Psychiatry & Psychotherapy Podcast - Non-Violent Communication with Matthew Lederman

Episode Date: August 11, 2023

In this week's episode, we have a conversation with Dr. Matthew Lederman, a board-certified internal medicine physician and CNVC Certified Trainer of Nonviolent Communication, as well as a prominent contributor behind the documentary Forks Over Knives. Dr. Lederman and his wife, Dr. Alona Pulde, recently published a book called, Wellness to Wonderful: 9 Pillars for Living Healthier, Longer, and with Greater Joy, and this conversation today revolves around the topic of nonviolent communication. By listening to this episode, you can earn 1.5 Psychiatry CME Credits. Link to blog.

Welcome to the psychiatry and psychotherapy podcast. I'm your host, David Puter. This is your gateway to the intriguing world of mental health. As one listener put it, this is the podcast that your psychiatrist listens to. And we're incredibly proud of that endorsement. Whether you're a loyal, active listener who's been kind enough to reach out, maybe send an email at DM or put in a review, or you're new to this community. We have an exceptional opportunity for you, not only to learn, but to also, earn continued medical education credits with each episode. Our credits are meticulously designed to empower you in your field, demystify complex mental health topics, and transform your learning journey into a truly rewarding experience. To access this and more, just visit Psychiatrypodcast.com. We're grateful to our valued subscribers who are already reaping the benefits of these credits. Your support is instrumental in allowing us to devote time each week to curate. this podcast, sharing cutting-edge insights, featuring top professionals, and exploring the latest

research. Whether you're here to learn, earn credits, or both, we're thrilled to have you with us. Get ready to deepen your understanding of psychiatry and psychotherapy, one enlightening episode at a time. All right, welcome back to the podcast. I am joined today with Dr. Matthew Letterman. He is the prominent figure behind the documentary you may remember Forks Over Knives. He has recently published a book with his wife called Wellness to Wonderful, which is beyond diet. I would say diet is one of the nine pillars that he has in his book. His book largely focuses on connection.

And he is someone who thinks very similar to myself. and we've become friends. I can brag that I am on his list. So if his parents get sick at school and he's not available, I guess I get to go and pick him up, which is like a high level of trust. Yes, welcome to the podcast. Oh, thanks for having me, David.

Yeah, and so I was thinking, first of all, there are no conflicts of interest for this episode. Yeah, so I was thinking we could start out a little bit with your story on how you got interested in nonviolent communication, Because I think that is as a kind of like, you know, our audience is psychiatrists and psychologists and nurse practitioners and physician assistants. And so it's like I think our audience specifically would be interested in kind of your journey to nonviolent communication as an internal medicine doctor and how that has kind of influenced you. Yeah. So I was really open to learning new things and that's how I got into nutrition.

and lifestyle and sort of I would test things out on myself, right? And I remember becoming plant-based and saying, hey, when I was reading this book, it was telling me how great I was going to feel, and I didn't want to be plant-based, for example, right? But I tried it out. And I ultimately said, oh, my God, I feel really good. I can do this. I can't argue with it. So I'm going to keep doing it. And over the years, nutrition was really helpful at reversing a lot of chronic disease, helping me feel a lot better and giving me tools I didn't have just with conventional medicine alone. But then there were still some issues that were, despite a really clean diet, a very strict exercise regimen, right, sleeping the right amount of sleep, I was still having some health issues.

and one of them was chronic back pain sciatica for about six to nine months, really painful, to the point where I was going to pursue surgery, even though surgery was not shown to be affected with the type of symptoms I was having. But at one point someone gave me a book and said, hey, you know, I don't know if you're familiar with John Sarno's work, but someone gave me a book on that. And I said, this is crazy. What are you talking about? This doesn't, you're telling me it's in. You know, it has to do with emotion and things like that. And I said, this is, this is not possible.

So it was like a mind-body connection. It was a very big- Maybe have some chronic anger. Oh, and that's what his premise was, was that it was repressed rage. I said, this is, you know, psychological mumbo-jumbo, and I'm not going to buy into this. But for some reason, I was like just curious enough to start doing it on a drive when I was going from San Diego to Los Angeles. And as I'm listening to them, it was like, describing the exact personality type as me. And I was like, oh my God, they're describing, you know,

the type A driven, some of the history stuff. And I said, wow, what's the harm in trying to do what he was saying? There's no risk really, right? But one of the things was being connected more to your feelings. And at the time, I had three feelings, good, bad, and angry. Okay. And good and bad, obviously, are not feelings. And angry is a feeling and emotion, but there's really stuff underneath that.

And I called my NBC mentor, a mentor, like someone that I, because I was exposed to nonviolent communication before, but it was an intellectual exercise. It was how do you talk nicely to make people, in my mind, how do you talk nicely to get people to do what you want more effectively? That was sort of how I used it, right? It wasn't very effective in that format. But I called her and I said, hey, I need to feel, supposedly that's going to make my back pain go away. I don't even know if that's true.

And then I did it. And I started talking to her and working with her weekly. And I couldn't believe it that as I started doing this self-connection and building a vocabulary of feelings and needs and connecting to what was going on inside of me, within months, my pain went away. Maybe it's all, I was like, maybe this is just a fluke. But I said, as I happened to do it,

I was, my marriage was getting better. My experience of my kids. My parenting was getting better. My connection at work was getting better. My whole life was getting better. So I was like, I don't even care if that was the cause. That's, that's, this is fantastic. And then I started talking to more doctors about this, this concept of neural pathway pain and learning more about it, learning, you know, with, you know, with, talking to, eventually connecting with like Stephen Porges and the polyvagle theory.

and learning about, you know, autonomic nervous system and talking to other, you know, neuroscientists and really, really enjoying learning about the connection between the autonomic nervous system and sort of how we show up in this world in our experiences and as such. So anyway, people have different opinions, right? Just like diet.

There's a whole range of opinions out there. But to me, this is this constant learning process that's been fascinating and also trying it out on myself. And my life is a lot better as a result of that. Yeah. And for those of you who don't know, when I look at nonviolent communication,

it looks very similar to like psychotherapy. But essentially you're teaching lay people how to do psychotherapy skills, like empathy, listening to needs, communicating clearly what your needs are. I think it might be helpful, though. I think some of the list of needs that I found when I was looking at nonviolent communication

are actually pretty, it's a pretty nice summer. So tell me about some of the needs that underline or underlie like what's under emotions, right? So it's like you have the emotion, you have the anger, and then you're looking at like, is there an unmet need? Right. So, and it's interesting that you say that because I've heard Marshall say in recordings that, because he was a PhD and very much interested in clinical psychology. but his thought was, why don't we give people the skills directly to support each other versus them depending on me?

And that was part of his mindset was, can we give them the skills and make it accessible for the people? So he came up with this process. The focus is on creating a quality of connection between two people that transform sort of the way you, what you say, how you say things, how you think, and what you do, so that compassionate giving and caring for each other flows naturally. Right. And that's where his system of this OFNR, observation, feelings, needs, requests,

was a framework to help people get to that quality of connection. So the focus is on, am I caring about a connection with you? And then through that connection, we can care about everybody's needs. and find strategies that will meet all those needs. So, for example, there's needs like safety. And these are universal. Needs are universal. We all have the same needs for food, for safety, for love, for connection, for autonomy, right?

