This is not about perfectionism. This is

not about guilt. This is not about

boundary setting. This is about the

fundamental programming, the rules of

the game that are in your mind through

which you interpret your interactions

with other people. The schema dictates

what emotions arise. And so if you try

to solve the emotion or you try to solve

perfectionism or you try to set

boundaries, you're not targeting the

root. As a psychiatrist, I see this

incredibly central pattern in so many of

the women and many of the men that I've

worked with that they are the default

caregiver. They are the responsible one.

They're surrounded by people who would

like fall apart if they stopped doing

the supporting role. And this leads to a

lot of draining first of all, but it

also leads to a lot of frustration

because these people feel bound by their

circumstances. And as the resentment

builds up, as the anger builds up, what

they'll sometimes do is like swing the

pendulum. So they'll be like, "Okay, I

need to be more independent. I need to

stop letting everybody rely on me. I

need to look out for myself. I need to

advocate for myself." So they sort of

swing into this hyperindependence. And

they may even do that for a while. But

as they do that, some kind of weird

circumstance or like gravitational force

pulls them back into that old

environment. And that gravitational

force could be feeling guilty, right?

They're like, "Oh my god, I feel like

such a terrible person and now all these

people are struggling." It could be

being vulnerable to guilt tripping,

right? People call you and they're like,

"Oh my god, you left and like now I

can't do anything." Then you kind of

feel bad. It could even be anger towards

yourself and other people. And sometimes

even when you try to pull away, you may

find yourself stumbling into additional

relationships where

people take advantage of you where like

you meet people at work and like they're

like they need help so you kind of step

up, right? There's this big attitude of

sort of stepping up. And so the tricky

thing about this is if you're someone

who's like chronically depleted and

you're someone who is surrounded by

people who don't have their [ __ ]

together and you're the the one that

they rely on. The real problem with this

is that you may look at this and you may

think like, "Okay, I need to set better

boundaries." Fair enough, right? So like

I need to set firm boundaries. But as

you try to set firm boundaries, like it

works for some people, but something

gets in the way. This kind of feels a

little bit like whack-a-ole and it seems

like nothing is sufficient. And this

problem of whack-a-ole not working is

something that I saw years ago, right?

So, I started making content on the

internet and it's like, okay, I teach

this. Here's how to deal with

perfectionism. Here's how to emotionally

regulate. But for some people, they

don't see outcomes. literally why I

built the coaching program because

sometimes what happens is you need

someone else to help you understand the

specific nature and kind of like

intersection of different problems that

you have and we our coaches get great

outcomes do a really really really good

job and so if you're someone for whom

whack-a-ole doesn't seem to be working

or you've watched a lot of content on

the internet and you're not getting the

progress that you're really looking for

consider working with one of our

coaches. So what do you do about this?

And this is where we're going to explain

a really important concept today, which

is the concept of a schema. And what a

schema is is like a foundational thing

that shapes the way that you interact

with the world. And the tricky thing

about today's video is if you guys have

this problem, actually the most

important thing that you need to do is

understand it. You don't actually need

to do anything. The problem is that what

you need to understand is so

subconscious is so baked into the

assumptions of how you interact with the

world that like kind of dictates what

keeps on happening to you. Okay? But the

challenge that that I have in this video

is like this is so foundational that

it's kind of hard to see and kind of

hard to understand. So what I want you

guys to do is first of all bear with me

because it's going to be a little bit

abstract and then we'll get into the

details and then after you are done

understanding what a schema is go back

and re-examine these issues. Listen to

the introduction again and then see it

through the lens of schema. If you are

able to do that will be the most

important step that you take for

breaking this pattern. Okay. So let's

start with what a schema is. So a schema

is a pattern of interacting with the

world. And what I mean by pattern is it

isn't like an emotion. It isn't a

worldview. It isn't a way of socially

interacting with other people. It's all

of those things put together. Okay? So

schemas are formed in adolescence. And

the way that I kind of describe it in

layman's terms, it is the rules of the

game that you learned. Okay? So I'll

give you all a simple example. There's

this game that I used to play many years

ago called Munchkin. It's a card game.

And the whole point of Munchkin is that

like cheating is okay, right? So, it's a

game that cheating is part of the rules.

