Psychology Gone Wrong with Dr. Maciej Zatonski

Danielle:
0:06
Welcome to the oscillations podcast, where we invite you to participate in conversations at the intersection of art, culture, technology, and the science of the mind. I'm Danielle persik.

Brendan Lewis:
0:17
And I'm Brendan Lewis. You it is with some trepidation that we approach today's topic. Nevertheless, given our through line of the science of the mind in this podcast, the founders feel strongly that we need to address the pervasive cultural trend of psychotherapeutic practices. Psychotherapy is often taken for granted in many modern societies, and it's often incorrectly seen as synonymous with psychology. It's also infiltrating culture, technology and art. We imagine that even the most open minded and skeptical listeners with the sharpest skills for intellectualizing may have a reflexive resistance to the thesis of this episode, that many of the foundations of talk therapy are either severely outdated, predominantly pseudo scientific or simply incorrect. Just like we did with Dr. Bruce Hood, in our conversation about self and identity, we're going to entertain the idea that certain concepts we take for granted are far from settled fact will challenge our listeners to consider that psychotherapy is neither a legitimate science nor a medical practice validated with demonstrable success. In taking a deep dive into the history of psychology, we'll see that it began as something more at the intersection of armchair philosophy and modern shamanism rather than as a medical practice emerging from rigorous science will cover the speciation of different approaches to the mind ranging from therapeutic practices to empirical sciences, each with their own evolutionary trajectories. We'll look at the modern infrastructure supporting these disciplines with their respective economics of knowledge production, and we'll discuss the perverse incentives to medicalize otherwise normal travails of the human experience for the purpose of selling new therapies, building academic careers, or writing sensational empty popular science articles in the era of clickbait journalism, chasing programmatic ad revenue. This is going to be hard. The benefits of therapy are touted everywhere in modern culture. Therapy is presented to us as a normal part of life by our friends by popular TV shows, celebrities, esteemed news organizations, such as the New York Times and even by our doctors. Yet, just as we wouldn't go in for an experimental brain surgery without evidence of its benefit and without understanding the associated risks. We shouldn't blindly adopt new therapies claiming to fix something is poorly understood as the self or the human mind without first thoroughly understanding the need and without examining the claims methods, risks and outcomes. If our goal in using psychotherapy is to be a good friend, family member, partner, lover, coworker, and citizen, or if it's to genuinely improve our mental well being, then we would argue that it's absolutely critical to understand what psychotherapy can and cannot do. To be clear, we aren't saying that mental health isn't important. In fact, we think it's very important and that's why it's also important to understand the fact and fiction surrounding the most popular approaches to mental health. But we're going to go beyond just focusing on the ways in which psychology has gone wrong, and also suggest a revised framework for understanding ourselves in the modern world. This framework will build upon other related ideas we've discussed, including the science of self and identity with Dr. Bruce Hood, and cognitive technologies for communication with Dr. Judy fan, and we'll continue to flesh it out across future interviews. Today we're talking with Dr. Macek tomsky. Dr. tomsky is a board certified EMT surgeon specialist in pharmaceutical medicine and researcher known for debunking unscientific therapies and claims in clinical medicine. He's a visiting professor at King's College London and University of Cardiff in Wales. He's the co founder of the Polish skeptics club and a leader in the public understanding of science and Poland. He's the author of over 30 scientific papers and 40 Popular Science and media articles. Hang on to your seats and try to remember to breathe and bring you Dr. tomsky. Okay, today we have Dr. Macek tomsky. Did I pronounce that right?

Unknown:
3:59
Yes, you sound native polish. Oh,

Brendan Lewis:
4:01
fantastic. I'm very flattered. Okay, so we're gonna dive right into the questions. Dr. tomsky, you are the co author of a book psychology gone wrong. This is one of a despairingly small number of diligently researched and well written books looking at psychology and psychotherapy with a critical eye. Other examples in this small but important category include House of Cards by Robin Dawes, psychotherapy, its religion by William Epstein and psychology ghosts by Jerome Kagan. Before we discuss how psychology and psychotherapy have gone wrong, why do you suppose society even its privileged intelligentsia are so resistant to taking a critical look at an allegedly medicinal practice. Why do so many people make such bold claims about things so poorly understood about the human mind?

