So he lives his life trying to live up

to images of what relationships look

like and he chases those things. So his

sense of self-esteem, his he's not like

he's like a 40some year old dude, right?

But he's not a for he doesn't act like a

40-year-old dude, right? So what's

really scary about abuse is that what

people who commit abuse, what they will

do is they will depersonify,

depersonalize themselves and the other

person in the relationship. Why do you

make me do this to you? Sitting with

these people is one of the creepiest

experiences I've had as a psychiatrist.

Okay, you guys want to do Aaron? Let's

do Aaron. Aaron Joerger. Okay, so here's

the thing with Aaron. So if we look at

Attack on Titan, so let's start by like

doing a quick summary of Aaron. Okay,

Aiden Jagger.

>> Okay, so there are going to be some

spoilers. Okay, chat. So if you guys

haven't watched Attack on Titan, there's

some spoilers. So Aaron is injected with

some stuff, right? And then Aaron grows

up when he's a child. He experiences a

lot of trauma. sees his mother, I think,

being eaten by a titan. And then they're

in this ensconce little area, right? And

then there all these titans and the

world is a very scary place. There's a

lot of trauma. And then what happens is

as Aaron starts to become heroic, he

starts to become more powerful. He has

more power. He realizes that uh the

Marleians are the bad guys. And so then

he's going to inflict upon them the pain

that has been inflicted upon him. Right?

So he's kind of got this sense of

vengeance. Okay. But it it's not really

vengeance. I don't think he wants

vengeance. So Aaron has been

traumatized. Okay. But I think the most

interesting thing about Attack on Titan

is how there's no way to get the train

off the tracks. Okay. So if you listen

to Aaron, he's like, you know, even when

he's talking to what's that guy's name?

The Armored Titan, right? And he's like,

"Look, you guys came here to try to

destroy us and like you didn't have a

choice. like you were just doing what

was supposed to be done because remember

the Eldians are like evil people, right?

We're the bane of existence. So you

Marley was concerned because we've got a

bazillion titans in our walls and we can

release the rumblings. So you showed up

here and you did really bad things for

the right reason. You didn't have a

choice. Okay, Riner. Okay. And so if we

look at this, there's a lot of

definitiveness. There's a sense of

powerlessness. There's a sense of lack

of control. like we're not really

responsible for our actions, right?

We're not allowed to say no. The world

exists in a way where you're doing what

you think is right. I'm doing what I

think is right. What I think is really

fascinating about this is how this has

been explored psychiatrically. So there

is a new form of PTSD that got basically

like got sort of finalized in the DSM

called moral injury. Okay. So these are

individuals who are exposed to traumatic

events that violate their moral values

may experience severe distress and

functional impairments known as moral

injuries. So basically there's a new

form of trauma. I mean this has always

been there but there's the trauma of

having something done to you that is

traumatic and then there is human beings

being forced into situations where they

have to do bad things. So we see this a

lot with like soldiers, right? who go to

some of these wartorrn places and you

like shoot some guns because or you

launch a missile or whatever. You're

like bombing something with a drone and

it turns out that it was supposed to be

a military target, not a military

target, turned out to be civilians in

there and now you have become the bad

guy. And this is traumatic. This is like

really damaging for you to be forced

into the role of bad guy. And now the

interesting thing is if we look at moral

injury, it's a form of PTSD that is

debilitating. Okay, so the really

interesting thing about Aaron is that is

he debilitated? Is he mentally ill? Is

he nonfunctional because of what has

been happened done to him traumatically?

And this is where like I remember I was

I was in med school actually and uh I

also have a masters in public health. So

I was in a dual degree program and one

of the most shocking things that I

remember learning uh in in my M. PH in

med school was that everyone who goes

through genocidal conflicts does not

have PTSD which is a weird thing, right?

Right. So when I was um in residency and

and stuff like that in Boston, there was

a large uh population of I think

Cambodian refugees. And so like if we

look at like refugee populations, not

everyone has PTSD. And the question is

why not? The intervention, the thing

that they experience is the same.

Everyone is running away from genocide.

Some people end up debilitated with

PTSD. Some people do not. And I think

what's actually really good about Attack

on Titan, I think it's actually a

psychologically in-depth anime because

it shows what someone has to do to not

fall apart from the trauma that they've

been to. And one of the scariest things

that I've seen for people who commit

vile acts is the justification of I

don't have a choice. Right? So, in order

to not be hurt by his moral injury,

because when you do something evil,

because this is what's so confusing.

You'd think that, oh my god, Aaron, his

family, his friends got eaten by Titans.

They were hapless victims of the

aggression of somebody else. You would

think that in that situation, and we see

this in Attack on Titan, right? We see

that some people on Aaron's team have

compassion for the Marlians and they're

like, "Hey, bro, they did this to us.

