And even if you're an expert in it, how well it works. So when you do this to me, when you care for me, like I know exactly what's going on. My analytical mind is like, well, I didn't know exactly what's going on.

I was caught off guard and then as you shared your story, I was like, oh, this is interesting, right? But it doesn't matter whether you know how the magic trick is done. The magic still works. Yeah, right, right. Because it's not really magic. I mean, I know you're meaning, you know, but it's sort of like being an art critic or something, you know, you still look at art and go, wow, that's some amazing art. It's working on me. You know, it's the same.

You know, love and support and expression and understanding and connection, you know, this is real. Or a cook who's like understands how everything is made, but, you know, they could still appreciate it. I love that analogy. Yeah. Yeah. Anyway, if I can circle back a little bit. Please. So I think we're going to, we're going to have to figure out.

What just happened here, I think, is very significant. And I think something, I don't know what to do with that, but. I also want to honor what we're kind of the work we're here to do and make sure we have enough time for that. Absolutely. But thank you for this quick tangent. And I have no idea how chat is going to be responding to this or what they picked up or whatever. I'm so curious about that, right? I thought you were watching.

I thought you were. Oh, so I tune in 100% when I'm talking to a human being. I really just completely ignore numbers and we're flying without the net. Yeah, well, absolutely. And I think because even if my attention is a little bit fractured, I think it changes the empathic resonance. Yeah. But we'll check in with them. I'm so curious.

But kind of going back to this, so I was hoping we could talk a little bit about schizoid versus avoidant personality disorder. And if you could talk to us about schizoid. Yeah. Because I want to say I've seen maybe three patients out of 5,000, 6,000, 7,000 that I've seen in my career that, like, have schizoid personality. disorder. Yeah. I've seen an increase, I think, because of the internet and because of the crisis of loneliness and because of the destigmatization of therapy and that therapy can now be sought out on the internet over Zoom or over, you know, video conference. And that is less of a, you know, of a risk for people to take. It's much easier to just click on connect than it is to

drive across town and park and da-da-da-da-da. So there's, I think, anecdotally been an increase, but to speak to the same language that we were using with avoidant person or the same format, I'll start with the original trauma as I see it. And this is related to research. I'm not just completely flying blind here, but it's hard to research the sort of thing because you're asking people to retrospectively self-reported what their child's was like we for good reasons don't have the ethical you know a leeway to take a thousand kids and take 500 of them and treat them in the way that we think will produce schizoid and take the other 500 and not do that and see what happens we can't do that so we have to you know hear stories and

develop models and and so this is an integrative model for me is that with the childhood neglect the childhood trauma is that of neglect mainly. So with avoidant percentage disorder, it can, it's, it's definitely on the neglect side, but it can also have classic abuse, you know, positive action, harm to children. But with schizoid, it's almost always, you know, significant neglect. They can be abused too, but, but definitely hands-off in schizoid people will report that. when they were young, they were left to their own devices at best and at worst, they were just actively shunned or sometimes even schizoid people will say that they were treated like an object, like a pet, like they would be, you know, like one story was that they were carted around to friends

and family, like they were so cute or they could do this trick or something. And they felt special when their parent was carting them around. But as soon as they got home, they were just completely ignored and rejected and they were like, oh, I'm just like a play thing, like a toy or an automaton, you know, which is something that schizoid people can sometimes start to believe that they aren't really human, that they're a shell of something because that's the way they're being treated. So the other element is that they're very commonly with this trauma of being neglected severely is emmeshment or invasive, enmeshment meaning lack of boundaries between the parents somehow. Like a classic example of this, which is a minority of reports, you know, of experiences,

is that the parent will suddenly and aggressively and dramatically invade the child's bedroom and accuse the child of hiding something, whether it's food or pornography or a diary. You know, you secretly are writing stuff. about me and you're going to you know so it can manifest a lot of different ways but there's this idea of just like at any moment i can be invaded if i don't uh protect myself somehow so the child learns early in life is that they don't have personal boundaries and no one cares no one's there for me and so they have a lot of motivation to attenuate their mindfulness and their noticing of their own emotions, which has to do with noticing your own

physical sensations. And so they will start to actively turn away from their emotions as a way of like, well, no one cares about my emotions. So if I don't feel my emotions and I don't notice my emotions, then I won't have to signal my emotions and be rejected. The other thing is that they're worried about being invaded. So if they were to accidentally reveal, what they are thinking and feeling, then that gives that invasive person the ability to get them, you know, that it gives them, it opens the door a little bit so that the invasive person might, you know, rush in and invade and control and harm. And so the child learns, I have to get rid of my emotions, and this is mostly unconscious, and I have to turn away from people. So they will isolate themselves and they will believe, for the most part, and this is a pretty heavy. the asterisk on it is that people with schizoid actually consciously think that they don't want relationships, but actually they do. And this is what really differentiates schizoid from the other isolated, lonely, personalized orders like schizophrenpt or something, that with schizoid people,

pre-treatment, pre-awareness, they will think that they actually don't want attachments and don't want connections. But they actually do. And there's a lot of theory. here and a lot of research and there's different consents I, if you will. But the general consensus is that people with Ski-Zoid deep down do have the normal amount of desire for connection and relationships, but they are defending against it because to feel that and to acknowledge that opens them up to being terribly disappointed and neglected and possibly harmed by other people. So the adult lifestyle of someone with Ski-Zoid personality is that they are alone.

