The Checkup with Doctor Mike - What Hollywood Gets Wrong About Mental Illness | Dr. Eric Bender

Episode Date: October 1, 2025

I'll teach you how to become the media's go-to expert in your field. Enroll in The Professional's Media Academy now: https://www.professionalsmediaacademy.com/Huge thanks to  @dr.ericbender  for joining us today! Check out his channel here: https://www.youtube.com/@dr.ericbender00:00 Intro01:32 Diagnosing Celebrities07:39 Diagnosing Fictional Characters14:00 Boundaries With Patients18:50 Silver Linings Playbook20:47 Self Diagnosis27:54 Reaction Videos32:40 CBT vs. DBT40:50 Medication51:10 Talk Therapy52:48 “Mania”54:48 The Body Keeps The Score57:55 Who Should People Call?1:03:40 Online Therapy + AI1:08:16 Reality TV1:10:20 Psychiatrists With Issues1:13:27 Famous Psychiatrists1:18:47 Good Will Hunting1:25:47 MrBeast1:27:30 The Joker1:31:54 Snake Oil1:34:25 Labeling Your Ex1:36:36 Primary Care Problems1:40:00 Couples Therapy + Divorce1:44:35 Misconceptions1:46:40 The Bear + Adolescence + The Future1:52:36 Should You Become A Psychiatrist?Help us continue the fight against medical misinformation and change the world through charity by becoming a Doctor Mike Resident on Patreon where every month I donate 100% of the proceeds to the charity, organization, or cause of your choice! Residents get access to bonus content, an exclusive discord community, and many other perks for just $10 a month. Become a Resident today:https://www.patreon.com/doctormikeLet’s connect:IG: https://go.doctormikemedia.com/instagram/DMinstagramTwitter: https://go.doctormikemedia.com/twitter/DMTwitterFB: https://go.doctormikemedia.com/facebook/DMFacebookTikTok: https://go.doctormikemedia.com/tiktok/DMTikTokReddit: https://go.doctormikemedia.com/reddit/DMRedditContact Email: [e-mail] Producer: Doctor MikeProduction Director and Editor: Dan OwensManaging Editor and Producer: Sam BowersEditor and Designer: Caroline WeigumEditor: Juan Carlos Zuniga* Select photos/videos provided by Getty Images *** The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional **

Look what I did to this city with a few drums of gas and a couple of bullets. The overarching theme of the Joker is that he is really a psychopath. So a psychopath is someone who's callous and uncaring. They will use people as pawns to get what they want in their lives. They really don't care. I feel like listeners or viewers might hear your definition of that and be like, oh, I dated one of those. Yeah.

Is that... I've been asked this before. When it comes to dating, psychopathy is probably an extreme version of narcissism. One of the traits for narcissistic personality disorder is you lack empathy. I think they're talking about people who are totally absorbed with themselves, not considering other people, think they deserve the best treatment. They should be the center of attention. They're pursuing unlimited power, beauty, money, whatever. Those are narcissistic traits.

And maybe you are seeing them in people you date. Are you displaying them also or what's happening? Welcome back to the checkup podcast. Today we're diving into the world of Dr. Eric Bender, a psychiatrist whose insights on the human mind have been featured. everywhere from the New York Times to viral videos with GQ. He's not just a doctor, he's a storyteller who makes the science of mental health actually click. You may have enjoyed his work on Batman Arkham Shadow, where he served as a consultant

to ensure the science was spot on. In this episode, we're diving into the surprising ways Hollywood gets mental health terribly wrong, where it nails it perfectly, and even into the social media trend of diagnosing your ex with a personality disorder. Trust me, you'll walk away from this one. seeing media and even your own mind in a different way. Let's get started. You've become quite vocal about how mental health is portrayed in media.

If you had to say positive, negative, neutral impact on your work, day-to-day working with patients, how has media impacted them? Media impacts them tremendously. YouTube just took over as the most watched from other streaming services. So people watch media, and whether that is YouTube or whether they're watching Netflix or whatever other streaming services, people get ideas from media. If you look back, I'll just remember some of stuff from when I was a kid, the karate kid, 84.

Karate had a huge explosion in popularity. And you go back farther, 75, Jaws. Sharks were suddenly hunted a lot more. Media gives people ideas. So to get ideas about mental health, let's make sure they're good ideas or real ideas. That's true. So how, if you're doing a report card, do you think it's a... been trending on the good side or have been more problematic? I think it's going in a very good

direction. When I first started doing work with media and mental health, it was back in 2008, 2009. And at that time, I had teachers telling me, why are you doing this? This is a waste of time. I was asked by ABC News, can you talk about Darth Vader? What personality disorder Darth Vader might have? So I was talking about borderline traits and histrionic traits with some colleagues. And one of my teachers I really liked, he's like, does Darth Vader borderline personality? Now, that's so stupid, but it's not. It's an entrance to talking about mental health, which even though we're going in good direction,

it's still very scary for people to talk about. So if we can talk about characters, movies, and TV shows they like, then they can start asking and learning more. I always worry when talking about mental health subjects are covering them, there's a way to talk about them responsibly where you are pointing out that this is not the normal way

that you would go about diagnosing things, but you're doing this as a form of entertainment in order to educate. Sometimes people blur the lines of that. Have you seen that happening a bit? I have. I think if I'm looking at, just to be clear, do you mean people looking at a TV show

and saying this is how it's done and this is how I expect the psychiatrist to be? Well, maybe we can talk about multiple avenues here. So the classic example is you see someone on television, perhaps a reality TV star, and people start diagnosing them. I mean, I get calls like that from trash hours. It's all the time that are like, oh, hey, do you think this person has borderline personality disorder traits?

So that's a great question. So if we start with that place, I'm often asked, what do you think of this person, this public figure, this political figure, this actor, this actress, you name it. And I always say I haven't evaluated that person and I don't have permission to talk about that person. I'm not going to comment on that. There's actually a rule in the American Psychiatric Association as the Goldwater rule, which dates back to when Barry Goldwater was running for president, psychiatrists from psychiatrists were surveyed from fact magazine or fact magazine sent out a survey to psychiatrists i should say and about 1400 responded saying barry goldwater is not fit to run for president or be president they'd never evaluated him they had no knowledge of him whatsoever and american

psychiatric association came out with the goldwater rule you cannot talk about these people that you don't know unless you have evaluated them and have their permission fact magazine was sued and actually went under after that. But yes, you can't talk about, I can't talk about ethically people that are in the public eye. And yet it somehow still happens. Why and how does that? I think people, there's no doubt people are fascinated by what is going on. Why is this person acting this way? Why is this person doing this? What do they have something wrong with them? I think it's natural to ask those questions. I think some people maybe aren't aware of the ethics. Some people don't, don't mind stepping across that line because maybe it brings them something, some joy, some fame, something.

But I think it's natural to wonder, but it's also, you know, there are ethics here. We should pay attention to. Are they, are these rules in place because it's ethically morally wrong or because you can't actually know what's going on from your limited knowledge superficially? I think both. I think both. And also you can do a lot of damage to people by saying, oh, this person is this. Clearly this person is this.

You have no idea. Or this person is doing this. you can talk in generalities. I can say when I see behavior where someone might do this, I think there could be these kinds of things going on. So I'm not diagnosing anybody that way.

I'm actually giving more information and using it as a way to teach. But you have to watch when you're doing media interviews because you can get clipped where suddenly they're saying it. And I'm sure you've had that experience or suddenly you're, wait a minute,

that's not what I said. Yeah. And this actually happened to be a point of prominence five years ago on YouTube, maybe a little longer, where people started labeling one of the Paul brothers, was it Logan Paul or Jake Paul, a sociopath? Oh, was it Shane Dawson? So basically there was someone who was doing content with Shane Dawson in the mental health space saying that these individuals are

sociopathic and essentially making the diagnosis without truly knowing them. And to me, again, from just trying to be factually accurate, throwing the ethics and morals, out of the equation for the time being, people on camera turn up their personalities, change the way they act, especially when there's viewership involved, money involved. So to judge and understand them as a whole person

feels like you're drastically not getting the whole picture. Correct. And that's the way I look at it too. You don't have the whole picture. I had conversation with my wife a few months ago. She said, do you realize how much power you have as a psychiatrist when you're telling somebody how you see them and how you understand them.

And I do. That's why I don't say certain things. That's why I'll help people explore what's going on in their lives. I don't want to label people with things. And especially people, I don't know. That's just, it's not ethical if we bring that back in. But also, it's just, who knows what's going on. Yeah.

What about from the standpoint if you're talking about a fictional character? Does the ethics then resolve and the accuracy is less important? These individuals have not existed, and they're great teaching tools. And it's a great way to start conversation about mental health. Now, when I first started again, people weren't necessarily open to this. There were some major comic book characters that colleagues and I looked at. And some of the people behind the characters are like, why are you doing this to us, almost thinking we were taking away millions of dollars because we're criticizing.

That's not the case at all. You can actually have more psychologically deep characters. and they're even more appealing to your audience. So people weren't always open to it. Why weren't they open to it? I think they were afraid of what would happen to our characters. If we have to change this, if these guys, these psychiatrists, these doctors,

these whatever, are telling people this about the character, what if we change them? But there's been a huge change over time. I mean, now I get calls about, hey, can you add psychological depth to our characters? We don't want to do this. show, video game in the wrong way. We don't want to do

anything it's stigmatizing. What does it mean to add psychological depth to a character? What makes somebody tick? Why do they have this kind of reaction with the world around them, to the world around them? How do they interact with people? What goes behind that? Why might they think this about someone? Why might they think this about

themselves? So all the pieces of who they are and how that comes together to create a character. Somebody like us who is going through the world, and interacting with the world in different ways, with some of where we came from and who we are has to do with a lot of experiences in our lives.

So it's understanding what experiences might make somebody like this. Do you think about a specific patient when you're doing this? I don't think about a specific patient. I think about the character. So I was really lucky to work on Batman, Arkham Shadow. It came out in 2024, and I was excited it got VR Game of the Year and camouflage the company that put it out

that worked for meta. they were so open to this. And what I would do is I would talk with them about the characters and what they wanted to show. And then they told me some of the story they had and I could say, oh, if someone came from this kind of background, then this would probably happen. This is how they might see this.

This is how they might understand their emotions. So it's not that I have a patient in mind, but I'm imagining them sitting in front of me. What can I understand what happened in their lives that would make them this way? Is it always that like fatalistic for lack of a better word? where if this happened, this type of upbringing,

that means they'll develop in this certain way? No, it's actually the reverse. I'm like, okay, this could come out this way. Like, they're acting this way. I could see that this could be in their background. Got it, okay. So it's not always just a one-to-one equation moving in both directions.

So then when we have fictional characters, isn't there ever a concern if people start seeing them being diagnosed as a way to scare them away from seeking help for their own mental health problems. That's an interesting question because one of the things that I remember most from one of the Comic-Con lectures

I was a part of is we were talking about mental health and comics and TV shows and at the end of the lecture a woman raised her hand and said when is there going to be a depiction of a character that doesn't make me feel like I'm going to be a criminal? When am I going to see a villain with mental illness?

It doesn't make me think I'm just going to grow up and be terrible. and I remember that so vividly and I think the way I go about this is never to teach somebody oh don't be like Batman it's more like let's understand

this how is he coming to deal with maybe PTSD or how is he dealing with this why does he react so strongly to this and I think that gives audiences little bits of themselves they're like oh wait I do that too oh wait Tony Soprano

he has a panic attack I've had those Oh, I could talk about that. Or, oh, Batman, he did this. Or Superman, he feels this burden of responsibility to take care of people. That's what I feel like with my parents right now. So it's just ways to people to understand themselves and see themselves. So it's probably good to do it with a variety of characters, not just villains, let's say, but heroes and everyone in between. Yeah.

And I think you've seen that over time. Where it used to be all the villains, the tropes were, oh, they were neglected, they had this, and they became this psychopath and this. Now you see anti-heroes more, like Don Drape. from Madman, or you would see Tony Soprano. You'd see these people that are borderline good, bad. It's not just a villain. And then you see heroes that are struggling with things. And I think that's really important.

