This is the whole problem that everyone

makes. Anytime we have a problem, the

first thing that we do is we try to jump

to a solution. If I'm unhappy in life, I

need to make more money. If I'm

struggling with dating, I need to be

sexier. It's a concept that I call toxic

fuel, and that will never work. Because

if I give you a glass of water, and then

I piss in it, and then I add sugar, it

doesn't remove the piss. Because no

amount of building something good will

remove something bad. In order to change

behavior, what you need to do is

save trees.

Dr. K is a Harvard-trained psychiatrist

and former monk specializing in modern

mental health, blending neuroscience

with real-life wisdom to help millions

of people unlock their true potential.

There's a loneliness epidemic, social

anxiety is increasing, and falling in

love seems harder. But we have all the

answers. The problem is that everyone is

doing the wrong things now. First of

all, talking about our problems can

absolutely make things worse, because

there's a particular way we have to

talk, but we're not taught how to do

that. The second thing is that we are

struggling to fall in love, and that's

actually because we're exhausting our

dopamine through things like devices.

Yeah, people don't realize. And then the

rise in social anxiety is because

everyone is texting. So the parts of our

brain that reassure us in social

situations are starting to rust. So

there are core things that we have to

start doing. So the first is that

Dr. K, why don't people achieve their

goals?

Now, this is really interesting. There

are two kinds of people in life. There

are people who like, I'm going to

advance towards my goals, and then there

are the rest of us who are like, you

know, I'm trying to be like these people

who are productive, but I'm going to do

nothing. And trauma is the big

difference here.

Really?

Yeah. And this is what tends to happen.

So

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Dr. K,

if you had to summarize

what you do for people

professionally,

how would you summarize it?

I help them understand themselves.

And now expand for me what that means.

Yeah, so so here's the thing, right? So,

there are two great traditions that have

taught us about how humans work. One

tradition is spirituality, which we've

had for a couple thousand years. The

other tradition is science, which we've

seen an explosion of, especially in the

fields of like neuroscience and

psychiatry, over the last 20 years.

And so, these are the two places that

human beings learn about themselves. So,

when I work with someone, what I try to

do is draw on both of those traditions,

and I especially focus on the area of

spirituality that has scientific

verification.

And teach people like how they work.

So, in the same way that if we think

about like, you know, when you buy a

car, you have like a manual that is in

the glove compartment that tells you

what everything is and how it works. The

problem is that in life, like we don't

have that manual for ourselves. But, we

do have these two great traditions that

can teach us so much about this stuff.

And so, what I try to do is basically

translate those two traditions to an

individual, the situation they face, the

challenges they face, and the goals that

they want to achieve.

And what experiences and work are you

drawing on

to arrive at the conclusions and the

support that you give people? What have

you done in your life? What experiences

have you had? How many patients have you

seen?

The first experience that I draw on is

my own. So, I struggled a lot in high

school, college, failed out of college,

was addicted to video games, had no idea

what I wanted to do with my life. Then I

went to India at the age of 21 to find

myself. And I found myself. I spent

about 7 years studying to become a monk.

Um so that was very, very formative in

helping me see how human beings work.

But then I was really like kind of

skeptical a lot of a lot of that stuff.

So I started doing neuroscience research

for a couple years. I had a couple of

spiritual experiences and I was super

curious like what is happening in the

brain?

I'm starting to change as a human being,

but like that has to be at a

neuroscientific level as well.

Then I ended up going to medical school.

So I was thinking about how can I learn

the most about human beings?

So I considered doing like a PhD in

neuroscience, but I ultimately went the

medical route because, you know, the

brain exists within the body.

Um became a a doctor, um became a

psychiatrist cuz the mind was my

favorite organ. Um trained at Harvard

Medical School where I was faculty for a

few years. And then, you know, over the

last couple of years I've focused a lot

on addiction psychiatry.

And also like performance-based stuff.

So once we understand, okay,

I once had a patient, for example, who

came in after about 2 and 1/2 years and

was like, "Dr. K, I'm still depressed."

And then I assessed them, right? So when

when someone has like a mood disorder,

they have like depression which causes

them problems in their professional

life, causes them problems in their

personal life. And I asked them, "Are

you having problems in your professional

life?" And they're like, "No."

"Are you having problems in your

personal life?" They're like, "No, but I

still feel the same." And that's when I

told him, I said,

"Mike, you're not depressed, you're

unhappy and there's a difference."

And then he turned to me and he's like,

"Well, what do we do about that?" And I

was like, "I don't know, but let's see

if we can figure it out." So really the

work that I do is on that whole

continuum of pathology where something

within you is broken.

But then going from -100 to 0 is what

medicine does.

Right? A doctor is not going to help you

become healthy, they're going to remove

sickness.

And then from zero to positive 100 is

when we really draw on things like

spiritual traditions. Because

meditation, if you look at like the

teachings of the Buddha,

the Buddha was not using mindfulness to

treat social anxiety disorder. He was

using mindfulness to attain

enlightenment, to attain the heights of

human perfection. And so that whole

continuum is where I work.

It's so interesting. You mentioned there

the case of Mike. He came to you and he

had self-diagnosed his situation. And

I'm not surprised, frankly, because of

the world we live in now, there's a lot

of people calling a lot of things

depression and anxiety. We kind of use

that word quite flippantly when we go

through different moods and situations.

How do you think the whole mental health

and psychology sort of revolution we've

seen over the last 10 years and the

TikTok application of mental health has

led us astray?

So, I think, um, there are some things

that are good about it and some things

that are problematic. So, I think the

really good thing about it is that there

is a lot more awareness of mental

health. So, we now realize, so what I

used to see about 10 years ago, right?

When I was seeing patients, is like

people would come in and they would not

realize that this is a problem that can

be fixed. So, people would come into my

office and they'd say, "I'm a loser.

Other people are able to get out of bed,

they're able to have discipline, they're

they're productive, they're happy, but

I'm a loser, I have no willpower, I'm

pathetic, I can't get people didn't

realize that that was depression."

I've worked with so many people who have

adult diagnosis of ADHD, which, many

years ago, you couldn't even be

diagnosed as an adult. ADHD had to be

something that was kind of like a

pediatric diagnosis.

So, now I think the the best thing is

that people recognize that, "Okay, maybe

this maybe what is wrong with me is not

like me. I'm not fundamentally broken in

some way, but there is some kind of

process going on in my brain, in my mind

that is responsible for my problems. And

if I fix that, then I can be well.

Now, on the flip side, what started to

happen is no one on the internet

understands the concept of differential

diagnosis.

So, everyone is like, "Oh, I have a

TikTok that if this if you sometimes

forget your keys, you have ADHD. If you

are happy in the morning and sad If you

have a kid who throws temper tantrums,

they're bipolar." So, everyone is taking

a symptom and jumping jumping to a

diagnosis. Whereas, like literally half

of what we learn in med school and what

we do as doctors is Everyone thinks it's

about treatment. It's about differential

diagnosis. It's about understanding that

if you lose your keys, there are all

kinds of reasons for that. If you have

difficulty getting out of bed, maybe

it's depression, maybe it's trauma,

maybe it's ADHD, maybe it's anemia,

maybe it's obstructive sleep apnea.