Killing innocent people is bad. How

about we don't do that to them?" And

what's really interesting is, so that's

one way, so this is what I think is

fascinating about Attack on Titan. It's

like when you have a genocidal conflict,

what are the different psychological

ways that people respond to this

genocidal conflict? And this is what's

fascinating as a psychiatrist, right?

When I work with people, something bad

happens to you. How do you rise to that

occasion? How do you adapt? How do you

respond? I mean, literally, how do you

adapt? So, adaptation number one is,

hey, this is bad. This hurts. This is

bad. Let's not do it to anyone else.

Let's have compassion. Option number two

is vengeance, right? This is like, you

hurt me, therefore I want to hurt you.

The reason I'm hurting you is because

you hurt me. There's no sense of like

overarching moral stuff beyond, hey, eye

for an eye. You deserve what you get.

But that's vengeance. It's a very

noticeable. It It's a discrete

motivation that some people have. I'm

going to do this because it's vengeance.

But what we see with Aaron is something

else. So when he's committing bad acts,

right? So there's a moral injury

diagnosis that could be made here, but

he doesn't have because he's not

impaired. He's not non-functional. He's

the opposite. He's hyperfunctional. And

how does he attain that

hyperfunctionality? By dehumanizing. Hey

Reiner, you didn't have a choice. I

don't even blame you. There's no desire

for revengeance. Right? Reiner did all

these bad things. Is he angry within?