For predictability, right? Relief, right? There's all sorts of needs that we all share. What's different is the strategies that we prefer or enjoy to meet our needs. And that's where the conflict happens when you're starting. in strategy, but if you back up and connect around needs, that's where that quality of connection is created. And feelings, from a nonviolent communication perspective, feelings are stimulated, are basically messengers around whether your needs are met or not. So I feel unpleasant feelings

when my needs are not being met, and I feel pleasant feelings when my needs are being met. And that's why we, in non-volent communication, there's a, to sort of attack the feeling as the problem or resist the feeling is sort of like shooting the messenger. So if I treat the feeling as the problem or the disease versus the state that you're in and the needs that aren't being met, we find it more powerful or effective to focus on the needs and then creating that self-connection. and then you can take action to try and better meet those needs. Yeah, so I like how you, I like how he's formulated it. It's pretty similar to how I would formulate it. So you observe, what is the emotion, and then what is the need, and then how do I communicate the need?

Is that the fore? So observation, and the big, and he also talks about the different, right? So a lot of people evaluate instead of observe. So, you know, a real simple example is, it's hot in this room that would be an evaluation this room is 72 degrees would be the observation

right so it's sort of differentiating or it's so like the observation would be like my stomach feels raw or my chest feels tight right and then the feeling is okay maybe feeling nervous

I feel shut down I feel nervous I feel anxious scared right and then the the need is is, okay, do I have a need for safety, respect, expanding, autonomy, connection. And then, okay, and then go, what's the fourth step? So the fourth step is the request.

So do I want to make a request of myself or someone else? So take an action that will contribute to those needs being met more effectively than they currently are? Because the goal is always to try and find, after you connect, to find actions or strategies that will be more effective and less costly. Okay. Than what you're currently doing or not doing. So give me like an example of like, let's say, you know, husband and wife are in an argument. Husband doesn't feel respect. That's the need that he has.

Right. So I'm glad that you see you caught that right there. Some people will say the need is the feeling, and you made it clear the need is respect. When I'm, my need for respect is not being met, how do I feel? I feel hurt. I feel nervous. I feel scared. I feel angry.

Right? So let's assume that's the case. Okay. So step one, so he's observing tight chest, step two, he realizes the need is for respect. Step, or no, step two would be anger. He realizes he feels angry. step three respect

I need I have a need it's respect and then step four would be what so step four you can some people

when they follow just the steps instead of the focus on connection they might say well how am I going to eat my need

for respect but what's more important is to first focus on the connection between you and the other person

because if there's not quality of connection it's going be very hard for them to want to naturally

care about your need for respect so if I said hey would you know and the observation

also beyond the feeling in your body is, what was the stimulus, right? What did you perceive? This person talked before I was finished speaking, which is different than they interrupted me. Interrupted me would be an evaluation. This person started talking before I finished speaking. So now, that's my observation that stimulated my need for respect to come up. Right? So what I want to do now is first connect, because I could just say my request is, would you be willing to wait to talk, until after I finish speaking. But if that person,

if the quality connection is great, that's fine. But if the quality connection is not good, right, then that might land poorly. It sounds like it would land poorly most of the time. Right. So that's where I'm going to say, you know, what's, this is coming up for me. I'm feeling these feelings right now

and I might even start, depending on where I am, with empathy for the other person, right? Because I want, because they so quickly will go into shame and self-criticism. So, oh, my God, I interrupted him because they've learned our lives that interrupting

is disrespectful. So now they're going to judge themselves as I was disrespectful, I was inconsiderate. They can't connect to me because they're busy judging themselves. So now I might say, okay, I'm going to empathize with them a little bit.

I'm going to say, hey, I know that you value respect and consideration of people. So I want to make that clear. I want you to be seen so you don't have to feel defensive, right? Because a lot of people feel defensive

when they're not being seen. Yeah. And then I want to say, hey, do you have space to hear something that came up for me? So now we're getting in a little bit of collaboration and agreement. And then I might say, when you started talking before I was finished, I felt a little stimulated, right? I felt a little twinge of anger because I was really wanting respect and I'm wondering what you're hearing, just because I want to make sure what I'm saying is landing and not, like, you know, landing is criticism for you. And they'll say, and I can, and then I'm checking in, right?

I'm like, are they tightening up or are they open and expansive? Right. Are they going to say, yeah, you're telling me I need to stop interrupting you. Oh, okay, so they heard criticism, right? Because that's different. I was, or they're going to say, oh, yeah, I'm hearing that you like me to wait before you, you know, to speak until you're done. So depending on what their response is, I'm going to be able to sort of attune to the quality of connection between me. Does that make sense?

Yeah. Yeah, I think there could be another need in there as well as just getting, feeling hurt and understood. I think I would almost be maybe more palatable, you know? I'm thinking, like, I need respect and I need you not to speak quickly after I'm done or have not finished talking. I'm trying to put it as an observation. Right. It's a little bit hard and clunky at first. So there's this sort of phase where, I remember, you're just sort of like.

like, just go for it, and it's the courage to make a mess and the skill to clean it up sort of thing, you know, where you're just like, but over time it does begin to flow, just like any new language, right? You're not going to be fluent right away. Yeah. But some people, what I would call, because in non-violent communication, they talk about, Marshall would talk about jackals and giraffes. And giraffes are people, you know, drafts are the animal with the largest, the land animal with the largest heart. So that's sort of the heart connected. And jackal was sort of more, hey, in my head judgments focus. That's how I navigate the world.

So there's sort of this heart way of navigating and then sort of the headway, right? Right. So the giraffe, right, to me, it's the focus, again, coming back to connection. And some people are natural giraffes where they don't know this OFNR language because that's just a tool.

The language, the words are a tool. Right. It's about the connection to the other person. Hey, I care about you and I see you and all you're trying to do is meet needs. You're doing the best you can with the skills you have and the awareness you have in the moment. And sometimes that stimulates pain in me,

but it's not because you're trying to hurt me. It's because just like when you bump up against me when we're walking, it's like, oh, I'm sorry, I accidentally bumped you. If I can see someone that way, and then I can react without judgment or I can process my judgment and anger, then we can get to the quality of connection.

So you don't have to get the words right. it's more that intention. Right. The words help, though. Yeah. No, I think the intention is, yeah, it's felt. Yes. Like on a mere neuron level, right?

If you, does this person intends to try to help, it's felt, you know, versus I use car salesman who's like, this person intends to take as much money from me as possible. And to me, and to me, that it's interesting with emotional pain versus physical pain, right? With physical pain, if someone's hurt on the floor, we run right up to them. Oh, are you okay? Yeah. Right? But it's easy to differentiate because I didn't cause, it's so clear I didn't cause

the physical pain. They're hurt. They passed out. With emotional pain, we tend to sort of blame ourselves or we get scared. Historically, it was dangerous, right? People get angry. So we back away from it. With NVC, the goal is to try and come together,

whether it's physical or emotional pain. And that I would love to see emotional pain treated the same way we treat physical pain, which is this person's hurting. How can I come towards them and connect and not take it, make it about me? Yeah, and I think there's inherent difficulty in that. Yes.

There's inherent difficulty in that. Well, it's how we, I mean, I don't know how you were brought up, but I was brought up that I was the cause of a lot of people's feelings. So my parents would say, you know, I'm feeling really angry because of what you did, you know, or you hurt me when you said that, right? So if I'm always the cause of their feelings, it becomes much more dangerous to be

there because I'm busy trying to prove that I'm a good person or deal with my shame because I believe I'm a bad person. That's a really weighty place to be, and it can't connect to the other person. It's awful. It's awful to feel blamed for, you know, your parents' emotional. and your parents, like, it's like, that's awful. Yeah. So NVC also gives me skills that even if the person can't communicate, so they're still communicating in this jackal language, I can choose to hear it with giraffe ears.

In other words, even if you said, Matt, you know what your problem is? You talk too much. And I would choose, instead of me thinking about, do I talk too much? And then I either feel like, I'm a bad person because I'm a bad person, because I talk so much, or I judge you back. Well, you know, I talk so much because you're such an idiot, and you can't, you know, you don't know what you're talking about. So I got to say everything, right?