And so, the biggest problem is that

everyone is jumping to a conclusion on

the internet, which then causes problems

because that may not be the right

conclusion.

We spoke last time about men.

Yeah.

Um and there was a lot of discussion

around just this this wild difference

between how men are feeling in the world

and how they're being understood in the

world versus women.

We Before we started recording, you said

your thoughts have developed even

further since we last spoke on that.

Yeah, so I think um there are a couple

things to understand.

So, the first is that if you're a man

who's struggling in the world today,

we as men assume that if we're

struggling, we need to fix something on

the outside, right? So, if I am not

making enough money, the answer to that

is to get some additional certification

or become more

productive, maybe use some kind of

supplement, so that men are

fundamentally different because we are

conditioned, and this could be somewhat

biological, but it's certainly societal,

to solve our problems externally.

But the one overwhelming thing that I've

learned about men is that, you know, if

you're a man who wants to get better,

90% of what you need to do is not

outside of you. It's actually inside of

you. But, this is not where men look,

right? We we think like, okay, I need to

get this kind of car, or I need to get

sexier, I need to be able to bench twice

as much. So, we always look to things

outside of ourselves. But, in the

majority of the work that I've done with

men,

really the work that they need to do is

internal. But, we're not taught how to

do that. There's a really great example

of this. So, if you look at the top 1%

of earners versus the top 10%. So, the

top 10% of earners on the planet have a

higher IQ than the top 1%.

The people who actually make the most

money

have a lower IQ than the the quartile

right underneath them. And the big

difference there is that people in the

top 1% have a very high EQ. So, we

grossly underestimate

the capacity to control oneself. And if

you really want to achieve the most in

life, that's what you really need to

focus on. And the more that I work with

men, I this is basically what I teach

them, and the outcomes that I see are

amazing. Right? We're talking like on on

the worst end, you know, I worked with a

32-year-old guy who started using drugs

when he was 13 years old, poly-substance

use, mostly opiates and heroin.

Uh so, at the age of 32, no job,

um not living on the street, crashing

with his girlfriend. And then, within

the span of 4 years, this guy became a

therapist himself, had a stable income,

got married, and published his first

dystopian fiction novel.

So, we're talking about a 4-year span of

like being literally a heroin addict to,

you know, being a published author and

like having a stable, fulfilling

relationship and job. And all of that

work is like internal. It's about

understanding the way that you work,

understanding the way that your brain

works, and learning how to control

yourself.

Is that the same for women, though?

Because I've got women friends who are

same age that are really, really

struggling, have

They're not doing heroin or drugs or

anything like that, but they're the

objective sort of situation of their

life is they're so far from all of their

goals, no partner, feeling lonely,

unhealthy, and seemingly out of control.

Yeah, so I've worked with plenty of

women for whom that is a problem, as

well. But I think if we look at on

average, right? So remember that like

within any population of men and women,

there's going to be more variance

between women than there is between men

and women.

Sure.

So I absolutely the case for a lot of

women. I think the big difference is

that a lot of the tools that we have

were sort of designed with women in

mind. A great example of this is like

psychotherapy or talk therapy. So if you

look at the gold standard of how we

process our emotions, it's verbally.

Now, studies actually show that if you

look at like estrogen, estrogen has a

very, very interesting effect on

awareness of your internal emotional

state and the ability to articulate your

internal emotional state. So as estrogen

rises, you literally feel emotions more.

So this is why men women will have uh

problems like premenstrual dysphoric

disorder, PMS, you know, when there are

these hormonal fluctuations, it's not

that we should treat them poorly or

anything like that, but they actually

literally feel emotions in a more

intense way because of the fluctuations

in their estrogen level.

So

It's like like that's like scientific

fact. It's not like it's not good or

bad, right? It

It's just something that's a fact. So

the higher your estrogen is, the more

emotional awareness you'll have. So

there are some biological factors, and

then there's also like if you look at

the way that women are conditioned,

they're conditioned to be good

listeners, to provide emotional support

for the the men around them. And so they

they use they're a lot better with that

verbal fluency, like that's not even

related to emotions. You can look at,

you know, boys and girls who are 8 years

old, girls will have a higher level of

verbal fluency than boys do at the age

of 8. So, there are a lot of things in

our mental health system that rely on

being aware of your emotions, being able

to articulate your emotions, using words

to process your emotions.

And so, absolutely they can learn more

about themselves. I think 99% of human

beings on the planet, myself included,

can benefit from learning more about

themselves. But, I think that women have

somewhat of a leg up, which is why women

are 70% of patients who seek

psychotherapy. Right? Even 70% of

therapists are women. So, there there's

like a a very clear gender gap in the

field of mental health.

So, going back up the river then, so the

crux of the issue is not being able to

control oneself essentially.

I will control is even a step too far.

Crux of the issue is not understanding

yourself, right? Good diagnosis precedes

good treatment. Control comes later.

Okay. So, first you need to understand

oneself.

Absolutely.

And how do I go about understanding

oneself? In in the case of the gentleman

you mentioned as the case study there,

how did he go about understanding

himself as a heroin addict who had poly

substance abuse to the successful

person?

So, I think the best place to start, I

know it's going to sound kind of simple,

but is to look at yourself.

So, what a lot of us do is

anytime we have a problem, the first

thing that we do is we try to jump to a

solution. So, if I'm unhappy in life, I

need to make more money. If I'm

struggling with dating, I need to get a

better job or be sexier or whatever. So,

we tend to jump to solutions. So, I

think the first thing that you've got to

do is slow a little bit down and look at

yourself. And when you look at yourself,

there are a couple of things that I

think a lot of people really miss.

The first is what drives a lot of their

behaviors.

So, we focus so much on fixing a

behavior, like using heroin for example,

right? But, we don't really ask

ourselves, why am I using heroin in the

first place? Where does the drive for

using heroin come from? And that is the

key question, right? So, it's not about

how you need to change. It's about why

am I the way that I am? And this is

where people make such a simple, simple

mistake.

I'd say the majority of people that I

talk to,

when they look at themselves, they don't

actually they're not critically

thinking. What they actually do is

they'll make some kind of conclusion,

I'm lazy. So, like think about what that

means. Like laziness, first of all, is

like not a thing. There is not like a

laziness circuit in the brain. You can't

measure laziness. Laziness is a lazy way

of looking at laziness. If we look at

human behavior, motivation, discipline,

things like follow-through, willpower,

these are all discrete functions within

our brain, and then we just say, "Oh,

we're lazy." But, which one of those

things is lacking? So, as we understand,

okay, why are we lazy? What does that

really mean? Where is my motivation

coming from? What is the status of my

willpower?

Um you know, as we explore these kinds

of things, that's when we see really

what the answer is. And the really cool

thing is if you look at a lot of

research on things like we use this

technique called motivational

interviewing, where

in order to change behavior, you don't

need to convince anyone of anything. You

need to help people understand things.