Unknown:
4:50
And great questions and good interesting concepts and I think this will open up a field to our to great discussion today. First of all, Thank you for the kind words about the book, it's always nice to hear that it brings value or people find it interesting. But let's start with answering that question. I think part of the answer is already there, you've said that the brain is poorly understood. And I personally think that every time where we have a poorly understood field, or a gap in our knowledge, it's a very fertile ground for cashing in, I would say, on, on our ignorance or the uncertainty. Partially, the problem is that, you know, we've as humans, we've been prone to, I call it the snake oil salesman, for for decades, for millennia, it's, it's safe to say that it's always been the case, we look through historical books. As far as the record goes, the similar practices have always been there. And I think there's a good reason for this. My personal take is that when we think about ourselves as species, humans, and the societies that we built, we tend to specialize within those societies or within those groups, right, we accept the fact that we do not have to know or we don't have to be an expert at everything that we do or get involved with. And it's, it's impossible in everyday life to question everything all the time, right? We assume that the cars that were driving were built by someone, you know, according to certain standards, you know, we assume that the airbags will go off, and we don't test those things, right, we don't test whether the seatbelts are strong enough to hold us when we have a crash, right? When I sit on the chair, I assume it's solidly built, and I will not fall through to the floor and might harm myself when doing so I assume someone built this and they were better at doing this than I am. We make assumptions about the sewage system. When I flush the toilet, I assume this stuff goes somewhere where it's safe to dispose of it, although I never tested it, right. And this is our default behavior for the vast majority of the things in our lives. So this is our basic model in which we operate on daily basis. And as we get more advanced as a society, we tend to delegate more and more responsibilities to other people. I think we see certain trends now that were far less present, you know, 50, or 100 years ago, many people don't cook, we buy pre packaged goods, and we just heat them up in a microwave or not even do that we don't even choose the groceries anymore, right? More and more frequently, we just ordered them online, and someone else does the selection for us. And those are very basic things. But it shows a certain trend in how we live our lives. Rely on an intricate network of competent strangers, or maybe better to say, we assume that those strangers are competent to deliver us what we want, we no longer hunt for food, or you know, or grown our vegetables. It's it's an entertainment today, it's not a way of living. I've never painted my home, right? I cannot imagine, you know, getting, although it's a fairly simple practice of, you know, I tried to take a bucket of paint and try to refresh the walls in my room. And my wife wasn't happy about this, you know, so I spent some money and had someone else do it. And they were much better, much more proficient and they did far less damage than I have. windows were not damaged, you know, the electronics were not soaked in paint, you know, the carpets were cleaned. And it's a reasonable thing to do for the vast majority of the things that we we do in our lives, right? The person that we delegate things to, we assume they're more proficient because they do it more regularly, and they somehow specialize and they have more experience with they might be able to do this better. We also tend as a society to have institutions that regulate certain things. And I think it's an important thing to to flag here. We do believe that someone sets standards and enforces the standards. For you know, how the cars must be dealt. We assume that someone trains or there is an institution that monitors how physicians stay up to date, to the next time we go when we need to have a heart surgery, you know, it kind of gives us a reassurance that those people were trained appropriately and then kept up to date in order to deliver us, you know, the service that we that we need. And there's a there's a price we pay for those automatic assumptions. It's very easy to sneak something in. So that's definitely one of them. of the reasons it turns

Brendan Lewis:
9:26
out that the public probably has much less of an understanding about the science and medicine, of psychology and talk therapies. We might think we know but really, we probably know about as much as how our sewage is handled, or you know where our garbage goes when it's taken away, or how the water that comes out of our sink is supposedly potable and clean. And we don't actually know who is in charge of those things and how is it done and are they actually doing what we think they are?

Danielle:
10:00
But I think there's also a double edged sword with psychology because we also have folk psychologies. And so, you know, even if a concept within cognitive science or neuroscience isn't necessarily well defined, for example, there are plenty of researchers who are studying emotion right now. And they don't necessarily all even agree on what that is what they're studying. It's a nebulous concept, and in many cases, but we all still have a personal inner subjective feeling of what we think emotions are. And we use this word that has been culturally given to us. So we assume that it's a real thing. And so in the case of of psychology, not only are we just outsourcing like we do with everything else to the experts, and sort of trusting, taking for granted that the narratives that they give us are real, but we also have this sort of inner dialogue of Oh, yeah, that that makes sense. And we start to just run away with those narratives.