Not at all. He's like, "No, actually, I

don't blame you." And here's the

beautiful thing. Here's the really scary

psychological thing. If I don't blame

you for doing bad things, guess who else

I don't have to blame? Not my fault. I'm

about to do some terrible things. And

this is just the way of the world. This

is just what happens. Nothing can be

done. So this is what's going on with

Aaron, right? So I think we're seeing a

moral injury kind of picture. But the

way that he responds to this evilness,

right, is by saying, "Hey, like I'm not

responsible. You're not responsible. No

one's responsible." And that is a really

really powerful way. I've seen this and

it's it's like I don't even know what

the right word is. heavy episode of

South Park with where I think it was

Jimmy starts using steroids and then he

starts becoming abusive and then he's

like why do you make me do this to you

right so what's really scary about abuse

is that what people who commit abuse

which is I think what we see in Aaron

what they will do is they will

depersonify depersonalize themselves and

the other person in the relationship why

do you make me do this to you know I

don't want to do it you're making me do

it this is I understand this is wrong

but I can't control myself. It's really

really scary. Like sitting with these

people is one of the creepiest

experiences I've had as a psychiatrist

because what really scares me when I sit

with these people and it's kind of like

sociopathic. Okay, which is another

thing that we can talk about with Aaron

in a second is that like you kind of get

the sense that once this person makes a

calculation, if I'm on the wrong side of

that calculation, there's nothing I can

do to change their mind, right? I have

no protection from their empathy. they

won't think that this is wrong or even

if they know that's wrongness will not

affect them which is where we get to

another really interesting aspect of

when people get traumatized why do they

respond in different ways. So if we look

at sociopathy or psychopathy, this is a

scale. Okay? So we'll say like, okay,

this person is a sociopath. The reason

they're a sociopath is because they're

high up on the scale of sociopathy. So

they're in the top fifth percentile. So

if you look at human beings and if you

look at the features of sociopathy, one

of the features of sociopathy is a lack

of empathy. The inability to feel what

other people are feeling. So I think

what we see in Aaron is someone who is

has some degree of sociopathy which by

the way is like somewhat genetically

inherited which we see from his dad

right imagine how sociopathic you have

to be to inject your child with Titan

serum right there's like there's like a

streak of some real madness sociopathic

kind of stuff in there somewhere. So

when you have a certain personality

makeup and you get exposed to a

genocidal experience, depending on how

that cookie crumbles and the decisions

that you make in your mind, you will end

up with Aaron Joerger, right? And this

is the work that I do and this is why

some people like this is why I'm

actually hopeful being a psychiatrist

because there's a decent chance that you

have a personality makeup. Maybe you're

a little bit more prone to rejection

sensitivity. Maybe you're a little bit

more sociopathic, right? Maybe you're a

little bit more narcissistic. You have a

personality temperament and then as

experiences happen to you, we make

automatic interpretations. We arrive at

conclusions. But the whole point of

psychiatry is that those conclusions are

not actually set in stone. That you can

re-evaluate and reinterpret the

conclusions that you come to. Aaron

comes to the conclusion that bad stuff

happens. There's nothing we can do about

it. We are all lifeless people who are

basically on this train. We have no

agency. And yet look at what he does. He

exercises. And look at how much agency

he believes he has. And this is what's

really scary when it comes to things

like relationships, right? Is we

actually have a ton of agency. But if we

don't believe we have agency, then there

is no controlling our destiny, right? So

I think it was Carl Jung who said,

"Until you make the unconscious

conscious, it will direct your life and

you will call it fate." So this is

what's really scary when I work with

stuff and we cover this kind of stuff in

the guide, right? There's a there's a

lecture on like animema and animus and

some of these yungian perspectives

because sometimes in relationships you

can talk about you know the dopamine and

the oxytocin and stuff but sometimes

like we have to talk about this deeper

stuff and what's happening with Aaron is

he's got a lot of stuff going on in his

unconscious but he's faded because he's

not aware that he's actually making

choices. He's making huge choices. He's

making catastrophic choices but he's not

consciously. It feels like he doesn't he

feels out of control. And this is what's

really scary about trauma is when we

experience trauma, we learn that we have

no agency. Y'all get that? So when Aaron

is watching his mom be gobbled by a

smiling titan, right? When he sees

person after person after person that he

knows and loves, he learns that he has

no agency. And this is what's scary

about trauma. Once you have that

conclusion, you carry it forward. So

when he was a 12-year-old boy, he had no

agency. when he's the founding titan who

consumes other titans. He has a ton of

agency, but in his head, he still

believes he was that thing. He's a

12-year-old boy trapped inside inside

the founding titan, and he doesn't

grapple with the fact that he actually

has immense power now. And so, he calls

it fate. This is the tragedy of trauma

is that you actually have way more power

than you even realize because you're not

the person who got bullied in in school.

You're not the person who is financially

dependent. You may still be financially

dependent, but financially dependent at

14 and financial dependence at 24 when

you actually have a lot more agency than

you realize, right? You are a different

person. And just like Aaron, and this is

why I like Attack on Titan because I've

worked with like literally dozens if not

hundreds of patients who my job is to

teach them that they are not the person

that they used to be and that they have

more control over their life than they

realize. And we'll see. I need to watch

the end of Attack on Titan. So maybe

I'll have a different answer, but like

we'll see, you know, if he discovers

this in some way. For deeper dives into

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So, I want to talk about uh Joe Goldberg

for a second. So, I think Joel Goldberg

is a good example of a principle that we

talked about with Aaron. So, if you guys

haven't seen you, I think it's a it's a

great show. So, spoilers for the show.

Okay. Not not like two big spoilers, but

you sort of figure this out early. So

Joe Goldberg is someone who's a stalker,

right? And he falls in love with people.

So I think Joe Goldberg is a really good

example of when we diagnose a person,

the shortcomings of using a single

diagnosis. So there's uh something

called lirance. Okay, we have a whole

video about liance. Limrance is super

scary. Limrance is when you develop this

idea of a person and that idea is so

encapsulating. It's so beautiful. This

person becomes a fantasy. They are a

fantasy embodied on the earth on the

planet. They are an angel who has come

down from heaven. And if you look at

people who are stalkers, we'll get to

stalking in a second. If you look at

lirance, the idea behind lirance is

someone has this vision of someone who

is perfect in so many ways. And the

really frustrating thing about lirance

is you look at this person and your

brain tells you, "Oh my god, this person

isn't as amazing. They're beautiful.

They're the person that I need." We we

fall in love with this idea of a person.

We fall in love with a fantasy of a

person. And a big feature of lirance is

that we actually don't often times

interact with them. How can I say, we

don't interact with them much. So in

some cases of liance that I've seen,

you'll literally meet someone once and

then for the next like 8 years, you'll

be fantasizing about how this person is

amazing. Okay? And then you start to

build this fantasy in in your head about

who this person is. The other really

scary thing about lirance is as you

engage in a relationship with them, they

become a real person and the limrance

disappears and can actually transfer to

another person. This is common. So

lirance shifts, the research suggests

that liance shifts every like 8 to 10

years. Within 8 to 10 years, your

lirance will move on to a different

person. So what's really scary if you've

got lirance is you you may actually

succeed in stalking them, dating them.

They enter into a relationship with you,

but then as they become a real person,

that fantasy shifts to somebody else. So

here's the cool thing I think about Joe

Goldberg is that limrance is something

that happens to you. It is not who you

are, but depending on your personality

makeup, if you have lirance happen to

someone who is sociopathic, you get Joel

Goldberg. He's not just a sociopath.

He's not just lirant. And this is what's

kind of like fun and exciting about

psychiatry is like it's not just one

thing. It is like if you develop

limrance, if you stick limrance in a

sociopath, it looks one way. If you

stick lirance in someone with dependent

personality disorder, it looks another

way. Right? That's a much more classic

picture of someone who feels or avoidant

personality disorder or narcissistic

personality disorder or lirance in a

borderline personality disorder. Joe

Goldberg is lirance in a sociopath. So

when he has that lirance his personality

I don't know if this makes sense he

feels attracted to them he has a fantasy

about this person that anyone can have

anyone can fantasize and have lirance

about a particular person but then his

personality organization how does he

organize around the lirance that's the

sociopathy he starts following them

around he has no empathy for them right

and this is what's really scary like a

lot of dudes and women that I've worked

with will be deeply in love with someone

like oh my god this person is amazing,

but what they're in love with is the

idea of a person. They're in love with a

vision of a person, not a real person.