And once a human being understands

something themselves, they will

automatically change behavior. Right? If

I touch If I tell you, "Hey Steven,

don't touch that that pan, it's hot."

and you touch the pan and you burn

yourself, you won't listen to me. But,

the moment that you touch it and you get

burned, suddenly your behavior will

change on its own. We learn through

experience. But, if you look at the way

that most people try to solve their

problems, it's not through experience.

It's through information. "Oh, I have a

problem, let me buy a book. I have a

problem, let me listen to a podcast. Let

me watch a YouTube video." And this is

what we see, right? There are literally

millions, if not tens of millions or

hundreds of people's millions of people

out there who are gaining a lot of

information about change, but aren't

actually changing. It's wild.

Why is that? Is it Is it a quite complex

psychological thing? Because there's a

certain type of person who is like a

self-development junkie, but they never

self-develop.

Yeah.

They go to all the conferences, they

watch all the videos, they've got, you

know, they can they they know all the

words, but they they don't actually put

anything into action.

Yeah, so there's there's a lot of

subtlety, but the craziest thing is that

see, anytime we engage in some kind of

self-help kind of thing,

it actually is a coping mechanism to

deal with some negativity within us.

So, let's say that I feel like I'm lazy.

So, then my mind looks looks at me and

says, "Okay, I'm lazy. I need to do

something about it." And then it's

really tricky, right? Because you have

your brain sees two options. One is that

I can do something hard, or the other is

I can do something easy. And we have to

understand this, the brain has evolved

to be lazy. The brain has evolved

laziness is efficiency. We want to get

the most yield out of the smallest

investment. So, then what happens is our

brain is like, "Okay, I could like go to

the gym, or I could watch a video about

working out." And if I watch a video

about working out, I will be more

efficient when I go to the gym. There

are all kinds of scams that we run in

our mind to actually activate parts of

our brain that make us feel like we're

making progress without actually making

progress.

That's how you become a self-development

junkie or self-help junkie.

On this point of psychotherapy not being

perfectly designed for men, I was

watching a clip before you arrived, um

where a lady who's an author of a a book

that's just come out said that talking

about our problems makes them worse.

And I was wondering if that's true.

It can be. So, I think this is a big

problem is that talking about our

problems can absolutely make things

worse. So, let's understand a couple of

things.

So, the first is that there's this

assumption that talking about your

problems makes them better. But, there

actually very specific things that need

to happen in order for talking about

your problems to make things better. The

most important thing is something called

an emotional catharsis.

So, this is where you have like a

breakthrough in therapy. So, there's

like this moment where there's a lot of

moment stuff. And Freud even described

this. Where you have this moment of

very, very intense emotion that is

relatively new. All right, I mean it's

kind of dormant, but it's not like

venting. We'll get to venting in a

second. And so, there there's a

particular way we have to talk about

problems that triggers emotional

catharsis. Emotional catharsis creates

something called like a breakthrough.

So, this is also like an experience. So,

this is not just talking about my

problems. This is experiencing my

problems in a different way. So, it's

kind of like touching the hot pan.

Usually, it's kind of painful. So, when

we're doing like work with a trauma

survivor, we don't want to just talk

about the trauma. We want to

sort of dig into it a little bit more

and have an emotionally healing

experience.

Um the the real problem is that

sometimes what will happen is people

will just talk about their problems. So,

they'll use therapy as essentially like

a venting session. And venting, if we

look at kind of the neuroscience of

venting, venting is useful for reducing

our negative emotion in the moment. But,

this is the really tricky thing.

If we kind of think about it, you know,

like I'll I'll ask you maybe you know

this, maybe you don't. But, why do we

have negative emotions, Stephen?

It's a signal.

For what?

It I would guess that it's a depends on

the negative emotion, but I guess it's a

signal

that is there to help us connect with

people.

Oh, okay. So, let's I think it can be,

sure.

Loneliness is a great example of a

signal that's designed to connect with

you. What about something like anger or

fear?

Why do we have fear?

To warn us against impending danger.

Absolutely, right? So, if I'm like

running through the jungle

and I see a tiger

and I have fear, fear gives us

information and what else does it do?

Gives us physiological energy and

releases adrenaline.

Absolutely. And for what purpose?

To

flee.

Absolutely. So, this is a big thing that

people don't understand. The primary

motivator for change is actually

negative energy, negative emotion. So,

this is the problem with venting. If you

vent and get rid of all of your negative

emotional energy, the drive to change

will disappear.

So, if we kind of think about it, what

motivates you the most? It's actually

negative emotion. And you can literally

look at the like the neuroanatomy of

things like the amygdala. So, the

amygdala is very close to the

hippocampus, which is where learning and

memory happen. So, we actually learn the

most through negative emotions. So, if I

if I'm if I've been happily married for

15 years and there's infidelity, right?

One case of infidelity, the negative

emotion from that one case of infidelity

can drastically motivate me. So, one of

the biggest problems that I see is that

we try to get rid of our negative

emotions and in doing so, we actually

hamstring our motivational capability.

So, that I've seen this a lot where

people will come in and they'll go

through

like what they think therapy is, which

is like

Actually same the same guy, Mike.

Came in and he'd like kind of talk about

his problems and I was like, "Bro,

I was like, Mike, is this helping?" So,

I was still a trainee at the time. So, I

he'd been seeing me for about six eight

months and I was like, "You come in here

and you kind of talk about your problems

and but like you're you don't seem to be

getting better." I didn't know how to do

therapy at the time.

And then And like, "Isn't that what I'm

supposed to do is come in and talk about

my problems? I was like, yeah, I think

so.

I was a second-year psychiatry resident,

but I was like, is this helping? He's

like, no.

And I was like, okay, we got to do

something else then. Coming in and just

venting is not actually psychotherapy.

That's not like So, talking about your

problems, reducing your negative

emotional energy can actually keep you

stuck. And if you pay attention to

people in your life, you'll notice that

there are some people who just like

[ __ ] all the time, right? They're just

like constantly complaining, they're

constantly venting, and they don't

actually do anything to change their

life.

It's interesting because with the advent

of social media,

you now get reinforced by deficiency

promotion, I call it. There's kind of

these two types of ways that you can

build an audience or a personal brand.

One of them is idea promotion. These are

my my ideas. This is how I think about

something. And the other that's emerged,

which is really interesting and a little

bit toxic, is like deficiency promotion.

These are all the ways that I'm broken.

These are all the ways that I'm

inadequate.

And you can build an entire audience

around that, which resonate with your

inadequacies. And then that inadequacy

that you you get held there, because

that's the speaking appointments you get

booked to do. That's what your book's

about. Your book is about all the ways

you're broken and flawed, all the stuff

you've been through.

And then you it becomes your your

profession. And I just I watched that

play out so many times. I'm like, I

talked to my friends about it. I'm like,

be careful of deficiency promotion, cuz

you might acci- you might accidentally

build a revenue stream that and then

you're [ __ ]

Yeah, absolutely. I I I think we what we

see is that there's a lot of empathic

resonance, right? So, and I think in

some ways that's a good thing.

So, I think when when I'm a broken human

being,

there are a lot of broken other human

beings. The problem is when you're a

broken human being, you don't feel like

you're a part of society. You're like

broken and everyone else is out there

living their lives and being positive.