Unknown:
10:57
I think it's a very fair point. And we do have a tendency to think, you know, an easy explanation is, is a comfortable explanation. Right. And, and we also have, and I think it's, it needs to be looked at, in in this context, there is often an unfulfilled need, we struggle as we go through life. And we've been struggling as we go through life, forever. And the struggles change, right? We live in a very complex reality, right? Life is complex, life is hard, it's random, is unforgiving. It's, you know, cruel for most of us and for most of the time, and this is a hard concept to understand. And it's even more difficult to get it to be at peace with if we take into account the constant bombardment by certain type of, you know, informations, images of success, you know, the images that we see, you know, carefully prepared and choreographed images of people in certain situations in social media, right, it creates a huge gap between what our life is, and what we can imagine it could be. And that leaves a void, that people are trying and successfully are filling it with grip solutions to our imagine problems. And after a seemingly, you know, offered by someone who appears to be experiencing something, and others, a miraculous therapist, and he or she, you know, uses complex words, and you know, they sound confident they appear to know something that we do not know, why wouldn't we trust them? Right? After all, this is our automatic behavior in exchange for a small amount of money. I mean, why wouldn't why wouldn't we fall for certain things, it's a natural thing to do.

Brendan Lewis:
12:34
Before we get to the next question I want to ask you to there's not simply a lack of reasonable skepticism and criticism about these allegedly medicinal therapeutic practices and theories. If you bring this up, even with your most open minded and skeptical friends, you're often going to get a very kind of stubborn pushback like, oh, this couldn't possibly be there couldn't possibly be any reason whatsoever to be skeptical of talk therapy, or social psychology or these disciplines.

Unknown:
13:08
So I, as you know, I My background is primarily as a physician, as a surgeon, I work and I have trained as a doctor for my entire life. And I have a specific way of thinking about therapy in general about treatment in general. And we're probably going to touch upon this and expand on this a little bit later. But there is potential harm in approaching any therapy with an unscared decal or unverified enthusiasm, I would say right, or unlimited enthusiasm. We wouldn't go to a heart surgeon, we wouldn't choose one based on an advertisement on the internet. There's a certain depth I believe two or two therapies, that is often dismissed as lack of harm, which I fundamentally disagree with. I think that an incorrect approach and incorrect therapy can have serious harms to individuals, much more severe than just you know, stripping someone from a couple of $100. Right. I think that's, that's the least of the of the problems. There's also certain general principles involved here, that when we think about skeptically, think about the approach to our life, of course, we cannot question everything, but we are, at least should be questioning certain things, especially if we don't really know what we're getting in exchange for our money or for our time. I think in the context of therapies, this is an extremely valid question. If we go to the doctor and he tells her we'll take this fail or you need this surgery, we are often given or we request a very solid description of predicted outcomes of our decisions. Or this hardly ever happens when it comes to therapies. The goal of the therapy is almost an end, and a time in which it should be achieved is almost never defined. Prior to starting therapies, I think that this is a general way of thinking not necessarily, you know, not necessarily applying in that particular space. But if we are coming up with an intervention, we should at least now, what are we trying to solve? What are the expected effects and consequences of doing so or neglecting or doing it. And while this is common in medical practice, I rarely see that type of an approach when it comes to psychotherapeutic practices, which generally makes me question their validity. I think that this is where the criticism is coming from, right? It's coming from the fact that we do not seem to be applying the same rigor in thinking and evaluating the value of intervention, when it comes to therapy. I want to know why, but it clearly see the the trend,

Danielle:
15:48
right? Yeah, it seems like in the realm of psychology, we're, we're kind of fighting an uphill battle, because the cultural messaging is so strong, you know, prioritize your mental health, but then we like you're saying, don't we take for granted that the therapies just will improve our mental health. But going along with what you were just saying, I want to push that a little bit further and ask specifically about how you would characterize what what is and isn't effective. So, you know, a listener who isn't deeply familiar with psychology, might not be aware that there are many different schools of thought, and these are often lumped together. So these schools of thought are actually quite distinct. They operate within completely different frameworks. For example, Freud, and Jung and other early advocates of talk therapy have very little in common with, you know, my field in cognitive science or neuroscience. And so modern cognitive science neuroscience, they're operating within the framework of the brain evolving as any other human organ would have evolved under the pressures of natural selection. But some of the frameworks within psychology, perhaps even those most popular with the public, simply don't fall under the category of a science of the mind. So how would you distinguish between a good science of the mind and a bad one?