They think that they are happy, but all of their emotions are subdued. They think of themselves as not having emotions. They will often think of themselves as being, quote, unquote, you know, sociopathic, because that's the first thing that will come up on the Internet of someone that doesn't have emotion. But it'll be found if they do enter treatment, which is rare, but if they do, or if they just do some self-experation, that they actually do have emotions. They're kind of proto-emotions because they haven't been developed or evolved

because they haven't had any chance to have it be mirrored or attuned to or discovered. And so even with a lot of treatment, you know, 20 years of treatment, someone with schizoid will still have kind of childish versions of the emotions, but at least, you know, they're getting at the emotions. And we need to be connected with their emotions to know what our needs are, right? To know when we need to be hugged or when we need to have freedom or when we need to have peace or whatever or know we're hungry or this sort of thing. And for people with schizoid, they can often become quite depressed because they're not in

connection with their needs and they're not meeting their needs. So they can become quite demoralized. and they're extremely lonely, obviously. So, yeah, they're characterized as being a loner as not showing emotion. They also will daydream a lot because they learned early in life that to escape the lack of stimulation from the outside is to create your own stimulation through daydreaming or through other kinds of vices, you know, substances or other. their behavioral compulsions, you know, they, they learned that the only way to have stimulation and any kind of pleasure if they even, because they also lack pleasure in things, which can also make them look like they're depressed and one could argue that they are. But is they can't

interact with the world or other people to create those kinds of things. They have to create it on their own. And when they're a child, they turn inward. So that's that explanation of schizoid that I have. Brilliant. Oh, I'm now convinced that we have an epidemic of schizoid, probably subclinical schizoid things in like this community and on the internet as a whole. So like my mind was just blown.

So I have so many thoughts. But first two questions. I'm going to have to restrain myself. So first thing is, well, you mentioned in meshment. And my understanding of this is a little bit different. definitely not my area of expertise. So you kind of talked about this like personal invasion of space and you've got a diary and things like that.

But like most of when I've dealt with an enmeshment, I may not even be using the term right, but it is almost like an emotional blending, right? So some amount of parentification of the child or infantilization of the parent. Does that qualify for this pattern as well? It's a type, right? So one type of emmeshment would be parentification. Yeah. But does that result and does that correlate with schizoid? Are we talking about a different kind of enmeshment? It could. Predivocation and those more classic types of enmeshments anecdotally isn't as common with schizoid. It's more of brief moments and non-classical types of enmeshment where the parent just doesn't respect the boundaries of.

the child, like the child's personal space, the child's emotional space, the child's privacy. So that could be preantification, but preantification probably would have more involvement and more contact with a parent, right? And with schizoid, the dominant feature is that they're emotionally being pushed away. And sometimes it's because the parents are, good people and good parents, but they're going through things, like they're depressed or a medical emergency or a chronic medical problem or war stress or something, you know, economic problems. So it can, but but the lesson that the two-year-old learns is the same. They don't understand

that their parents love them, but yet are struggling with depression. They just think there's, no one loves them and there's no point in turning to anybody. Okay, so it really is more of that, it sounds like it's more like that random, heavily invasive, kind of like meteor out of the sky, kind of like, just very severe. Okay. And then you mentioned the phrase proto-emotion. Can you help me understand what that means? Yeah. So when a three-year-old has, shall we say, empathy or compassion for,

a sibling or a parent or a puppy. It is not easily understood by them. They don't have the ability to differentiate from the feeling and look at it. They maybe don't know how to manage the feeling in a way that is appropriate to the situation and meets their needs and doesn't invade other people's needs, you know. or if they're they feel an injustice and they feel angry about something you know like a three-year-old that is not given that second cookie they feel like there's an injustice and they you know throw a tantrum they don't have the ability to say well I feel like there's an injustice but let's look at this or I I feel angry in this moment and I want to like you know, punch a wall, but I'm a seven-year-old now and I've learned that that's not okay. So for someone that has been putting off and denied their opportunity to learn their emotions and understand them forwards and be able to differentiate from them, when they discover them

at the age of 35, they are just beginning that process and will have a, a, a, a proto awareness, but also the feeling, you know, I see this in my clients, and I extremely rarely will minorly experience this, but I do remember enough about my very early childhood to remember that emotions almost felt different when I was very, very young. They were unbridled, you know. They were all encompassing and, I think, more complicated in some ways, more. confusing, overwhelming. And so when I have clients for whatever reason are emerging into their body and emotions later in life, the way that they display and report their emotion, and the way that I worded, it is, you know, proto-emotion, but I'm guessing there's other, there's other terms for it.