So, if someone cheats like and they win,

that's not something that pisses people

off. I mean, it may still piss people

off, but that is something that is fully

acceptable. Versus, let's say you're not

playing Munchkin. Let's say you're

playing like bridge or something else,

okay? or chess or whatever and then

someone cheats, the way that you

perceive what they're doing, your

emotional reactions to their actions,

and even the way that you engage with

them will all be shaped by this set of

assumptions. So, schemas are sort of the

like the rules of the game of life that

we are taught. And for people who are

consistently depended upon, consistently

emotionally depleted, who just surround

themselves with various people,

subconsciously you are playing the game

of life with a certain set of rules that

creates these reactions over and over

and over again. Okay. So let's start

with the first major schema which is a

self-sacrificing schema. So this is

characterized by a couple of really

important things. The first is excessive

and voluntary focus on meeting others

needs at the cost of one's own

satisfaction. Okay, so there's a couple

of important features of this. It's kind

of like compulsive that you take care of

other people more so than yourself. The

tricky thing about this, the really

confusing thing about this, the really

frustrating like self anger kind of

provoking thing is that this is

voluntary, right? You kind of choose to

do this. People will ask you for help

and you can say no, but you don't. And

not only do you volunteer to help

people, but the amount of help that you

provide is usually excessive. Like you

don't do a mediocre job, you do a very

good job. If you're taking care of

someone who's sick, you're going to

really knock it out of the park. If

someone needs help, you are not going to

be the person that halfasses it. So, it

is both excessive and voluntary. And

often times meeting other people's needs

comes at the cost of your own

satisfaction. Second thing is a sense of

guilt when you prioritize yourself. So

notice that a what a schema is. It's

like this pattern, right? So it's not

just that you have guilt. It is that if

I do something for myself, the way that

I am wired is like even if it's

completely acceptable, if I'm like, hey,

like this is my day off, I get days off.

it's completely reasonable to get days

off. But if someone asks for my help and

then on my day off, if I take my day

off, I feel incredibly guilty. So this

is how a schema works. It's kind of a

pattern that evokes certain emotions

in inappropriate situations or in

maladaptive ways. Right? So the the way

to get underneath a schema is not to

just focus on the guilt. It's to really

understand the pattern that is creating

the inappropriate guilt. This

self-sacrifice schema also has an

element of self identity in it which is

specifically an inflated sense of

responsibility for others. So it as

human beings in life we all have some

degree of responsibility to our fellow

human beings. But in people who have a

self-sacrificing schema their sense of

responsibility towards others is

inflated. You know other people should

help people a little bit but I have to

help people a lot. That's kind of this

core drive that you have, right?

Somewhere written in your programming is

the idea that I have to help other

people a lot. And there are all kinds of

thoughts that go with with this. So if I

don't, then things will fall apart. If I

don't, then other pe people will suffer.

If I don't, they're not going to be able

to handle it. So this sense of

responsibility has two major kind of

divisions. It's other people's needs

become your responsibility and other

people's feelings become your

responsibility. So think a little bit

about how you feel this grippy

responsibility towards other people, but

like it's not good enough to just do

what they need. It is also important for

you to make sure that they feel good

about it. Okay? And we'll get to where

this comes from in a second. The last

part of this schema, the

self-sacrificing schema, is difficulty

in receiving care or attention. So

here's you overworked, taking too much

responsibility, and burnt out. And then

along comes someone in your life who's

like, "Hey, bro, you seem burnt out and

tired. Let me help. Let me do something

nice for you." And you kind of like on

some level you may appreciate that, but

something in your programming makes you

feel really uncomfortable.

If people are focusing on you, if people

are taking care, it becomes hard. You

have this weird reaction of like craving

other people's support. But when they

actually give it, some part of you can

activate and feel really uncomfortable.

So how do you get to be this way? How do

you end up with this set of rules in

your head? Well, it turns out depends a

lot usually on your upbringing, right?

Cuz we are psychiatrists here. So it's

all about your childhood. So let's

understand. So a really common feature

of these people is parentification. So

this is when a child grows up in an

environment that is unstable in some way

where the parents don't do the job of

parents. So the child has to do the job

of parents. So this can look like a

couple of things. Okay. The first that

oftenimes people miss is an emotionally

unstable environment. So you may be

thinking like, oh, like it's not like I

had to cook myself food or anything like

that. Like my upbringing was okay. So if

you grew up in an emotionally unstable

environment, what often times children

learn is how to manage the emotions of

their parents. So, I see this a lot um

when I have kids who have parents who

are have a substance use disorder or

basically addicts, right? Because even

as a six-year-old child, you learn as a

survival skill that you need to manage

your parents like anger, frustration,

their depression, their sadness, right?

This happens so unconsciously and it's

quite devastating because it becomes

kind of like your unconscious

responsibility to keep dad or mom calm.

like let's not have them flip out like

we can't have them flip out. Now

suddenly what's happening in this

scenario is the parent is no longer

responsible for their emotional

regulation for their outbursts. It

becomes the child's responsibility. And

so if you sort of think about a parent

child relationship what's supposed to

happen is kid is the one that's supposed

to be throwing a temper tantrum right is

the one that's supposed to throw like ba

their fits. I don't want to go to

school. I want to go to school. And it's

the the parents job to be the emotional

container. So emotional instability

really can lead to parentification on

the part of the child. Another really

common example is an ill parent. So when

our parents are physically ill, have

chronic illness, usually this is what I

kind of see. We have kids who will have

to step up. They will have to do

everything from like, oh, mommy needs

like medicine or daddy needs medicine.