And so, this is what confuses these

people is because they're like, I do

everything right. I'm so kind. I I get

them flowers. I'm there for them. I'm

there to pick up their I have I I

express a lot of positive affection. I

express love. I express patience. I

express compassion. I do everything

right. I honor them. I I worship them. I

sacrifice for them. And why don't they

love me back? I'm doing everything. All

of these stories that we have about

love, sacrifice love this, that right?

This is what someone, if you really love

someone, this is what you do. You give

them a kidney. You pick them up from the

airport. You answer the phone at

midnight. This is what you do. I'm doing

everything right. Why don't they love me

back? What's wrong? I don't know what

else I can do. Right? What you're doing

wrong is there's no empathy. How does

the other person feel? How are they

responding to what you're saying? Is

there space for another person in your

head that is full of fantasy? Does

another real human being exist? He has

no empathy for them. He has a cognitive

empathy. He can predict what they're

going to do. He knows how his actions

are going to make someone feel, which is

why he engineers

these scenarios that make people feel a

certain way, right? And then they get a

flash because they they have empathy. So

then at some point the scariest thing

happens is since they have empathy they

see him and when they connect to him

it's empty. they begin to realize, oh my

god, this person doesn't like literally

when he looks at me, he doesn't see me,

he sees a vision of me, right? And and

Joe Goldberg is a great example if you

guys see the later seasons, right? So he

ends up in a relationship with kids and

then his lirance immediately transfers

to somebody else. Show has to be written

by someone who's either experienced

lirance or worked with people who have

lirance. Really good. Joe Goldberg is

when you have lirance in a sociopath. So

then he's willing to do anything for the

sake of preserving his fantasy. He has

no moral compass at all. He thinks he

feels if you ask him do you have a moral

compass and he's like yes absolutely I

will do anything for this person I will

kill I will bury I will stalk I will

chase them all over the world right so

he feels like he's he's got a it's like

a weird kind of morality it's like a

morality of a pedestal but it's not like

real morality it's not real empathy he

doesn't actually he's like even when

like people are like get the hell away

from me he's like oh I don't want to

hurt you he sort of fantasizes

everything gets twisted by his like

obsessional thing right so he doesn't

genuinely understand that somebody wants

distance for him. He's willing to make

that sacrifice for the person he loves.

He's willing to deprive himself of his

own joy and passion as a sacrifice for

the one that he loves. So, this is real

narcissistic parent level stuff. Oh my

god. It's not that I'm toxic. It's that

you're so distorted in your thinking.

But as a mother, I have to sacrifice for

my baby no matter what. Even when

they're wrong. So if you need to cut me

off, I will I will bear that cross and I

won't Oh my god, I'm a victim. But I

will bear I will I will be put on the

cross of sacrifice for you. I'm going to

be They're telling you, hey, you're

violating my boundaries all the time.

Please respect my boundaries. And

they're like, "No, instead of respecting

your boundaries, what I'm going to do is

twist your boundaries into an astronomic

sacrifice on my part so I become the

good guy and you become the ignorant,

pathetic bad guy." which remember if you

guys know this is kind of an older

system of diagnosis but there's a system

of personality diagnosis that involves

something called cluster B and

sociopathy and narcissism share certain

features so we see that in Joe as well

but he's more sociopathic than

narcissistic make sense oh wow we've got

a raid of 1,916 people thanks for the

raid welcome everybody appreciate it we

are doing fictional character diagnosis

so Joe has lirance so remember lirance

is something that happens to you. But

he's a sociopath. So he's a sociopath

with limrance, which is like the recipe

for the worst stalker on the planet, the

scariest stalker on the planet. And so

this is where, you know, a lot of times

when people talk about fictional

character diagnosis, they'll be like,

"Oh, this person has this." We will

think of their diagnosis as

undidnimensional, but one of the things

that I love about this is some of these

characters are written really well, and

it's not just one diagnosis. This is a

really great example of lirance in a

sociopath. So he has features of

sociopathy. He can kill and dismember

people. people that he loves. He can

keep them in a cage for days on end so

that they can be together the way that

they're supposed to be. So there's love

of a sort, but it's not genuine love. It

is lirant love. And the other key thing

about Joe is that when he finally ends

up with the person that he has liance

with and doesn't have to butcher them,

then his lirance transfers to somebody

else, which is a really common feature

of lirance. Okay. So Michael Scott's

diagnosis is going to be a little bit

strange. So I think he's actually a

really good example of someone who is uh

developmentally deprived. Okay. So his

core problem so we can we can look at

Michael Scott, right? So he seeks

validation. He's hyper sensitive to the

opinions of others. He wants to be

everybody's friend. He wants to be a

cool kid. But what's what's his problem,

right? Does he have social anxiety? Not

really. Does he have borderline

personality disorder? Not really. Does

he have anxious attachment style? Sort

of. But his real problem is

developmentally stunted. That's

Michael's problem. So if we look at

Michael, one of the core features of

Michael, so he he loves relationships.