Unknown:
17:06
That's another great question. And it's an it's not easy to give a simple answer. I generally struggle with using those value statements when we're talking about science. And I assume treatments should fall under that category, right? Treatment is a certain scientific sort of should be a scientifically validated intervention. Science, as I understand this is a method of, you know, tools that are used for researcher to eliminate their own biases, whether we're trying to eliminate ourselves as researchers from the equation, and it's a hard process. It's a complex process, it's something you have to learn. It's unintuitive. It's laborious, it yields very narrow answers to very narrowly stated questions, you know, if it's used correctly, and applying those tools requires, as I said, you know, discipline commitment, years of diligent research, and often ends with nothing, most of the testing season science end up with nothing, we cannot conclusively say anything about the what we've done, right, we failed to test, we fail to observe differences. And sometimes we get, you know, even counter effective or counter intuitive outcomes. And it's not easy, right? The scientists, if they're in their proper scientists, they do not have an easy life. Because that type of work doesn't really fit into many people's immediate expectations, right? They need for recognition, success, attention or money. But let's go back to the question, right? You've asked, what is what is a good medicine? Or was a bad medicine? Well, good or bad? Those are value statements that imply that something is universally good or something is universally bad? Is paracetamol a good medicine? Right? Is amoxicillin, a good antibiotic? Right? I don't think we can even though I'm not sure this is the correct way to ask. Because when we think about therapeutics, you know, we can only say that let's say amoxicillin has a positive balance of benefits to risks in certain diagnosed condition, right, for example, for your sinus infection or for your, for your chest infection, right for pneumonia. Otherwise, it's harmful, right? So it's good in certain situations, but it can be very bad in the others right paracetamol is is you know, you have a headache, you take a certain dose at certain circumstances might help. But you know, it's also used as, as a it's one of the most commonly used drugs for attempted suicides, leading people to misuse of that product and you know, permanent liver damages and many other problems. So I don't really know how to answer whether it's good or bad in terms of therapy,

Brendan Lewis:
19:50
he brought up science as a set of tools to get the kind of empirical approach to to knowledge that the empirical epistemology is how do we know what is True, we're trying to separate our biases and the kind of naturally evolved faculties of our mind from the world that we see. And one of the critiques that comes up often in the books that I mentioned at the onset of the discussion, is that psychotherapy and the therapeutic practices, you know, Freud and Jung and talk therapy, these are more like armchair philosophies or even religion in the sense that they start with a hypothesis and work backwards to prove it rather than systematically taking aim at their own intuitions and chipping away with skepticism until you arrive at something that seems empirically validated. Would would that be fair to say that, one way we could maybe distinguish whether or not we're looking at a science of the mind or something else, is whether it's taking an empirical approach, or it's starting with a hypothesis, and then working backwards to prove it kind of like religion there, we're starting with the idea that there is a God, there is a heaven, there's an afterlife, there are spirits, there are all kinds of things. And now we have to kind of fit the evidence to that claim.

Unknown:
21:05
One clearly is a scientific method, and the other one isn't, right. Fitting claims into our beliefs, it's not science, regardless of how people you know, feel about this. The whole point of scientific research is to eliminate those preconceptions and biases from the field. Well, that there are also many different types of throats, right, we can discuss the concept of truth in many different philosophical ways, which I don't think it's the point. Now, what I'm interested in is the objective truth rather, the one, not the personal one, not the political one is the objective reality, and it doesn't really care much about what we think about this, right? It is what it is. And we can gain that knowledge. And we can use that knowledge, regardless of how uncomfortable it might be, you know, to to better our society in our lives, when we can choose to ignore it. But you know, that's, that's, I think that's an entirely different type of conversation, what I'm discussing science, and I'm trying to think about a way of establishing an objective reality, right. And it's, and the tools are not perfect, and we don't always, easily get there. But I do believe that this process is applied correctly, they do have kind of a self correcting mechanism built into them. I think the great example of this is, you know, when we build a plane of using science, it works. Right. And in ancient Greek, if you know, the Icarus and Daedalus, you know, they have, you know, didn't really apply those principles and they fail, right? There's a good reason to believe that if something's correctly tested, it works because it reliably gives predictable outcomes every time it's applied in a certain situation, right? It doesn't hold true for beliefs. You know, we are smart creatures as humans, and we can find the rationale and interpretation and come up with thoughts and rationalizations for everything we do. That's great. It's a great skill to have. It can help or, you know, or, or the opposite in many situations. But that's not how I understand science. Right? Right. So I think the pursuit, pursuit of an objective reality,

Danielle:
23:10
and it's easier to be more or less objective, in some sciences like physics, where you're measuring outcomes within the physical world and there can be high degrees of predictability, consistency, even within medicine, it is relatively clear in many cases, whether something is in a particular context, harming a patient or, or helping a patient again, given a context of, okay, we're trying to reduce their headache or, you know, reduce the bacterial infection, but in the case of the mind, it is much murkier. So what does it mean to be mentally healthier? What? What would we be looking for, for a therapy to be doing? Good? Certainly, there are some cases that are clearer than others. But in many cases, I think most people don't even know what, what they would be hoping for in terms of an outcome. are we hoping to be generally happier? Well, that's not as you said at the beginning. That's just not human life.