Can you get me water? They have to do

things like they have to handle homework

on their own. They may have to prepare

their own meals. They may have to

prepare meals for the their parents,

things like that. And this is another

scenario where children have to grow up

way too fast, right? And if we think

about what's happening with the child

there, the child is learning that okay,

my role in this household is to take

responsibility. Without me, things will

start to fall apart. The other big

pattern that leads to this schema later

in life is conditional selfworth. So a

child learns on some really basic level

that love, acceptance, and even

proximity with a parent depends on the

value that I bring to the table. So if I

do a good job, like let's say dad works

really hard and isn't really available,

but if I do a good job, then dad will

take me out for dinner to celebrate. But

the only time I see dad is when there's

celebrations involved. When dad is proud

of me, that's when he pays attention to

me. Okay? So this conditional

self-worth, this is what's so tricky

about it. It teaches the child a really

important lesson, which is my

self-esteem depends on what I give to

others. Because there are some children

who, this is so sad, but many people in

our community will be like, I don't

understand unconditional love. Like, I

just don't [ __ ] get it. We don't live

in a world with unconditional love. The

only thing that matters is like what you

give people, right? People will say

like, "Well, what have you done for me

lately?" And in a prof professional

setting or something like that, like

fair enough, right? Like you have a job,

there's an exchange of your time and

energy for some amount of compensation,

like yeah, like you do have some worth

in the world that is somewhat

transactional. But hopefully when we're

growing up, like I have a couple of

kids, like hopefully they don't feel

like my love for them or their value as

a person depends on their performance.

that my affection as a father is not

contingent upon their behavior. But

there are many people who grow up in

that way where they basically learn okay

I get safety I get proximity by doing

good by being good and then something

really tricky happens which is their

self-identity their self-esteem their

self-v valueue gets intrinsically tied

to doing good for other people or living

up to other people's expectations. And

this explains why this pattern is so

hard to break. Because if your sense of

self-esteem is tied up, is correlated,

the rules of the game for you are

self-esteem means doing good for others.

I've also seen this pattern in highly

religious households, which we'll get to

in in a couple minutes. Right? If these

two things are are intrinsically linked,

then you can even as an adult look at

your situation and say, "I'm sacrificing

too much. I need to look out for myself

more." But as you start to pull away

from the people that are dependent on

you, the schema will activate and your

sense of self-esteem because this is the

equation of self-esteem will start to

drop. This is why you will feel that

gravitational pull because you feel it's

not just guilt. It's something that is

even deeper than that. Your sense of

identity starts to disintegrate. Your

personhood starts to disintegrate as you

move away from the role of a caregiver.

Because if you are not a caregiver, then

who are you? And so the body and mind

don't like it when you move away from a

secure sense of identity. You know how

to play this game. You know who you are.

you know how you fit into this drama,

right? You know which play which part of

the play you're supposed to occupy. But

when you move away from it, it's very

very anxietyprovoking. Causes this weird

existential dread and like it basically

the feeling is like I don't know how to

do this. So what kind of problems do we

see in adults who have this kind of

schema? Okay. So the first thing is that

there are relationship problems. People

with the self-sacrificing schema are

drawn to people or partners, friends,

co-workers, whatever, who have one main

feature, accept care without

reciprocity. So, you're drawn to people

who are like okay being helped. So,

sometimes this will be people with like

once again like a friend with a chronic

illness, a friend who doesn't have their

[ __ ] together, a co-orker who's always

like, you know, behind on things and

needs a do me a solid bruh. Do me a

solid bruh. Right? So, you're drawn to

these people. And why are you drawn to

these people? Because the rules of the

game in your mind are like, I'm the PC

and these are the NPCs. And the problem

with NPCs is that they have side quests.

All these [ __ ] NPCs need some help

from me. And it is my job as the player

character to run around the town talking

to random people, getting their side

quests, and then going and doing

something. But unlike most RPGs or

whatever GTA take your pick where the

rewards are designed to be worth the

labor that you do, there's a second

problem with people who have the

self-sacrificing schema which is that

they have a lot of discomfort or anxiety

with reciprocation or what really really

really gets them bent out of shape,

makes them very uncomfortable is when

other people try to initiate care. So

what these people have a lot of

difficulty tolerating is a sense of

lopsided care. So I'm okay giving but

I'm not okay receiving and the only

circumstances in which I will receive is

if I have given first or you you are

guarantee that we'll be able to

reciprocate this right and if you kind

of think about this what these people

crave is exactly what makes them

uncomfortable which is like I'm spending

my whole life taking care of other

people oh my god I wish someone would

take care of me so this also manifests

professionally so these people tend to

be what we call overfunctioning at work,

right? So they're like basically like

some of these people nowadays who are

using AI to do three jobs. You're like

that except you're not doing AI, you're

just doing three jobs. So these people

struggle a lot with delegation. They

struggle a lot with assigning

responsibility. So even if you have

maybe subordinates or co-workers who

like have work that they are responsible

for, you have a tendency to micromanage.