But the way that, the reason why I will say that is because for clients, they often can be quite alarmed if they are experiencing these emotions and will compare themselves to other people and say there's something wrong with me why are my emotions like this when other people report their emotions like this their image and so i you know will uh have them pump the brakes and say like you're experiencing proto emotion and so we have to go through those steps before it can feel more handleable so yeah yeah super cool so like i heard so many things there that um I think really honestly blew my mind. So I want to tell you about the prototypical healthy gamer.

Now, I think that this isn't actually true of the majority of people. It's honestly the minority of people. So when we started out, you know, with this community, I was predominantly thinking about younger versions of myself. So kind of failed out of college and was sort of like lost in life and then went to India and then found myself. We can talk about that if you want to. And so what I was sort of realizing is what I really needed more than anything else was some degree of guidance, some degree of understanding of like how I work, how some of these things work. And you're describing the blend of things that I think I experienced and I think a lot of people in our community experience.

So like this sort of not so much the neglect and enmeshment, but some of the more. later manifestations, right? So the more symptomatic manifestations as opposed to the roots. So the first is kind of like turning away from your emotions. So we deal a lot with alexathemia in this community. It's like a major, major focus of the work that we do. Second thing is this sort of vague demoralization depression. So I take kind of like a more spiritual perspective on it.

but I like the way that you kind of describe this like general depression or demoralization that doesn't quite look like a mood disorder, right? It's much more chronic. It's a much more dysthymia kind of picture. So much more chronic kind of life has the zest isn't there in life. So it's not that I'm depressed. It's just that since I'm numbing all of my emotions and when I numb my emotions, I can't selectively numb my negative ones.

I have to turn it all down, right? So then these people aren't like depressed in the sense that they're between negative 50 and negative 100. They have a very constricted range of affect. So their capacity for enjoyment is very low. And so it's not necessarily that I'm depressed because of this. It's just that life feels kind of empty and bland and whatever. Right.

So this demoralization, depression, and Alexothymia picture is something that we do a lot of work on. then it's really interesting because daydreaming and maladaptive daydreaming, and I would even extend that out a little bit into like random things like a love for anime. So what I tend to find is that these people will, in the absence of this natural connection to your emotions, we require some kind of artificial or hyper-stimulating response to get that out of us. So I've talked with people in our community who just like, you know, in anime, I don't know if you watch anime, but there's like over expression. It's like over-stimulation of emotion, right?

It's like when someone is yelling, they're not just yelling regularly. There's like these lines that are moving behind them. I don't know what to describe it, but there's all this like lines moving behind you. And then like their eyes are gigantic and then there's tears coming out of them. And so like there's almost like this hunger for a hyperactive emotion because that's what. what it takes to overcome the dampening effect within me. Yeah, I never saw this way, and I'm thinking of a lot of clients and others who absolutely are candidates for this analysis that you're putting forth.

Yeah, and so we see this, right, because we will deal with things like technology addiction, but when I work with people who are, like, addicted to technology, I find these kinds of things, a predisposition for daydreaming. There's also other random connections, like maladaptive daydreaming. may be a subtype of ADHD, and you get lost in the daydreaming because you lack that executive function, that attentional control, right?

And then there's also people with ADHD, there's a subtype that may be an emotional dysregulation subtype. So when you have this intentional, like inability to control your attention, a daydream that has some soothing psychological effect, and some weird stuff going on in your negative emotional circuitry with numbing or whatever,

like you kind of create this daydreaming picture. And so it's just really, interesting because there's kind of like this like prototypical person in our community who's like really intelligent, really capable, is trying to navigate life but seems to like not have access to a compass. They don't know what they're doing. They're kind of going through the motions. They're demoralized. That's a great word. They're not necessarily depressed. It's not like they have trouble getting out of bed every day. Some of them do. But like it's like I don't understand what the point is. So like life is kind of this shade of gray. And it's really interesting because what you

kind of describe in terms of the traumatic upbringing, I think we see shades of that too. Their upbringing wasn't necessarily frank abuse, but there was some degree of neglect, single parent household, a couple of adverse childhood experiences. Yeah. And I've never thought about it in this way because I just don't know. I mean, you know, we are taught in avoidant personality disorder. The training that I got was that these people, like, something is busted in them. And they don't actually crave relationships. But I wouldn't say that my training in the area was very strong or things like that, right?