I mean, look at Superman, lost his parents and Krypton, and he's here to take care of a human race. He's never going to be a part of. So there's huge psychological weight there. So we can talk about that, and people can understand just more about themselves. Yeah. Before we get into psychoanalizing Batman,

because I want to do that and more. Yeah, yeah, sorry. No, no, no, that's really good. The third part of that conversation of when media starts doing psychological coverage of, we started with nonfiction, then fiction, then what about

when they're in a fictional program depicting what therapy is like or who needs therapy? I feel like that's the third section of it. Do you think that has been portrayed in an accurate light? I'm trying to be responsible for making sure it's portrayed if I'm asked about shows

or movies and comic books. But yes, I think it's getting better. I think the Sopranos did a great job with that with Dr. Melfi and what it was like for Tony Soprano to come into therapy and develop this relationship with somebody. I think there are a lot of shows that are doing it really well. I also think if you've ever watched a zero zero baseball game, some people are really bored of that. They're like, oh, there's no scoring, there's nothing. Those are people shit on soccer all the time. Yeah, exactly. Same thing. Yeah, we'll take soccer. People are like, oh, this is boring. But there's so much going on and therapy's like that too there's so much going on in the moments where there's not

a goodwill hunting moment right that i think people don't want to necessarily see that and that takes time so a tv show is limited to a certain amount of time you're not going to show therapy unfold the way it would yeah but you can take elements of it i think it is getting more accurate i think it's being depicted any particular bad examples of therapy that stick out of your head it's not that i find them as bad it's just i'm like oh i wish they'd done that a little differently so i think i'll give you a great example of where I was really excited and I thought, oh, they could have even done a little bit more was never have I ever, Mindy Kaling's show, I thought it was great. There was a adolescent, a bunch of adolescents. One of them was seeing a therapist after the death of a family member

and had been seeing that therapist for years. It was really great because that doctor had an understanding of adolescent behavior and understanding how this teenager might have seen herself and the teenager went to that therapist repeatedly for help and guidance. But there were a couple things. I think it was a comedy. Like, she would break in to the office, kind of like bust into the office when the therapist was having lunch. And there could have been a patient in there. Like, people just don't do that. So there I was like, oh, it was great. But, you know, and then also there was a time when the therapist hugged the patient. And you're not going to touch your patients in that way. But again, I love that they showed an adolescent needed help. Are hugs unethical in the psychiatric? It's not, it's unethical. It's individual. But I would say, I've had some teaching that once you touch the patient, the relationship has changed. Now, I will touch a patient because I'm taking their blood pressure or something like that or, you know, a handshake, something like that. But a hug to me and the way I was taught is like, that's a little much.

So I've had patients ask. In your teaching, in the time that you were being taught this, what were they saying that the patient then attributes something different to the relationship? Yes, there are certain boundaries in psychiatry. And they call that the frame. And you have to think, why are you breaking the frame? You always have to understand. Tell me more about this frame.

It's, the frame refers to the boundaries. you have with the patient, and they're in place to help the patient. So you wouldn't go out drinking with your patient. You are not your patient's friends. They need somebody who can be objective, somebody who can see them in a certain way, somebody who can understand them. And when you do things like that, there starts to be meeting added into something. So if I brought coffee for my patient every day, there's something more in there for that patient than maybe just the coffee. It's like, oh, this person's thinking about me in an extra special way. I must be their favorite patient. Then there might be a pressure on that patient to be like, I need to be extra

good. Like, what if he stops bringing me coffee? Like, if I don't bring it one day, then somebody would be like, am I bad? Like, there's all kinds of things that can get read into this. It basically becomes another place for cognitive distortion to creep in. Yeah. Correct. Interesting. But how do you maintain like a healthy, happy doctor-patient alliance while maintaining this very strict frame i think that's the the art of medicine when it comes to psychiatry if you're doing therapy is how do you do that and what i will say to patients is when they'll say you know i wish i could be a neighbor i wish i could be your friend i'll ask them what would that do what would that be like if we were friends you know and if you imagine that world what do you

imagine because i want to know what it is they're getting out of that so i'll explore it i'll also say yeah that there are boundaries here for a reason because i i need to be someone that is different from everybody else in your life. It's also just a unique relationship to be in therapy with someone. And our relating this way, our relating the way we do, the therapy happens here and all the feelings you have, you take outside. So more therapy happens out there.

And our time is just this hour, two hours, three hours, four hours a week. And I want to see how you're reacting to that. Yeah. Have you heard about this case that's not even a case? probably giving it too much credit on TikTok going viral of an individual sharing what she describes as a relationship that has formed with her psychiatrist or psychologist. And she does this like multiple series of TikToks sharing this story about why they're interested in her.

And the internet is like really interested. Is she making this whole story up? Is this fictional? Is she sharing her real life? And no one really knows. And because of all this curiosity, it's, garnered a lot of attention. Interesting.

No, I haven't heard about that. I'd be interested to learn more. What I find is, if you think about your patient and what your patient needs, generally that guides you pretty well. So that comes to, when it comes to self-disclosure, talking about something about myself, it's because I have the patient in mind. I think they can learn something from it. I shouldn't be filling up that space.

I don't need my patients to take care of me. And if they ask me certain things, you know, You don't want to be weird. So if people are saying, oh, where are you going on vacation? I might say, well, I'm going to go here to the East Coast. I'm just going to go visit some family. But I don't want to give them details about things because it's not for them to think about. It's just for me to think about you.

Sure. So in the past history of examples of therapy, of seeking psychiatric help, there's some movies that come to mind, the beautiful mind. a lot of very powerful Academy Award winning movies. Do you think that they've given people an accurate representation of certain conditions? Or do you feel like because they're trying to suspend reality and allow everyone to understand and have buy-in that they've lowered the accuracy level to a degree

where perhaps becomes a bit harmful? I think you can have a wide range of, consequences to how things are depicted and there's a wide range of how they're depicted. So I think, for instance, Silver Linings playbook is a movie people really love and the depictions of bipolar and mania I've commented on before. I think there are some great scenes.

The knock on that, for instance, is that love in the end will cure mental illness. And that's not actually accurate. But you take away from it what is accurate and then you can talk about, wait a minute, it doesn't really work that way. And hopefully have somebody you can talk to about that. But love is not going to cure it, but love and connection is really important to getting through life with mental health issues and even without. So I think you look at things. If it's doing a disservice, that would be saying, for instance, let's show

a treatment that's very effective and let's make it look horrific. Like, I think that does a disservice because then people are like, I don't want to do that. That sounds horrible. Right. So I think that can do a disservice. But if you're starting to show mental health on screen, I think that's a first great step because for so long it was just not something people wanted to see where people were afraid to show. I think it's great that we can show it more nuanced because I do think it's more interesting for audiences and I think it's better to be accurate. What about individuals self-diagnosing or perhaps discussing their medications, their therapy styles? on social media.

Because I think about one of the problems we discuss in the medical side of things is direct to consumer advertising with pharma. And these days I'm like, yeah, that's a problem, but I feel like it's less of a problem now because the things that go viral are not direct to consumer ads. It's the things that give social proof. So someone making a very passionate plea of everyone should be on this medication, it saved my life, and really going to bat for it. perhaps can be a disservice way more effective than any direct-to-consumer

advertisement from pharma. So what's your stance on individuals making videos like that? Do you generally discourage it in your patients, or is that not something you cover? I think, I think, again, anything gets the conversation going great. However, there's so many complexities to medications and treatments and responses. I think that people just need to realize that. Because this medication was great for this person doesn't mean it's going to be excellent for you. and I do have a lot of patients come and say,

oh, I saw this on YouTube or I read this on Reddit and like, okay, all right, so you read it, what do you think? So have a conversation and say, well, we've been over this before. Sometimes people will come back with saying, I've read this again, I read this again, say, well, what are you trying to accomplish? What do you want to do?

And we could try that. I don't know that that's the best way to do it for you, for these reasons. So I think people can't come in with those questions. I encourage you to bring them to your doctors talking to your audience here. Bring those questions to your doctors, but realize not everybody's going to respond the same way.

Yeah, because I think about how difficult it is to access mental health support, seeing a doctor, let alone in any specialty. But then they see some of their friends that are perhaps sharing their mental health journey, getting a lot of support. Does that ever start becoming addictive, perhaps, contagious where they're like, oh, this person's getting support, maybe I'm all, I too

am suffering with that and they kind of see themselves in those people. Especially younger and more influential minds. Yes, I think people can be influenced by other people. So in that case, it could be a good thing. If someone says, hey, I've gotten some help and I'm feeling better, maybe someone else is willing to say, oh, my friend did this. So, yeah, I'm going to go try to get some help. So I think that can be good.

Whether it's contagious, maybe too strong of a word, but the fact that we can actually have people say to each other, I'm really struggling with depression. I went to talk somebody had helped or I'm really struggling with anxiety and I don't know what to do. And then maybe their friend that they're talking to you can say, have you thought about talking to a professional or talking to somebody that might be able to really help you? I really like when that happens. I really hope that happens more. Do you think there needs to be a healthy balance between being comfortable breaking the stigma and sharing that you have a mental health diagnosis versus wearing it like a badge of honor almost?

Yeah. Like, how do we balance that? The way I look at that is mental health is a part of who you are. It's not everything. It's a part of your story. It doesn't have to define you. So how do you understand your mental illness and how do you understand your mental health? And what does talking to other people about it give you?

What are you trying to get? I think that's one of the big things with patients is what are you hoping for? What are you wanting when you talk to people? and asking them, how would people respond to that? Are you finding they're responding well, or what are they thinking, and what do they tell you they're thinking? And then this can be something that we can look at.

Like, is this pushing people away to talk about your mental health or to talk about anything? Like, you're talking about it. What does it do in terms of your relationships? So I think we need to look at each individual case and understand what's happening there. Yeah.

I've definitely seen a fair share of my patients, like, meaning, that I've seen stigma be broken to some level on social media where people are more open to talking about their mental health journey. And I view that as a win. But then I also see patients of mine that have not been seen for some period of time. They don't have insurance, lack of access, et cetera, end up self-diagnosing because they saw someone. So I'm trying to, obviously, I would love for them to spend time with a psychiatrist like you and have the ability to reflect on these emotions. But knowing that many of them won't, what are,

some guardrails that individuals can have for themselves when watching content online. I think realize you are who you are, you're not this person you're watching. And even though you might identify with them, you're still who you are and you need somebody to see who you are and understand what you might need. So if you're self-diagnosing, it's good that you're taking an interest, but then talk to your doctor and ask them, this is what I'm seeing, is what I think. Do you see this? Is there a way to figure out if this is a diagnosis? Often people will come to me say, I can never concentrate, I have ADHD. I'm like, well, there's actually a lot to ADHD. So let's talk about what you're experiencing. Can I have your consent to talk to family members?

Do you have old report cards? Do you have things that show there's actually a history of this? I think you really have to spend time with your patients understanding what they're coming to you with. What have they been self-diagnosing? And they might be super excited to finally get help. So I want to figure that out. Or are they super excited to get a stimulant? Yeah. So what do you do in a scenario like that? where someone comes in and they kind of self-diagnosed with ADHD and they are looking for a stimulant or believe that they should be on a stimulant

and you do the research, you talk to family members, you look at report cards, and you don't see that pattern involved. What are you doing those? That's happened to a bunch. I'll say to people, I don't think you have me criteria for ADHD, actually. I think you might have more anxiety, and that's actually holding you back and that the way your brain is going from one thing to the next

is because of anxiety. Or I'll say, I'm not sure that this is, ADHD, I think you might have a learning challenge here. And let's look at that a little bit more. There's a neuropsychologist I know that you might see. And they can do a lot more detail testing, looking specifically at that. And let's see if there's something there. So I'll have a conversation. I'm not going to shy away from it. Do they ever get negative about that? Yes. There have been times when I'll say to somebody, you might have ADHD, but I think your addiction issues are what we need to address first. And let's have you see

somebody who specializes in that type of addiction, sometimes people get very upset. Like, I came to you for ADHD, not addiction. And I have to say, I understand that. I also don't ever want to do my patients a disservice. And I would be doing you a disservice if that's what we're focusing on. And you're very confident in going about that. Yes, I am. And I don't mind people not liking me because that's also part of being a psychiatrist,

is tolerating how people feel. And I'm okay with my patients being mad. I'm okay with my patients being really unhappy. with me because I think that's part of being in therapy, having that space to be angry, to be upset. I feel like a psychiatrist and are the perfect profession to be on social media because part of being on social media is tolerating that experience of people being really mad at you. Yeah. Yeah, it's a good point. Yes. Yes. So I, yes, it's a muscle like continuing to flex every day. Nice. What's been your experience making some of these reaction

videos commentating on superheroes and villains? Yeah. I feel really lucky. A lot of people have really loved it. They want to know more. If you think about your favorite TV shows and movies, you're like, oh, I wonder what's going on in that world still? Or why did you get that way? Or how did she respond?

And why did you do that? Why does she have that relationship with her father? So when I talk about what might be there, people love it because it's their characters. It's their shows. And they want to know more. Every now and then I'll get some negative comments. Like, you're wearing the wrong glasses.