He's all about relationships. He's all

about connecting with someone, being

someone's best friend. I love inside

jokes. I'd love to be a part of one one

day. So what happens with Michael is he

does not have an actual template for

what a relationship looks like. He

doesn't know what a friendship really

is. He doesn't know what a healthy

relationship is supposed to be. Right?

So, if you look at Michael, his big

thing, he tries to live his life based

on the idea of what a life is supposed

to be. You know, he's like, "Oh yeah, I

got a flat screen TV." And it's like

tiny. And he's like, "Oh, yeah. People,

humans like flat screen TVs. Flat screen

TV. Good. Let me check that box. Inside

joke is something that humans do. Let me

have an inside joke. Check that box."

And the really interesting thing about

that is that you know he has this idea

of what a relationship is. Relationship

is loyalty. Relationship is

togetherness. And Dwight is there

offering it to him. Let's be best

buddies. Let's be together. And he

rejects him time and time and assistant

to the regional manager. Right? So this

is a case. This this is what happens

when kids grow up without the

appropriate upbringing. They don't know

they don't have a template for what a

real friendship looks like. We don't

know too much about Michael's

upbringing, but it seems to me like he's

severely deprived, probably didn't go to

birthday parties, probably wasn't

socialized properly. This is like kind

of Romanian orphanage stuff where many

years ago there were a bunch of Romanian

orphans that got basically like they

didn't have sufficient caregivers. So

that while they were fed and stuff like

that, no one could play with them, no

one could interact with them, and they

were just developmentally stunted. He

doesn't know how to be friends. He's

like an alien trying to be human. That's

his biggest thing, right? So, if you

look at the way that he relates to

people, why does he put up with who's

that guy? Packer. Why does he put up

with Jan? Right? These are people who

are abusive to him and he craves their

attention. So, people will say this is

low self-esteem. Sure, low self-esteem

is a part of it, but it runs deeper than

that. What is the origin of the low

self-esteem? The origin of the low

self-esteem is that he never had

connections to begin with. He doesn't

know what a real connection even looks

like. So, he has this idea, okay, Jan's

got big tits, so I want a relationship

with this person. Todd Packer gets laid

a lot is misogynistic. That's a real

bro, right? Whereas he has he has

loyalty chasing after him in the face of

Dwight. But Dwight doesn't fit his

image. So he lives his life trying to

live up to images of what relationships

look like and he chases those things.

And that's what becomes so hard for him

when he's in this like basically toxic

relationship with Jan. It takes a bunch

of women to kind of tell him time and

time and time again like, "Hey, this is

not normal. This is not healthy." Right?

and she like sells his car and starts a

candle company and like the dinner party

thing which is one of the scariest

episodes on the planet really hard to

watch really shows what he's looking for

he's looking to be something great he's

looking to be respected looking to be

admired that's why he does Scots tots

right so this is a good example of he

doesn't know what a relationship even

looks like really because when he has

the opportunity for them he kind of

messes it up and when he has the

relationships he engages with are based

on his idea of a relationship and this

is something that's like really

challenging because Like you know we we

talk about this some in in in the guide

to love, sex and relationships where you

know we all like one of the biggest

problems with like dating and mating and

making friends today is that we are all

trying to live up to our idea. What do

you want? I want 6 feet 6 figures 6 in.

I want 32 15 32 or whatever. 36 14 I

don't even know what they are. Right?

This is what I'm looking for in a woman.

She needs to be subservient. She needs

to be this. We don't we we have this

idea. It's like Michael Scott is a is a

prophet of what the world will become.

And now we're there. We have these ideas

of what friendship are. We have these

ideas of what relationships are. We

don't even know how to form genuine

relationships anymore. So instead of

what we do is we have criteria instead

of connection, right? It's really scary.