But like, I think if you look at even things like, I don't know if the DSM says that these people deep down crave relationships or not. I don't think that's like a part of what I would imagine we would find in the DSM for them. But it makes sense because all human beings do. Right. And then the last kind of like thing that you're kind of is really like popping in my head is, is this idea of a loner, right? Is that I don't, everyone says I should have relationships, but I just don't really care for them. And then if we really want to go far out into left field, this is a less tight of a correlation. It's more of a question in my mind. So I think a lot of this stuff maps on very heavily with a lot of what we see. And the last thing is actually some of this stuff around Red Pill culture. black pill culture black pill I haven't heard of that one so I think it's people who are just

very very demoralized and don't believe that success is even viable right so it's just very very dejected life is meaningless so yeah I think they're quite nihilistic but not not even not even that life is meaningless

it's that it's I don't I think life is meaningless. I think it's that life is meaningful for some people, but I'm not one of those people. I don't have access to that dimension of meaning, joy, success, love. Yeah, right. People with Skizoid will look at others and go, how do they do that? How do they enjoy things? I wish I could enjoy things. It looks nice. Or are they faking it? What's wrong with people? You know, there's, there's, they feel there's a separation. There's a difference there. So I think there's also a lot of subjective experience of like, am I a robot? Right. And so I think we see that a lot where people also say like, oh, am I a sociopath because I don't feel things.

So like a lot of this is tracking with stuff that I've encountered. I've just never viewed it through that lens. That's super fascinating. So in terms of, what is the process of working with these people? Yeah. So the corrective experience, the therapy, the treatments is among, you know, the consensus among specialists is that it involves awareness and it involves understanding emotion and getting a touch with that, which is a whole thing. Sometimes this is framed as connection with the self or a sense of self, which I could talk a lot about. But that is getting to know your body, getting to know your emotions, asking yourself, what do I need?

What do I feel? What do I want? And then also having a relationship with a secure other, ongoing, dedicated, caring, attentive, attuned individual therapist, maybe, or a friend or a spouse or something, who is safe and there and pay. pays attention and might be, you know, that's, so this is the countertransference, transference problem with schizoid clients is that I will feel a urge to, what I would say is draw them out, right? Because I want them to use the therapist. Yeah, me as a therapist. I'll try to draw them out

so that I can show them that it's safe to be in the world, you know, to spread their wings. But if I don't watch it, I will be invasive like their parents were. I will reenact that because of the nature of the situation and through their projective identification and their transference. They're actually seducing me into a reenactment of that. And so they'll come out of their cell and then they'll start running away. And consciously, they think they're actually doing the right thing and doing therapy, but also like going at their own pace.

But what that does is it creates these moments where I'm chasing, right? And I might even become frustrated. I might even become angry. And I might feel rejected. And I might start to, if I don't notice it, I might actually go on the attack. And so this is why when you have schizoid and you start to interact or you have moderate schizoid and you have, you know, mild relationships that you're trying to work on, you can actually create. you can actually create these dynamics where the other person will feel neglected and harmed and rejected, pushed away, and the other person will feel an inducement to invade, which will

just recreate this whole thing. And then that's why, you know, like with borderline, they assume that everyone is going to abandonment. And so they react against those people. And then those people do abandon them. And so it's the same with schizoid. But the corrective experience is for me to manage that as well as possible over time so that they feel that, okay, he's close to me and he cares, but he's not a threat and he lets me have my space when I need that space, you know, because the skeezoid is trying to protect their space and their integrity. And so it's, one, rare for schizoid people to go to therapy because they don't think there's anything wrong with them in that way. or they think it's something that therapy can't help right they're the you know of the personality

disorders they're one that would believe like why would I do that it doesn't fit whereas people with borderline are much more likely to go to therapy because they are more dependent on other people anyway so um but if they do enter therapy then I have to navigate it so diligently it's really hard because at any moment, they can just say, eh, therapy is not for me, you know, and just drop it. So I have to, like, draw them out and be in contact, but not make them feel like I'm invading and not pay too much attention to them because that is associated with invasion and eventual harm, but I can't, like, neglect them. So it's really hard. Personality sort of work is really hard. And a lot of my trainees when they encounter someone with a person who started for the first time will have a

you know a moment of crisis in where they come to me and they're just you know their their initial complaint will be more on the surface of like i'm this client who just doesn't seem to be working hard in therapy and it's really annoying me and then we talk through and like oh kind of sounds like schizoid and then i say if you're going to be a real therapist you're going to have to get into the mud and it's not going to feel good to you. I don't know what you thought being a therapist was going to feel like, but this is the meat and potatoes of therapy is this work and it's going to feel like shit. So I think, so Dr. Honda, you seem like an amazing therapist to me and I'm not, I just, I have to express that. I was debating about whether I want to say that because that'll start this mutual,

whatever we're into. But, but I also, like, I think if, if, if, anyone is wondering. So I think what you just described is such a great representation and advertisement for therapy. So I think the first thing is like a lot of people will ask like, I don't understand what talking about my problems does. So this is what I want you all to understand. This is what a good therapist does. It's not just talking about your problems. It's about understanding that in your mind, there are all kinds of reactions that.