And so, it can feel so relieving to

connect with someone else, to realize,

oh my god, I'm not alone.

Right? So, I think with some of these

deficiency promotion, and we see that a

lot in like psychotherapy groups on

trauma and stuff like that, where

there's a lot of like trauma bonding,

and there's also some weird ego there

with like, I'm more broken than you and

my trauma's worse than you, a lot of

toxic comparison. There's a lot of stuff

that can kind of go awry. But I I think

it there's absolutely a reason why

that's a way that you can build your

brand, because there are a lot of people

out there who feel broken and feel

alone.

Mhm.

And I'd rather be broken and with

someone

Yeah.

than broken and alone.

It's all about belonging at the end of

the day.

Yeah.

All of these things are about, you know,

feeling like you belong.

Absolutely.

What role does

dopamine play in all of this? Because we

we talked at the start about taking back

control, but much of the reason, as I

learned from Andrew Huberman, that it's

hard to gain control, is because many of

us are on this sort of dopamine roller

coaster in our lives.

Yeah, so I I think uh dopamine plays an

important role, but the one thing that I

really come to appreciate is that how

little of a role it plays.

So, everyone is like hung up on

dopamine. But dopamine, first of all, is

a neurotransmitter, right? So, dopamine

is also like deals with things like

smooth movement. So, my ability to go

like this is governed by dopamine.

You were waving your arm.

Yeah. Just like so so like anytime you

have a smooth motion, so if we look at

something like Parkinson's disease,

Parkinson's disease is a deficiency of

dopamine.

So, there are there are all kinds of

things that dopamine does. I'd say

dopamine is like a letter in the

alphabet for the brain. We use it in all

kinds of circuits to create all kinds of

behaviors.

So,

dopamine is uh absolutely important,

we'll talk about it, but I think that

there is almost like too much of an

emphasis on dopamine, and we

oversimplify the problem when we focus

too much on dopamine. I'll give you a

really simple example of that. So, one

is

in my clinical experience, it's almost

like dopamine and serotonin have an

inverse relationship. So, dopamine is

what gives us a sense of pleasure.

Dopamine also gives us behavioral

reinforcement.

But dopamine gives us pleasure, but will

not give us contentment. So, I have I've

had plenty of patients who chase

dopamine, right? And we know that, you

know,

partying a lot, using a lot of drugs,

having high adrenaline activities that

all activate your dopamine system,

don't usually leave people feeling

fulfilled and contented at the end of

it.

I've had plenty of millionaire playboys

in my practice who like tried that to

find happiness and maximize the pleasure

in their life, and it doesn't work. It's

never going to work. And the the problem

with that is that our brain has this

principle of tolerance. So, the more

that you activate your dopaminergic

system, the more tolerance you'll

develop to it. This is why people need

higher doses of drugs to achieve the

same goal. This is why people when you

first play a video game, it's a lot of

fun. But hour five, six, seven, eight,

it becomes less and less fun. And then

you have old gamers like myself who are

still chasing the beauty and the high of

the games that we used to play when we

were kids. So, dopamine is almost like a

scam neurotransmitter because it offers

you pleasure temporarily, but in an

unsustainable way.

On the flip side, we have serotonin. So,

serotonin is is associated more with

like contentment and peace. When we look

at things like mood disorders,

oftentimes what we're doing is improving

the serotonin level, boosting the

serotonin transmission in the brain. So,

peace and contentment is very different

from pleasure.

And these two things are almost

inversely proportional where and it's

really interesting. You can look at

something like orgasm, which is a great

example of this.

So,

when you have an orgasm, you get a spurt

of dopamine and you feel a ton of

pleasure. And then after your orgasm,

you actually get a rise in serotonin and

you feel incredibly contented. The

really interesting thing is that if your

serotonin levels are high, you won't

feel horny.

So, like what will happen is is we know

this because if we give someone

serotonergic medication, if we boost

your serotonin transmission, one of the

side effects is anorgasmia and like you

can't have an orgasm. And then you also

like aren't as sexually you're not as

thirsty, okay? So like this is one of

the side effects. This is one of the

number one reason why my patients stop

serotonin serotonergic medication has to

do with the sexual side effects.

But if we kind of think about the

neurotransmitters involved, right? When

we boost serotonin, and we also see this

in monks who are like super content and

peace and they're not very thirsty.

Right? So if we kind of think about it,

peace and happiness and contentment in

life comes from serotonin.

Dopamine is like actually kind of the

opposite. And monks aren't like thrill

chasers, right? They're they're able to

develop this internal sense of

contentment. So dopamine is absolutely a

part of the problem. It's a very

important part of the problem. But I

think that it's like one piece in a in a

larger whole.

Does this explain why people's sex lives

typically get worse when they're

comfortable

and they're married?

Absolutely. It's amazing how much

science can tell us about the formation

of relationships and falling in love

that we just don't apply.

So, being attracted, falling in love,

developing a relationship, these can

discreetly be described

neuroscientifically.

So being attracted actually starts in

the thalamus. So the thalamus is our

sensory organ of the brain. It is kind

of the sensory gateway. So it interprets

a lot of sensory stimuli. So when I

first meet someone, I'm like, oh, they

look really good, right? Looks really

fantastic and I I feel physically

attracted to them. They smell great.

Their laugh is beautiful. So the initial

stages of attraction are all about

sensory input.

Then what happens, now this is what's

really interesting. Falling in love is

actually very dopaminergic. So this is

one of the reasons why I think we're

seeing declining birth rates. This is

why it's like if you talk to people

nowadays, like it's hard to fall in

love. Everyone's dating, everyone's

going out on dates and stuff, but like

falling in love seems harder. And that's

actually because of dopamine. So what

happens is if you look at the phase of

falling in love, what that involves is a

dopaminergic connection. And a great

example of this is like if we're going

to dinner, right? And I put my hand out

to see me and hold my hand. And then

we're All we're doing we're gazing into

each other's eyes and we're just holding

hands.

And then we feel in love. And if you

kind of think about people in love, like

it's like a dopaminergic high because

that's literally what's going on. Now

what you see if you see if you go out on

if you go to a restaurant and you people

watch, which I love to do, what you'll

see is two people on a date both on

their phones.

So what's starting to happen is we are

like developing this dopaminergic

tolerance through things like devices.

We're actually exhausting our dopamine,

which is something that a lot of people

don't understand. We run out of dopamine

because we're using these devices and

then we have none left to fall in love.

And then there are later things in the

relationship that are more serotonergic

in nature where it's not as much about

pleasure, but it's about connection and

all kinds of other stuff.

So what does that mean if I'm single

and I'm looking to find love?

So if you're looking to find love,

there's this is where we have start with

diagnosis before solutions, right? So

the first question is, do you have

trouble falling in love?

Do you cuz a lot of people who are

single are like, oh like I don't feel

anything, right? I don't feel a

connection. This is something that I've

heard so much from our community, so

much from patients anymore. I just don't

feel a connection. They seem great on

paper, but I just don't feel a

connection. There's actually

neuroscience behind how to form a

connection, too.