Those are sort of my two choices in conventional, you know, conventional systems. Or I can say, oh, he's feeling really frustrated because he wants to be heard. And that's what's happening. And when I'm saying more words than he can take in observation, he feels frustrated. because he has a need to be heard. And then I go to the connection. I'm imagining that's really hard for you. It's really irritating.

And maybe this is a sensitive spot for you because all your life you wanted to be heard. Is any of that true? And then that's my request. That's the connection request. What's coming up for you? Am I getting it? How's that feeling?

To see how now I'm tending in, I made that guess that I did before, and then I check in with him. That's building the quality of connection. Yeah. Yeah. So essentially, you've done psychotherapy training by another name, and you're certified now, right? You have this great skill set. And in your book, I really enjoyed how you're like parenting with this. I think that was like, I was thinking, man, this should almost be a parenting book. Because of how you're, you talk about like, how do you navigate kids with feelings, right? kids with, you know, helping them see what their needs are, empathizing with them.

Do you want to talk about how the, or maybe tell the story of how you, how did you parent before and how did you parent after you sort of started using this type of language? Yes. So, so parenting for me was very, I grew up in a very authoritarian, you know, model. Yeah. was the sign of respect, right? And if my needs weren't being met, I could raise my voice and yell and be really scary

and I could get my needs met, but there was a huge cost. Right? So a lot of times, and this is an NBC, you'll ask, what action do you want your children to take? But the second question that's even more powerful is what do you want the reason to be behind why they take that action.

So if they're afraid and they take that action, that's not really meeting my needs. And when I started to think about this and learn about this, the only reason I wouldn't come at it from an NBC perspective was because I didn't have the skill set

and the practice to do it. So that took time where I could control feelings like irritation and anger and even rage, right? because that was so impactful on other people, especially kids. So that was my big motivation to do something different. I saw the impact of doing it the old way.

Similar to how I felt the impact when I ate the old Western American diet and switched to a healthier diet. I could see and feel the impact. So now it was how do I make it become a normal part of my life? it was much easier to change my diet than change my parenting. That parenting is, and I went to medical school, and learning NBC was so much harder for me than becoming, you know, studying to be an internal medicine physician.

Yeah, because you're literally, you're not, you're rewiring tens of thousands of memories, and you're already just like the way of doing things, right, that were imprinted on you from your parents. Yes. And then, yeah, it's like there's an emotional connection with that or like an intuitive, unconscious reactivity to the way that you used to do it. And now it's like it's not enough to just have knowledge.

That's exactly right there. The hardest thing is to go from the intellect to the action. That, like in medicine, it's all intellect. Yeah. So you memorize, and I was good at memorizing. and learning things that way. But to go from this process that I had to take in through my head,

but expressed through my heart, and to do it when I wasn't thinking, right? Because when we're reacting, we're not really thinking. Yeah. So that's the challenge. And that's the, you know, and that's how I,

so the first thing I would do with kids, we did something called a redo. And I would do redos all the time because I was sort of like running my body through the system and I'd yell or raise my voice or snap. or say something that was really disconnecting.

And I would catch myself sometimes an hour later. And then I'd say, hey, can we do a redo? And I'd go through the exact same. I'd say, like, we're role playing. Can you say the same thing and I want to do it differently? And it was just trying, it was like every way possible to get it into my body. I would watch TV. And while I'd try and guess what the feelings and needs were, I'd pause the show and try

and guess what they were feeling and needing because the quicker I got the vocabulary and the quicker I was able to tune in and start changing and creating these new neural pathways, the more effective I was going to be. And so over time, that's sort of how I measure progress, right? It wasn't that I, you know, everything was just better at some point. It's like the magnitude of sort of my, my quote-unquote mistakes, the frequency of the mistake and the duration of the mistake, all of those got smaller and smaller. Okay.

And that, to me, was where I'm at now. And it was funny, I'm going to be really vulnerable here. I talked to my kids the other night. And I said, we moved here about a year ago. And I said, I haven't yelled loud enough, really yelled to where you were scared since we've been in this house. And I just want, and I, one of the needs is for celebration, right? That's a, we often miss that need a lot, right? Appreciation and celebration.

And I said, I'd love to celebrate how much work I've put in to trying to share. show up differently as a parent. And they said, you know what, Dad? You're right. You haven't yelled loud since we've been in this house. So to me, and I've been doing, I've been studying this for, you know, intensely for five years, but I've known about NBC much longer than that. So for me to just finally in the last year get to that point, means for four years of my learning,

some things I'm hitting home runs and sometimes I'm striking out. So anyway, I just wanted to name that because that, that's, a lot of people get discouraged because they'll see it and they'll say, this sounds so simple. Right, right. No, but I think it's, it's, I mean, I don't think it's simple because I think like if you were a patient and we were doing the same process, it would probably take a couple years, you know, of dedicated work and, you know, weekly work to kind of reverse the course of how we attach and

how we connect. And I think. And building that trust. with the kids back. Because when we parent, the old authoritarian way, you erode trust. And they're in that submission rebellion dynamic. Right. You have to choose either to submit or rebel.

And usually when they're younger, they submit. And then as they get older, they start to rebel. And that's a sign that trust is just gone. And, okay. So, like, I think I want to go to an example that I've heard you talk about with getting kids to do dishes. Okay. So you check it, you have some sort of number measurement, and then you don't want them to do it unless it's above a certain number of like desire.

Yes. And then you're smiling because you're like, oh, you actually did read this thing. And then so your son was like out of five, which was like a low desire. And so you said, well, before you make a decision, if you're going to help do the dishes, I think you said something like, would you listen to how it's helpful for me and, you know, your mom? They're like, okay. It's like, well, you know, it helps us get ready to play after more, right? So we have more time to play.

And it seems like that was kind of like the thing that maybe made them think like, oh, okay, yeah, we could all do the dishes and then we could all play together. Right. I don't know. Anything you want to? Yeah. So there's something, one of the NBCD. trainers, Ike Aslass, Lasseter, I think it was his name, yeah, came up with something called the duck meter.

And the duck meter is basically saying, in NBC, that you don't want to do something, ideally, without the energy that you would have of a child feeding a hungry duck. That's ideally the energy you want to have behind the actions that you take. That's good, because kids love feeding ducks, right? Exactly. And they're not feeding ducks because they have to, right? They're feeding ducks because they just want to contribute to the ducks. It's playful.

It's like, you know, make the duck happy, right? Yes. Yeah. So it's, so anyway, with the dishes, so we will say, hey, so once we got that scale clear, we would say with the kids, well, I don't want you to do anything. Like seven ducks is you're willing. Eight is, you know, I'm really willing. Nine is I'm excited.

And ten, it's fantastic. So it's not that everything has to be fantastic, but there has to be sort of like a real willingness to contribute versus like six and lowers, I don't really want to do this. I'm doing it resentfully or out of obligation. Yeah. So the goal, and I'm not saying we're always there,

but our goal, and that's the trust we have of the children, is don't do anything that's not seven ducks or more. And now what's the average parent would say, well, there's just some things that have to get done. And kids would never want to do anything you know, as far as helping around the house, if you didn't make them. Maybe that, I don't know, something like that, or what would you say would be the typical response to something like what I just said?