that are going on. Even if it with avoidant PD, and I think I've worked with people, I don't never realize, I think they had avoidant PD. But I would say that, you know, I developed a kind of like personal technique.

Just because I wasn't sure what it was. So what I would, the way I would describe it is I would sit next to them and I would eat with them, almost like parallel play. So I'm not looking at you. Because if I look at you and I notice you, if I see you and you're trying to hide and you're not ready to be seen, You crave being seen because you want to be accepted, but being seen is dangerous.

So I kind of have to like, you know, I kind of got to like side eye you a little bit. Like I can't look directly at you. Yeah. And this is the real challenge is that I think a lot of people don't realize what a good, how transformative a good therapist can be. Because there are all these things where if you push too hard, and this also is something that I want everyone to kind of take away, is even this. reenactment business is like pure gold, right? So this idea that human beings will do something to trigger you to do something. It's not quite manipulative, but like I think a really good example of this is one of my favorite papers is one called the hateful patient. I don't know if you've

ever read it, but. Winnicott. Yeah. Oh, is a hateful patient Winnicott? If I'm thinking of the same one, 1949, Donald Winnicott? I was thinking about it. Maybe it's a an illusion to Winnicott then. So I was thinking about a more recent one by Jim Groves. Okay. Anyway, maybe I didn't, maybe I need to read the original. I'm going to what you're talking to, so that I can just be reassured. It makes sense if it was when it caught.

But, let's see. Hates in the countertransference is the name of the famous paper. Sorry. Yeah. So I think a hateful patient is Jim Groves. Also a great read. So, you know, I think he talks about, like, sometimes doctors will have patients who are help seeking, help rejecting. So, like, you may have people in your life like this who are like, oh, I need help, I need help.

So they induce you to help them. But the moment that you try to help them, they become like a stubborn mule and you're yanking on it and the mule doesn't want to move. And it really frustrates you. And then, like, I don't know, like, why I try to help this person. And then they push you away and then you feel frustrated. And then they do something to make you feel guilty. And then you're back to helping them. That's how they induce the help seeking behavior.

Right. So there are all of these dynamics that are going on within all of us all the time. This is how the brain and the mind work. And you have, like my experience of therapy has been that, you know, most people, myself included, as the one who's doing the therapy, have no idea what. But, I mean, we have some idea, but, you know, I've seen outcomes that I would not have expected the first time I sit down with a patient. When I do an intake, I have no idea the progress that we're going to make, the directions that we're going to go. And it's all this kind of stuff. Just how thoughtful you have to be as a therapist.

How much, you know, if I try to help this person too much, they're not even going to realize they're going to say this isn't for me. I'm not getting anything out of this. And so you have to play like 5D 4D, 5D, 6D chess, right? You have to think about, okay, how is this person going to respond to this? And the reason that we're so quiet is because we're processing all the time. We're thinking about what is this person feeling? What is this person need? What am I feeling?

Am I saying this because I need something? You know, how much do I push this person? And if I push this person too much, am I enabling them? Am I actually taking the responsibility away from them? what is the right amount of help? And so I really love the way that you kind of describe that. I don't know how much people got from it, but I think that's like this whole idea of the right amount of pushing.

And then calibrating that, and it's not like there is a right amount or a wrong amount. It all depends on the individual. Yeah. You can't prescribe it. You can't plan for it. You have to intuit it in the moment. when I teach this to my students, I tell them, I'm sorry, I can't tell you what to do.

You have to just absorb and experience and reiterate on your form and your intuition. And in the moment, you have to just make a call based on all of it coalescing into a motivation to do something. And the other aspect of the 4D chess is you, yourself, I myself, myself, as a therapist have my own relational traumas that I'm reenacting with the client that I'm inducing them to agree with and I'm recreating with them and I have to keep an eye on that too you know because it doesn't feel good to be rejected and I have rejected trauma as a lot of people do and so when a client rejects me subtly I'm going to become a little unglued and if I don't keep an eye on that as well then that will become a problem as it inevitably does does at times, but, you know, if the overall experience is monitored and managed well, then, you know, me and the client, you know, go down the road together. Makes perfect sense. So I want to just be a little bit cognizant of time. So we have somewhere between five and 20 minutes left. Okay. Howard, um, is that work for you? Yeah. So I'm going to rely on you to guide me on how you think we should spend that. So I'll, I'll toss out three or options if you're okay with it.