You have a tendency to check. You have

to like make sure that they don't screw

up because they're fundamentally

unreliable. So I have to make sure that

things are okay. And the really scary

thing about this is that in a

professional setting or in

relationships, what we see with a lot of

these people is the buildup of a silent

resentment. So, as you engage in these

patterns and you're like, "Oh my god,

like this person is like such a dumbass

and like I can't rely on them. I have to

check. I have to check. I have to

check." And as you do this, you feel

cognitively, and this is what's so

confusing about a schema. You feel

cognitive. You can look at this and you

can say, "Hey, this is unfair. I

shouldn't be doing this." And so, as you

end up doing it again and again and

again, and things become more and more

and more lopsided, this gap is where

your resentment starts to build. And

sometimes what'll happen with these

people is that resentment builds. so

much that they kind of crack and they

shift gears into this pattern of like,

okay, it's just going to be all about

alloc all the time. F everybody else. I

just got to look out for myself. I got

to separate from the world. Other people

can go f themselves. But unfortunately,

deciding overnight to become a boss babe

and over reliance on yourself, severing

your connections is sort of this like

rebound response from the schema. And

often times what these people will do is

they'll do that for a while, but then

the feelings of guilt, these other

fundamental things of I'm going to be a

boss bay, but when someone shows up and

tries to do something nice for me, that

still doesn't work, right? Because what

I'm doing is there's this schema of like

I'm the caregiver, they're the

caretaker, and becoming like

hyperindependent is actually scrapping

away with that entirely. And then the

problem is I don't have a clear way to

relate to people, right? So if I've

decided like I'm going to f everybody

else in my life, I'm going to live my

own life. Then like how do I form a

healthy relationship because it's all

about me me? And then that really

bothers you because you're not selfish,

right? So, you have a sense of

self-esteem that is based on your

capacity to give. And you don't want to

be the selfish person because there's a

selfish person, there's a selfless

person. And why don't you want to be the

selfish person? Because you know what

it's like to be on the receiving end of

unrescrocated care. So, emotionally,

these people feel a lot of fatigue and

burnout. And this is the really

interesting thing. The fatigue and

burnout are seen as often times personal

failures, right? So, I'm so tired. Like

let's say you have a you know a parent

who's ill and one day you're like man

I'm just so tired. And then how does the

child respond to that? They're like oh

my god I'm so weak. I need to be better.

This is a personal feeling. The the

seven-year-old child who's like making

chicken noodle soup for their

chronically ill mother is not thinking

to themselves the reason I feel tired

and burnt out is because of my

circumstances. Now often times as we

grow up we'll start to have insight into

this. But understanding that your

fatigue is not a personal failure but is

a structural problem based on the the

structure and shape of your

relationships is a really important

shift that needs to be made. Often times

the other primary emotional thing that

will happen in the schema is people will

feel a lot of guilt or some kind of

negative emotion. A sense of self-

judgment or weakness is also pretty

common um when you relax, have fun or

engage in pleasure. So, when you try to

do the things that you crave, and this

is why it's so hard to break out of the

schema, just think about this for a

second. I'm like, man, I I wish I had a

day off. And then when your day off

comes, oh my god, I'm so lazy. I'm

wasting my time. So, I want you guys to

think about when you engage in pleasure,

if your internal emotional reaction is

guilt, then like how can you possibly

engage in pleasure? And that's the

problem with the schema. The schema

shapes your reactions to things that are

healthy for you, right? So in a real

game, cheating is bad. In Munchkin,

cheating is good. It so your reaction is

being perverted by the schema. So that's

why it's so hard to take a day off

because when you take a day off, a

normal person, a person without this

maladaptive schema may experience

pleasure, relaxation, oh my god, one day

off is never enough. I wish I could have

be retired, right? They want more of it,

but your emotional reaction to some

pleasurable activities is negative. And

so then how are you supposed to move

towards that if your body is punishing

you, your mind is punishing you with

like guilt and like self-critical talk.

The other way the schema manifests is in

our thoughts. Okay. So schema therapy is

built off of cognitive behavioral

therapy and a lot of other things that

are mixed together because there are a

lot of shortcomings of cognitive

behavioral therapy. But the cognitions

are also well well mapped in schema

therapy. So these are cognitions like I

have to do it. If I don't do it, nobody

else will. if I don't check it won't be

good enough. And also that that's one

side of cognitions. The other side of

cognitions is if you need help, that

makes you weak. That makes you a burden.

That makes you pathetic. That makes you

fundamentally not a good person. Okay?