Unknown:
24:13
I think you have touched upon quite a few important topics here, and I probably forget half of them so we can be coming back to that question. Let's start with kind of the very basics. You've mentioned that in some in physics, you know, it's certain things are easier, right? And when it comes to doing science, because they're more easy to measure, for that reason, we had let's say scientific experiments in physics conducted much earlier than in medicine, for example, right? It took a lot of understanding before we can you know, with before we knew but the bacteria exists. We couldn't create specific or targeted therapies for pneumonia right for lung infections, for example, that so so they mentioned this cumulative character and self-correcting character of science as we deepen our understanding of what is we becoming better at predicting and manipulating that reality with those tools. And that happened, it might be easier, in fact, in a field like physics, but it doesn't mean it's not possible in other sciences. Now, maybe one of the reasons why, you know, we're just suddenly starting to apply those principles to something that we call softer sciences, is purely because it's not as easy to apply them as it is to other fields. But easy. It's it's not, you know, just because something is hard. There's another reason why we shouldn't be attempting to do this. And here's an important thing that I believe that people who repeat those lines that we should keep science away from psychology, right? The good thing about science is that if we test them intervention, we don't have to know anything about the mechanisms in which certain things happen. So for example, if I'm testing a therapy, I don't need to know and have an in depth understanding of the mechanisms, which leads to the outcome, but I can easily test whatever my approach yields or gives an outcome at the end of the experiments, right, so we can test whether something works, even if we don't understand why. Therefore, it means that it's completely appropriate and necessary to apply scientific method to testing in therapies, even if we do not fully understand why they do or do not work. Right, we can still get a reliable, objective confirmation of their effectiveness, regardless of our understanding of how it happens in detailed mechanisms, and that's the case in medicine as well, where things were tested in medicine, and later discovered to be true or lay grounds, even to a completely new new fields of science. But we can do that reliably. Right. And we can, probably the social sciences, right and deepen the understanding later.

Brendan Lewis:
26:52
And we'll get into the problems in just a moment here about why it's sometimes difficult to do that, or why it hasn't been done in therapy and in psychology, but you can do it, as you pointed out, you need a few things like falsifiability, right, this is a problem. This is the same problem that religion and that other ways of knowing have is one thing they don't have is a kind of is falsifiability. So you need, you need to be able to test observe and determine whether or not your hypothesis was true, or whether it was falsified. And oftentimes, when you're looking at therapies, explanations for things, they look a little bit more like, as you said, at the beginning, snake oil salesmen, they look a little bit more like these roundabout answers that priests might give you, or religious figures where they're always going to kind of circle back to explain something. Of course, that's what I thought would happen. If it didn't happen the way they said, they'll come up with some other explanation like, well, you know, the gods were angry, or what I didn't see was that it's this memory from your childhood about your grandfather, and they'll just kind of find some way to make it fit no matter what. So there's not really a falsifiability there. And so that's actually a red flag that can help you determine whether or not this is a science, right?

Unknown:
28:07
Absolutely. It's precisely what it is, you know, and this is precisely why, you know, my writer, as a, as a physician, as a scientist goes up, I would probably even challenge that certain things in therapy cannot be falsified. I think it's easy to design an experiment that shows Well, this is the problem. This is the intervention, this is the outcome, where you can easily test whether the intervention achieves the result and outcome and compare it to the group where the intervention is not there, or, you know, or is different. And this is a falsifiable concept that can be applied to the outcomes of therapy. But you're absolutely right. Every time you hear we are as humans with greater explanations and rationalizations. And each time, you know, we hear that narrative, you're absolutely right, there should be a alarm bell ringing in your hand, or there's something's wrong, because there's there's just no other explanation. If something if something has no outcome, why do it in the first place?

Danielle:
29:00
Right? Yeah, you often start with the observations. They are predictable to some sort of degree, and then you later dive into the mechanisms and then that generates more hypotheses about what you could or could not manipulate. And this is how I was trained. You know, I mentioned I was trained in biology, neuroscience, cognitive science. However, I did my PhD in the Department of Psychology, because oftentimes, and at least in the United States, psychology departments are encompassing of many different sort of sub disciplines. And so when I tell people, oh, I have a PhD in psychology, they automatically assume certain things. I don't like to say that anymore, because I don't like the assumptions that they make. And I wanted to ask you, what would you say are the biggest and most common public misperceptions about psychology and psychotherapy?