Those are terrible ties, that kind of stuff. But then the other thing that people really feel strongly about is certain things with treatments. Like, I would never offer that. treatment. Why are you offering that treatment? You're a psychiatrist. You have no business talking about therapy. And that, you know, I just have to tell people I actually sought out extra training in therapy. And just because I'm not a psychologist doesn't mean that I'm not a therapist. And of other people say, you're a pill pusher, you're a psychiatrist. I can prescribe medication.

I went to med school. Doesn't mean that's what I do the bulk of my day. So I think some of these I have to let roll off my back. And I think if someone really took the time to understand, they wouldn't have the negative comment, or I think sometimes people have been really scarred by experiences. Maybe that had a navigative experience with mental health professionals, or they had a negative experience. Someone in the family had a mental health issue. So I always think this person's coming from somewhere. I don't know what it is. I just want to be here and I'll answer questions if I can. Do you ever get the sense of, and someone just mentioned an example. I don't remember the example offhand, but I felt like two things were true at the same time that felt like they couldn't

be true. There was two individuals speaking. One was an expert, I believe in the mental health space, maybe a neurologist. And they ended up going down this pathway of, oh, did you do this in your childhood? Oh, did your mom do this while she was pregnant with you? And they went down this checklist. And he's like, well, that's why you're feeling this way. And my thought right away in that moment was, A, that's bullshit because you're not really evaluating the situation you can't know. And B, it could be true because there are some examples of maternal exposures and how they impact the development from a neurophysiological standpoint. So it's like you need to have in your head, this is bullshit, but also can be true at the same time. How do you, do you feel like

those worlds coincide in? I think, let me think it. how to best say this. I have the belief that we really do see the world because of experiences throughout our lives. And a lot of them, we aren't even aware of anymore. They're in our unconscious. But they've shaped how we go about interacting with people, how we see things. And there are times when you're speculating on that saying, this did happen when you were a kid. What I'll say to people is, from my experience, I have seen people who had that experience look at the world this way and I wonder if that resonates with you at all but that could also not be true at all so that's the way I handle it it could be that it could be something else and people will tell me often

like that would make sense I don't feel that way or no that's not what happened the reason this happened is this and then they'll actually tell me like this is what happened so I think there's different ways you can balance the maybe this happened maybe it didn't and a lot of the therapy I do is is exploratory therapy it's exploring what people have experienced in their lives and and how does it affect them? And are they aware of certain things? And I'll see people sometimes for a while. And then they'll say to me,

you know, I haven't told you this, but this is something I've really thought about this happened in my life. And I feel really honored that they feel so comfortable to talk to me. And then that one's a huge door. We're like, you know, that sounds really, really painful. And I wonder if that's been behind a lot of what you feel.

Yeah, I think about in the medical side of things, how I watch either like a house MD, go down a checklist and make this miracle diagnosis. I'm like, oh, that's so not realistic. Or on the flip side, I see some influencer huckster that's like, oh, you have headaches. It's because you're not consuming enough pink Himalayan Seasalt. You know, some like wild claim like that.

And to me, there's obviously various forms of misinformation there. But to me, what bothers, I think, bothers me on a larger scale is that it's ruining people's understanding of how we actually go about making, a diagnosis so creates a barrier next time they go see a doctor. Has there ever been a patient where you've seen them come into either a therapy session or a medication visit? Maybe you don't even make that distinction when you see patients, but they are working off something that they saw somewhere else and they expected something completely different than what you were offering them.

Yes. I've seen it in many different ways. I've seen one patient start many years ago. and they'd been in therapy before and then they said after few visits it's like so this is therapy with you huh I said this is how I work and they're like I have no idea what I was doing before with the last person

almost in a flattering way like oh this is different and then I've seen the opposite you know this isn't working the last therapist did this and this and this with me and I don't think this is a good fit and I'd say I understand that I can look at some of those things but the way I work is this

particular way. I use elements of CBT or elements of personal therapy or elements of this type of therapy, but this is the way I am. It's very much the way I'm acting with you right now. I'm not acting. This is me. I'm asking questions or responding to questions. And some people are not used to that. They'll come in and say, I used to have a therapist to be really silent the whole time. Or the worst is any therapist, is it normal therapists to cut their nails during their session with me? I was like, I don't typically hear of that. So self-grooming is not ideal. So something Sometimes it's in that way, but other times there are people that, you know, I do better with homework, I do better with CBT that's strict and manualized. I'll say, I don't, I don't do that, but maybe you should talk to somebody and let me give you some names of people. I just want people that come to see me to get the help that they need. And if that's not for me, that is fine. Can you take us through some of the different modalities you started mentioning them already, but I think it's cool to lay it out for people. Sure. So cognitive behavioral therapy is a form of therapy that was developed at UPenn. years ago, and it looks at your cognitive thoughts, your thoughts and your behaviors. So CBT,

cognitive behavioral therapy. And you're looking at the way you think about things. You have automatic thoughts about things. Do you have certain distortions when you think? Do you have catastrophic thinking? So you're looking at these and you're keeping even thought records. You're starting to categorize your thoughts, understanding them. And when you understand them, then you can start to have some behavioral changes too. There's exposure response prevention therapy they can be part of CBT so you make a hierarchy of fears you look at the bottom rung like what's something let's say you're afraid of snakes start with that at the bottom let's just use the word snakes a bunch and you monitor how you feel on an anxiety scale one to 10 you keep doing that till

the anxiety goes down to a two or three or four over time a couple days weeks whatever when it's down consistently then you go on to the next wrong so this can be part of CBT too for anxiety and people have fears so that's cognitive behavioral therapy now I'll use elements of that in my therapy. What I do the bulk of is called psychodynamic psychotherapy, and that's looking at relationships, the dynamics between people. Oh, I noticed that this relationship you're describing with your father, it seems to mimic actually the relationship you have with your husband. Can you tell me more about that? They're looking at what is happening in their lives, and what are patterns of behavior that might still not serve you well that you're doing, or what are

patterns that might be different that could serve you better? So that's psychodynamic. work looking at relationships. Psychoanalytic is looking at the unconscious. It's looking at experiences earlier in your life that you might not have realized impacted you. So I'll use some elements of psychoanalytic psychotherapy. Then there's acceptance and commitment therapy where you're looking at, okay, I do tend to see the world this way and I do have this understanding of it. So let me accept that, commit to possibly seeing something different or looking at it in a different way. So I use elements of all of these different therapies. Some of them are strictly manualized, meaning there's a manual. And if you are a strict person in terms of CBT, you do the 10 week.

This week we do this. This week we do this. Some people love that. They love the homework that comes with that. They love the, I guess, schedule to it. For me, I find I like to get at the root of things more, which the psychodynamic and psychoanalytic stuff helps me to see. Then I can bring in elements of CBT also. What about DBT? DBT dialectical behavioral therapy is a therapy that has the most evidence for treating borderline personality disorder or borderline traits. Borderline personality, when I first heard about it at med school, I'm like, borderline

what? They even do it, don't have something. But the way it was originally described as borderline, meaning somebody on the border between psychotic, having a break from reality, and neurotic, using all their energy to maintain and hold on to their anxieties, try to manage their anxieties. So borderline traits, that's best depicted most recently on television, in my opinion, by the mother in the bear. So Donna Berzato, played by Jamie Lee Curtis, there's some incredible scenes in the bear where she really shows borderline traits. In the episode The Fish is where she's cooking the Christmas dinner for everybody, she shows an unstable sense of self.

She shows that she can devalue herself very quickly. There's even some suicidal type gestures. the idea that people are abandoning her and this frantic reaction to perceived abandonment. So DBT is used to help with those types of traits and features and personality styles.

And what happens in DBTs, there's a very comprehensive team that looks after someone. There's a 24-hour care group. There's group therapy, this individual therapy. There are techniques. You do things called chain analyses,

for instance, like, oh, this event happened and set you off. Tell me, what was the start of that? And then what was the start of that? And then how'd that go? So there are very strict things you do. Why is that so well suited for specifically BPD? I think that, and it's not something I'm an expert on, so I want to be clear on that.

I think that there are ways to get people to look at their behaviors that help them say, oh, maybe I don't need to respond that way. I think that's part of it. I also think, to be honest, and I remember learning this too, some of the stuff is so tedious. They're like, I don't want to do that. I'm going to change my behavior, so I don't have to go through a chain analysis next time with my provider.

Right. I think that I also think with all these therapies, a lot of it comes down to the connection you have with people. When there's a team looking after you, you're connected to people. People are thinking about you. People want to make sure you're okay. And that's really what I find is the base foundation for psychotherapy

is just being with somebody, understanding them, being curious about them. I probably ask 500 questions in my day because I want to know about people and I want to ask and some people say to me well maybe just observe and I do that too

but there are ways to make people feel like they're important and I think when that has not happened in someone's life when they've not understood that their priority then all kinds of dysfunction can happen in their lives

have there been I mean I know they've existed to some degree maybe wars is a bit of a strong word but disagreements about is psychodynamic therapy, the right approach versus CBT versus analyzing what has shifted and what has been sort of the mainstay? What I think, and there's some studies showing this, is that it's really

about the connection with the provider, no matter what modality is about the connection with the provider and feeling there's a relationship there. So you could do CBT or you could do psychodynamic work and it's really the provider. So that said, there's still belief that cognitive behavioral therapies, the gold star for people with, say, OCD or severe anxiety. And if you're not doing that, you're doing them a disservice. And I will work with people in the way I do. And if it comes to my attention that they're not improving over time, they're really still distressed. So why don't we have you try something with a CBT provider? So there's still certain beliefs about things, but it really does come down. Evidence shows that it comes down to the relationship you have with

your therapist. And how does medication start playing a role into the therapy? medallities with your patients. With my patients, so a lot of psychiatrists will prescribe medication and do what's called medication management. And at some point I can go over how to start with a psychiatrist 101 because a lot of people get confused. Yeah, psychologist is talk therapy,

psychiatrists, usually medication, but also could be therapy as well. Yes, psychologists have gone to graduate school. They can't prescribe medication and they can do evaluations, they can do psychotherapies, lots of stuff psychologists can do. Psychiatrists have gone to medical school.

They can prescribe. medication. Some people have a medication practice where they see people and they just prescribe medication. Maybe they have 15 minutes slots, maybe 20, maybe 30 minutes slots. And they do that back to back all day. I feel like I'm missing something if I'm not talking to the patient in psychotherapy. And so I prescribe in the context of seeing somebody in therapy. And medication, as I tell people, can be a part of treatment. We talk about when it might be indicated and what does that mean? And what are the risks? What are the benefits? What are possible side effects? What are what happens if you don't take medication?

When you start? When are you going to stop? All those things. So we have conversations about that. But I see medicine enter the picture as a part of treatment. And I see it in particular when someone's not functioning throughout their day. They're not getting through their day the way they should. Have you felt like over the years since you've been in practice, there's been an uptake with comfort surrounding medication or a higher reluctance to want to be on medication?

I think there are a lot of factors that play there. Some of them are, do I know people on medication or do people get better on medication that I have heard have been on medication? I think people want to know that there's been some success or a reason to take it. I think people get scared sometimes because they see, again, back to depictions of media, terrible side effects depicted on TV or they see people not themselves, whatever it is that they've seen. and then there's also family and cultural values and beliefs like what does it mean to be on medication what does this do for my identity and how I see myself and my flawed am I broken and do I need fixing

is that why I'm taking this so there are a lot of reasons for people to come in and be excited about medication and a lot for them to be not so excited about it and I haven't necessarily seen an uptick inpatient acceptance I think with younger generations there's a lot more destigmatization of mental health that's happened over time older generations still feel when I see people when they're 70s, 80s, 90s, sometimes they're kind of looking over the shoulders as they walk in the building and want to make sure that everything's okay. Yeah. You know, I imagine it's tough for someone who's being recommended to take a medication

that we as medical providers say we don't have a perfect understanding of why or how it works. How do you manage that? I say exactly that. We don't know exactly how this works. The studies show that serotonin, the serotonin system is involved. in mood regulation and an emotional response, these medications somehow affect serotonin. And it could be in the pathway itself. It could be in the receptors. It could be potentially that it increases serotonin. We're not exactly sure. That seems to have been dispelled.

But some more research recently is showing this or this. So I have those conversations. I don't want to hide things from my patients. Say, but there are a lot of people that feel better on these medications. And as soon as they're starting, I'm thinking about when we can stop it too. Do you ever feel like, has it ever happened that you recommend the medication to a patient? You're like, man, I know this is a good candidate. This is a great case for it. But the patient is just reluctant for cultural reasons or reasons that perhaps are not medically sound in nature.