And then the really common result of all

of these things is people will sort of

like push up against the schema. They'll

try to do things like I got to set set

better boundaries. I got to like treat

myself. I got to take days off. I got to

learn how to relax. I got to do this. I

need to learn how to meditate. I need to

learn how to therapy. I needed to learn

how to emotional regulation. Right? Once

again, what are all these things? What

do you need to do? These are all

personal failings. Yeah, you need to

learn how to be better. Right? That is

how deep a schema goes. Even in your

attempt to solve the problem, you are

operating within the problem. This is a

personal failing of yours. So, usually

what ends up happening and this is not

like permanent, but people will run

against they'll have a lot of friction

against the schema. they'll be unhappy

building up this silent resentment.

They'll try to break out and then

eventually what happens and this is what

causes people to like fall back into it

is a sense of surrender. So they're like

ah I just can't handle it. I can't

figure this out. And then you'll kind of

slip back into the pattern for a while.

Resentment builds up and then you try to

break free and then you're like ah. So

there's sort of this sense of

resignation. And this is where the term

burnout really comes in. When these

people get burnt out, that's when they

stop fighting against the schema and

surrender back into the pattern. So, the

really interesting thing is that

self-sacrificing as a trait isn't

necessarily maladaptive. What happens in

a lot of people who are self-sacrificing

to the point of depleting themselves is

that that that the self-sacrificing

schema combines with a second schema,

which is the unrelenting standard

schema. So this is a schema that has a

couple of different rules. First of all,

a sense or a drive for perfectionism

that is independent of achievement,

right? So many of us want to do a good

job, right? So I'm I'm perfectionistic

and I want to do good. But then what

should happen if I'm perfectionistic is

when I try really hard and I do a really

good job, I should feel good about it,

right? So it's like, hey, I studied

hard. I got a test. Time to relax. Time

to have a good time. Time to celebrate.

But for some people, their sense of

perfectionism is not satisfied by actual

achievements. And this is what makes it

feel so relentless. Okay? Because even

if you do a good job, that internal

voice is still there telling you you

need to do good, you need to do good,

you need to do good. So it is a

perfectionism that is unusually

persistent. And this schema also has two

things that we've talked about. One is

selfworth that that depends on

performance. Right? So this is the

unrelenting standards. So my sense of

identity, my sense of self-worth depends

on doing a good job. And a lot of

difficulty with rest and relaxation

because if I'm resting, if I'm relaxing,

that's scary. That's not good. Maybe

I'll screw up. The perfectionistic

tendency in my mind is going to not let

me relax. And I think schemas are this

is another important point here where

you may say okay is this perfectionism?

Well if where if we look at like

perfectionism this is the important

thing about a schema. You can be

perfectionistic and still be like

relatively mentally happy right? So

perfectionism is a personality trait

that in a certain upbringing you have

certain perfectionistic tendencies and

in a certain upbringing that

perfectionism becomes mutated to be

incredibly self-critical. something that

does not allow you to enjoy the the

results of your labor. Okay, so this is

another good example of why people with

this schema may say they may look at

themselves and they say, "Okay, I am

perfectionistic. How do I target

perfectionism?" Whereas that's not

actually what you need to target. What

you need to target is a mutated version

of perfectionism. You need to target

that mutation. So these people also have

another really important feature which

is they need proof of their self-worth.

So their sense of identity is not

something that is internally born is not

like I feel good about myself like I

practice self-love and self-compassion

or they don't pra I mean maybe they do

practice because it's not intrinsic for

them. They have to practice self- loveve

and self-compassion, all these kinds of

things. But what they usually find, what

what their mind really craves is proof

of their status, proof of achievement,

proof of productivity, proof of

caregiving because when they get those e

external signals, they kind of calm

down. So now let's talk about how this

develops and hopefully this this will

give some some clarity. So these people

with this sort of hyperp perfectionistic

internally criticizing voice usually

grow up in an environment that is like

fundamentally unsafe or fundamentally

has conditional acceptance. The same two

that we kind of talked about earlier but

they manifest in a slightly different

way. So they grow up in environments

where their nervous system so there's

some really fascinating research that

this is like just as physiologic as it

is mental. So, the nervous system is

panicking. And what does what calms down

the nervous system? Like getting an

award, like getting an A. And then the

nervous system calms down. It's like,

"Oh, thank God." Like, "If I don't get

an A, like mom or dad is going to be

pissed. Like, I'm going to get my ass

beat. So, like, I got to get an A." Or

when I get an A, this still happens to

me, which blows my mind. Like, but it's

just so baked in, right? So, I'm Dr. K.

I'm all Kenoji. I spent years studying

become a monk. Went to Harvard Medical

School, was faculty there for years. one

of the most followed psychiatrists on

the planet. And the thing that blows my

mind is like how quickly my mom compares

like it's automatic. She compares all of

the things that random people are doing

better to me. She's like, "Hey, these

people take their kids to church every

week. These people are doing this with

their kids. These people are doing this

with their kids." And it's just like

automatic. Like I enter the room and

she's talking about how like all these

people are doing all this [ __ ] that I'm

not doing. And I'm like, "What? What?"