Well, they're going to have a boss someday who's going to tell them to do things they don't want to do. And so, like, maybe it's good to get used to doing things they don't want to do. Right. So maybe you're helping actually contribute to them by teaching them how to do things you don't want to do because you can't always, right. Yeah. So what I would say is we always want to come from a place of choice, right? So instead of saying, I have a job where I have to do something, which to me right away puts your body into sort of more of a threat mode because I'm being forced to do something

I don't want to. Yeah. Right? It sort of puts you on high alert or stimulates the sympathetics a little bit. We want to switch and always be in a place of power. That's choice, right? So if I have choice, then I have freedom. And I immediately go into a sort of a physiological state of safety and that posture of feeling more safe.

So I like to reframe everything as I have choice. And I can choose to do anything, right? So I'm choosing this job because it's meeting certain needs. Or I'm choosing this job because I can't think of another way to meet my need to make money right now. then I really want to have a roof over my head. I'm choosing to live in this type of house that costs this much or in this community that costs this much when I, because X, Y, Z.

So I would teach the kids that, hey, if you're choosing a job where the boss is telling you to do something you don't like, you have a lot of choice there. One, do you have skill to connect with your boss around what's coming up for you when they're asking you to do this? Do you have skill to empathize with your boss around why they're demanding something versus requesting something. Do you have skill to even bring up this consciousness that maybe will make work a better environment,

not only for you, but for your boss? And then do you have choice and skill to find a job that does contribute to all your needs, particularly because I might not want to do something, but that doesn't mean I don't do it. It means I connect with that person around what's coming up for me. Because when I don't want to do something, there's another need that's preventing me from saying yes. So that's how we think about no and nonviolent communication. We don't say a no, I don't want to. We say, hey, there's this need that's preventing me from saying yes.

Because my guess is you would always want to do something to contribute to someone else if there wasn't another need preventing you from saying yes. That's my belief. Right? If you can help somebody, you will always want to, right, unless there's another need preventing you from doing that. I'm following you. Does that make sense?

Yeah. So that's what I want to connect to. So then I say, hey, here's what's preventing me from saying yes right now. And if I trust that they care about my need, if my child trusts that me as a parent cares about their need and that my reason for talking is not to just creatively get them to do it, we're going to create a quality of connection through which our needs will be met. So the dishes, for example, I would say, I don't feel like doing dishes right now. So I'm not going to do them.

Yeah. And I would like some empathy for this sort of experience that I mean right now, because I have a thought in my head that if I don't do them, they're not going to get done. And I have a thought in my head that no one else in my family cares about the dishes and cares about keeping this house clean. So I would really like some empathy. Now you see how we have to pause there because they're probably going to go into shame or trying to convince me that they're good kids and good people and care.

So that's where I can make a clear request and say, hey, I try. And first, see, I empathize with their needs. I know that you care about the house. I know you care about supporting me, and there's probably something that's coming up for you right now. Before we get to what's coming up for you right now, what would really help me in this moment to feel more connected to my heart is can you just say,

hey, dad, I imagine you're feeling this when you have those thoughts. So I'm owning my thoughts, and I'm saying, hey, can you help me get empathy? So I'm basically making a request for my child to meet my need for empathy, which is what I really need in that, moment. I don't need the dishes done in that moment. I need empathy in that moment. And that's how I make a

clear request for them who may not know what to do. Yeah. Say, I don't want you to feel bad about yourself. I actually just want empathy. And they'll say, Dad, I'm imagining when you have those thoughts, that you feel angry. You want some help and support, Dad. So how old are these kids who are saying that? Here's the thing, though. This is really cool. People are like, oh, my God, your kids. They actually do say that, nine and 11. Okay. And, but we've been doing this. like intensely for five years. Wow. And so some of them longer, more of their life,

they've been exposed to NBC than, you know, then they've been a lot, you know what I mean? So. Right, right, right. So it's almost like speaking Spanish. They're going to get it. Yeah. So they might not get it, you know, fluently.

They might have trouble connecting to those skills. But if I can sort of serve it up on a platter like I did, right? Right. Right. An NBC expert that's an adult might be able to just, I might be able to say, I don't want to do dishes and they're jumping right into empathy. my kids, I might have to support a little bit more and say, hey, I have to own my thoughts,

I have to see them and not make them feel, help them go to defensiveness, and then make a request of what they can do action-wise to meet my need for empathy. So I'm helping hold a lot of that. Does that make sense? Yeah, yeah, yeah. And boy, when they say it, I feel fantastic. And then I say, you know what, guys, I feel great. That really helped me. So now I'm celebrating how they met a need for empathy, and my heart does feel softer.

My body feels softer. the dishes still aren't even done. And then I say, let's work as a team here. And this is a big one. We're a family team. And I also ask them, I don't come up with all the ideas on my own. I'll say, boy, I don't want to do the dishes, and you don't want to do the dishes, and we got these dishes that get done.

And I'm thinking about some of the bugs. What should we do? Do we have any ideas, how we can meet everybody's needs here? Do you see what I'm saying? So now is this collaborative parenting. Yeah, yeah. So it's like, yeah, getting them to be a part of the process. And I'll say, you know what?

And you know, I probably have space to stretch into the dishes tonight. If you're busy, how do you feel about doing dishes tomorrow? And we could talk that way. Or they'll say, Dad, what if we all do them, but can we do them in a half an hour? Or, Dad, can we all do them but we play music? Or, Dad, can we do them but I watch my show while I'm doing them? And I get some more iPad time. Or, Dad, you know, let's all, should we all pull our money together and ask the neighbor if they'll do our dishes?

But we joke around, right? And we're like, there's all, but the strategies become infinite. Once we're in that quality of connection, it's playful and fun and not this tight submission, rebellion, awful place. So it takes a little bit more time on the front, but it's much better at the end because I haven't said all these things that are disconnecting. I don't have to clean up all the hurt and shame afterwards. We're not, we're not, I'm not walking away, feeling heavy in my heart, right? So it's really worth the investment up front. How's that to hear all that?

I, yeah, it's, it's, you know, it's definitely making me reflect how I could do things better, you know. And so, yeah, maybe a little bit of like, yeah, it's a good reminder. Yeah. You know, it's one of my favorite qualities about you is the humbleness, right, the humility to always, oh, I could do that differently. Oh, I'm going to learn from that. Oh, this book's really helping me. Like, I love that. Like, that to me is what can make.

life wonderful, it's just that openness. Yeah, and you know, when I was reading your book and I text you, I was like, you know, this is actually really helping me in my journey. Something about, actually, I think I wrote down why it was helping me, but this idea of like safety and like, do you feel safe? And I think that we have, oh, here, what we need is to give our bodies the message of safety instead of messages of danger. and I was kind of meditating on that

because I do have a lot of patients who are really ill some suicidal and I worry about them and that worry gets me in the middle of the night sometimes and thinking about what I could do differently, what am I missing and so it's like, okay, how do I tell my body

like their safety I can, I don't know, it's like live in this tension of taking care of people who are really ill. How do I get back to safety? I don't know. Something about that was helpful. And then also just, yeah, I guess I could do, I could practice the very things that I know work, right? Like the things that I recommend to my patients at times, you know, like whether it's holding ice or doing mindful walking. or, you know, like exercise, eating healthy, you know, like there's things I can do that maybe

attack it from different angles. And that's what I like is to connect to the need for safety. And like, how do you feel when your need for safety is coming up, meaning like, oh, it's not feeling fully met in the moment here. I'm a little nervous or anxious or worried, something like that. So the question is, what do I feel in my body? Yeah, like, what's your felt experience when that need for safety? is sort of getting stimulated.

So sometimes it's like a shot of adrenaline. And it's like at night, like after I get that shot, it's like, okay, I'm not sleeping for at least 10 minutes, you know? And so I'm up. Yeah. Yeah. So that, to me, just that self-connection. Because to be like the power of everything ultimately to me comes down to connection.