Um but what what the first question that

I ask people is, okay, do you feel like

you just can't feel an emotional

connection to people? Then what you

actually need to do is reduce your

dopamine activation through things like

cell phones. Uh we see this also with

pornography where we know that

pornography correlates with like

unhappiness in relationships. And that's

probably also like a dopaminergic effect

as opposed to all the other things.

There's a lot of stuff going on there.

So play fewer video games, be on your

phone less, and especially before you go

on a date, you want to like give your

dopamine a chance to recharge. So go on

a walk for about 1 hour before you go on

a date, and then your literally your

brain's capacity to engage in a date and

fall in love and activate those feelings

is going to be higher.

Also, I'd avoid as much dopaminergic

activity as you can before the date,

before you see that person. And the more

that you do that, the easier it will be

for you to actually fall in love.

Am I right in thinking from what you

said there that dopamine is required for

us to initiate sex and want want to have

sex? Is that what you were saying?

Yes and no. So, dopamine is not actually

required to initiate sex. It's so so

fascinating. You can like So, I tried to

figure this out. Like where where how

does love work in the brain? It's like

every circuit is involved. Every

neurotransmitter is involved. Um so,

dopamine is what gives us the pleasure

of orgasm. But initiating sex also for

men and women is somewhat different. So,

like you know, women will say like, "Oh,

foreplay is really important." Right?

And dudes are like, "We don't need a

whole lot of that." And so, the question

is why? So, this is what's really

interesting. So, to develop an erection,

you actually need activation of the

parasympathetic nervous system, which is

the part of our nervous system that

involves rest and digest, which is why

we have morning wood, right? So, when

dudes wake up in the morning, we have an

erection. Why? We're not like horny in

the morning. Well, I don't think so

anyway. Maybe, who knows? But like it

there's a physiology to it, right? Where

when we're relaxed, we'll develop an

erection because the the

development of an erection actually

involves relaxation.

And then the sexual act involves

transition to the sympathetic nervous

system. Now, this is the fight and

flight kind of response. So, what we

want to do is like we want to be relaxed

first, and then we start getting sweaty,

our heart rate increases, blood pressure

increases. And this is the other thing

that a lot of dudes don't understand

because our ours nervous system is a

little bit different. So, when it comes

to women, they have the same thing going

on where they need activation of the

parasympathetic nervous system before

they get activation of the sympathetic

nervous system. And then as you activate

the parasympathetic nervous system with

something like a massage or making out

or something something like that, some

playfulness, relaxation. People really

need to feel safe.

Then you can sort of graduate to the

more explicit sympathetic nervous system

sexual act.

This has answered so many questions that

I had that I've never sort of vocalized

because I didn't realize the issue, but

I have come to learn that

I am most aroused when I'm not stressed

in any way. But I don't just mean

stressed as in like uh stressed. I mean

if it's Friday night and I've just come

back from work and I've got home at 9:00

p.m. after a really really long day and

week, I I'm not aroused typically. So,

what tends to happen and like we know

this in my relationship, and it's the

same for same for my partner, is on like

Saturday once I've had time to relax and

I've like chilled down and I've all

those kind of things, then I'm then I

get aroused. Um and there is this I

think misunderstanding between men and

women because we get aroused in

different ways.

Absolutely. Once again, like we're we're

seeing so many problems in

relationships, so many problems in

dating. And and you know, what happens

is like women will get branded as all

kinds of the she's an ice queen or

whatever, she won't put out and like

there's a lot of like toxic misogyny

there. And then men will also get

branded as like oh men only want one

thing and they're they're, you know, so

horny, which can somewhat be true. But I

think this is the kind of thing where

once you understand, you know, how does

the male body work, how does the female

body work, what are the ways because the

majority of us is actually very similar.

So, like the what separates men and

women is less than what we share.

Um so, if you look at for example like

how to create romantic attraction on a

first date, like that's there's a lot of

good like neuroscience data about things

to do and it's not surprising at all

because if you look at what's the trend

in dates, everyone is doing the wrong

things now. Dates are turning into like

interviews, right? Where it's like I

don't know I don't know what I need to

know if I'm going to waste my time or

not. So, we're going to sit down at a

table. Oh, do you want kids? What do you

want this? How much do you like to

travel? How many trips per year? It

almost becomes a negotiation. And if you

look at the science of how human beings

fall in love, it's completely different.

What is that relationship between cuz as

you're describing that dating process, I

just my head I thought god that sounds

stressful. And then I thought of how

expectation generally creates stress. So

whether it's in the bedroom, having an

expectation that we're going to [ __ ]

tonight cuz it's Thursday and it's date

night, or having an expectation when you

go on a date, the impact that that

stress has on your dopamine and your

ability to be like open and receptive.

Yeah, so it's it's it's so interesting,

right? So like I know it sounds kind of

weird, but let's use your example of

it's Thursday and we're going to [ __ ]

tonight. So that can be stressful or

like I don't know if you've been in a

relationship like this, it can be

awesome. Right? So like if I haven't

seen you all week and you haven't seen

me all week and it's like Thursday and

this is the time we've set aside and

like we're finally meeting and we both

are like we're going to [ __ ] tonight,

then it's great. Like you know what I

mean or not so much or I don't know.

No, no, yeah, yeah.

Right? So like this is the key thing

that a lot of people don't understand.

So attraction is not about whether we're

going to have sex tonight or not. It's

that we you and I need to be on the same

page. This is a really fascinating study

that looked at first dates on bridges,

okay? So one bridge is a stone bridge.

One bridge is a rickety wooden bridge

that's wobbly. And what the study found

is that when you have a date on a stone

bridge,

it's like you people feel less attracted

to each other than when you're on a

rickety bridge. Now, what's the

difference? On the rickety bridge, I'm a

little bit scared and you're a little

bit scared. So what what really the the

foundation of romantic attraction is

actually empathic resonance. When I feel

the same things that you feel, when we

both feel it doesn't even have to be

good. It can be negative things, it can

be good things. We just need to both be

feeling the same thing. That's what

creates attraction. This is also why

people fall in love in rehab. Like

literally at the rehabs that I've worked

at, like we have to like almost have a

rule, right? We can't technically

control them, but we're like, "Hey,

no [ __ ] in rehab. So this is going to

we're going to have in because people

will trauma bond, right? We're sharing

all of this deep emotional stuff. You

can be honest, you can be authentic, and

there's someone else in the group who's

also honest and authentic, and you feel

connected. What is the nature of that

connection? It's shared empathic

resonance.

So, one of the biggest things that I

tell people who are, you know,

struggling to succeed in dating is like,

what are the emotions that you're

bringing to the table? What are the

emotions they're bringing to the table?

And if those emotions are not aligned,

how can you do some kind of experience

that creates an emotion?

So, this is also where like movies

aren't necessarily good or bad. The

question is, do you guys like the same

kind of movies? If y'all like the same

kind of movies, and you both laugh a

lot, that's a great date. You don't need

to talk. You just need empathic

resonance. So, whatever you can do to

get empathic resonance will create a

connection.

My brain went in two directions then.