Sure. One is I want to ask you about spirituality, but that's purely selfish. Second thing is that I think you've developed a really great framework. And what I was thinking about doing, I've been taking notes. What I was thinking about doing is actually like pulling up like a screen sharing app of my iPad and then I would kind of write things out and we would kind of leave people with like a nice like packaged. Because I love the framework with which you approach personality disorders.

and we could kind of like reconstruct it a little bit. What is the trauma? What does it look like? The third thing that we can do, we had some posts and stuff to react to, but I just couldn't break myself away from the conversation. And the third thing, which may be a good idea is we can ask questions. We can open things up for questions and we can field questions. What do you think we should do? I'm open anything.

The spirituality conversation intrigues me. and then the Q&A sounds like some people might have questions. So I'm going to ask chat real quick. So like what do you all, so do you guys want? So there's a sentiment that, you know, we should do this again? Okay, but it looks like most people, oh, this is tough. Okay, so most people, it seems like, are voting for spirituality. And keep in mind,

oh god what's happening there's conflict among people in the jet yeah so people feel very strongly about spirituality and the framework so here's what I'm thinking so I'm thinking that the framework we can do the framework another time

I mean I was thinking even with a little bit more formal prep I think the framework could be super super strong right so like in actually you know what I'm going to do the framework. We're going to do the framework in five minutes. And then does that work? Yeah. I'm curious.

I'm so conflicted. But, okay, let's do it. Let's do it. I kind of have been doing it. So let me, hold on a second. So we're going to do this. I'm going to go to here first. Then I'm going to go.

Okay, so this thing doesn't work. So they're not going to see your face here. Oh, wait. Does this work? Nope. G. Who needs to see my face? So I'm going to do this, but what I'm also going to do, I got to go over here for a second.

And I'm going to screen share with you too, okay? Can you see this? I always have an impulse to do this as a whiteboard oriented professor. And I fantasize about doing this, so I'm curious how you're going to do it. Tell me about your fantasies. Okay, so here's what I... What does that mean, Freud? Are you going to use a stylus?

Yeah, yeah. Because with mouse, you know, I'm always like, oh, no, no, I'm going to use a stylus. It's more phallic. Okay, so when we're looking at avoidant PD, okay, so the first thing is that we're going to have a certain kind of trauma. So the trauma is going to be neglect plus forced social situations plus lack of attunement. It can be classic abuse as well, like physical abuse and other kinds of abuse. Plus minus abuse. Yeah.

Fair enough. Yeah. Okay. Forced. I mean, I would say terrifying social situations is probably more precise because you can force a child and they could enjoy it. But there has to be some level of terror. Okay. And lack of a too much.

Okay. Terrifying social situations. And then this creates essentially a. I'm going to use the word complex. I'm not quite sure what to call it. So, like, in the moment, what is the root issue? So, and I was going to put perception up here at the top, but I'm going to put perception down here. Okay.

And the reason for that is, okay, no, you know what? We're going to stick with yours for now. I mean, it's all kind of in the same category. It's the, it's the schema that's developed. It's the defense or the way of predicting the world that the child develops. So I think that I'm going to go and stick with perception because that's the framework that we talked about today, right? So the perception is that I am fundamentally broken and other people can see. Okay.

So now what happens, I think if we look at schizoid. And by the way, people wonder how to pronounce schizoid. schizoid or schizide, none of us know. Yeah, I'm using, I used to say schizoid until an expert on personality disorders showed up on stream about an hour and a half ago and said schizoid, so that's the way I'm going to say it now. Yeah. Yeah. So we see also neglect, okay?

Yeah. And then plus, let's call it intermittent, intent. intense invasiveness plus minus automaton or pet

style upbringing fair enough so I think it's really interesting because you know neglect is a feature of both and then plus a different thing results in a different perception

So the perception in schizoid is what exactly? Is that my emotions are unwelcomed by me because if I feel them, I have to realize that no one cares. And if I signal, I'll get rejected. And also, if I signal, then it gives the other a chance to get into me, which I can't allow. so I have to turn all the emotions down. So I don't know how to briefly. Yeah. So that's kind of,

yeah, so I think that's more what I understand is the pathophysiology of it, right? But I think the perception is like, that's kind of why I'm trying to work this. Because this is the subjective feeling. No one is there for me. No one is there for me. And my emotions. Also, can I add something to that? Yeah, yeah, please.