Unknown:
29:52
That's another great question, Danny. I think if I had to choose one, although this is hard to do, I will probably say that the believe that most of what people know about psychology or psychotherapy of the findings, fundamentals and the scientific grounds for psychotherapy is verifiable, replicable and scientifically solid. Right? It definitely is not the case. Yet a lot of people do believe that it is. And this allows them this assumption triggers that automatic trust, an automatic reflection, less trust in therapies, but it's not where it ends. I think there are many other misconceptions. And, you know, some of them furiously defended, you know, for example, that, and we just touched upon this, that psychotherapy and psychology, it kind of defies the scientific method, right? It's all mysterious, and we don't understand enough, and therefore we cannot apply the tools we're applying in other sciences. Again, it's a massive misconception that many people have. There is more, I think another one and it's just as important is that a lot of people tend to believe that psychotherapy is some sort of a panacea for all the personal challenges that people can be going through. Right. And, you know, I do understand that the good cognitive behavioral therapy, right, will help you with addressing and phobias for example, but it will not be a fix for loneliness, or a lack of friends or being unhappy or, you know, having or setting too many expectations for yourself. And it's also very unlikely to be able to completely address many of the of the real mental health issues and conditions. I think there's, there's probably more right. And it's more related to our institutions. Yeah, that's we tend to trust in when we hear therapy, it triggers certain way of thinking, right? For me, therapy is a very well defined construct, people conducting psychotherapy, you know, are all of them appropriately trained? You know, the same way you don't expect for physicians are the up to date with the latest knowledge and scientific discoveries, but be held accountable, you know, to the to that knowledge and application of that knowledge? You know, do they have your interest as their priority? How many patients ask the question, how many patients start the therapy and ask, well, how many sessions do I need until I see improvements? Or define what the improvement is going to be? How many of them say, Well, do I only pay at the end of the treatment? Right? At the end of your therapy, it's like seems imaginable to you know, to go to go for a car mechanic and tell them, Well, there's a problem with my car, and then they take your car away for an hour and they give it back to you have no idea what they've done. And if it's worth it, what are you laughing, but a lot of people go into therapy with exactly that approach. They don't see the problem.

Brendan Lewis:
32:37
Moreover, imagine if you went to your auto mechanic, and they said, there are so many things systemically broken with your car, that you're going to have to bring it in at least once a week for the next 30 years. And maybe in 30 years, your car will be not fixed, but better than it is now.

Unknown:
32:56
But we don't think about it that way when it comes to on to our health or to to therapy. You know, most of the patients that I have come with, they never asked for the treatment plans for their psychotherapy, therapeutic interventions. They don't know, you know, hardly ever link the intervention to the diagnosed problem, even the diagnosis itself, right, the the finding what the problem is, that's another can of arms, you know, forget the efficacy of the evidence of the efficacy for the intervention itself. It's just knowing what is being addressed. And correctly naming it and resolving is another huge challenge.

Brendan Lewis:
33:31
So there are some other impacts not so we've been kind of focused on the individual. But there are also some social impacts as well, from psychology and psychotherapy misapplied. You've talked about in the book, some of the foundational ideas that have been discredited, but they remain dangerously pervasive. They're embedded in our legal systems, in our medical practices, that you know, my doctors, I know that doctors will tell you these are, you know, medical practitioners, they will tell you to incorporate therapy, go go see a therapist, even if you don't have a problem, just go see one like you everyone should have one, right. This is just kind of assumed. So it's, it's in our medical practices, it's in our legal systems. A few examples I recall from your book are the impact of childhood experience and the reliability of memory. Our beliefs in these ideas have very real legal implications. You know, there are therapists who go into courtrooms and determine the outcome of somebody is alive based on these ideas that are largely discredited.