And you're very frustrated that you want to be able to help them. And you know this is a potential way of helping them. What do you do in those scenarios? I hang in there with them. I have to meet them where they are. and just say, you know, I know we've talked about this. It'll be weeks. I'll say, I really think we should try medication.

There's one patient I'm thinking about in particular. It was a long time before they were willing to do that. They kept thinking, I don't want to take medication. I don't want to take medication. And then they felt better. But then they were dealing with what's it like for them to be on a medication. And we talked about that for a long time. And then they wanted to go off and symptoms came back.

So we tried a different medication. So it's all part of where the person is. And if that's where they are, that's what I'm going to deal with. them. Has there been a good example in pop culture of medication or the use of medication that you thought stands out? I had to think about that with medication. I think, actually, you know what? I just remember it. So your friends and neighbors on Apple TV, the main character, John Ham's character, his sister has a bipolar disorder. And I really liked that she was not on her meds and said, I don't want to be on those meds

because this particular side effect happens to me and I hate that. So I think there are ways to talk about it and she's also able to say, yeah, well, maybe they help me in this way, but there's this that I'm dealing with. So you see that conflict patients have sometimes. You know, what I would say is if you're having that side effect,

maybe there are other meds we can try. So there's always something else you can try. Yeah. I think about how a single hit TV show episode, movie, can really harm our ability to practice quality help for our patients. Like, we know all medications carry risks, not even medication therapies carry risks, surgeries carry risks, vaccines carry risks. And yet, if we put the focus on the scary part only and really blow up the fear of the risk,

that can carry repercussions across the board. where I remember there was, I forgot the name of the movie. I'm blanking on it now where some very famous actor said that Merlot is trash, the wine. Yeah. Sideways.

Sideways. And as a result, Merlot sales just, again, had nothing to do with the quality of Merlot. So I think about that and I'm like, oh man, how quickly we can harm the medical system by doing something like that in modern media. At the same time, how do we allow for authenticity

and encourage authenticity, from people who have been hurt by these things. Yeah, I think you can have authentic conversations. I think that can be part of a TV show when they're going to the psychiatrists. Like, well, what about this? And what about this? And actually show that real dialogue.

You know, I think people would get a good idea of this is how we deal with it. And I have had some patients coming to be like, this medication, I cannot feel my groin. Like, okay, that is the wrong medication. So we should change that. And that must be really uncomfortable. So I think those kinds of authentic conversations

in a TV show would work. You can do that. Yeah. How do you decide, or I guess, what is your approach in discussing with a patient, side effects of a specific medication, when you know that discussion on its own can raise the likelihood of those side effects occurring? I don't know that I always follow. Find that to be the case.

Really? Yeah. I think just saying, hey, this is, these are the medications. This is how it works. The science behind it is supposed to be this, or this is how we understand it. common side effects might be the following but before I go into that just note not everybody gets a side effect you might be somebody who gets none of them some people get some but we don't know until we try we're going to start at a lower dose than even usual because I just want you to get used to

taking it and seeing what it's like and then we'll increase it over time so I think when I start out that way and people are like okay this might happen this might not and I'm saying I don't know let's just see but I'll be with you as you start this I think that can actually make people more comfortable. So you don't see the nocebo effect? No, I don't. I actually don't. Because I think if that were the case,

my patients wouldn't have gone on the medications. Because I've talked about some wacky side effects from things too. So I do think it's important also to dispel rumors. Like, so if I take this, I'm not going to start screaming in the middle of the night, am I? I'm like, if you do, that would be highly unusual. Please let me know. Case report. Exactly.

But I do think just talking about it and saying, that'd be really disturbing to imagine that happening. Where'd you get that idea? Yeah, I think my mind's going to an example of like a statin, a cholesterol lowering medication, which in pop culture has been associated with muscle aches and take me for someone in their 60s who's not having a muscle ache. That's an age group that experiences frequent muscle aches. So I always try and balance that conversation with the type of patient I'm having the discussion with because some of my patients outright say, hey, do you want to go down the list of the situations that can go wrong with this medicine? Or are we comfortable monitoring and you bringing it to me and we're deciding together if this is a side effect of the medicine?

Interesting. And it's an approach that has worked well, but I feel like could, you know, not work perfectly every time because patients sometimes say, I don't want to know, full on, because they believe that they will have that side effect if they're aware of it, almost it's almost like they're expecting it. And that happens to me a lot surrounding pain and discomfort where patients who are guarding, basically if they've had a low back strain and a few days go by and they say, I'm still getting up very slowly and gingerly because I want to protect the area. And they're almost like putting their antennas out to feel the pain.

And it sets them in the cycle of waiting to feel the pain and they're amplifying the pain. versus when I say, hey, stand up, you feel the pain, you're not going to throw your back out again, it's such a mild issue, just go through it. That breaks that cycle a bit, and I wonder if this plays into that psychology of it. Yeah, I find, again, just talking very much outright, this might happen. If this happens, you might feel this. It might go away in a few days. As you stay on the medication, you might get used to some of the stuff.

If it doesn't, we'll figure it out. I think that part reassures people. Like, let's figure it out. Oh, this isn't the end-all, be-all of anything. Oh, there's other medications. Oh, you're going to listen to me? Oh, I can talk to you between sessions and send you a message. I think people feel reassured and they're willing to try something.

How different is talk therapy in someone who's experiencing a condition like depression, major depressive disorder, generalized anxiety disorder versus someone who's, let's say, coming to see you with schizophrenia? So I don't specialize in psychotic disorders. I actually have a colleague who does, and I send all of the patients with psychosis to him because he specializes in that. But that does present very differently. Someone with schizophrenia, that's a psychotic illness. So there's been a break from reality and they would be hearing things that aren't really there. They might have disordered thinking. They might have delusions. And that will really play into how you interact with someone. You can imagine

if someone's already delusional and maybe suspicious, those patients in particular might have a really hard time with medication. Oh, wait, you're giving me something? You want me to put this in my body? What is that? So someone who's specifically trained with psychotic disorders, I always like going to that person. I know how to treat those patients, of course,

and I can do that, but I don't. That same type of suspicion and worry, though, with anxious patients I have, can certainly impact the treatment. Somebody who's really anxious, if I make a small change or suggest a small change to something, that can trigger a huge reaction.

Like, oh, I can't do this. It's the medication and then they start looping. They'll use the word looping on this or they'll have ruminations about medication. So it depends on what they're dealing with, but that can impact therapy and the treatment itself. Yeah. I'm crazy. I'm depressed. I've PTSD from that date.

all the colloquial terms that people use that are actually words that have meaning in our field. What do you, what's your take on that? How do we correct? Do we need to correct? Well, I correct because I think it can reassure, it can, not reassures the wrong word, it can educate people. So when somebody says, yeah, I don't know, maybe I have a mania. I'll say, I tell me why you think that. And they'll say, okay, in psychiatry, there's actually a real strict list of criteria for what mania means. I know we use it colloquially in songs or in whatever, say you're going back and forth, but that's actually not what mania is. Mania is when for five to seven days, you've been awake for days at a time because you have

increased energy. You might be taking on more activities, and your behavior might be unusual compared to what it is. You might be having sex with multiple people or starting to gamble or your finances. You made 200 transactions, so you might be doing things are different, and you're grandiose, and you think you're going to change the world, and you're going to meet God and create a new language. Those are criteria for mania. and they're like, oh, I don't have those. Got it.

So you're able to insert some education there. How do we, or do we need to discuss using those words colloquially in media or on social media? I think so. I think it depends. If more and more people are like, oh, I'm totally manic, then... Well, like PTSD is a common one these days. Yeah, I do think that's worth having some corrective measures taking. What's your general stance on that right now?

What I say to people is, it sounds like you might have had something really traumatic and it is affecting you for sure for PTSD there's strict criteria but that doesn't mean what you're going through isn't traumatic and we should deal with it I'm not going to treat you because this diagnostic criteria is met I'm going to treat you because you're here in front of me and this is what you're going through so tell me about it what was that like it sounds awful if you want to talk about it or let's find a time when you feel comfortable in the future talking about it I'm not going to push you but it sounds like something has really bothered you speaking of traumas what's your take on the book, the body keeps the score? I think that I don't, I haven't read the whole book,

so start with that. I think your body does remember things. And people who have had traumatic experiences can find themselves remembering those experiences. Flashbacks are different than memories. It's, you feel like in the moment, you are back where you were before. So I think it's important to talk about what are the criteria of PTSD? What are you experiencing? What, when you feel you are back in that kind of a moment, your body might keep the score. Your body might have a memory. Oh, when you are touched there,

that is not something that's okay. So I do think there's some truth to this idea that our bodies react to trauma physically and emotionally. Have you seen within some of your patients emotional or mental health symptoms start taking a toll on their physical body. Yes. And I'm imagining you see this in patients too. Somatic symptoms are when elements of mental health issues present as physical symptoms. And it does not mean, I'm very clear

about this. It does not mean the pain is not real. It means that when you experience pain, you might also have it exacerbated by mental health issues. So when I have patients with chronic pain, they'll tell me, oh, this pain is acting up. So I know that's a sign that I'm actually more anxious. So we can talk about the anxiety as opposed to talking about the physical pain. They understand that. And they'll tell me, yeah, I definitely see a correlation. So I can see and do see physical symptoms as a result of emotional symptoms. But it's very important to make sure your patient doesn't think you think they're not having real pain. Yeah, how do you, what's a reception like from patients on that? They feel like they're understood that they can hear

that. Because pain won't go away, even though they've been, say, had a neurologist or two primary care doctors or a bunch of people and evaluated and they say there's no root cause we can't see anything pain is pain it's what somebody's experiencing so a lot of times they'll say you know I am experiencing this I'm not faking this I'm not not thinking you are faking it I'm really not I wonder if it's perhaps different for you because they're coming to see you already accepting of the fact or at least open to the fact that they're discussing their mental health but when they're coming to see their primary care doctor for an elbow pain and their mental health

is brought up, I face a lot of reluctance. I'm sure you do. And that I've seen before. My colleagues in your field and internal medicine, I think it's really in the art of how you do it and say, you know, we've gone through a lot of the physical tests. There's nothing physical.

I do wonder if you're a person who experiences physical pain as a result of some emotional things too. And maybe it's worth talking to somebody about that. I don't think you're crazy to use that word. I think you're really in pain and we want to get to the bottom of it, we've exhausted these outlets.

Why don't you see a psychiatrist, see if there's something there? When a person is having a struggle, whether it's physical pain related, or let's say mental health related for this example, who should they reach out to first? There's so many options these days from a social worker perspective,

life coach, therapist, psychiatrist. What should one do? First thing, I think, is just starting to accept you want to talk to somebody or get some help. if you have a primary care doctor, I would start there and just say, hey, this is going on, and I've been feeling this way, and I don't know what to do. So hopefully the doctor can give some guidance. Because a lot of times people say, I don't know, do I start with psychiatrists? Do I start, you know, how do I know? And I'll tell people, a psychiatrist can prescribe

medications. If you think medication might be a part of your treatment, like, well, how will I know? And I'll say, that's a good question. So why don't we have you just try to start with finding someone you're comfortable talking to? Our finance is a concern. Do you have insurance? Do you have insurance? what will you be paying out of pocket? So really looking at all the factors that have to go in. It's an ugly world when you think about it that way. But there's a huge range of what people charge. And some people have what's called a sliding scale.

And some people don't. And you find out what your insurance covers. Is someone in your network, meaning that your insurance company is contracted with that provider to allow that provider to give services to people with that insurance? That's a lot easier. That's when you pay a co-pay, a small fee for going. or is the psychiatrist out of network?

Do you have to pay them out of pocket? And at the end of the month, they give you a bill that shows you've paid and then you could submit that to your insurance for what's called out-of-network reimbursement saying, do you have out-of-network reimbursement? Will they recover any of that? I have some patients that get like 15%

of their bill covered by their insurance and others get 95. So it really depends on your insurance. So really understanding, okay, what do I have to work with? What are the financial obligations that I will have. And then I say, call people, email them,

ask them if you can talk to them on the phone and understand how they work. Do they have an introductory session? Do they charge for that? Do they have a 15-minute session on the phone and they don't charge for? Just ask a lot of questions. Don't be afraid.