Like so, so I realize that this is

something that's very common for South

Asian parents, right? Oh, you got like

you got an A on the test. Like, why

aren't you number one, right? Oh, like

this kid, like you may be at the top of

your class, but this kid this your

cousins, aunts, nephews-in-law

is like not only number one in his

class, but he's also an astronaut. Like,

why are you slacking, bro? So, people

grow up in these environments with very,

very, very high expectations. And the

really scary thing is it's not just

expectations. It becomes safety because

there is a threat within the household

that unless you live up to these

standards, there is going to be some

kind of punishment. So this is what

becomes really scary is like achieving

is not about achieving anymore.

Achieving becomes survival. Achieving

becomes safety. And so what that means

is unless I'm getting these really

positive signals of achievement of

perfection, like the only way I can be

safe is to be number one, right? Their

nervous system in the same way that we

have like evolved to have like be scared

of threats, right? So if like I'm

walking down the street and like a bear

charges at me, my nervous system is

going to respond and I can't really like

control that response. And this is

what's so scary and what is

transformative about schema oriented

work in psychiatry is these people are

going through life with their nervous

system telling them unless you at the

top of your class unless you're [ __ ]

perfect the reaction that it has is this

bear is charging at you. So these people

will say why is it that when I do a good

job over and over and over and over

again why does that not build my

self-esteem? I've been doing such a good

job. I've been taking care of people for

so long. Why do I still feel like [ __ ]

Why is the feeling of relief, the

feeling of being good, the feeling of

pride, why is it so temporary? Cuz you

look at other people and you're like,

"This person did a good job and then

they did this and then they did this and

they've developed confidence. Now they

have the internal strength to set

boundaries. They know what their own

worth is, but I do all of the same

things, but I don't know what my worth

is. My worth still feels frustratingly

dependent on the approval of others. How

do I break free of this? And this is

because at a very young age, they

learned that making other people happy,

doing an exceptional job is the only way

to protect myself. And this is where

things get really interesting because

oftentimes what these people will have

Young describes this beautifully. He

says they have an internal critical

parent. Okay? So they he calls it

demanding parent but it's like an

internal critical voice. And so these

people will look at this and they'll say

like yeah I have this running dialogue

in my head that like gets pissed at me

unless I do something perfect. So if I

try to relax it's like oh my god you

could be doing this you could be doing

this. You could be doing this right? It

has this really critical voice which on

the one hand we may say on a

psychological perspective is just

internalized from your parents like

literally right so they spoke to you in

a certain way and then you internalize

their words into your own internal

dialogue but sometimes that realization

and working on that doesn't work and

this is the critical step that people

are missing if you have a critical

internal dialogue and you're saying I

need to learn self-compassion uh I need

to talk better to myself I need to do

cognitive reframe all Those techniques

are good, but sometimes there's a piece

missing and this is that piece. It is at

the internal dialogue. Remember,

achievement is safety, right? This is

the only way that you can be safe. So,

how can you guarantee safety? You

criticize yourself relentlessly. So,

when your parents are brutal with you,

like, you're a piece of [ __ ] This kid

did so good. This kid did so good. That

kid did so good. And that hurts, right?

Like it hurts to try your hardest and

have your parents be like, "I love him

more." Instead of being proud of your A,

they're like disappointed in you. So,

how does a 12year-old, 13year-old,

10year-old, 8-year-old child protect

themselves from the hurt of a parent who

is disappointed in them when they

achieve? Really simple. You program

yourself with their voice. I know what

I'm going to do. I'm going to beat

myself up because if I beat myself up

enough, the likelihood that I achieve

increases. And if I beat myself up, then

I achieve. And if I achieve, mommy or

daddy will be proud of me. The internal

demanding parent, the self, the internal

critical voice is not a problem. It is a

solution. It is your avenue towards

safety. Those are the legs that help you

run away from the bear that is chasing

you. And until you realize that this is

the core function that it's serving,

it's really hard to break free. So the

unrelenting standard schema manifests in

a couple of ways. So let's start with

relational. So this this is people

becoming people pleasers, but not like

the dormat style people pleaser. This is

like I cannot afford to have people

dislike me. So this isn't like the the

obsequious like, oh please sir, don't be

mad at me. Don't be mad. This is like

okay, I got to be good. I got to have

people like me. I got to be dependable.

I have to have people like understand

that I'm dependable, that I'm a good

person. I need to show people how

dependable and great I am. Right? So,

it's sort of this weird inflated

standard that you are living up to. You

want to be great in other people's eyes.

And once again, this relates to safety

because if you're great in other

people's eyes, that means you're no

longer in danger. Okay? So, this can

also manifest as more obsequious, people

pleasing, trying to make people happy.