And that's what we try to make a point. Like, why are doctors talking about connection? Right. We even get into the anti-inflammatory effects of connection, right? And the, so to me, just your ability to connect to yourself and to just sense in to and sort of tend to your feelings. And that need for safety is the first step. Right. A lot of people try to resist their feelings.

How do I make them go away? Right. And it's like, no, no, how can I be with them and let them flow? and then once that natural flowing happens, then what action can I take so I don't stay in a state of sort of helplessness? Right? Because there's always action we can take to contribute to our needs. Right?

We can essentially meet, and the safety is actually a big one, safety and security, because a lot of people try to meet their need to safety or security by getting other people to do things or to change their external surroundings. But what can I do internally? what can I do to meet my own need for safety and security is very empowering. And that to me is a reframe of these are the needs that are alive in me. What action can I take to better meet my needs? Right.

I think this is kind of a theme I saw which I liked of, it has some stoic connections for me. I don't know if you've read any. No? Oh, that's fun. Well, part of the stoic philosophy is that, like, when you have anger, when you have an emotion, like, you are responsible for that. That is, like, your, and taking the power away from the person that's making you feel that and, like, bringing it back to yourself. And so some people, when they hear that, like, I would never say that directly to a patient because they might feel a lot of shame.

they have to like almost like people have to like kind of come to this realization themselves you know in a way that's helpful not in a way that's like shaming right so it's like it shouldn't be another should like I should only take responsibility for my emotions okay so if I'm feeling that fear

in the middle of the night patients at risk whether they're like psychotic and not wanting to take my meds or you know suicidal and it's like okay what is my responsibility in the midst of that for my own self-care versus making the patients responsible for what they're bringing? Because often they would have these symptoms, even if I wasn't in the relationship with them,

they would, you know, people commit suicide, I think about 1% of the U.S. population or whatever. It's like awful. and so people will commit suicide even if I'm not in relationship with them. So how do I get back to a place of safety? It's a tricky thing. And then how do I sort of get to a place of like, well, my role is empathy and connection with them

even if usually that works, right, over time, sometimes it doesn't. Right. And how do you navigate that, right? Because to me, there's some really key needs here. There's regulation, which regulation of your nerve systems in need even before empathy almost, right? And it sounds like sometimes you get that shot of adrenaline and you have a need for regulation first, right? Okay.

Whoa, you know, like I'm in, I just went into high alert, fight, flight, type of thing here. How do I help my nervous system regulate? Right. So there's also needs around mourning. So morning, so celebration and mourning are two needs that, hey, sort of life energy is just, is flowing. And sometimes needs are being met and sometimes needs are not being met. And when we don't mourn, in fact, I asked, I said, aren't. I asked my mentor, I said, aren't needs things that you want?

Like, why would you ever want mourning? Right? Aren't, you know, it doesn't make sense to me that morning was a need until she said, well, look at the amount of suffering that happens when you don't mourn. And I said, wow, you know, like, that's really interesting to me, that mourning is meeting that need as a way to really support me. So, for example, you can't control your patients. You can do the best you can to contribute to them.

and a lot of them you're able to contribute in a way that sort of shifts the path that they're on and shifts the strategies they choose to meet their needs, right? Because suicide is a strategy, right? And most likely the needs immediately are relief, right? Just this world is so heavy or bad or so many, you know, I just don't know how to cope other than they get out of it to escape it, right?

So, but to me, that's their, How do you own, like, what is your role with the patients? Is it to stop them from committing suicide or is it to contribute? And then when there's a patient that commits suicide despite all of your efforts and my guess is their immense amount of effort, right? If that's happened, how do you mourn that versus take responsibility for their choices and their feelings? Because that's the other thing is that our feelings and I'm not responsible for their feelings. I'm responsible for my feelings.

I can contribute and support. But if it's my effort is to try and change your feelings or to change your choices, that's not really about connecting. That's my agenda for you, what I think is best. And that's why I heard you say that your job really is empathy and connection. Right. But I think a lot of, I don't know what your thoughts are, that's, do you feel like all therapists share that? Because my experience is that some do and some don't, although I align 100% with that.

I think that people who are therapists often get pulled into camps where they think that the solution is a variety of things other than empathy and connection. And so I think I tend to argue that if you look outside of modalities, because you can compare like acceptance commitments, therapy versus cognitive behavioral therapy. Very different modalities, but both very similar outcomes. But within those modalities, there are some therapists that are better than others. And the therapists that are better than others tend to have higher EQ,

higher empathy, higher ability to connect. And so I like to lead with those things and kind of how I make sense of things. And yeah, if someone has a memory of something, it's like, how do I connect with them in the midst of that memory? So they're a little bit less lonely or a little bit less isolated. And one thing I've realized about patients who feel suicidal, it's like, number one, they feel very afraid to talk about it because they don't want to be hospitalized. And hospitalizations often do not make people feel better. A lot of patients that I've had, they experience it as something. traumatic. Now, it can be life-saving, but in general, your rights are taken away. You're seeing people who, you know, you don't have a lot of control. You lose it on me. And I've worked with a

number of patients who, it is a small T trauma almost to be there, right? Or if they're psychotic, it could be a big T trauma because they're also, the paranoia, the paranoia is getting attached to the people that are now doing things against them, that are really doing things against them. So if someone's suicidal, they have a strong desire to not fully tell you how suicidal they are. And because not only do they fear being hospitalized,

but they can also fear consequences outside of you know the legal you know legal consequences maybe work consequences um maybe it'll be overwhelming for you i i know a person who told their psychiatrist they were suicidal and the psychiatrist fired them um just absolutely blew my mind hearing that you know and it's it's a little bit more complicated than just straightforward that but um I would say that's not the usual course. The psychiatrists deal with suicidality often. That's what we do.

But I think it can be overwhelming for the provider to navigate their own internal emotions. And I wouldn't want to put that on the patient because, and as I talk about this, I also realize that some of my patients listen to my podcast. So it's like I would never want my patients to feel responsible for my feelings. Right. And I tell them I'm on my own emotional journey and my own spiritual journey. And I have, you know, a therapist and a supervisor and Dr. Tar and, you know, like I have resources of people that I connect with over this.

But it can be heavy, I think, even for, for the providers. There's like vicarious trauma, you know, of the things that we hear every day and the weight of it. And so I think it's like part of the job description, but it's also when we really care, it makes it that much harder, you know, and we're not going to be good at what we do unless we do care. So it's like we have this, we have this tension there. So, okay, so getting back to it. And getting support. when the pain that gets stimulated for you're doing your best you can to care and support, and it's still, they're still struggling or they're still having outcomes that are really painful for the patient as well.

And I think we don't, in health care in general, get enough support to process and mourn, right? Yeah. To become aware of our feelings, to connect to our unmet needs, and to allow that to flow. I think that we don't get that. And that's so important to be able to continue caring. Yeah, so it's like empathy, empathy and connection in the midst of suicidality. I think it's complicated because we want to be able to connect with them and empathize with them, which can be counterintuitive because it can almost sound like in hearing them,

We're also hearing why they feel so drawn to that conclusion. But I would just hope that they would feel less lonely in that place of feeling suicidal, because it's an incredibly lonely place, incredibly isolating. I love that you point that out because to me, unpleasant emotions alone don't cause suffering. It's when you're alone with your unpleasant emotions. that you experience a lot of suffering, and then what's more when you resist them, right? So it's dealing with all of this alone

is where I think most suffering happens. So you're, and your focus on just giving them company while they're in pain and them trusting that you can handle that and not take on water, right? Or react and try and change them. Yeah.