Like this is just one of the interesting

things that when I was doing research

for the guide, we explain all of this

stuff like how does an actual

relationship form? So staggering blow

mind-blowing statistics. And I'm not

talking about percentage of people who

are virgins. Here's a mind-blowing

statistic. I'm going to ask you all a

question. How many hours of contact does

it take to make a friend? Right? Some

people are saying 1 2 3 5. So the

average amount of human contact to

become friends according to research is

50 to 200 hours of contact. Now, there

are absolutely situations where you meet

someone at an anime convention and

you're like, "Oh my god, brother from

another mother, sister from another

mister. We're like instant kindred

spirits." And I felt those connections,

too. But if you look at the research,

this is why everyone's like, "Oh, go to

like join a hobby group." And like I

joined a hobby group two months ago. I

go once a week for two hours. I still

don't have any friends. And it's like,

yeah, if you go for two hours once a

week, that's eight hours a month. That's

16 hours in two months. you're not even

at the minimum. It takes 50 to 200 hours

of contact. Contact, that's the other

thing is you don't have to have some

sensitive interaction. You need to be

around each other. So, if you look at

like making friends at work, you make a

friend at work after you go at the end

of the month. You're at work for 40

hours a week. About 6 weeks into work,

you make a friend. That's completely

normal, right? We don't make friends

like within the first week. Sometimes we

do, but sometimes, oh, like, yeah, we've

been working together for about 3

months. That's when we started hanging

out. And it turns out that we're like

actually really then over the next year

we became BFFs. So a lot of stuff around

dating relationships, how the stuff

forms, it's like we don't know the

science behind it. So like once you

understand what really creates

relationship formation, that's what

we're trying to help people with. And

Michael Scott would benefit from the

guide for sure, right? Because we would

teach him the fundamentals of how do you

make friends? What is an inside joke?

How do you flirt? Right? Michael doesn't

know how to flirt. Like what is we've

got a stream coming up science of

flirting, right? We're going to teach

people like how to flirt. He needs to be

He's actually the quintessential he he's

the one who needs to watch it. We could

have helped Michael a lot, but that's

his that's his diagnosis. I think he's

developmentally stunted. So, his sense

of self-esteem, his He's not like he's

like a 40some year old dude, right? But

he's not a 40 He doesn't act like a

40-year-old dude. He's developmentally

like 19 or 20 or 21. He's like a

freshman in college. That's what M

Michael is developmentally

psychologically developmentally stunted

is his diagnosis. And the cool thing

about Michael Scott is that you can be

developmentally stunted in one direction

and still be amazing in a different

dimension. So, he's been a salesperson

for 20 years and he's grinded sales and

he's leveled up sales. Sales is a

specific skill that he's really good at,

right? Which is why he can close deals

like nobody else. Has one of the best

How can someone so incompetent have such

a successful branch? It's because he's a

beast at selling. He knows how to sell.

And even what's really interesting in

the show is when they show him selling

things, he is a different human being.

He's not the same Michael Scott. He's

like a completely different human being.

That is also really common in people who

are developmentally stunted. Just

because y'all are 30-year-old virgins

doesn't mean that you aren't amazing at

something else. You can be incredibly

competent and proficient at League of

Legends, at Minecraft, at Dota 2, at

something else. All right, who do you

all want to do next? It feels like

people want to do Saul. Okay, Saul is

interesting. So, I think Saul is the

quintessential survivor. First thing

about Saul is that he grows up in a

situation where there's a golden boy and

a black sheep, right? So, he develops a

sense of identity and and this isn't

just him. This is his older brother,

too, right? There's the person who's

really really good and then there's

Saul. There's the high-powered attorney

and there's the guy who's this Jimmy

who's only good at delivering mail,

right? So Saul, first thing to

understand is that from like an IQ

perspective and capabilities

perspective, Saul is just as good as his

brother, right? He's got the gumption,

he's got the intelligence, he's actually

brilliant, but he's been told that he's

not. Like maybe he's got ADHD, I don't

know. But I think like I've seen this a

lot with like ADHD, right? where it's

like the scary thing if you have ADHD is

you can have normal IQ, you can have

high IQ and you can even recognize that

you're just as smart as everybody else,

but you've got a deficit. You've got in

the case of ADHD and attentional

deficit. I don't think Saul necessarily

has ADHD. His frontal loes developed

more slowly. That's absolutely something

that he's got. Right. So, we look at

Saul, what happened early is that he

he's impulsive. He takes risks. He

doesn't think through things. He gets

enamored with how things could go

instead of really gauging the risk of

how things could go. Right? So he's like

he sees the glasses not half full. He

sees the potential of the glass being

completely full when it's only 10% full.

He bets on the long odds. So if anything

like he's probably got some combination

of frontal lobe developing slowly,

right? So he makes poor decisions. He

may be almost like a little bit of a

gambling addict, right? where his like

risk threshold is really low. Like he'll

take big risks and hope that things work

out well. And this too can be related to

his upbringing because when when a child

is not given love, support, and respect,

sometimes what they can do is fall into

dreaming. And this is Saul's biggest

problem. He has dreams. He has dreams

and a poor ability to assess risk. So

he's always like he's a big dreamer. I'm

gonna be with my brother working at the

law firm. I'm gonna go to night school.