But generally speaking, it is the need

to be great in front of other people.

But this is not ego. This is not

narcissism. This is safety. Second

thing, behavioral. This leads to a lot

of overwork. Okay? People work

incredibly hard. You may do a lot even

if you're burnt out. This also leads to

having a lot of difficult with this idea

of like don't let perfect be the enemy

of good. You're like, "Yeah, [ __ ] that."

Like we got to be perfect. Like we don't

good enough is not good enough. Like

this is terrible. it feels like

antithetical to to be good enough. The

foundation of this is not the emotional

reaction that you have. You can try to

control that reaction, but as long as

the schema is persistent, it will be

dictating your emotional reactions. Next

thing, so this is fascinating from an

emotional perspective. Young has some

beautiful stuff written about this.

These people have what I would call a

persistent percolating anxiety. So they

have this feeling of like always looking

for relief but never actually finding

it. You have this like lowgrade like

background like you know whatever the

the black body radiation in the universe

level of like anxiety, right? You have

just this constant like oh my god like

oh my god. It's not even like focal.

It's not like oh my god this thing or oh

my god that thing. It's like just this

background oh my god oh my god. And it's

kind of unformed. And that's why it's so

hard to pinpoint. That's why it's so

hard to fix because it's just this

background level of like, oh my god,

these people also have this this feeling

of always looking to relax, but they

never get there. So, it's like, okay, if

I do this, like there's this very

intense hunger, this perfectionism,

right? I need to achieve this. I need to

achieve it a lot. I need to do a really

good job. I need to do a good job and I

need to go do a good job. But even if

you achieve a uh have a do a good job,

that feeling is very temporary or you

never achieve it. Even after doing a

good job, this is a really common

reaction. You're like, "Oh my god, I

have this presentation. It's got to be

great." You go and you do the

presentation. It's great. And your

reaction is, "Oh [ __ ] now people are

going to expect this of me every time.

Now every presentation that I have to

do, if I do even 1% less than this,

people are going to be disappointed."

It's like instead of celebrating a

victory, you're already terrified of

future disappointment. And so it's it it

really wears on people. Like really just

wears on your nervous system. Burns

people out. Last thing is that it in

terms of cognitions we see a lot of

black or white thinking, a lot of all or

nothing thinking and the other really

common thing is like different standards

for yourself versus other people. You

guys have heard me talk about imposter

syndrome. These are also elements of

that, right? Where it's like other

people can do a have a good presentation

and that demonstrates how hardworking

and awesome they are. But if I have a

good presentation that means I got

lucky. That means that I barely scraped

by and other people can afford to

celebrate. I cannot. So now hopefully

you guys understand what I said at the

beginning of the video. I want you all

to go back and like listen to that

initial presentation and see how this is

not about perfectionism. This is not

about guilt. This is not about boundary

setting. This is about the fundamental

programming, the rules of the game that

are in your mind through which you

interpret your interactions with other

people. The schema dictates what

emotions arise. And so if you try to

solve the emotion or you try to solve

perfectionism or you try to set

boundaries, you're not targeting the

root. So how do we target the root? So

the first step arguably sufficient,

arguably the most important thing to do

is actually insight is to actually

understand. So as I've done work with

people as a psychiatrist, I'm more and

more convinced that their biggest

problem is a misdiagnosis problem. They

think this is perfectionism. This they

think this is weak boundary setting. So

you try to solve this little problem.

But once you see the pattern, once you

realize, oh, my internal self-critic is

actually trying to protect me from doing

a bad job and if I do a bad job, I'm

going to feel terrible about myself. I'm

going to feel unsafe. My world will come

crashing down unless I do a good enough

job. That's why I have an internal

self-critic, right? So, the solution to

that is not to get rid of the internal

critic because then everything will fall

apart. The solution of that is to learn

how to feel safe independent of your

performance. So the next thing that I

think is important to develop is what I

would call like a healthy schema. Okay?

So there's like all of these schemas are

designed to protect you from a certain

environment in your upbringing. Okay? So

they like they're like they're

misapplied over here. So, I think about

this, you know, was my mom asked me the

other day, why is it that so many

college football stars don't become

great NFL football players? And my sense

of this, I don't really know it's I'm

not an expert in this, but what I've

noticed is that there are some

strategies that work at low rank. Like,

if I'm playing like low rank League of

Legends or Dota or like Valerant or

Marvel Rivals or whatever, like I can

get away with some stuff. But as I move

up through the ranks, as I move into

different situations, these strategies

start becoming ineffective. They become

maladaptive. So what we need to do is

learn a healthy way of engaging in the

world. And this has a couple of really

important points. Okay. The first is

learn to accept help. So recognize that

when other people try to help you,

you're going to have this very negative

reaction. Wait for it. Look at it.

Practice receiving help. Second thing,

be on the lookout for an absence of

reciprocity. And this is the really

weird thing. Absence of reciprocity in

relationships will make you feel

comfortable. Won't make you feel good.