The first question might that pops into

my head was about the role oxytocins

playing in all of that, because I've

heard about this chemical called

oxytocin, which is

there to help us bond, etc. Um and I

remember Simon Sinek saying to me that

when like cities have earthquakes, it's

crazy how much the city comes together,

but and that's he pointed oxytocin as

much of the reason for that sort of

shared struggle. Thinking about your

rickety bridge scenario, life sometimes

becomes a rickety bridge, and people

bond because of that. So, should I be

taking my dates to theme parks, for

example, to terrify the [ __ ] out of them

or watch a

Only if you're equally terrified.

Okay.

So, that's why it's so important, right?

For you to figure out like, what is

something that is going to give us a

shared emotional experience?

Uh okay, so you've got Okay, we've got

to both have the same emotion.

Absolutely.

So, if I'm not scared by it, and she's

terrified,

then that's generally speaking not good.

Now, there are other versions of that.

So, like, you can demonstrate caring,

right? So, if I'm terrified, and you

take care of me,

then that can feel good in a different

way. But generally speaking, like, what

gets us like,

I'm into this person, is that we feel an

emotional connection, right? That's what

I'm like, into this person. They're like

like, what is the nature of the

emotional connection? It's shared

emotion.

So, oxytocin is another phase of the

relationship. So, oxytocin forms

emotional bonds. So, when we feel like

not this And this is what's so

interesting, there's different parts of

the brain, different neurotransmitters.

So, oxytocin is what we get from

cuddling, what we get from different

kinds of touch, something like a massage

can form oxytocin, hugging, holding

hands, all this kind of stuff triggers

oxytocin. And oxytocin will form an

emotional bond, will alleviate feelings

of loneliness. I think one of the

reasons that men are so lonely now

is because we don't feel bonded to each

other. So, oxytocin is more about

forming emotional bonds.

And the other way my brain went when we

talking about that is

a question I've asked a lot of sex

therapists I've spoken to, which is

should we be scheduling sex?

This is such a tangent from where we

started, but um based on what you said,

Thursday night, date night, etc., should

we be scheduling sex? When I ask sex

experts this, they they go in two

different directions. One group says

yes, one group is so passionately saying

no because it kills that spontaneity,

they say.

Um and that, you know,

Right. So, so I think this is a good

example of like this exactly what I'm

talking about, where

we know so much more about physiology

and neuroscience now that the right

answer to that question depends on the

science. So, you can schedule sex, it's

just make sure that you do the things

Are you killing some degree of

spontaneity? Potentially.

Um and but at the same time, like so

what is it about the spontaneity? Like

let's let's tunnel down. I think this is

exactly what we need to do. What is it

that makes spontaneous sex fun, Steven?

Oh, gosh. Uh

[ __ ] Um

what makes spontaneous sex fun?

It is

exciting, novel, it is

Hold on. Who's excited

by spontaneous sex?

Me.

So, and is it going to happen if your

partner is not equally excited?

Well, I think most couples would say

that they much of the reason why their

sex life is not great is because it's

became become boring and predictable and

samey. So, this sort of

spontaneity element adds a bit of

surprise and intrigue and

Now, hold on a second. Okay, great. So,

this is we're going to we're going to

figure out an answer. When things become

samey. So, if I watch like what's your

favorite movie, Stephen?

Mhm, The Pursuit of Happyness.

Okay, so if I watch Pursuit of Happyness

for the first time, how am I going to

feel emotionally?

Oh,

it was profound the first time I watched

it.

Second time you watch it?

Mhm. You know, interesting.

fourth time fifth time. So, the more

that we get exposed to something, what

changes within us?

Our emotional

the emotions change, right? So, the

first time I do something

Yeah.

emotions are activated. When it becomes

habitual, emotions no longer become

activated.

Right.

is the problem of non-spontaneous or

spontaneous sex. Is it it has to do with

that emotional empathy, that emotional

connection that leads to attraction. So,

this is exactly what I'm talking about.

When we look at problems in life, should

couples do this or should couples not do

this? Let's understand the mechanisms at

play and then if we can activate those

mechanisms in the right way, then it'll

work. So, the the issue about

spontaneity is is like, you know, if you

feel like having spontaneous sex but

your partner doesn't, that's not going

to work because y'all aren't emotionally

I mean, they can accommodate you and

that can be fine. But generally

speaking, what spontaneity adds is more

of that emotional connection. So, when I

work with um you know, patients who are

exhibitionistic

right? So, like why do they like

exhibitionism?

What's exhibitionism?

Having sex in public places.

Okay.

So, um it's a it's a kind of fetish,

right? Can get you into trouble. That's

how sometimes how they end up in my

office.

Um but so so what what if you really

look at it like what what it's all about

is emotional resonance. So, if I'm

having sex in a public place, that's

going to activate me emotionally in some

way. It's going to activate my partner

emotionally in the same way. That's why

we do it. So, it all comes down to

emotional resonance. So, the second

thing is that if you're going to have

scheduled sex, so like spontaneous is

great, but if you're going to have

scheduled sex, that's still fine, too.

It doesn't kill the spark. You just need

to figure out how to activate it, right?

So, this is where activation of the

parasympathetic nervous system. Do

something like, you know, give a massage

or even like the sex should come after

some kind of emotional resonance. Let's

go out and watch a movie together or

let's do something that we both find

emotionally Then once you're emotionally

connected, the sex will be it'll be a

lot easier.

I have a friend who has been trying for

a baby.

Uh-huh.

I'm trying for a baby as well, by the

way, but this is not about me. This is

not me like asking for a friend. He

lives in America and he has just had the

news that he's having a baby. Very, very

happy. And I saw him recently and I was

asking him him about the process of, you

know, timing the sex around your

partner's cycle and they'd gone for I

think 3 years trying to have a baby, so

it got increasingly more difficult. All

of the complicated emotions. He was

saying to me, he was like, "Honestly,

bro, like sometimes we were having to

have sex like three or four times a

day." And I was like, "Bro, how do how

do you keep an erect like when it

becomes a job

in that in that context, you're doing it

because you need to try and hit this

egg,

how did you arouse yourself?" And he was

like, "No, I couldn't." He was like, I

I really struggled. I'd lose my erection

all the time. Um

Um and he literally said to me, yeah, he

was he was having sex

40, 50 times a month to try.

And he was basically being ordered to

have sex with her. Like, "These are the

five days you better have sex with me."

Now, you know, that that is maybe the

extreme case of

total dissipation of emotional resonance

as it relates to sex.

Yeah.

And the other case the other end of that

pole would be pursuing someone for the

first time, I guess. A stranger for the

first time.

And I guess the job for people in their

relationships is how do you keep that

emotional resonance.

So, I I think that that's that's exactly

the kind of question. And I think the

first thing is that's half the answer.

Is that a lot of people don't realize.

So, like when people get bored sexually

in a relationship, right? So, we have

two populations of people. Some people

will get married.

Mhm.

And they'll continue to have healthy sex

lives like well into their 70s. Like one

of the craziest things that I remember

encountering in med school was like you

know, when I meet a 70-year-old, I don't

think about sexual health counseling.