That is such a sweet place to live. or to be, right, and to heal within. And when I do it properly, I feel gratitude from them. And that feels good, and we can sit in that towards the end of the session, but it doesn't always get there. You know, it's like when you're playing the orchestra correctly, the orchestra of connection, you end up not feeling as lonely.

And then, yeah, there's gratitude. dude, there's joy that comes from that, which is, I tell residents this. And it's like, they're listening to me often. And they're like, okay, is it really just about connection and empathy? And I'm like, yeah, let me show you some more studies if you need that, you know, for the left side of your brain. And then sooner or later, they get it and we're watching them. We do like videos of their patient interactions and they're really connecting with someone. and you feel the joy from the patient build as the session goes on.

And it's a beautiful thing. And it's like, why, at the end of the day, why do we do it? Right. It's like, yeah, it's like you said before when you were learning about it intellectually, it's like, oh, I'm going to do this in order to get my needs met. It's like, well, I mean, connection, I guess, would be one need, right? But also it's just like the joy of. of connecting in and of itself.

It's like that's why we live. Right, and the connection, and that is the contribution to the patient, because I believe that there's a sort of an organismic wisdom. Our bodies naturally go towards healing if you can remove the barriers. And they're the ones that are aware of what the barriers are, or at least they can say, yeah, you're getting it,

no, that's not right it, that's not quite it. So if we can sort of move out of the way, the toxicity or the, you know, sort of you pull the bullet out of the arm and then the arm can heal, right? To me, you take two bones that are fractured and you put them together and the fracture heals. We don't heal it. We just put the bones next to each other and the body heals it. To me, that's similar here where we sort of help the patient put thing, you know, we help them get it together and then they do the healing, right? And that's where the connection and the Empathy allows that process or the bones to sort of set, right?

To me, that's the magic. But then trusting that they and their body has the wisdom to heal. We don't do it for them. Yeah, and I think that also helps us not get too prideful in the midst of participating in such, you know, meaningful types of work. It's like, yeah, we are bringing the two bones together and the bones heal because That's what the body is programmed to do, not because I'm making that bone healed to that bone. Right.

You're right. And my guess is, especially when I, at least when I came out in medical school, I was like, I'm the doctor and I can fix things. And you sort of learn over the years, right? There's sort of a shift around that mentality, I think, at least for some doctors, right? I think it's like some patients who are in a psychosis.

I was talking to a patient about this yesterday. They felt really good in that psychosis. They were like communicating with God. They were communicating. They were everything, every thought that they did would come true. The whole world was looking at them. And everyone was in the world for them, not for themselves, but for them, right? Incredibly grandiose ideas, right?

And they actually believed these things. Coming out of it was incredibly sobering. And I think for a lot of doctors, it's like you can be sobering to think, like a lot of the change that occurs is not the medication, right? It's going to be the connection. It's going to be diet. It's going to be exercise.

It's going to be play. It's going to be things outside of what you are acting upon. this person with, right? And I think what you said, too, is that, like, to me, when I think about that, where you said the patient really enjoyed being in that state, my belief is that everything we do is to meet needs. So even if we start to sort of shift, we don't, we no longer, the way I would describe is we no longer have a shared reality, right? But there's, and for a lot of patients, particularly with mental health, my experience has been

they don't feel safe, they don't feel secure, and then all of a sudden they can start changing reality to help them meet needs for safety and security, potentially even meaning and purpose. Right. So, and it doesn't mean that, you know, we don't want to help them, but are we really trying to help them and sort of accompany them? Or are we saying, this is the way you should be, and my job is to get you back to here? And what I'm hearing you saying is you were able to sort of hold all of that, right? You were able to say, I can understand that you're enjoying, it makes sense why you're enjoying where you're at right now. And I'm imagining it's meeting needs essentially. And is there any cost, right? Because remember we talked about, your strategies, you want to be

most effective at meeting needs and the least costly, right? So can we connect to that? Again, without an agenda to fix or change you, right? Let me just check in. Are you tuning into yourself and saying, hey, am I aligning my behaviors with my values? Am I meeting all of my needs without cost? Oh, they would say the cost was enormous. I mean, this is a person who has a lot of insight, actually, into what happened. So there was huge cost for them? Oh, yeah. And they were aware of that? Huge costs, yeah. Okay. They did not want to go back into that state, although they realized that that state was, there was something very, very pleasurable about that state. So it met some needs at the expense of others.

Yeah. And I would say also, like, I think in connecting with this person, I like to think about how in a similar fashion, I might be prone to have those similar types of fantasies. Maybe I'm not psychotically registering them. But it's not foreign to me to want to, or to any way. I think to create a grandiose world at times that protects them against, you know, the harms of the world. Right. And does, and this is something I have in the general, just in general, right? And whether it carries over into medicine or not, you know, to each their own. But is, is labeling somebody help contribute to them getting better? versus right so to me like for example if a child and this i'm curious what you think we've never

talked about this if a child has an imaginary friend are they crazy are they right at what like is there something off because hey i do not share that reality i don't see the friend is is the is it depend on whether that friend is telling them to do something i think we meet with curiosity i mean you know i think i think with that situation it's a whole lot easy than with an adult who has an imaginary friend. But would you say a child who has an imaginary friend is... Well, what I'm saying by easier as in, like, as an adult, approaching it with curiosity is easier than you might have curiosity approaching an adult.

I'm not saying that there's anything wrong with an adult having an imaginary friend. Actually, I would put that in the category of, like, fantasy and fantasies. I love to explore fantasies because they tell us so much about a person. Yeah. I'm hearing what you're saying. I think the context of if someone is bipolar or schizophrenic struggles with, if someone is a person who struggles with, you know, bipolar, schizophrenia, and they need to be on chronic medications to push the threshold

at which these things will cause them to lose insight over them, right? then I think there can be some value in the understanding the disease. And I had a patient the other day that it was like, here's why we're in this delicate balance between your medication. Like you have this mesolimbic track, which is causing you to have, you know, a psychotic level of anxiety. And then you have this.

And it's like, it's so careful with patient. I'm so careful with patients. because I don't want them to start arguing with me, right? And I think one thing that you're right about is that once you label something, it's like it can become a point of contention or argument and that. Or they lose their power because there's another that I can do. I'm this label now.

Yeah. But at the same time, I hear what you're saying, right? Like, especially early on when you're trying to help regulate them and get them into a place where they can actually... It's so hard. Yeah. trying to get them to have enough buy-in so you can get enough of a dose of an antipsychotic so that they move

into reality right where they can do all this other stuff but and you know therapy helps to some degree but in my experience medications are like completely necessary when someone has one of those illnesses like to get them out of that state and but you don't what I know about you is that you don't just say, here's your medication, and we're done. The medication to me is almost like a bridge to allow you to do all this other healing work, right? Right. So with the psychotic patient doing the therapy,

I think actually will help them gain insight into potential future events. So they'll know, like, hey, Dr. Peter, I need to go up on my met. Or I think I can go down a little bit and let's see what happens. Okay, I'm starting to feel this, this tension. starting to hear these voices.

And then, you know, can we find a lower dose where they can do some of that work? You know, and that's complicated. Right. That's, I think, where the nuance of the work comes in. And, you know, can, I mean, if they have, like, depression or anxiety, you know, can they understand why exercise or diet will make such an impact on their, trajectory as well as therapy

and if it's at a level where it's like you're not able to help them like how much medication which medication there's a lot of nuance there but yeah my approach is more I don't know it's it's not as like easy it's not it's not cookie cutter like algorithmic

you know it's nuanced for the person and thinking outside the box. And that's what I love that. Because to me, that's how life is. It's not static. It's dynamic. It's fluid. And whether you're talking about all the pillars that we talk about, right?