I don't need anyone. Yep. Right. So some people with Ski-Zoi can develop a bit of narcissism, what will look like narcissism. Not always, but that they feel superior to others, you know? Right. And then I think there's also like some amount of, as we've said, like demoralization. Mm-hmm.

And then also like emotions are the enemy. Yeah. And then furthermore, the reason for that is that people can use them as, they're kind of chinks in the armor, right? You said that there's an invasiveness that they're afraid of? Yeah, I mean, the metaphor I use is that it puts the door ajar so that someone can burst in. Beautiful, right?

And then you were also alluding to not just emotions as they relate to other people, but in your experience, do these people, have a perception of their own emotions, not just in terms of a weak point, but like, how do they relate to their own emotions? Well, it evolves over time when they're very young, which they might not remember, they consider them a nuisance and they don't like them. They're quite confused by them. And they create pain, essentially.

Emotions, even joy, is pain because to feel joy and to show joy only results in pain. It only results in rejection and loneliness and an acknowledgement of, wow, no one is there for me. So early on, it's emotions equal pain. But later on, because of the effectiveness of the defenses, emotions are just not there to them. So they don't really have or yeah. So the perception is also emotionally numb. Yeah, numb. Or I, or I just don't have them. you know i'm not capable of them yeah so so or uh perception of sociopathy or i'm a robot right because in order to have empathy uh in terms of the classic form you have to feel someone else's feelings you know when you were talking about being bullied i felt the uh you know the

injustice and had my own way of dealing with it, you know, and had an emotional feeling and then a reaction. That's one form of empathy. But if you're cut off from your own emotions, then you don't, you don't feel your emotions that are triggered by other people's emotions. So it can feel like you don't have empathy, you know. You have the capacity for empathy if you would take notice and connect with your feelings. But, but you, uh, but you, uh, aren't given the opportunity to do so. So it's tempting to conclude that you're a psychopath. Yeah.

I think that's so I like the way that you walk us through that because from a subjective experience, I think it describes really well what a lot of people, you know, why they can, exactly what you said. So I think this is a strong, really resonating, subjective kind of experience. And the last thing that I didn't want to leave out was kind of social anxiety. And I think like you were saying, the key thing there is that there's some degree of when calm, insight into the wrongness of your thoughts. Right? And sure, lots of asterisk. They're definitely along the similar spectrum from avoidant personality disorder. But people with avoidant PD really, they're convinced. that they're this way, right? So it's a little bit deeper.

It's a little bit... Pretty treatment. Yeah. Completely convinced, yeah. And so, and with social anxiety, like, people have, and here's my understanding, you know, they have some degree of maybe less severe traumatic upbringing. They have a period of arguably more normal development. Yeah, probably more attunement, you know, maybe similar, difficult social experiences,

but they had parents that were attuned. enough of the time. Right. So I think when I'm hearing you say that, what I'm interpreting is that attunement gives them, protects them from the rawness of the abyss. Yeah. The, you know, if you're loved enough and your parents are supported enough,

you don't think there's a fundamentally broken thing. But as we move more towards the surface of symptoms and stuff like that, the difference is, you know, people with, you know, social situations are scary, right? They all agree with that. Social situations are stressful. Avoidant PD and social anxiety agree with that as well. But as we kind of go deeper and deeper in, like at this deep level, people with social anxiety don't quite feel quite as fundamentally broken or unsolvable based on my understanding of how you've described avoidant PD. as it relates to the social anxiety because you could have a fundamental sense of brokenness that is unrelated to the social anxiety if that makes any sense yeah so BPD with social anxiety for example fundamentally unlovable in abandonment is inevitable right for the avoidant personality they actually the social anxiety generates from that sense of defect okay so that's that's yeah so the social anxiety comes out of the blackness within. And if it comes out in this way, then we'd call that avoidant PD. And now we've stopped summarizing. And we've started re-exploring. So, but is it, is, professors must

love the shit out of you because you retain and, you know, can summarize like better than, I think professors can. You must have been really loved by your teachers. I mean, I think you did a yeah sure i mean some teachers liked me um but but i i i think i think you honestly your framework is like awesome dude so like i i don't think people teach it this way so you know and and i mean i like i had wonderful teachers i i don't think they were bad or anything it's just especially with avoidant pd and schizoid pd it's just not something we see quite as much right so i got excellent training in cluster b um and and and you know but like the place that I trained has a unit for like borderline personality disorder.

We don't have a unit for, I'm going to go and move this over here. Yeah. Yeah. Yeah. It's one of those things that I lament a lot of my career as a professor, therapist, and podcaster, is trying to provide people with what I wish I was provided. regarding this topic and others. Yeah.