Unknown:
34:33
Yes. And it is a it is a problem. It's very multifactorial, I believe as well. I think it's a good to start with certain analogy here. Let's imagine that you have a physician Right? Or don't you go to a doctor with a fever and he says, Well, you know, I have this book from the 18th century and it tells me to give you mercury, right intravenously to cure your problem because that was a practice some time ago in medicine. describes in 18th century European textbooks, right? It's absolutely unimaginable that any of us would fall for this ancient practice, right? Because there are institutions in medical sciences outside that guard us and require physicians to be up to date with the latest achievements in that field. But let's go back. So I need just want to set the scene here. So let's go back to the question about some of these fights false ideas, and how the fun finding their way into the systems. You know, I think that there's a lot of already discredited ideas that are very, very common and very, very popular, it will be probably best to get an experienced, you know, up to date experts to talk about this. But in my experience, psychoanalysis is one of them, you know, the recovery memories that you've mentioned, you know, therapy is based on addressing childhood traumas, they definitely do not hold at all to scientific scrutiny, right? There might be interesting from the historical point of view and learning how they made into the mainstream psychology at some point in time in the past, as it's been with medicine, right? There's been plenty of crazy things happening in the past, but we know better today that they shouldn't be applied, they are not really, you know, beneficial, and they're mostly harmful. For some reason they persist, it's relatively new as well, right? 100 200 years ago, you know, you would never hear a physician recommending something or a lawyer making a judgment based on certain crazy ideas or ideas that have been long disproven, I think the best way to call it as you know, in a book in the in the psychological realm, we did analyze quite a few of them, we've actually counted hundreds of different modalities of different therapies. And it's, I think it's safe to say that from the evidence that we have collected, it seems that most of them don't work. I think it's absolutely safe thing to say. Now, you've started with a couple of examples, right, for example, about memory. And we know today for the facts, that memory is not reliable, right? He humans or do not have reliable memories, we do think that our eyes record things as the you know, as a camera would. But it's not the case, right? It's an illusion that we live under. Our memories are prone to information being planted there as well. Right? They were struggling with recall, we falsely recall things that did happen or didn't happen. And in not only we understand a lot about this today, we also know you know, we know how to abuse that right? We now know how to plant memories. And we see certain signs of progress, right in more in well established practices. You know, now, when it comes to, for example, to do the witness interrogation, there are certain techniques that are no longer allowed, for example, especially when interviewing or interrogating children, right, because we know how easy it is to plan certain things into memory, and how the huge kind of well described cases where method of interrogation was leading to, you know, false accusations of child abuse in the past, purely based on on planting or implanting certain memories and minds of innocent children. We know about this. And when we see those institution working better, you know, that that science slowly creeps in as well. The challenge is that it's much easier to make up random stuff, then then properly validate this and correct mistakes, or beliefs that were planted in our heads before. And I think that in cognitive science, and again, I'm not an expert here. But my understanding is that, you know, research shows that we are much easier with accepting something than when rejecting something as

Danielle:
38:44
default accept things, right? Yes,

Unknown:
38:47
we accept by default. And even if we ask very simple questions that and that can be measured as two plus two, four, or is two plus two, five, it's quicker to answer when it's correct than when it is like the the negation or recall, it's an extra step. It's an extra hurdle that our brains need to go through. And as you said, this is not the default model of our brains. So once some major thing makes up into, you know, into people's minds, it becomes increasingly and increasingly more difficult to get rid of this, our childhood from I think it's another, you know, huge bucket of controversial issues here. And there's all the people that that say that it shapes who we are, but you know, we do it to great depths in our books to show that this is the case especially

Brendan Lewis:
39:32
in our age cohort millennials. I think it's almost like a badge of honor to have had some kind of traumatic childhood experience. I can't think of very many people my age that don't make some kind of claim to childhood trauma and how it's shaped their person today

Unknown:
39:47
we overuse the word. Yes. And I think the overuse of that word and is it an over diagnosis, it's difficult to to say, but you're absolutely correct. You know, what is it a childhood trauma, you know? I've worked with patients for a long time. And they often sometimes in certain conversation, this comes up. But you know, I had a very traumatic childhood. So what does it mean? Well, I've heard answers from my parents were killed in front of me then executed by, you know, the Nazis and kind of, you know, concentration camps. And in the second world war, two answers like, you know, my dad told me, he'll get me a black Mercedes for my 16th birthday, but I got a red one. Right. And, and they're both fall into the same bucket of a having lived through a childhood trauma. I leave it here, because I don't think it requires any other commentary. But one thing I'm sure of, is that blaming things on our past is much easier than taking responsibility for something ourselves, right? Blaming some things, or someone for what is happening to us right now is, I think it's a, it's a kind of a defense mechanism. That is very easy to apply, right? This is not my fault. And if we had someone who constantly feeds us that narrative, but this is not your problem, your everything you're doing is great, it's probably because some of the external circumstances, it's a nice thing to hear, right? I would, I would love, you know, to pay someone to keep telling me those nice stories, and that completely take responsibility for what's happening in my life. For myself, I'm not surprised this is happening.