And you're balancing them. And some days more need attention, some days less. Right. But similarly, like the medication I'm hearing for you, my understanding of how you practice is that it's one of the many tools in your arsenal and you're always evaluating all your tools. Do we need to go up? Do we need to go down?

Do we need to add this one? Do we need to shift here? Do we need to spend more time just being heard? Oh, now, now maybe you need a little bit more learning, right? Like, that's that dynamic, lifelong sort of flow that you're in with each patient that's unique, that you can't cookie, you know, there's no cookie cutter, right? Yeah. A lot of my patients aren't on any meds. And they, you know, and that's because that's how they don't want to be on meds, you know, or they want a different approach.

So yeah, it's very individual and it's, you know, what works, right? Have you ever had patients come from another practice where they say, I want to get off my meds and you're able to get them off? Yeah. Yeah. So it sounds like you're open to everything. Sometimes they need meds. Sometimes you'll take them off. Sometimes it's a...

Yeah. It's really patient focused. It's really patient focused. You know, if someone is willing to, like, let's say they got put on meds and then, you know, they did like a ton of psychological work right and then they cleaned up their diet they're doing exercise they're sleeping good they come in on meds it's like yeah let's see what we can do let's take it down let's watch you know yeah and then sometimes you take off something and you're like oh okay that was doing something really powerful there right like okay you have some choices now you either

need to optimize your you know do some more therapy or you need to change your diet it. You know, there's, yeah, so it's a constant sort of dialogue conversation, trying to figure it out step by step. Yeah. And that's what I like is that collaboration, right? That collaboration with the patients. And hey, you know, you're having, you know, it's my, my perception is that you have this

really hard time, you know, regulating this or, or navigating, you know, this experience. and my belief is that some of this medication will support you and allow you to meet all these other needs and goals that you have. Right? To me, that's the energy, you know, versus focusing on, you know, you are this diagnosis or, you know, and like to me, there's just a different energy between the two. Right.

Yeah. I'm hesitant to tell people you are this diagnosis. Yeah. Like, that's not, unless they ask me or, it's like, then it's like, okay, well, before I tell you what you could fall into, why don't you tell me, like, what's behind your curiosity there? I love that question. What's, you know, and we talk about this, too, a lot.

What's the need behind the question? Because sometimes they ask a question, but really they're needing, you know, empathy, right? It's not actually, the answer to the question is not really what they're looking more. They weren't aware of that. Or maybe there's some other need. But I love that curiosity. They could say, like, well, I fear something is really wrong with me. Or they could say, well, I've never seen a psychiatrist before.

And, you know, I think I must be really sick because I'm seeing a psychiatrist. It's like, well, okay, yeah, that would be awful to feel like something is really wrong with you. Yeah. You know, like, you've, I think that would, that would feel absolutely awful. Yeah. So you see that response versus just answering the question would actually potentially contribute them thinking there's something really wrong with him because you just gave them a diagnosis versus, oh, I imagine that must be awful to imagine something's wrong with you.

Yeah. Maybe lonely and scary too. Right. Yeah. And then you might still wind up giving that information. But if you're focused on the connection, maybe that information is on hold for a little bit. Yeah. Maybe you never give it to them.

I don't know, but that desire to really tune in to the connection. And some people like to know so that they can do research and, you know. Yeah. Do look up what are the treatments and sort of get their mind around it. So, yeah, some people come in and they, I do a lot of the big five personality types on people. Like pretty much every one of my patients I run this thing. And so I know how to like look at these now. It's fun to look at them.

because a lot of times it gives me a diagnosis which is very different than a regular diagnosis. You have high conscientiousness or you have high neuroticism and you're probably wired that way. I think some therapy would decrease it. I've seen therapy decrease neuroticism when I like test and retest people. So it's like, you know, this is because you have a negative internal critical voice and we need to work on that. and we can decrease that over time. So then the treatment becomes more therapy often when it's neuroticism or, you know,

like this will lessen as well if you do positive things for your body. So, yeah. Love it. And I love what you said earlier also where you really took into account that patients, hey, they're afraid to share authentically, and vulnerably sometimes, right, because of your potential reaction, right?

Or not you personally, but like, if I'm suicidal, I don't, I'm not sure I can share that. And to me, that's, like, what NVC allows or and supports is can we be comfortable sharing? And a part of how what, like, I'll say, I have a need for authenticity or honesty. And I realized that I think that that sometimes the other person has to do something. to meet my need for authenticity. And when they're not authentic with me, I think it's something about them. And I've learned over the years

that actually my reaction is what contributes to authenticity more because if I tighten up or like with my kids, if I start to lecture them or I get angry or I take something away or I'm reactive or I, you know, all of that takes away their off,

they're going to be more likely to hide. And I think what you're doing for your patients, giving them this gift of, hey, I am going to be a thousand percent stable when you share authentically with me. That is so important. And I was telling you earlier before we started the podcast, right, about when my wife shared something with me. And if I started to take it personally, she would not be likely to share that with me in the

future. But if I could just, if I had some pain, do a little self-empery. and then be with her pain. Now she's getting that message of, oh, I can share with him. Yeah. Same thing. So with the kids,

with our partners in life. Right. You know, with our employees. Yeah. Yeah. And so that's where, like, I think, moderating or sort of figuring out ways to decrease shame in someone's experience of sharing,

I remember one of my mentors who was not a trained therapist. So he just had lived a lot of good life in a way that was meaningful. And I remember sharing stuff with him. And he like, instead of shame, instead of like shaming me, I just felt like he was just going to yell at me, you know. Just love, you know. Just simple love and compassion. and how healing that has been my journey.

I can think of a number of times where I've almost expected critique, you know? And to receive the opposite, it's surprising and it's just like really meaningful. And so I think that's what I try to give my patience. It's like, yeah, let's have an open conversation. And, you know, if there is things that trigger me, then it's like, I'm going to do work on.

that and it's ongoing you know like i don't know as a as a medical mental health professional how you can't do ongoing work it's like it's a you know like you need at least every other week you need therapy it's like you need that like space to just process some of the stuff that's coming up for you and then you process through it and i feel like i'm i mean i have an even bigger container to hold for my patients. That's huge, right? Just getting that support and that empathy allows you to show up, resourced enough to give back to your patients.

And they can feel it if you have it. They can feel it if you don't have it. It's not like this is going to be consciously registered often. It's like unconsciously registered. It's like unconsciously registered. It's like I feel. Like, I can just start sharing. I was talking to, I have this therapist that works for me.

And people will just start talking to him. And he's commented on this. He's like, I don't, I like, people just, they don't even know I'm a therapist. And they just start sharing. And then they start realizing they're oversharing. And they start, like, you know, feeling shame. And then, but they feel like they can continue to share type of thing. So Dr. Tar, my mentor, he's 97, I think, now.

When he goes on vacation, tells people he's a salesman. So he can, like, reduce the amount of oversharing that people do because he needs to have that break. Yeah, like a little bit of a boundary there. Yeah, he has a little bit of a boundary. So, yeah, anything. I think that the other thing that's really exciting for me is around social change. I think that's the key for social change is for people to be able to share the, there are quote-unquote ugly thoughts, right?

So if we can't do that, if there's not a space to do that where you're going to be received and supported, and I don't think we can achieve social change, right? So there's all these people that have different feelings about race and gender and, you know, abortion, right? Whatever your thoughts are, right, I would love for us to be able to create an environment where we can share that.