What are those good questions to ask? What we were just saying. So how do you start out practicing? Do you meet somebody and what if it's not a good fit or do you have any particular way of working if, say, somebody's heard about CBT or something you wouldn't necessarily want to go to somebody who does dialectal behavioral therapy if you're looking for CBT. So I think asking people, how do you practice? But probably the best way is

it's possible to meet you and see if it's a good fit. And do you charge for that? That's a great way to start. Also knowing as a provider, does the person come in to you have a preference for a man or a woman? That's the other thing. So if you're a patient considering seeing someone in mental health, do you want to work with a male provider or do you want to work with a female provider. That narrows down the field. That's one flow chart direction for sure. Do you want to see somebody that can prescribe medication? Because if that's an option, you don't want to go to somebody else. That's called split treatment. You have one person for therapy, and then you see a psychiatrist or your primary care doctor for prescribing medications. So do you want that or do you want the

convenience of seeing one person? Psychiatrists can often be on the higher end of fees because they've gone to medical school. And I think the rates that they're reimbursed. I know this, in fact. The rate psychiatrists are reimbursed by insurance is very low. So typically, a lot of psychiatrists don't take insurance. So you should know if you go see a psychiatrist, you might end up paying more than you would if you see somebody else. So just having all this stuff in mind and asking questions is really important. If you're seeing a psychologist, is there ever a world where they say, we think you may be a good candidate for medication? Absolutely. That's how a lot of people who have a psychologist,

psychiatry medication practice, get referrals. They know therapists, therapists say, I think this patient can benefit from medication. Can you do a medication consultation? Can you meet the patient? Now, in that case, the consultation is not as long as necessarily three or four meetings. It's often

maybe one hour or two hours. It depends on how people practice. But then you would meet that person for follow-ups that are, say, 15 minutes, 20 minutes, 30 minutes. Your therapist is still the primary person you see. But there should be a good collaboration, between the two and psychiatrists are notorious for not calling back therapists. I was always taught

call back the therapist. So as soon as I finished with a patient back in residency when I was treating them for meds only, I called the therapist. They just saw so-and-so, they look okay. Let me know if you have any questions. And you'd be shocked, how many people would be like, you're the only person that called me about this. Yeah, like I like to be the quarterback of my patient's care as a primary care doctor. So when I send a patient to a subspecialist, I'm doing it in the sense, of you know something that I don't know because it's very complex case or you do a procedure that I cannot do or have the equipment to do. So I expect to get some sort of report or at least a chart message, something to know

what is the plan so that me and the patient can meet again and discuss it. And that is a dying art these days of having that level of communications. I actually really like that when I am working with other providers because I like collaboration. This person sees this aspect of the patient. And sometimes I'll even say to a patient, can I have consent to talk to your doctor? And I'll say, you know, how would you feel about me meeting your partner? Because maybe that would help. It sounds like there's a lot of stuff going on between the two of you. And I get a different perspective from that person. So the more perspectives I can have, whether from a relationship that they have with their partner or providers,

I think it's good. It's helpful. So we talked about the different varieties of mental health help you can get. What about these online better helps? Are you a fan? Yes and no. I think online therapy can be helpful. Maybe I'm old school, but I feel like the connection you have with a person in the room can't be beat. I think that I see the way somebody's tapping their legs. And I can say, are you, oh, are you nervous? Or it seems like you're tapping your leg. Maybe just make that observation. Or I could say, you know, I noticed when I said this earlier, you kind of winced. And so making observations that AI can't, and that can open up doors that AI can't. At the same time, I have had some very anxious patients, and some of them have told me, yeah, in between our sessions,

I've asked AI this or I've asked AI that. Whether that's good or bad is arguable, because I think it's good that they can seek something in between, but it might perpetuate seeking reassurance, which is something you're trying to help someone anxious not do. I think there, in the future, what's going to happen is AI is going to be a base level of care and then it's going to go up from that. Maybe the most expensive care is going to be seeing a person in person. Got it. So that's in the AI space. What I meant with the BetterHelp specific analogy or question is they have, I don't know if they have therapists, they have some kind of online virtual person that you could meet with. And perhaps it's a different person each week. And it's like one of these platforms where you get zoomed in to a

visit. Do you like that approach in general? Sure. So the reason I answered as I did, too, was I thought that that was mostly texting. There are some sites, and I could be confused with better help. There are some sites that are just texting therapy. That's why I think you miss some things. I think any connection to get people to mental health providers is good, but people often have not been in therapy before. So I would say, if you're on a Zoom session where you've been zoomed in because of this program, do you feel comfortable that person? What does it feel like. And if you don't feel comfortable, bring it up with the provider. That's the other thing. I really want to see happen. So I think it can be great. But if it doesn't feel right to the person,

don't feel like you have to keep doing this therapy. So use that as a way to get to somebody else. Yeah, I always think about this from a perspective in my world where there are companies where you can basically self-diagnose yourself and get a prescription for whatever you want. And maybe I'm exaggerating when I say whatever you want, but you could say, oh, I have male pattern baldness. So I need an esteride. I have erectile dysfunction, so I need Viagra. And even as far as I have strep throat, so I want amoxicillin or penicillin, what have you. So I like that these websites offer access to people who perhaps don't have access due to transportation barriers, cost, because they're usually a little cheaper than actually going to see a doctor in person. That should tell you a lot.

and the fact that perhaps they can get a prescription virtually sent over to them, and it's easier to get the medication than delivered, especially if traveling is difficult for them. But at the same time, I'm like, are we hurting that alliance between doctors and patients and all the other benefits that come with a patient coming into my practice? Because if they come in and they start asking about erectile dysfunctional medications, perhaps that's an early sign of heart disease, diabetes, that we now catch a condition in its early stages where it's much more treatable

or we could get the biggest impact on their life versus, oh, yeah, here's some Viagra and I'm never going to check what your sugar level is. So does that function the same in the psychological space? I hope that people don't go online to get their psych meds because while I agree with all those benefits of it, there can be side effects. And there's also things to follow up with.

So if you're on certain medications, you might want to check an EKG every now and then, or you might want to check your lipids, a blood sugar, things like that. Are you following up with that? As someone who's prescribing this, doing that, I've had a patient, tell me he's gotten some meds, a GLP1 online, and I'll say, do you ever talk to that doctor? Like, nope. Do you ever get any follow up? Nope.

I'm like, okay. So I think in psychiatry, no, because medication is a piece of treatment, but there's also a time when it might be appropriate to stop it. Is anybody paying attention to that? And again, a huge piece of psychiatry is the relationship. So who do you have a relationship with? I think you'll get better on that medication if you're actually seeing somebody at the same time.

What about some of these reality shows that are actually showing what therapies like? Couples therapies. Yeah, I think that can be good. Just realize not every therapist is going to practice that way. So if you go to somebody thinking, well, this is not how it's done on TV. it's probably not how it's done on the TV

because that's a different person and they have their own style. So I do think it's interesting to show that and maybe it doesn't scare people. Maybe it actually makes it more accessible, like, oh, that's what that would be like. And also, I do think it's brave of the people on those shows to allow their lives

to be broadcast in some way. My understanding with couples therapy, while I haven't watched it, is people are talking about real issues that they have. and that's not easy to open up about anywhere, let alone with a camera and then it's shown millions of people. Yeah, I've seen this also play out

in the podcast sphere or similarly they have these interviews, these sessions and then they play clips of them and I'm like, oh my God, if we think about all the, like to me, that takes away your frame. Yeah, ideology to some degree. Well, that would have to be clarified right away. Like, look, we're going to have this medium

where people are going to know your stuff. So I just want to say that's going to be unusual for the kind of treatment that we have. And there's, I see some professional athletes and sometimes I have to say the organization that you guys are playing for, they have a certain way of going about this. The way I go about my practice might not mesh with that, but I'm going to treat you the way I treat any other patient. But just so you know, this might come up and I will go to bat for you and I will make sure that I explain why I'm doing what I'm doing. but this is probably going to come up. So I think if you address all that stuff up front, it's fine. But it is, it is, I wouldn't want somebody in on my therapy.

Like, I wouldn't. But, but again, the idea that you can show, this is what a therapist looks like. This is a real therapist. This is a licensed therapist who's not totally doing crazy things. That's good. Yeah. Where do you stand on psychiatrists or psychologist who have their own psychiatric, issues? I think you wouldn't be human if you didn't have your own issues. I think that

psychologists, psychologists, providers, primary care doctors, everybody should know where your issues start and stop and where your patients start and stop. And you can be a better provider in mental health in particular when you're a patient yourself. So understanding what it's like to be in the other chair, literally and figuratively, to be vulnerable to have feelings that you don't want to share or that are hard for you. So you know what it's like for the person you're sitting across from. So I think it's really important. Now, if the provider's issues are toxic to the therapy, that's a problem. Meaning, let's say they're really narcissistic and they need you to praise them. Like, I don't, that's, is the therapy for the patient anymore or is it for

the provider? Or if there is a substance use issue and the provider's falling asleep in the session or the provider's very inappropriate and slurring words, things like that, that's a problem. So I think if people are dealing with their stuff, great. If people aren't, that's an issue. I'm curious in a scenario, this happened to my therapist, my psychologist that I was seeing. And she pointed out that she was discussing another case, again, with no details whatsoever, but the fact that someone was looking, was saying things about that happened in their life, and they were looking for reassurance that what had happened to them was terrible, but objectively, it wasn't terrible.

And I don't remember the exact details of it, but when the psychologist went and told them, hey, look, what happened to you is terrible, the fact that you're feeling this way is terrible, but just so you know, that's not this, and it kind of created a conflict. The patient ended up leaving. But the psychologist said to me that if they were continuing to say that this was actually harm and this was terrible to them when it was a fact not harmful, it would have yielded a bigger problem. How do you handle discrepancies like that? What I would say in a situation like that from hearing me is I would say the patient,

clearly this has hurt you and you're telling me this is still sticking with you. There is a population of people that wouldn't have the same reaction. They might have reacted a little bit differently. I'm curious what you think about that, hearing that other people might have reacted differently. So wanting to understand more about their perspective, if they go on believing it's harmful, that would be a pattern I could point out.

So if they continue to believe it's harmful and it's actually not, I would say it seems like it's really hard for you to see this differently. I wonder what that's doing for you because when people get stuck on the same idea and keep doing the same thing again and again, and they're getting something out of it that they might not be aware of psychologically. I'm curious what you get from this

or what do you feel when this is considered still terrible when maybe other people wouldn't see it that way. Interesting. Do you think it becomes problematic when a psychiatrist or psychologist becomes famous? What do they do with that fame? That's what I want to know.

So I feel like I've had... Let's say they do good things. They want to help patients. they're trying to educate. But does that fame then take them out of the frame? I think it can, but I can only speak from my experience. I've had some degree of fame doing the things that I've done. And what I find is, if somebody's coming to me because they've seen me in a video,

like I want you to be my doctor, why me? Why not some doctor close to you? What is it about me? Now maybe they say, oh, I like the way you interact. with people, sure. But if someone's just starting to take on more and more people and more patience just to make a lot of money, I think that can be problematic. Not that I have an issue with money, but are the patients the primary thoughtful concern you have? And I think that should be it. When it's not the patients, that's a problem. Then go off and do whatever it is you want to do

that's not patient related. But I think the fame of the psychiatrist, if it comes into the room, it's part of the therapy. What is it about this person wanting to be treated by me? Or if they say, I saw you in a video and I'll say, oh, I'm curious,

what brought you from seeing the video to calling me, what was it? And if it seems like, oh, I just wanted to see your real person, I am. So I think that that can be a problem. The other thing is for the psychiatrist

to realize a lot of people might reach out to you as a result of this. And if people, if people are really in distress, you have to have some way of just reacting in a blanket wide way of saying, if you're in distress, I can't give medical advice to anybody, only my patients. So please realize that if you're reaching out to me in distress, I'm concerned about you, but I can't actually follow up with you.