I'm gonna be the golden boy. He has an

image of the golden boy. And if I work

hard and if I do this, I can fulfill my

dreams. My dreams is going to be the

respect of my brother. I'm going to no

longer be the black sheep. I'm going to

be a somebody. I don't want to be a

nobody anymore. And so when you combine

this golden boy, black sheep, right?

This creates the idea of a dream. I want

to be I don't want to be this. I want to

be this. I'm gonna bridge that gap. And

then what you do is you take that idea

and then you add his like basically

gambling addict kind of brain, frontal

lobe impaired brain. Ability to assess

risk is impaired. Ability to see up

upside is also impaired. He only sees

the upside. So then he makes a lot of

bad decisions. But he's smart. He's

adaptive. He's capable. He's scrappy.

Another feature of ADHD, people with

ADHD thrive in chaos, right? So, I don't

think he's got ADHD, but he's got he's

like subclinical ADHD, maybe where once

things get chaotic, right, normal human

beings are overwhelmed by chaos, but

Saul is resilient. He finds a way. He'll

slither to where he needs to go. Okay?

So, and this is what's really cool about

Saul, right, is he is capable. He's

brilliant. And so even though he he kind

of like create like his story is one of

creating these situations for himself

and then he squeezes out of them and

then he creates them again and he

squeezes out of them. Saul is a really

good example of someone who doesn't

learn from his mistakes. His capacity

for this is a really interesting he

probably has this deficit too.

Counterfactual thinking. There are two

features that we're going to talk about

counterfactual thinking and something

called errorreward processing or reward

processing errors. Okay, so our brain

has a capability where when we make a

mistake, it goes back in time and

hypothesizes an alternative future.

Okay, so a really good example of this

is, you know, when when you get a meal

from your waiter or waitress and they're

like, "Enjoy your meal." And you say,

"You too." Or when this I do this, I'm

boarding my flight and the gate agent

is, "Have a good flight." And I say,

"You too." They're not going anywhere.

They're not eating anything. So I make a

mistake. And when I make a mistake, my

brain tortures me that night. Oh my god,

you're so stupid. Why did you say that?

They're not going anywhere. That's not

bad. That's good. That's how we learn

not to do it again because we feel

stupid about it, right? So there's this

capacity in our brain that when we make

a mistake, we thought something was

going to happen and it turned out

something else was going to happen. So

our reward prediction error, we

predicted a certain reward, we didn't

get that reward. So then our brain is

like, wait, hold on a second. We

miscalculated. We need to adjust our

calculation. And people who struggle

with addictions, this part of the brain

doesn't work well. Which is why like

when they lose a bunch of money

gambling, like they just wake up the

next day and they do it again, right? So

he's kind of like this closeted gambling

addiction kind of person. So his ability

to learn from his mistakes is not great.

He learns some things, but he doesn't

learn some of the fundamentals, which is

like, "Hey, Jimmy, just do things

slowly." If Jimmy learned patience, his

life would be so much better. And then

we see another thing with Jimmy which is

that he doesn't want to be patient.

Right? And this is the real scary thing.

There is what makes us successful and

there is our vision of success. And

Jimmy is attached to his vision of

success more than he is to actual

success. Right? He wants to do it

flashy. He wants to do it impressive. He

wants to do it he has this this

opportunity to be a partner at a law

firm. And they recognize they recognize,

"Oh my god, this guy is brilliant. We're

going to make you partner. You brought

in this huge case. This is really

amazing work. Here it is. Everything

that you've wanted, respect, support,

money. Here it is on a silver platter.

We recognize your ability. And what does

Jimmy do? Sabotages. This is really

important to understand because this

happens all the time. See, we have

certain psychological needs. And what

happens is we think about solving those

psychological needs through external

behaviors. So what does Jimmy want?

Jimmy wants the respect of his brother.

That's what he wants, right? And right

now in the manosphere because we're

talking about dating and relationships

and and sexy, right? This is sexy May. I

see this all the time in terms of

relationships because I work with some

people and they'll be like, "Okay, you

know, I'm a virgin, therefore I'm a

loser." And if I get laid, that means

that I'm a I'm a winner. I want to be an

alpha. I don't want to be a beta. So,

what starts to happen is we have a

psychological need. I feel like a loser.

And we equate it to an external

performance. Okay? So if I get laid that

means I am a good person. That means I

have value. A man's value is his body

count. Right? So we have some of these

attitudes. But do you guys see how the

basic issue here is that there's the

action up here and we are associating

that action with a psychological need

down here. This is what Jimmy does. And

then what happens is even if you get

that thing, it doesn't solve the

psychological problem. And then you end

up sabotaging up here. See this all the

time in relationships. You are looking

for the relationship. So there's a

there's a video that we have about what

are the risk factors for an unhealthy

relationship. And one of the key risk

factors is the moment that we use a

relationship to satisfy needs that are

outside of the relationship. So

relationships can be a great form of

self-esteem. They can be a great form of

like financial support, right? But the

moment that we start dating someone

because we need them for self-esteem

because in order to feel like a

successful person, I need another human

being. Now, there is a pressure on the

relationship that transcends the

relationship itself. You are bringing

something to the equation. And if y'all

have been, if y'all have dated someone

who's done this, you felt the emotional

baggage, the pressure. You're like,

"Hold on a second. you are wanting me to

be all of like you're trying to turn

this relationship into some vision of

your dreams where like that's not what

this is. I'm a human. You're a human. We

have something beautiful here, but you

can't turn this thing into some dream.