It'll make you feel comfortable. It'll

be familiar territory. So, when you

start to enter into reciprocal

relationships, literally what this is

going to look like is you're going to do

something for somebody else and then

they're going to want to do something

back for you. And if they do something

back for you, it's not quits. Now you're

like, "Oh crap." The only safe way to

exist in a relationship is for somebody

else to be indebted to you. So if you do

them a solid and they do you a solid,

that's not good enough. I got to do them

a solid. You always want to stay one

step ahead. And here's the really scary

thing. As you're as you're always

staying one step ahead, you never want

to be in anybody's debt. And the safest

place to be is for other people to be

indebted to you. You're always going to

build up resentment because things are

unequal. So you need to notice this

pattern in your life and let things be

equal. And oh the other scary thing you

can do is let someone do something nice

for you and then you do something really

weird. Okay, this may sound really

confusing. So there's this thing that

normal humans do when someone does

something nice for them. So they say

thank you and then they don't do

anything else. They just stop. They say

thank you. They express appreciation.

They receive the gift with love and then

they stop. Right? So these are the

microscopic things that if YOU'RE LIKE,

"OH MY GOD, that feels so bad.

[screaming]

You see how it's like saying thank you

after someone does something nice is

what we teach our children to do, right?

We're like, "Hey, if you want to be like

a social human being, little one, when

someone does something nice, we don't

say panic and put them in your debt,

bitch." We say, "Say thank you." And

that's like literally what we teach kids

is the end of the interaction. And here

you are with someone doing something

nice to you and you say thank you.

You're like, "Ah." You see how the

schema shapes your reaction to things,

right? And then like here's the other

really like interesting sign that it's a

schema. If I ask you what's wrong with

saying thank you and some part of you

goes a and you cannot verbalize it, that

means that this schema formed before you

had it's preverbal. Really cool concept.

So like this was these rules were baked

in before your brain had the capacity to

put things into words or understanding.

So it's like this really weird primitive

feeling. So you got to learn how to say

thank you. So another part of healthy

adulting is being able to relax, right?

So it's recognizing that when you relax

there's going to be some kind of weird

like obsession with efficiency. So the

only way that these people can relax is

they're going to say like, "Okay, if I

relax, if I relax, then I'm going to

come in on Monday morning and I'm going

to be so energetic that I can work twice

as hard." Relaxation is how I become the

most productive and most efficient ever.

No, no. Relaxation has no benefit beyond

shocking beyond your enjoyment. You're

like, [screaming]

there's that preverbal schema happening

like I can't do that. Can you just take

a day just one day that is not for any

other reason than your enjoyment and

you'll say oh yes the schema will

operate it'll say yes wonderful Dr. K is

teaching me about schemas. I know what I

need to do to chip away at my schema. I

need to relax one day. But if you do it

to chip away at your schema, you are

turning your relaxation into

productivity. No, you have to have

useless relaxation day. No benefit. Just

enjoy yourself. And it's got to be a

waste. There's no psychological growth.

There's no leveling up. There's nothing.

Being a healthy adult means sometimes

taking some time for yourself. And be

prepared for the wall of fire that is

like all these emotions when you try to

do that. Be prepared for the sneakiness

of the schema trying to hijack your

relaxation and turn it into productivity

and efficiency. And if I can learn how

to relax, I will be a more perfect human

being. I know I'm flawed. I can't relax.

I need to be more perfect. So therefore,

let me learn this skill of relaxation,

then I will be a more complete human

being. Don't let the schema work it its

way into it. Okay. Last thing, the

schema is structural. So if you are in

an environment where people demand this

of you, it will be perpetuated and

perpetuated in the way that a potter's

wheel is perpetuated. It's not that it's

going to be forever, but as long as

you're in that environment, it's like

spinning the wheel, right? So if you

leave the environment over time, it will

start to die down. And often times

what'll happen is y'all will be in

situations like a marriage with kids or

parents who are ill where you can't just

unplug from the situation. But this is

where you have to sort of build your

bridge one brick at a time. And so it

can feel very very like unproductive or

inefficient. But be aware that the

environment will perpetuate it. So if

you guys want more concrete skills on

how to behave within that relational

structure, strongly recommend you guys

check out a membership video we have

with Dr. Gori Aragam. Dr. Dr. Aragam is

a friend of mine from residency, also a

Harvard trained physician, also the

number one psychiatrist that I would

send people that I love and in my life

to. She's just an absolutely brilliant

psychiatrist, probably better than I am.

I don't know. I've never seen a

head-to-head comparison, but she has

this awesome video called Being

Authentic with Family. It's a 2-hour

deep dive that really gets into this

stuff, and she's really good with female

relational issues. So, thanks for

watching and y'all can find the link in

the description below take you to a free

trial where y'all can check it