I mean, I've had my own, quote, unquote, ugly thoughts that I would be scared to share, and I've tried it. And when it's received, then I can get the healing. Because I'm aware that, hey, I don't want to think this way. I want to be able to shift and grow. But I could use support and healing and not have to hold this alone. And to me, when I'm with people that can support hearing those. ugly thoughts, then I naturally grow versus, I think a lot of times the way we focus on,

and we, I'm generalizing, social change around, this is the right way to do things. And if people don't do that, you know, we point them out or there's shaming, like you said. You know, so how do we, to me, it comes back to that same thing. Can we share authentically and that be received versus shamed? Right. Yeah. And I don't know, I think I have two thoughts. One thought is, I think there is an evolutionary, adaptive place for shame.

Like if my kid is running and they're about to run into the street and I yell, stop! And they feel shame and they just crumble, right? This happened one time. And then I go over there and I men, you know, pick up the child and help them regulate. but like, hey, they didn't get hit by a car. That's like the protective use of force. The protective use of force, right? Yeah.

Which is different than the punitive use of force. It's not a punitive use for force. It's like, hey, I love you so much that I'm going to try to like set you on the right path, you know. I think that what's happened in our culture, though, is because social media has algorithms that are next level, people go down and they find people. that believe very similar things themselves, and they just get reinforced. Right. And then when they get in contact with someone else, the natural inclination is you have all of this built up anger and shame that you want to unleash.

And so it just makes for a very hot political landscape. And people mistake, like, if you hate this person the same way I hate this person, they mistake that for empathy, right? It's really not empathy, though. empathy would be with the pain behind my hate and then connecting with that. But a lot of people don't know how to do that. So we just sort of, you know, can you believe my boss did that? And they're like, yeah, your boss, I hate him too.

Right. Right. That's not really empathy, but that's sort of the best a lot of people have. And that's sad to me. It's like connection through negative gossip. Right. Essentially, it's like, which is, you know, it's a way that some people connect. At least you're not alone, but it's not really.

healing either. Yeah, it's not healing. It doesn't move towards building good culture, building a culture of like love and authenticity and mutual respect. It takes us away from, we can feel it in our hearts, right? It makes one person a bad guy and one person a good guy. Yeah, and so the world that we live in is very complex. But I think that patients inevitably are going to have different viewpoints than we do. Yes. and so we have to work through our own reaction so that we can be ready to be that container for whoever comes through the door.

And that's why I actually don't broadcast my political or a lot of my views. Right. Because I want a lot of people to come through and I want them to be different than me. Right. Maybe I'll learn something. You know you're part of a tribe when you believe everything that the tribe believes.

and then there's another tribe that believes the exact opposite and there's like a hundred things that each tribe believes and you believe 100% of what this tribe believes and you don't believe any of this stuff that the other tribe believes. It's like, wait, what if there's like, is that group think? You know, like how do we step out a group think and think independently? But it's so hard if you're not reading, I think, especially ancient literature. Right.

I think if we read more ancient literature, and then we kind of like get out of our own unique experience of this here and now tribe that we're in, and we can start to think critically. Yeah. So. and it's so needed right now, right? And the more we can just show up, a lot of people are, what can I do? And me, if you can just show up with empathy, and if you have hate towards someone, then you have work you can do on your own, right? So if you hate one of the presidents, or you hate one of the candidates, if you're having hate, that's your own work to do

before you can help anybody else, right? So to me, that's where I try to focus my energy. That's good. Yeah, I think as well, I would say, so I've been off news and short form video for about six weeks now. Okay. Completely.

And it has been great. It's been great for my brain. Yeah, I can imagine. I've read some books again, and actually, like, I could read your book where, like, I was telling you, like, I think a month ago when you asked me this, I was like, I was like, I gotta be honest, like, it's really hard for me to read. Right. And it was the short form video. Once I eliminated all that and news, it's like my brain can just, like, read it. It's like, I can read again.

And so the power of, I think, reading some of the ancient literature that I've been doing, like older stuff. is it gets you outside of the tribes that you're in or that you were in. Right. And it lets you think a little bit like outside the box of like, oh, okay, maybe some of these arguments that we're hearing now have been going on for a long time. And like, how do we look at them differently? Anyways, we got to wrap up our time here and get some lunch. Yeah, anything else?

I mean, there's so much more that I could add that I appreciated. I think that the nine pillars that you put in are great self, you know, self-compassion, nutrition, a lot of plant-based moving away from processed foods, activity, exercise, cardio, strength training. That's stuff I... Movement, yeah. Yeah. Play, you know, learning how to play. So good.

I think that's like really... Just even connecting, a lot of people don't even know if they just could take, do something for themselves for fun. Yeah. Right? They don't know what that is anymore. If we've forgotten how to play. Yes. I would say adults have forgotten how to play with their kids a lot of the times too, which is, it's really sad.

I see it. Yeah. So play, sleep. It's hard to play when you're in fight and flight. Yes. It's like if I'm stressed out from the day, it is hard for me to enter into play. And so I'll jump in my cold plunge for like four or five minutes and that'll snap me. That'll snap you out of it.

And on the flip side, it's hard to be anxious when you're playing. Yeah. So if you can get into play, it's a wonderful escape from anxiety if that's a challenge. Yeah. Sleep, you talk about sleep and the importance of sleep and it's great. And then you kind of go through connection as kind of the broad overview, right, of the next four things? Right, so there's self adds the connection to your self.

Okay. And then there's those four sort of internal world, sleep, nutrition, activity, and play, which really resource the body so that then you can connect to what we call the external world, which is the family friends, meaning and purpose of work, spirituality, something greater than yourself and our interdependence, and then all of the natural world, which is all of the life on the planet. Yeah. And how do we connect?

that process is when you experience more joy, which is not about being happy all the time, it's being more connected, even if it's unpleasant or sad. It's that flow of life energy that's allowed to flow. And these nine pillars are, you're tending to them almost like nine children, right? And you're sort of just saying, okay, it's a lifelong process. It's not like you get someplace and you're done, right? You're always raising children. Yeah. And it's who do you, You can't take care of all night at the same time. Where do you, oh, well, someone just fell down the steps and someone needs help with their homework.

I'm going to attend to the kid that fell down the steps first. So that's sort of the same way. Which one needs our attention most? And then it's this lifelong balancing act. Yeah. Yeah, that's good. It's a journey, you know? It's a journey.

And I think that... That's where the joy lives, actually, is in that... A lot of people can hear these things, and I think you talk about this in the book, which it's like, absolutely. It's like, you could hear them, and you could be like, oh, these are more shoulds. Like, I should exercise and I should diet

and I should, you know, meditate or I should, you know, all these things that we know help us, but to kind of move from those shoulds and into that like feeding the ducks, you know? Right, that internal, shoulds are coming from external and we're so used to, because people even ask us, what are the, so tell me the three things I need to do to live a wonderful life.

And that mentality is the issue, Instead, it's don't look at me to tell you what to do. Cultivate the skills to look inside you and what your values are and what needs attention in the moment and grow that skill set. Because we've been taught how to be good kids because our parents told us. We were taught how to be good students because our teachers graded us as such. We were taught to be good workers because our bosses boned us as such. But it's all external. What we have to cultivate is the skill to look internally, figure out what our values are, our needs,

same thing, values and needs, and then align our actions, our behaviors to be congruent to our integrity with those needs. And when we align our behaviors with our needs, that's when we experience joy. Yeah. So that's a good summary. Well, awesome. Hey, this was so much fun. Oh, yeah, I love talking to you, David. It's been good, yeah. And now we're going to go eat some food and enjoy that as well. So we will leave it there for today and I hope you have found this interesting and illuminating. If you want to learn more, I will put in the show notes, link to his book, website, and maybe some social media if you have any. And we will go from there. So thanks again for having me, David. I appreciate it. And I appreciate your friendship.