Like it's not working. Like you have

some fantasy that you're trying to play

out. This is what I'm trying to say. You

have a fantasy that you're trying to

play out in this relationship. And Saul

has a fantasy he's trying to play out in

this job. And so the really cool thing

is we feel trapped in these situations,

right? Because nothing makes me happy.

This is where the cool thing, this is

the great thing. As a psychiatrist, what

do I do? I help people with the

psychological needs. We actually solve

the psychological needs without the

surface level actions, right? So, I help

people develop a sense of self-esteem

and confidence without getting them

laid. And then the really cool thing is

once we solve those psychological needs,

then the stuff up here starts to work

out because we're not putting that extra

pressure. We're not self-sabotaging in

terms of behaviors because we feel

fulfilled in here. There's a a beautiful

quote that I I I saw today. I was

reading a book about trauma and the soul

and and it's written by this guy named

Colshed. I I don't call shed. I don't

know how to pronounce his name. It's K A

L S C H E D. And one of the things that

he's a he's a psychoanalyst. And one of

the things that he talks about is that

relational problems must have relational

solutions. Emotional problems must have

emotional solutions. If a rightbrain has

a problem, right brain has to fix the

problem. You can't fix a right brain

problem with a left brain solution.

There's no amount of intellectualization

that will substitute for feeling loved.

Core thing. And so for y'all out there,

this is what's so scary about

relationships is if you've got a

psychological hunger, if you've got a

psychological need, if you have a need

for self-esteem, build that thing on

your own, right? And relationships can

be a very important part of it. I'm not

denying that. That's the one of the most

important places that we get self-esteem

is from our relationships. But his

biggest problem is that he's got

psychological hungers that need to be

addressed. And then he's got some

constellation of poor risk assessment,

poor ability for counterfactual

thinking. He doesn't really learn from

his mistakes. Thrives in chaos. Trauma

bonding. Yes, that's what helps people

fall in love. Okay, let's talk about

Levi. Okay, so everyone says Levi has

OCD because he's very obsessed with

cleaning. And I think um Levi is a

really really really good example of

clinical thresholds. So Levi will get

bent out of sh No, actually he gets

upset like there's this you know image

of him where he's got his his sword or

whatever his blade and it's like covered

in blood and he's like this is

disgusting and when he has this house

fortress or whatever, right? Like so he

has all of his uh pupils like basically

obsessively clean it. So he's

obsessively clean. Does Levi have OCD?

And we'll we'll ask Dr. McGrath if he's

familiar with Levi. But you know my take

is that sometimes we forget that a

diagnosis involves impairment of

function. So everyone has some degree of

anxiety. That doesn't make it an anxiety

disorder. Everyone has fluctuations in

mood. That doesn't make us bipolar. So

the first question that we have to ask

ourselves if Levi has OCD. So is he

clean? Yes. Is he obsessively clean?

Yes. Can he put himself in dirty

situations? Also yes. Does he regularly

put himself in dirty situations? Also

yes. Does being in dirty situations

impair his functions? Absolutely not. He

is grossed out by Titan blood on his

sword hilt. But he will chop Titans

right, left, and center all day. Right.

So I think he's a really good example of

sort of like subclinical

OCD tendencies. Is he somewhat of a

germaphobe? We don't actually know. So,

so this is where I think there are like

other features of OCD, right? Is he

willing to share food with someone? Like

maybe it's not super clear that like,

you know, he's clean and he's

obsessively clean, but he doesn't seem

to have an impaired function, right? So,

he can he can get dirty without a

problem. Whereas some of the people, you

know, I once worked with a a patient

with OCD or not worked with a patient,

but I I was learning about OCD from an

OCD expert in residency and they were

telling me about a patient that they had

worked with where like this person was

so scared of insects that they started

to like dig a moat around their bed and

then they filled the moat with like

toxic stuff so that insects could not

physically crawl across. So Levi, I

think, is a really good example of

someone that when people say he's OCD, I

don't think he is. I mean, is he

obsessively clean? Sure. But I don't get

the sense of compulsions, right? So this

is where a lot of people don't realize

that a compulsion is some kind of ritual

you either do in your head or in the

outside world that alleviates the the

thinking in his head. I don't think we

see that with Levi. So I I don't know if

he meets criteria for OCD.