And it's one of the biggest mistakes we

make as doctors. Like, you know, when

you have these retirement communities

and stuff, no one's worried about

getting pregnant. You can get outbreaks

of like syphilis and gonorrhea that'll

tear through the community like like

COVID. Like it's crazy. Like we just

don't but sexual desire doesn't

necessarily decrease with age. I know

it's crazy. But we you know, so then the

question becomes, okay, how do you

maintain a healthy sexy sexual

relationship over time? So, at the very

beginning, there are things like

thalamic inputs, right? So, what you see

arouses you. There's some amount of

novelty, which is also like new

emotions, right? So, then then the 10th

time we watch the same movie, our

emotional connection is less to the

movie. But then this is also how couples

have sex over successfully over time. Is

that they do have emotional connections.

So, they as you continue to bond with

your partner over the new experiences

that your relationship has.

So, I think having kids is a great

example. Where like having kids will

destroy your sex drive for some amount

of time.

They say what, 2 years or something?

Uh on on average. But even within that,

it's amazing because you'll find these

moments where like you sort of forget,

right? Like how good sex with your

partner is. And then the stars align and

you have sex and it's actually like

incredibly fantastic. It's like, oh, we

should do that more.

Right? Like that's that's like what kind

of starts to happen. So, over time what

we want to do is really lean into still

that shared emotional connection. Oh my

god, I had such a like I can't believe

that our kid like finally like they're

the fever's gone. They're relaxing.

We're going to sleep and then at like

2:00 a.m. you're going to wake up and

you're, you know, it's going to be

great. Right? But like and so as long as

you maintain that bond, it's totally

fine.

Um when we think about the mechanisms in

neuroscience that drive our behavior

once we're in a relationship, and even

if it's a platonic relationship, um

how do we

keep the relationship thriving? Like how

do we What are the mechanisms I need to

be aware of in the brain and in

neuroscience that are going to enable my

relationship to be strong and thriving,

whether it's platonic or romantic?

You know, cuz we talk about loneliness a

lot and there's so many people that are

struggling with loneliness and it's and

you know, the reasons that we often

attribute to that are the way we're

living our lives or we're behind screens

or social media, but you know, your it

was really illuminating to me that you

were able to point to a mechanism in um

smartphones and social media that is

actually inhibiting us forming

relationships. And I wondered if the

same mechanisms might inhibit us keeping

the relationships that we have.

Yeah, so I think there are so many

things that are going on there. So one

is like how is technology negatively

impacting our relationships? And the

second is how do you maintain a healthy

relationship over time? So there's like

two different things, if that makes

sense. Like what gets in the way? And

how do you how do you keep your tire

nice and full of air versus how do you

uh fix it if a nail punctures it. So

let's start with like what technology is

doing. So this is what technology is

basically doing to our social

connections.

There is a whole scale social skills

atrophy and a deconditioning of certain

parts of the brain when we use

technology. So the first thing to

understand about the brain, this

beautiful thing about the human body,

inanimate objects, the more you use

them, the worse they get.

But the moment that you have biology,

the human brain doesn't wear out, it

rusts. So inactivity of the human brain

is actually what causes problems.

Okay? That's number one.

So, we can look at studies of like

dementia prevention. And what we know is

that encouraging neuroplasticity through

things like learning how to play the

piano at the age of 60 will protect us

from dementia. So, we need to utilize

our brain to make it the strongest.

This also where you can look at the

physical body, right? So, when I when I

think about what causes muscle atrophy

and what causes muscle growth, the more

I use my muscles, the more they grow.

The more you use your brain, the more it

grows.

So, when we look at connections,

if you actually look at human

communication, words are maybe I would

say 25 to 50% of communication at most.

So, you can walk into a room and without

even hearing a single thing that's said,

you can know there's tension in the air.

Something is wrong. You can even like I

remember when I was a kid, I used to get

bullied a lot, right? And I would walk

into a room and I immediately knew that

they were making fun of me. Like all the

conversation would stop and everyone

would look at Like one person would look

at me, I'd see alarm in their face, they

would all see Everyone else would see

the alarm in their face, and they'd look

over and they'd see me and know everyone

would stop talking. I know I'm being

made fun of. So, body language, tone,

volume, this is really interesting. So,

there even video game companies that are

starting to ban people over voice comms.

So, how do you know if someone is

toxically communicating or not? What we

used to do is use like words, right? So,

if you say some kind of racial slur in

chat, like if you type it out, the game

knows to scan for that and then people

will start to get around that. They'll

use an at sign instead of an A. So, now

what they're doing over voice comms is

measuring tone.

Oh.

So, depending on the volume of what

you're saying, right? Like that's how

they're actually detecting toxicity

because that's where toxicity exists.

It's not, "Oh, hey Steven, you're a real

loser. I really dislike you." It's like,

Stephen, bro, you're such a loser, man.

All my god. And even if I say that,

right? It's not negative at all, even

though I'm using negative words. It's

another quick aside. So, men are really

specific for using the negative

expression of a positive affection. So,

this is something that's different about

men.

So, what we'll do is we'll actually say

negative things to a friend of ours to

express approval. Like when someone gets

engaged or gets married, it's like, oh

man, like it's the old ball and chain.

We're going to lose you. You're whipped.

But everyone's smiling. Everyone's

congratulating you. But we just express

it in a negative way.

Yeah.

So, so much of our communication is

tone, is body language, is volume. Now,

what's happening is everyone is texting.

So, then the brain does something very

that it's designed to do. It's like,

hey, we're not using this thing. Let's

lose it.

So, if you don't speak a language, our

brain forgets it. So, as you

This is what a lot of people don't

realize is that there's a rise in social

anxiety. Why is there a rise in social

anxiety? It's because the parts of our

brain that reassure us in social

situations are starting to atrophy. So,

when we don't pay attention to body

language, when we don't pay attention to

tone, those parts of the brain shut off.

And then when I go into a social

situation, those parts of the brain are

inactive. So, they can't reassure me.

Now, what happens is I go to a party

that I was invited to or I go to dinner

with my friends that I was invited to.

I'm kind of sitting at the end of the

table. No one's really talking to me.

And I'm like, oh, like I really

shouldn't be here. These people just

invited me out of politeness. They don't

really care about me. But if your brain

is functioning well, you're able to read

all of this nonverbal communication

that's reassuring.

So, when it comes to platonic friends

and why this is hard, we are atrophying

a lot of the social skills, a lot of

these brain regions that allow us to

form connections, allow us to feel

reassured, allow us to feel safe. Right

now, I kind of feel like, oh, my friends

are inviting me, but I'm bothering them

by going. Like all these kinds of things

we're seeing more and more of.

Are you hopeful about generation Z that

have been connected from birth?

Yeah. So so I I I think that even though

things are problematic, right? We're

talking about how things are negative

and social anxiety is increasing and

suicidal suicidality is increasing. I'm

very optimistic because I think we have

all the answers. Like that's what's so

cool. Like we have a problem

but we haven't been addressing it

directly.

Even between the last time I was here

and now, we've learned so much more

people are taking social stuff more

seriously. The Surgeon General of the

United States released like this this um

a bulletin on lone like the loneliness

epidemic. Right? So even like the

medical establishment is starting to see

loneliness as a problem that we need to

target.