And even if you're not in distress, I can't follow up with everybody and offer advice. And it's not because I'm being a terrible person. I just legally can't. And I'm actually focused on the patients at my practice too. Yeah. I think about, I've had some guests on the show who were taking on patients for nutrition sake, even though they weren't in a nutrition space, and they were getting all these great outcomes in their patients. And to me, I was like, well, is this just a selection biased? They're coming to see you because they read your book and they think you're awesome

and that you're going to help them. Do their subjective issues go away once they're seeing the person who quite literally, he said he could heal any condition with his diet? don't you think like you're pre-selecting people who are almost in a cult-like fashion following your advice and will get better at higher rates than if you brought your diet to my community health center. And that person didn't quite get what I was saying. But I'm curious. Do you think that could be impacting how well the therapy is landing to a better level, but perhaps for not the right reasons? Or does that not matter at all? I think it's, well, that's where I was going. It's like, well, does it,

doesn't really matter. I've had some people, it's funny. Years ago, I was seeing a lot more children in my patient. I still see some kids, but I was seeing a lot more. And there was one that just wanted to come because I had this one particular game. And I was saying to a colleague, I'm like, because we have this relationship in psychiatry called supervision where you talk to somebody who's seasoned about your cases just to make sure if you have questions or issues, you can get some guidance. And I remember saying a colleague mine, they just want to come because I have this game. And the colleague said to me, so what? They're in your office. They keep coming back. So I think it can be fine that they keep coming back for whatever reason. And they were saying

that because they were getting help, not because they're like, oh, you got another patient. Exactly. Exactly. They were getting, yeah, they were like, they're coming back. So I do think that there can be that idea of a placebo effect. Like, okay, this medication is going to help me. It's helped so many people or this doctor seems to know what he's doing so he can help me. I will do my best or that doctor might do their best. It may or may may not help, but if they feel like, okay, I'm getting really good care, that's also important to feel like you're getting good care. Yeah, I try and check that, almost like saying check my privilege in that regard when I see a patient who recognizes me from social media and perhaps are way more attentive in listening or making lifestyle changes because they're aware of what I do

and they're like, oh, I trust you way more than I would just any other physician, which shouldn't be the case, but is it bad that they're trusting me more, or is it going to lead them to make healthier lifestyle changes? I was going to say, if you can take advantage of it, everybody has, how should I say this? A friend of mine, I was talking about this too, she was saying me, what's your platform? What are you using that for? And I think if you can use it for good like that, maybe people will listen to you more. And you can use that for good. It's not like you're telling people, hey, make sure you take this pink Himalayan. Yeah, exactly. Make sure you take that pink Himalayan salt and you're not giving them information. That's not.

true or evidence-based. So the same thing. Like if I can, anybody with fame, if they can use that message to help people, great. But if you're, if you're being a huckster, you know, shame on you, let's not do that. Yeah. The movie Goodwill Hunting is one of my favorite movies. I was just having a podcast the other day debating on whether or not it was a good movie. I can't believe I was having that debate with another Dr. Mike. And I love the Robin Williams character who gave gave Matt Damon's character therapy. Thoughts on the movie, thoughts on the visualization of the therapy that was given?

Yeah, I really liked aspects of Goodwill Hunting. I think there was some stuff that was done very, very well. What specifically? I think that showing a patient, first of all, Will Hunting's character came from a severely traumatic background, seeing his hesitation to connect with people and seeing how Sean McGuire, Robin Williams' character helped him figure that out over time

was really cool. That is what is supposed to happen as you recognize how you might be doing the same thing again and again and pushing people away. Then you realize why you're doing it and maybe you don't have to do it. So I really like that. What I found very interesting,

and you might know this being a fan of the movie, is Robin Williams improvised a few things, more than a few things in that movie. The famous, my wife woke the dog up with a fart in the middle of the night was improvised by him And even the, Matt Damon, you can see him laughing genuinely there in the movie. And another couple of things that he did, he improvised. Psychiatry and therapy is kind of like improvisation, too.

And I think people respond to that movie because it felt so genuine. Robin Williams was so genuine in that movie. And that is what a good therapy can look like. You have a genuine provider, genuinely concerned about this person. I always laugh at the scene where Will Hunting is meeting all these psychiatrists and therapists and kind of poking at them all. and getting them to say, yeah, you know, I'm not going to work with you. He makes a comment about the artwork Sean has in the office that his wife has done,

and he realizes, oh, here's a soft spot. And so Robin Williams' character grabs him almost by the neck, puts his hands on him. That wouldn't happen in therapy. In fact, there are probably illegal consequences. There were probably all kinds of things. But what I like is in the next session when they do come, Robin Williams, he apologizes. And often I'll talk.

to patients and my therapist. He'll talk to me about this in life when I when I see people. They have big issues with their kids or other people. There's going to be rupture in your life. It's about the repair. And Robin Williams did a really good job of this is the repair. I'm sorry. That shouldn't have happened. So I really like those moments. And I like how you start to see will do things a little differently. I love the psychological parallels. He's hiding. He's hiding from people. He's been so hurt. He doesn't want to be hurt. He's hiding as a janitor. And, when he starts to solve the second problem that Professor Lambo puts on the board, he's still kind of in the distance.

He's running away. He runs away from that. So I like how that's brought up later. So these experiences the person has in real life show certain thoughts to have about themselves. I should be hidden. I don't want to connect to people. The one thing that in that movie I find funny too is the, it's not your fault scene, the famous scene.

Breakthroughs and therapy don't necessarily look like that. They can. There can be a lot of tears. But it's not necessarily going to look like that. But again, self-disclosure that he made allowed for a closeness, the closeness that he has with the therapist I really like. That's why I said again, because the importance of that relationship is emphasized in the movie.

I like how Will Hunting is there. And Robin Williams tells him, I gave up my ticket to the Game 6th, the World Series. He said, really? So there was something to learn from that. I gave it up because it was important to me to connect with this person, this wife, had to see about a girl. And so Will Hunting can understand that.

So you can self-disclose to help the patient, not for him to say, oh, I'm so sorry, you missed the game. It must have been terrible. So there are a lot of aspects of the movie that I really have liked. Do you think he shared too much of his personal life? Perhaps maybe not with that line because that was so for the patient, but talking about his father being a mean drunk or any of these other aspects. Like, is it ever too far to start sharing aspects of traumas that you've had?

that's debatable. I think in the movie, there's insight that the doctor, that Sean McGuire has into will, that allows them to know that's okay to share. And that comes from knowing your patient. If you're just sharing that willy-nilly with somebody, I think that's not helpful for the patient.

But if I've gotten to know a patient and their issues over time, I might say, you know, when I only reveal something about myself when I think it can be helpful. So I feel compelled to tell you that I had this experience.

and it really made me see things differently because I think it can help them see something differently. So I don't think he overshared in that case. If he started to go into and then I cried and then I was in my bed for this many days, I did this, then it becomes more about him. But when you share enough, so it's for the patient to grab onto and do something with for themselves, that's what about from just the aspect of creating empathy and fostering that connection? frequently if someone has lost a parent or in kind of a similar but very disconnected form of loss or grief, professional athlete that got injured and can no longer play their sport of choice.

I tell them that I too lost a parent at a young age or I too got injured when I was on my boxing journey and it creates a moment of wow, okay, so this person would actually see me differently because I know about their experience. Is that valuable? I think it is. But I don't go that detailed with a patient. I might say something like, they might say,

I just lost my so-and-so, and I say, I'm terribly sorry, that sounds awful. And then they might keep talking. And I'll say something like, you know, from personal experience

and from seeing lots of people, I'm seeing you, this must really hurt. Like, I leave it at that. God. They don't need to know which family memory I lost or the details,

because that becomes more about me. But in that case, there's a way to do it so that they have something that makes them see, oh, he gets it. Yeah, because I have to do this quite often where someone has a torn rotator cuff, a meniscus injury in their knee,

and I'm like, well, you don't need surgery. That's not guaranteed. You know, 90 plus percent recover with physical therapy and conservative management. I have a torn rotator cuff and issues with my meniscus, and look, I'm functioning quite well. So I try to use myself an example.

And that seems appropriate. Yeah. But it's obviously going to be very widely different. depending on what you're using that for. Yes, and what kind of tool. Especially grief. I mean, everybody responds to grief differently. You lost a loved one.

For some people, they don't even acknowledge it for six months or for some people they're angry. Others are sad. Others will tell me my bad person, I don't feel sad. So my experience has nothing to do with their experience. Yeah. Have you seen, speaking of bereavement and grief, the recent Mr. Beast video where there was a gentleman

that was living in a secluded home away from family and loved ones and was trying to lose Sam 100 pounds and in the midst of it the personal trainer that they hired for him ended up dying and they told him in the middle of this experiment and he had a very viral reaction i mean over a hundred million views right on that content now have you seen that i have not oh yeah i would have been curious to show that to you just to what you what like it was a good to show that to the general public is that valuable with all consent obviously he was for it he wanted to continue on the journey one month 183 million views wow on the long form wow imagine the clip version of that yeah what that is so are those scenes that we need to be comfortable sharing more often or is that

something that needs to be kept private i i think you can go both ways are you trying to do this gratuitously to get 183 million views in a month? Or are you actually showing this because you can show people that there's grief and people grieve? And I think there can be a good side that comes out of it. Maybe you are showing it hoping for the views, but maybe you're also doing good at the same time. But I do think that showing expression is important, showing how connected he was to his trainer is important, showing this was an important relationship and that you're going to grieve a relationship when it ends. I think there can be good things from that.

I'm often skeptical and I see somebody just trying to get views, but again, there can be good that can come out of it. Speaking of superheroes and villains, the Joker has been one of your hit reactions. Tell us about the Joker. What's going on in that movie with that character? What I find interesting is that movie,

Dark Night is one that we've talked about, colleagues and I've talked about, I've talked about, and even in the most recent Joker, talked about that. But there are all these different depictions of these characters. And I find that interesting because it's almost like when I see people in different days. One day they'll come in this way, one day they'll come in that way, and they might feel this. So it depends on the depiction, but the overarching theme of the Joker is that he is really a psychopath. So a psychopath is someone who's callous and uncaring. They will use people as pawns to get what they want in their lives. They really don't care about anybody else other than that person.

and affecting them in a way that they want. So he really is a psychopath, and he's not psychotic. Psychotic means a break from reality, hearing things, seeing things, hallucinations, delusions. He doesn't have that. Now, there may be one or two stories out there in comics from the 60s that shows something like that, or 70s or 80s, but he is not a psychotic individual. He is a psychopath. So I often use that as a starting point.

He doesn't really belong in Arkham Asylum, which is the, the universe, the Gotham City equivalent to a forensic hospital where someone would go to get treatment for the mental health issues rather than get into the criminal justice system. He belongs in Blackgate Penitentiary. He belongs in a prison because he knows what he's doing. He knows what he's doing is wrong and he continues to do it. So he's really a psychopath and I think people are interested always to hear about that. With villains, when it comes to villains versus heroes, villains are unpredictable. We don't know what they're going to do. We know Superman's going to do the right thing. We know Batman's never going to kill anybody. We know Wonder Woman's going to do

this. We don't always know what the villains are going to do, and the Joker seems to be one of the most unpredictable. Which depiction of the Joker was most interesting to? I really like the Dark Knight Heath Ledgerversion, and my understanding was that previous to his death, they were actually going to have him in another movie. So I really liked his depiction. He was just creepy and scary and so callous. It was like, wow, this is a scary villain for Batman. I'm glad Batman's ear. Yeah. I mean, it's been theorized, and some people have debated it. Does playing a role that dark impact an individual's normal day mindset? I don't know, and I've seen those reports too. Jack Nicholson, even back to the 89 Batman and other people saying this was really disturbing to play. Heath Ledger

dying and the drug issues. And Jared Lido, I think, said something. I think if you immerse yourself in a dark world, it certainly can affect you. There was a time when I was doing some work that involved me seeing lots of very disturbing things, and it definitely did affect me. I was like, this is, this world is pretty horrible. And so it affected me,

and I was only doing this for, you know, maybe a year or so, a little bit more. And, yeah, when you're not... Is there some truth to the fact that when you smile, you know, you get some of the same... Endorphins? Endorphins or neurochemical pathways start firing. And perhaps when you're exposed to that world,

much like when you watch an athlete perform a task, your brain lights up as if you're performing the task, something along those lines. Yes, just smiling can make you feel better. It can make somebody else feel better. There was some recent data that when you ask someone for help, their experience of that is the same way as if you had flirted with them. So there's this endorphin rush,

there's this feeling, wow, I can be useful to somebody. I can be important to somebody. So, yeah, all of these things, I think, impact your... Do you think there are people that are out there trying to hack those mechanisms? In what way? I don't know, like pick up artists or con artists. Oh, I'm sure, yeah.

I mean, yes. If you ever read the game was the famous book. I mean, yeah, people trying to figure out how to pick up women, pick up men, whatever from that. So yes, I'm sure. And con artists pray upon... And actually cult leaders even, to pray upon people who have psychological needs

and feel like, okay, I can give this person a purpose. and I give them jobs. Now I'll cut them off and mess their family and create this space in their lives just for me. Yes, people do try to pray on what people need.

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Maybe you seem pretty level-headed, you don't get pissed off. Yeah, I try not to. I do, I do. I save that for my own therapy. But I think whenever anybody's saying, this is going to cure everything, this is going to cure everybody. I'm very suspicious. What about the word cure in psychiatry? So cure, that's a great question.

What does cure mean? Does it mean you no longer meet criteria for this diagnosis? That could be, but what I often tell people, because they'll come into my office and say, I want to leave all this behind. I don't want to do this ever again. And a conversation I frequently have with people is, I think we need to look at it differently.

This is always going to be a part of you. It is always going to be painful when you think about this. How do we help you move along with it? So is that the cure? You learn how to move along with these things and you know how to dial down the volume, like it's a radio knob. It's always going to be there.