Also protecting me from my bullies. One bully at a time. Because once I understood personalized disorders, and especially when I started reading that, people have been understanding personality disorders for over 100 years. So this isn't new. And once I understood, I was like, oh, it's so usually. This is so helpful because the most difficult clients and frankly the most difficult family members are those with at least on the spectrum precise orders and it explains so much.

And once you get it, it's just so helpful. And if you suffer from one of these things when you're provided with this framework, it's so liberating to people like, oh my God, you know. Yeah. Like when people find the subreddit for avoid a personalizer or schizoid personized short or a schizoid personized sort, they're just like, I have this and I'm not happy about it, but I'm so glad that I have a label for this and that you all have been talking about. It's, you know, it's important. And the way that it's often taught in graduate school is there's like a module on all the personality disorders. And it's just very surface level explanation.

Like someone that doesn't really understand personality disorders themselves because they have to understand the entire DSM. Yeah. And they just kind of glance over it. And you leave the class with an A and you think you get it when you don't. Really well said. So I think it's, they're just so, I mean, our clinical training is oftentimes just so dominated by acuity. Right. And so we focus so much on suicidality and some of these like very, very like mania and, and things like that, or at least mine was.

But, and so totally get it. And that's why I really appreciated your perspective on it. Because I think you really do break it down in a very simple way. One or two kind of last thoughts. One is I wanted to just show you something real quick. I'm going to screen share with you again. So I've got to change this for a second. We're going to do this.

We're going to do this. I got to figure out the right order of operations. And then I'm going to move you over here so I can screen share with you. But you know, you were talking about people with, speaking of subreddits, this was on the avoided PD subreddit. I don't know if you've seen this post. But if you have avoidant personality disorder, this is what your schedule looks like. Right.

Yeah, and people will literally schedule it sometimes. Oh, really? Yeah, I mean, at best, honestly, because they recognize, well, no use beating around the bush because I might as well set aside the time. Because if they rush into the meeting, not having psyching themselves up, that can make it worse. You know, prep can actually help. You know what I mean? It's not where you want to end up. You know, this is not where we're saying,

okay, that's the end of the road. But it's better than, you know, just flying into a meeting without any kind of prep. Or at the last minute, not showing up because you make an excuse as to why you're not going to go and then you get fired or whatever, you know. But yeah, interesting. It's pretty funny post.

Yeah. So thank you so much, Dr. Honda. You know, we, I really love this. I think, I know people were hungry for spirituality. I'm hungry for it too. It's a big part of our community for some people, but we're not like, you know, it's, we start with really science and clinical perspective. I love to talk about spirituality.

Whenever I get a chance, I like to ask questions. I'd love to ask you questions about your belief and your journey. Yeah, absolutely. So I think the other reason I sort of called an audible there, even though I think probably more than 50% of people wanted spirituality is. I felt like if we got into it, we wouldn't have enough time. Yeah. And so, and this framework is just too good to pass up.

Like, it's just too, it's too, it's the best simplification that feels really true to the clinical perspective as well as the subjective experience. It's really cool. So I just wanted to kind of tee that up. But thank you so much for coming. Before you head out, do you want to tell us once again where we can, find you, you know, what kind of work you do? Just psychology in Seattle. Just Google that.

Okay. And Dr. Honda runs an awesome podcast, I guess, where he does all kinds of things, really churns out a lot of stuff, everything from, so you all can definitely get more of what we saw here today, because you'll do dissertations on personality disorders, as well as he does a lot of awesome React content. So, like, I think does a really fantastic job of taking things. that we are all watching and taking all of this knowledge and information and filtering it through a relatively entertaining react piece to like something like love is blind.

And you're going to learn a lot about how to relate to people. Attachment theory. I know we didn't talk about that. But like I think a lot of this stuff that is really relevant to people. So definitely check out Dr. Honda. Well, I want to speak to you and to your audience and say that I am. very honored to be here. I'm happy that I didn't, at least in my mind, make a complete fool out of myself like I was

worried about this morning. And I know that you are doing so much good work and helping so many people. And, you know, you could stop all of it today and sleep well for the rest of your life, given just how much good that you've done and how much education you've given and how many lives you've transformed. And, you know, there's a lot of things you could have done with your life and you decided to give and to help and, you know, and put yourself at risk, you know, put yourself in the cross airs of stuff, which happens at times. Yeah. And, you know, I just want to, you know. Thank you so much, Dr. Honda. That means a lot from someone who's been in the field

and, you know, for such a long time. And I think your opinion matters a lot to me. I think it carries a lot of weight. So I'm grateful for that. So thank you so much. Sure. And until next time, I guess. Thank you so much.

Take care. All right. Thanks for joining us today. We're here to help you understand your mind and live a better life. If you enjoyed the conversation, be sure to subscribe. Until next time, take care of yourselves and each other.