Half of the problems that we see in the

world today is because we haven't tried

to fix them. They kind of crept up on

us. Things like video game addiction,

things like loneliness. Now we see okay,

this is a big problem. So let's start

devoting resources to it. Let's

understand what's going on. And we see

this a lot like even on our community

like where we start targeting a problem

and people do better.

The only reason we're losing the war is

because we haven't been fighting back.

Why haven't we been fighting back?

Technologies

must play a pretty significant role in

in this.

I think we were slow we we're really

good at creating things without

understanding what they will do to us.

Because the impact doesn't show its face

for a couple of decades and

Absolutely. And there's there's a

there's an even more insidious thing

which is right now the since it's

isolation, like since we're seeing more

isolation,

we don't see the impact because

literally these people are staying home.

So the majority of of, you know, young

men for example, like won't ever go to a

therapist, which is why we can't help

them with their problems. They won't

share their problems with other people

because first of all, they don't know

how to

and secondly, they don't even know what

they're feeling so that they just like

feel like they're a loser. So what we've

started to see is that these problems

have been going on for about 10, 20

years, but they're now reaching a

critical point where like we're now

noticing what's going on. But, this has

been going on for a while.

Are people becoming more narcissistic?

Yes.

They are.

Yeah, absolutely.

And what impact is that having?

I don't even know where to start. Like,

so I I think it's affecting our

relationships, it's affecting our

happiness, it's affecting our

professional ability.

I was thinking is social media making us

more narcissistic and is that then

driving us to be more lonely? And if so,

how do we first define the word

narcissism in this context?

Yeah, so I'm going to lean into um kind

of a more yogic definition. So, we have

this this word in Sanskrit called

ahankara. And ahankara means ego. So,

ahankara is your sense of self. I am dot

dot dot. Okay? So, I am tall, I am

short, I am doctor, I am father, I am

winner, I'm loser.

The first thing to understand about ego

is that it is not a real thing. It is an

abstraction.

So, if you were to look at me and you

say if I say I am a doctor,

I know this sounds kind of like kind of

a weird question, but is that true?

Like, what makes me a doctor? I can't

biopsy myself and find doctor. You can't

find doctor anywhere within me. Doctor

is I have a piece of paper on a wall.

That's what makes me a doctor. I have a

license to practice medicine. That's

what makes me a doctor. It's an

abstraction. So, it's not like a truth,

it's like a societal shared delusion

that we all agree that I'm a doctor,

that's why I'm a doctor. Okay? And does

that make sense?

Yeah, of course.

Okay.

So, this is the ego.

Now, what we also know is that from

studies on narcissism that narcissism

has its roots in insecurity.

So, if you think about someone who's

like egotistical and confident, like

Stephen, I'm sure you know both, what's

the difference between the two?

Confidence feels more secure and

egotisticalness feels more insecure.

Absolutely.

Where does a confident person's esteem

come from?

Inside.

Where does a egotistical esteem come

from?

Outside.

Beautiful.

So, this is what's what social media is

doing.

Social media and technology is

externalizing our perception.

So, if I think about it like think about

a couple thousand years ago,

what was my mind focused on? So, I would

go out to hunt.

I'm looking for an animal. I shoot a

deer.

And then I walk 3 hours back.

So, for some amount of time my mind is

paying attention to the external

environment. Maybe I'm talking with the

people that I'm hunting with. But what

is there to say? Like I can't talk to

them for 10 hours a day. There's no

substance There's no

news, right? We're like this tribal

community. So, if you really look at the

history of humanity,

our perception has been internally

focused at least 50% of the time.

Literally what we are paying attention

to is our own thoughts, our own

feelings, the voices, the desires, the

drives that come within us.

What technology has done is whole-scale

externalize our perception.

And this is even where like, you know, I

used to be like an efficiency junkie.

And so, when I was in med school, I was

going to be like you, Stephen, and I was

going to be super efficient. I was going

to be super successful. So, I was like

listening to a podcast in the morning

about self-help.

I was going to listen to lectures on my

way to the subway. I was going to read

on the way on the subway. I was going to

listen to a lecture on my way to the

classroom, pay attention in the

classroom, then do some questions, like

some test questions, whatever. So, my

mind was constantly outside of me.

Social media makes this even worse

because now we're doom scrolling, we're

looking at what other people are doing.

So, we are starting to exist outside of

ourselves.

Once we exist outside of ourselves, all

of our esteem comes from the outside

world cuz that's where we're spending

our time.

So, what's happening is as we become

more externalized, we're becoming

insecure, because where does confidence

really come from? It doesn't come from

inside.

This is a big mistake a lot of people

don't realize, which is

if you do really well

and you don't believe in yourself, you

don't become secure. A lot of people

think that becoming secure is about

being successful. That's not the case.

If you're really successful, you don't

end up with security. You end up with

imposter syndrome.

So, I went to Tufts for medical school

and I did my residency training at

Harvard.

And what I saw is that the more

successful you become, that increases

the rate of imposter syndrome. There's

way more imposter syndrome at Harvard

than there is at the University of

Texas.

There's way more

imposter syndrome at a place like

Goldman Sachs than there is at Bank of

America.

So, lots of success actually creates

this idea that I don't really know if I

can do this.

Everyone else is so much better than me.

So, we see actually lots of success

leads to imposter syndrome. Confidence

doesn't come from success, it comes from

surviving failure.

It's also far more internal. So, it's

not something that anyone else gives

you. It's like when you believe in

yourself, then you're confident. And

then the beautiful thing is that once

you believe in yourself, then other

people can think whatever they want to

about you. The way that you receive

criticism, if you if you criticize an

egotistical person, they will argue with

you and convince you that you're wrong

and call you stupid. Whereas, if you're

confident, someone says, "Hey, you're an

idiot." I can say, "Okay, help me

understand why." Like, I could be an

idiot. Help me understand.

Mhm.

Right? So, this is where what's Social

media is doing is externalizing our

perceptions, building our ego. We're so

focused on the judgment of other people.

I see the amount of body like subtle

low-level body dysmorphia that I see in

young women is skyrocketing.

And I have a buddy who's a plastic

surgeon at Yale and you know, he's just

stunned by you know, you you have now

young women in their 25 26 27 who are

getting plastic surgery like on a yearly

basis like small amounts of Botox

injections or lip fillers or like

whatever.

Men, too.

Men, too. So, that's also what the other

great equality thing we're seeing is

body dysmorphia has a meteoric rise

within men. This is another situation

where it used to be primarily a female

diagnosis. That's evening out real

quick.

So, social media is making us focused on

our external appearance. We lose our

connection to ourselves. And then once

we lose our connection to ourselves, we

lose the capacity to gain confidence.

And how does this then result in

loneliness on a societal level?

Oh, it's so many different things. So,

the first reason it makes us lonely, so

this is I've also seen the highest level

of

being around people and being lonely.

So, I see so many people who have jobs,

even have girlfriends, boyfriends, have

friends, and they feel so incredibly

lonely.