Just do we know how to mute it? Do we know how to get it so it's not affecting everything? So I think cure is really kind of an interesting, interesting thing. And you were saying that there's some people that claim to have cures? I mean, I've seen this diet will help you. Maybe it will, but it's not going to cure this or that. Are you thinking of the recent research surrounding keto diet? No, keto diet actually, I have seen help.

That's what I'm going to say. There's evidence. Sure, again, if there's evidence behind these things, I'm absolutely for it. So there's keto diet suggesting it's beneficial for people on seizures that have had seizures. even and it's protective against that. I think that there can be improved mood with vitamin D. It's not going to cure depression, but it might improve your mood. Maybe it's a piece of something else. Although I have had a patient say, yeah, my mood did go. I no longer had depressive symptoms of vitamin D. It doesn't mean that everybody needs to take vitamin D in that. Sure. So I think

that's the thing to think about. So there are no like specific supplements out there. There are like, this is your mental health supplement. I haven't seen that. No, and usually I'll sell people, the issue I have with supplements is you don't always know what's in them because they're not FDA regulated but there can be supplements that we can use. That there's supplements they add to something. So if you

take a supplement, magnesium might help people feel calmer. That's certainly one. Elthineine is another one. Maybe it helps with sleep. So all of these are supplements but they're not going to necessarily do everything and when I see something like this will cure all depression like I don't know about that. Yeah. Something's stuck

in the back of my mind when you were defining the word psychopath. I feel like listeners or viewers might hear your definition of that and be like, oh, I dated one of those. Is that? I've been asked this before. So the psychopath term means you're essentially people say you were born that way. Sociopath, we used to say, means over time society created and morphed you into that. We kind of use them interchangeably now is really psychopathic or sociopathic and it doesn't necessarily mean you're born that way or society created you that way. There's an idea that sociopath adapted to that behavior

because it helped them survive in the world around them. When it comes to dating, psychopathy is probably an extreme version of narcissism. One of the traits for narcissistic personalities disorder is you lack empathy. So an extreme version would be, say, Ted Bundy or a serial killer or something like that. So I think when people are talking about that, they're talking about extreme narcissists. And I want to understand, well, what's going on?

I want to start helping people. And I see a lot of people dating. I've seen in California, New York, Florida. I see a lot of people dating different places, different ages. And we'll talk about people that are dating and say, oh, do you feel like any of that's concerning? And sometimes this stuff comes up. Whether they're a sociopath or not, I don't know.

But if they're doing things that are pretty harmful to you, maybe it's not the right fit. Let's forget our labels. Let's just think about what's going on here. Yeah, because, I mean, if you just searched the word narcissist on TikTok or something. think you're going to get a lot of dating stories. You'll see two individuals from the same relationship, labeling one another, the same

traits. It's interesting how you could see it from both sides. But it's just like you asked about other language, bipolar and mania. There's specific criteria if you're talking in a psychiatric sense, psychological sense of narcissism. I think they're talking about people who are totally absorbed with themselves, not considering other people, think they deserve the best treatment. they should be the center of attention.

They're pursuing unlimited power, beauty, money, whatever. Those are narcissistic traits. And maybe you are seeing them in people you date. Are you displaying them also or what's happening? Makes sense. What do you think primary care doctors should do better when it comes to mental health? Hmm.

What I would love to see more of is I'd love to see psychiatrists and primary care doctors talking more and saying, you know, this is how you might ask about this. I'd love to see primary care doctors, say, are you having any thoughts of suicide? Are you having your thoughts of harming yourself? And following up with those questions, too. I'd love to see them not leading the patient in answers. Like, are you having any of this?

Like not nodding their head, but like, that's the question. And then see what patients are saying. It doesn't have to all be forms. That's one way to do it. Like the PHQ9. You don't like those? No, I like them, but I'm saying it doesn't have to be only that. Like if you look at it and it's low score, I'd still ask, ask your patients.

I notice on here it's, you wrote these things down. Just want to check, have you been having, have you been feeling lately? Just asking that question. Now, I understand the reason primary care doctors don't. Limit amount of time, huge amount of patients. But I think maybe asking things like that, you know, how are you been feeling lately mood-wise? I do see in primary care offices, which I really like.

I think they're going in this direction. The person initially taking vitals, the nurse or an NP or who, whoever it is, we'll say, you know, however things at home, having any concerns about safety at home. Similarly, they would ask, how does your move? Would you have any depressive thoughts? Yeah, they do like a pH, Q2 or something like that.

And then intimate partner violence, obviously. Screening is something that we do. So I honestly think, keep continuing to do that, maybe add more detail if you're noticing something with patient. Don't just rely on the form. If you see something with the patient, ask more. And then also, don't be afraid to reach out to your mental health colleagues, be like,

I'm concerned about this. Asking men about eating issues would be great. Tell me more. Saying things like, how much you're eating. What are you eating? What is a typical day look like?

Because they're eating disorders that are presenting in men, restricting food and trying to sculpt their bodies in a certain way, teenage boys in particular. So I would ask about that for teenage boys.

I think that would be important. I think also asking, quite frankly, asking about porn online, things like that, like how much time you're spending watching the internet, how much the time spent. Is that a growing issue in patients?

In what way? I think a couple ways, teenage boys and girls. Exposure to porn at earlier ages, looking at it, not really understanding of that age, what it is. I think it can be an addiction for men in particular. Same for women, but I tend to see more men with that issue. It can also get in the way of realistic expectations, sexually with partners,

that they want their partner to do certain. things I see in videos or I've had a ton of people that are dating in my practice tell me yeah you know when I'm with these people sexually they all need porn to get off and it's I want to be with somebody that doesn't need that or they'll say things like yeah they have these crazy ideas and they want to do things that I want no part of so I'm having to tell people okay you know when you're dating maybe you should set some ground rules with patient with your patience sets some ground rules with your partner say things like all right look no hitting no biting no spitting and i don't want any derogatory language like sure so asking people actually about these things i think is becoming more

and more important um in terms of uh partner communication do you ever do uh partner therapy group oh yeah i couple's therapy is one of my favorite things to do oh really why is that yeah i i i think it's so interesting to have two people who at some point and hopefully still love each other and are really having a hard time understanding each other because inevitably what I see is they're going through things that are very similar to each other and they're not knowing how to talk about it. And I want to give space for them to understand each other in ways they never have before and to talk about each other and think about each other in ways they have not even considered trying to point out that while you're seeing your husband having a tantrum, let's figure out what

he's actually feeling in the moment. And then he can say things like, I feel totally alone. I feel totally disconnected. And then being able to say to the partner, do you hear what your husband's saying? He feels totally disconnected to you. Yes, you're seeing all the childish behavior. No, that is not a good way to get your partner to want to go back to you. But can you see that he just feels totally alone? Here's a very interesting question. I'm going to phrase it the way that I am purposefully. Is a good outcome of couples therapy ever that the couple separates? Yes, I think so. I think so. If they're doing so much damage to each other. But amicably. like that it was oh wow this went great this person's awesome but we realize we're not right for each

i think so yeah i mean i think if if for them it feels right if for their kids if they have kids it is right why why is it wrong because i wanted them to stay together well no in the sense of like does that actually happen or is that some fairy tale that i'm i think there there are times when people come in and say look we're and i've had people call me we're going to get divorced we want know how to do it in a way that's going to help our kids and not hurt them. So I think sometimes they come with me, come to me with that idea or they get referred to me with that idea. It's often when I see people, they really do want to stay together. If it's really contentious, I'll say, all right, you need to stop, wait, you know, and then it gets a little bit more

heated, and that's hard. Or with families, because you asked about not just couples, but I see families and groups. When I'm seeing a kid, I sometimes have to sit with the parents. Now, if the parents are together, I'll meet with them and talk to them about their kid. If they're divorced, I will try to meet them separately because what use is it to put them together? But what I'll do is I'll say things like, okay, I spend about 10 minutes with you. If your child who lives with you feels any degree of discomfort, the way I feel after spending 10 minutes with you, there's really a problem because I feel completely ignored and your child lives with you. So I just wonder if you're really ignoring them. So I think in those moments when

there's more than one person in the room, I really like that there's different dynamics and I could point out to them, look, right now what's going on is you're saying this, you're not even hearing this person. And you're saying this and he's not even hearing you. So we need to figure out what's happening. So it's the idea of, all right, let's work together. I think they've missed feeling worked together in a while. What's the right way or what's the optimal way to get divorced so that it impacts children less? And is that even possible? I think that the teaching has always been how the parents communicate during and after the divorce is most important. To each other? Yes, to each other. So if you're horrific to each other, that is going to impact your children

much worse than if you can be civil and if you can be amicable. And that takes some restraint. So if that means you limit the amount of time you have with your partner, fine. But I I think that was what we were taught impacts the kids. Because otherwise, it's incredibly stressful for the kids. And I've had some people say, I'm thinking about divorce. I'm really concerned about my kid. And what I'll say is,

I'm not pushing you into this marriage. I'm not pushing you out of this marriage. We should talk about it. I will tell you that with kids, if it's a very toxic environment when you're with your partner and you get divorced, the time with your child may be even more meaningful to all of you. That's powerful.

It can be. Yeah, because, like, that's not even a thought in people's minds. They automatically assume divorce is the worst outcome for their child, but it might not be. It might not be. It really depends on many factors.

And I'm not advocating for divorce. I'm not saying it's not good. I want to be clear. But I think that it's important that people realize is your relationship with your kid affected because of this relationship you have with a partner?

And if so, can you change that or are there other issues here that are just too difficult? And in that case, maybe your relationship wouldn't get better. That's so interesting. What do you think the most misunderstood part of therapy and psychiatry as a whole is? I don't know if this is a misunderstanding,

but one of the things that I find I'm laughing, because I will see people, they'll come in and be like, they'll talk. All right, so how long enough to do this? And then, like, there's a deadline. Yeah, I'm like, okay, so therapy is a slow burn. You're not going to necessarily feel like you're in another place in six weeks. it takes time. You might, hopefully you will, but it's going to take some time for you to really make a lot of the changes. You're going up against often decades of things. So there are people

in my practice that I've seen for a decade or longer, and hopefully that doesn't mean I'm a terrible doctor. Hopefully it means that they're still getting something out of this relationship. So I think one is that. Two, an understanding I hope people can have is that most of therapy happens outside of the office. You have that hour, two hours, three hours, four hours, depending on how often you're senior therapist with them in the office, but what is sticking with you outside? How are you thinking about what you left with when you were talking to your therapist? So I think that's another thing to realize and that there aren't always breakthrough moments and it doesn't look like goodwill hunting all the time. Yeah. So I think that's important. Not that that did a

disservice, but it's not that you're going to come in and feel like you're super connected. It's going to take some time. It's going to take some time to figure out what it is you're trying to work on, too. Do you ever have patients who come in and say, look, I'm not interested in talk therapy? Medication is what I need. Fix it. Yes. So typically, I'll talk to them on the phone and say, are you looking for therapy? Are you considering medication? It says pretty clearly on my website. I do therapy-based practice. But if they do that, I'll say, look, I don't do that, but I can offer you these people's names. I might also say, if I'm talking to them on the phone for 15 minutes. I might also say it sounds like while you're looking for medication, there might be a lot

for you to talk about. I wonder if it's worth you coming in just to see what it's like. So that's another way to do it. But I will refer them to just psychopharmacologists if that's what they're looking for. What's your favorite movie that has had a hint of psychiatry in it? I actually will say, I think that most recently the TV show, not a movie, but the TV show, The Bear, I really like the elements of psychology and psychiatry in that. I think it shows so many things really well. As I mentioned earlier, Jamie Lee Curtis, the character she plays, Donna Brazzado has alcoholism, has borderline traits,

has histrionic traits. And the impact she has had on her children, who are adults in the show, is so true to life, that they had to always look out for her, that there was no room for them, that they were shaped because of her actions. that I think is incredible.

I really like Jamie Lee Curtis's portrayal. I think that's awesome. Other things that I think have been recent, I do like, as I mentioned, your friends and neighbors, I like the way that there's this idea of bipolar disorder and people come off their medications and they don't like their medication.

I think there's elements in different things. What about for kids? That's a good question. But never have I ever, for teenagers, I thought was good showing a therapist in an adolescent interacting. I thought that was really good. What about adolescence?

The show? On Netflix? Yeah. I thought that was good. That was, I don't know if people knew the language of that, but that was a forensic evaluation of that kid. And if you remember,

the female provider that went in to evaluate him, did an amazing job acting, and also did a great job portraying forensic psychiatry. And she wasn't keeping things confidential. This was all going to go in a report. And the way that kid was getting angry, at her. I've had forensic evaluations where, you know, forensic meaning the intersection of mental health and legal issues. I've had them where

people are not happy. They suddenly stopped talking. I really liked how much emotion came up in there. I think that was really well done. And the toxic male culture that they talked about outside of just the forensic evaluation, it's very true. A lot of that is swallowing the red pill or whatever color pill you want to use. There's all kinds of stuff there. And I'm glad it's being addressed. Yeah. And I know you're working on some projects regarding media. Tell us what you can share about some of those projects.

Well, right now, I am working on a screenplay, on a pilot for a TV show that deals with psychiatry and hospital work and patients and the providers. I'm also doing more media work where I'm consulting with video games, TV shows, films, people are asking me, can you give your input on this? I want to make sure I don't do anything. stigmatizing. This needs more depth. So those things are things that I've been working on. And then also just trying to do more of this, getting out talking to other providers that I like and admire and we have a big audience to reach about mental health and not to be afraid of it. Right. And before we

started talking on camera, you mentioned you're an author of some interesting books. Yeah. So I wrote some medical humor books with some colleagues, some friends, also doctors. There was that old series of advertisements you might remember on TV. Nine out of ten doctors recommend this. Nine out of ten doctors recommend this. And I always thought, what happened to that one other doctor? What was that guy doing? So we wrote a book called One Out of Ten Doctors Recommends

Unusual Medical Research Remedies and Recommendations and looked at historically what were some unusual things like drinking urine, using potatoes to stop bleeding, those kinds of things. And did any of them show any medical promise? Or drinking urine not great. Yeah, actually there's a coagulant in a potato. I wouldn't necessarily if you're bleeding out,

you're probably not going to shove a potato in this. there but and then also some weird stories like a potato inserted in the vagina after childbirth because it would stop the bleeding but you leave it in too long and also sprouts so just looking at things like that interesting and that was one book and then another book I wrote a long time ago I wrote it under a pseudonym scrambled all the letters in my name and came up with rich e. Dreamen and it was very Batman yeah Joker shit yeah exactly there's a urban legend that actually happens in the ER where patients come in you might be familiar with this and they have complained of stomach pain,

and they'll say, oh, it really hurts. I don't know why it happened. And then you're doing your evaluation. Did you travel anywhere? Did you eat anything unusual? Did you injure yourself? Did you fall?

No, no, no, no. Then you do an image, and it turns out there's something inserted in the rectum. So I wrote a book called Stuck Up, 100 objects inserted and ingested in places they shouldn't be. And we have x-ray images that we owned and were able to get possession of and showed some of these things.

just to highlight the variety that is the... Yeah, and honestly, we didn't do any harm to patients. Patients were all okay with sharing. It's the idea nobody's named. It's the idea that laughter sometimes is the best medicine and to be able to laugh at ourselves is really important. Obviously, those patients weren't laughing at the time. Of course.

But it's just the idea that, wow, this is kind of absurd and the way that people go about trying to pleasure themselves in some ways. It's interesting. But I do think that I learned from my patients a lot. And that's the other thing. Just to go back to something you asked about Goodwill hunting, what I really liked in there was that the provider,

Sean, learned a ton from his patient about himself. And he could apply these things to himself. And that's something that happens in psychiatry is I am constantly learning from my patients. One guy asked me once, he's like, do you ever get anything out of talking to me? I'm like, of course I do. So there's this idea that it's just about the patient.

and I've really emphasized that with you, but I do learn a ton for my patients. I understand worlds in ways I wouldn't before. I understand how someone who's completely different for me goes through experiences. And I really liked how that was done in the movie. And I really like that from seeing patients, I can write books and do this kind of work.

What kind of personality? Because we have individuals who are met interested, perhaps psych interested, I can imagine myself doing this. What kind of personality or characteristic fits best in your line of work? I don't know that there's a personality type. I think if you can be empathetic, if you can be, if you're able to understand yourself and tolerate yourself and your own emotions, know what those are so that you can be in a position

to help somebody else with that. I think that's really... So you need a high level of self-control. A high EQ, I think, a high emotional quotient, yes, I would say that would be best. But if you don't have that, there are other ways you could practice psychiatry. But I do think if you're going to do therapy, you really need to be able to sit with somebody. And that can be really painful, really painful. If you're sitting with somebody who's just lost a child, if you're sitting with somebody who's, I don't know, dealing with all kinds of pain, just to be able to sit with that, it can be really hard.

And then to realize, and I'm still learning this, my therapist is often telling me this, sometimes just being with someone isn't enough. Just sitting there. I'm all these thinking, what do I do? What do I say? Sometimes you don't have to. It's just a matter of just being quiet, sitting.

If you were having someone shadow you as a med student or pre-med, and they're interested in your field, and you sense they tell you they have a low EQ. Do you discourage them? Not at all. Even though I said a high-E-Q would be great. I would say, well, tell me, about that. Let's figure that out. What's going on here? And when I do teach med students,

I will, first I'll ask them, how do you learn best? Do you want questions? Do you want, how do you like this? So I'm trying to meet them and understand them. And then oftentimes if somebody has a low EQ, it might be because emotions were never okay in their family. So we've got to figure that out. And when someone actually starts to get in touch with their own emotions, that might open up the door like, whoa, this is really helpful. Let me go into psychiatry. It's almost like you're doing a session with your students. Exactly. So you've got to figure out what's holding you back. And actually, that's something I want to touch on in the pilot that I'm writing, is what is holding somebody back from that.

And 32 hours a week can be compassionate fatiguing. Do you ever experience compassion fatigue? Is it reasonable to expect to have compassion fatigue? It's hard to, like if you're seeing multiple patients in a day and they're all telling you about loss and grieving, that's got to to be heavy, no? It can be heavy. I think of it a couple ways. And I was lucky at my med school to give the speech at graduation. I was voted by my classmates to give a speech. And I talked about it. Then it's such a privilege to sit with patients and to be able to understand them. And in psychiatry, especially, you're talking to people in their most intimate moments. They're sad. They're happy. They're married. They're divorced. They've lost somebody. They've

sold their company. They've created a business. Their household name now. All those things. They made a professional team. So I find it a privilege and always remember that. And that helps me with any kind of compassion fatigue. It's like, I get to do this and they're choosing to do this with me. They could choose anybody that's in the mental health world and they've chosen me. So that helps me. The thing I get most fatigued with is not so much compassion. It's more the focus for 50 minutes on somebody. Because I have 50 minutes sessions, something that's do 45. And when you have a number of those back to back. It's like, whoa, I got to make sure in the middle of the day I have a break just to be able to reset. And I don't save enough room sometimes for people at the end of the

day. So if I finish eight, nine, ten sessions, and someone says to me, how was your day? Like, oh, it's fine. That's all I say. That's it. And we move on to the next thing. So I think that's really tiring just to be able to do that. What is your way of resetting? I find exercise incredibly important for me. So I will work out four times a week with weights and then other days do other things. I like to bake when I can. I find that important fiction, reading, watching television or something I can do like that. I really like just being with family, my immediate family, the family creation that I have is really rejuvenating.

So I find that a lot of things. Is there, like, I know I get a benefit of it, my patients do, watching mindless TV shows that you know are garbage. Yeah. But, like, for some reason, because their garbage makes them watchable? Yes, and I won't name the shows, but I have a tendency to watch some of those. It's because, in my opinion, there's something on in the background. You don't have to tune into anything.

Deeply. It can still be there. It's like white noise in the background. Got it. And I think it can let you be alone with your thoughts in some way without maybe feeling completely alone. I do think that there's a predictability to that, to the reality shows, to the baking shows,

the competition shows, the whatever shows you're doing and watching, there's something formulaic about them. Those procedurals in an hour, everything's wrapped up. It's amazing. It's like, oh, it's nice and neat bow, whereas people's lives are not nice and neat.

It takes a lot longer than an hour. And also, when you're seeing so much heavy stuff during the day, at the end of the day, to know, like, oh, this person can't find their... Yeah, whatever. Perfect match. I lost a shoe, great. So I think there's something comforting too

in seeing people have issues that really aren't that big of a deal or sometimes watching movies where you see people have really big deals and you can look at your life and be like, oh, it's not about that. Yeah, like I used to, when I was younger, and maybe my late teens, early 20s,

loved watching hard-hitting dramas, serious bits of movie. and then like now I come home after a long day and there's like oh best drama award I'm like god I just I can't watch a sad drama like where are the silly stupid comedy exactly yeah same thing my wife will always want to watch something sad I'm like nope not gonna watch that she's like what are this nope

not watch that I'm like I have had enough enough nonfiction I need fiction yeah I felt that in watching the pit the first episode I was like oh this is this is too real right yeah yeah I actually really enjoyed the pit I felt like and I saw your take on it too. They finally did it right. The psychiatry elements, I think they did, they did it right in a way that made people mad, but that's what they should feel about the way mental health is sometimes done in the hospital. Like the crack in was this guy who was given this name of a monster. He was going to wake up and pee on somebody. And I think that is the way. A lot of times in medical ERs, patients that are psychiatric patients are looked at. So it is terrible,

but it's also true that that's how that's looked at. And there was a comment. made to one of the characters in the show, I think it was Mo, like, you can go into psychiatry. But it was almost cutting, like, you should get out of this. And I think that is accurate. The way people in medicine might look at psychiatry and the way it's looked down upon. And I think they really captured that.

So I don't think that's necessarily a flaw of the show. That's a problem with how we see mental health. Yeah. Yeah, big time. Did you read House of God? Yes. Yeah, Samuel Shem. It's a, there is a, there is a,

truth to it, a brutal reality that's not sexy and not talked about. But there is, like, in taking care of sick people, it takes a toll on a human mind and body. And it's, there are weird coping mechanisms that people don't get, like the dark humor at nursing stations. Yes. Yeah. People don't get that. No, absolutely. They don't get the dark humor and that happens. And I had a colleague who ran an ER during COVID. And the way people came together, the way it felt like the city was coming together. It's very true. So the Pitt did a great job with that.

I didn't find that too much like work. I think in part it's been so long since I was in a medical ER. I worked in a psych ER for a while. Got it. But I did think, wow, they really got it. Was there ever a show that made you feel that? Oh, yeah.

The show on HBO in treatment from years ago, the one with Gabriel Byrne, that was like coming home from work. He was a therapist. And the Monday shows had a Monday patient. And the two-day patient. And I'm like, this is true, this is work. I don't want to do this.

And sometimes there'll be stuff, you know, where couples are fighting or, you know, parents are not being great with their kids. I'm like, I don't need to see any more of this. You're like, here's what I would tell them. Yeah, exactly, exactly. And I've been asked that. Like, okay, so if you were the psychiatr in this show, what would you say it to do? Oh, yeah.

That's great. Where can people follow along your journey? If they go to Dr. Ericbender.com, all spelled out, D-O-C-T-O-R-E-I-C-B-E-N-D-E-R. Dr. Ericbender.com. That's my website. That has lots of videos. Why do you choose

to do Dr. spelled out? You know, I think because because I did it too, that's why I'm asking. Yeah, oh, that's good. You know, I don't recall exactly maybe because it just felt weird to me, not to have the period,

DR period. Oh, okay. So I don't know if that was it, but I chose that one that people can see me there. I'm also, I have a YouTube channel. I haven't done videos on there in a while, but what's there,

I'd love people to look at because it's about shows that are still on. Yeah. And looking at Yellow Jackets, looking at Ted Lasso, which is coming back for season four. It was looking at some other shows, too,

including Euphoria. That show made me feel like work was in front of me, and I wanted zero to do with it because not that it was bad, it was like all these teenagers behaving badly, and for a while I had some really difficult cases where teens were doing bad stuff, but also there's a lack of mental health care

and that also reflects real life. Where are the child psychiatrists? But that show made it hard. But you could see all those videos on YouTube, My, there I think I am Dr. Bender. Okay, there you go. I did it because there were too many other DR mics. Oh, that makes sense.

To distinguish myself, I guess somewhat. Well, thank you for the work that you're doing. Thank you for this awesome conversation. I definitely feel more enlightened. I really am excited to see medical dramas in the psychiatric and psychological space. Just do better. Yeah, me too. Thank you so much.

I admire what you do and it's been awesome to be part of it. Thanks very much. Thank you. In this episode, we talked about how Hollywood gets mental health wrong and right. But how about a conversation with someone who actually worked in Hollywood and worked with some pretty toxic people in Hollywood?

Check out my conversation with Tony Hale. Scroll on over to find it. If you enjoyed this episode, don't hesitate to give us five stars as it means the world to me and allows us to find new listeners and viewers. And as always, stay happy and healthy.