Danielle:
41:18
That's a really good point. And it actually demonstrates one of the cognitive biases that we are relatively certain exists, the general idea that we tend to think of ourselves, we tend to rate ourselves as for competent, as you know better at whatever it is than than the average. And because we have a sort of rose tinted glass perspective, on ourselves, we do try to protect that image. And if we can sort of outsource responsibility or blame, and there's a practice of therapy and institution that is giving us an easy way of doing that, of course, we are going to be biased to accept that. And I think the problem is even trickier. Because one of the things that we do also know to be true, but it's it's almost so obvious that it doesn't actually offer much value is that well, of course your early experiences have some sort of effect on you. If that wasn't true, it would be tantamount to saying that fatalism was true, no matter what your experiences were, you'd have the same outcome. So yeah, obviously, yes, the things that you encounter throughout your life will have an effect on you. And also, we do now know that the unconscious, is doing most of the work behind the scenes, there's very little that we are consciously aware of in terms of how we are making decisions, these two things, the fact that our early experiences, do some work in shaping who we are, and that a lot of what we are is sort of unknown to us, provide this entry point for people to try to then find all of these stories for how they can uncover from their unconscious, what their early experiences are revealing to how something you know, traumatize them or makes them unable to deal with something in their lives right now.

Brendan Lewis:
43:11
I just wanted to circle back to how you were talking about, you know, war stories you were talking about when you're talking about trauma. And this is where a lot of that language comes from it comes from, you know, the soldiers coming back from the World Wars. And this was around the time that therapy was starting to become institutionalized. A lot of the critiques of therapy that I have encountered, bring up this idea of concept creep, and how words like trauma and PTSD, these conditions, even defined by psychologists, back in the day meant something very circumscribed, they meant something very, very intense. So like you were pointing out, if I saw somebody brutally murdered in front of my eyes, maybe a family member, that would be a very clear example of where you would have some kind of memory that haunts you, and it would it would impact your life in some kind of negative way. But as you point out, now, you can be traumatized by getting the wrong color, BMW, I think we all have these stories. I once heard somebody talk about how they had post traumatic stress disorder from writing term papers for university. And I think that what they simply meant is that, you know, writing papers can be hard, and sometimes you have writer's block, but to call that a form of trauma or PTSD is certainly an example of what they call concept creep.

Danielle:
44:30
And it undermines people who actually do have this more intense form of trauma. So there's, there's actually a real reason like a pro social reason to avoid this concept creep and to kind of change the cultural narrative around some of these overused or misused words.

Unknown:
44:51
So I think you're absolutely spot on. I think it doesn't require any significant commentary at this stage. I just want to reflect maybe you know us and and listeners as well, on the fact that this is one of the harms that I've mentioned at the beginning, right that the unnecessary an expansion or mis interpretation of what certain concepts mean and what trauma actually is or can be. If those concepts are getting diluted, it means that those people who genuinely suffer from those very rare conditions, they're not one getting the attention and care they deserve. That's one thing. But the other thing is, the important thing to remember here or the I would say, maybe the lens that would be worth looking through at this problem is, you know, we live today in in peaceful times, how many people they are today with a genuine trauma, emotional trauma or PTSD type of experiences, in a way that they were originally defined, right? It's hardly anyone. But the amount of therapists that we have, compared to what we used to have, you know, on the verge of the end of World War One or or two, or even the Vietnam War, is disproportionately higher, right? Those people somehow need to make their living. And I think that's partially responsible for the problem of this dilution of those original concepts and expanding this into an areas where they should should never be expanded into, I think there's a huge difference between a soldier suffering from PTSD and an entitled teenager.

Danielle:
46:29
Yeah, I think, on the one hand, the goalposts will always keep rising as as civilization progresses. And that's a good thing. But it comes with this cost of, you know, our expectations are getting higher. And I do want to push a little bit further, later on what you hinted at with the sort of institutionalization of some of these practices and that and the harm that they can have. But before I do, I just wanted to ask, is there the possibility that, you know, we have this cultural narrative that therapy is so important, and maybe it feels good to some people? But is there the possibility that we've maybe substituted therapy for the roles that friends and social organizations, religion civics used to play in our lives? I

Unknown:
47:17
think it's obvious that we have. Here's, here's the way I think about this, you know, because we're also quite critical at this stage. But the truth is simple. You know, that some therapies may be sometimes effective. In some patients, when we think about all we talk about substitutions, right, that are creeping in, into our life, it's definitely happening. The example that we give in our book is related to, to the fact that you know, a conversation with a friend or with a hairdresser, you know, or with someone who's serving drinks in a pub is getting replaced in it by a formal therapeutic sessions, right? That a normal conversation that we used to have with people on a daily basis about things that we're going through and the things that are affected in our lives, is happening less and less, right, or it's also social interactions are becoming scarce and very superficial. And yes, we, you know, that the conversations that we have on social media, definitely not the types of conversations we used to have over drink with, you know, when we think friends, we can see this formal, I call it a medicalization of life, not only happening in, in psychotherapy, and in psychology, I also see that happening in medicine.

Brendan Lewis:
48:37
Yeah. And so I'm going to jump around a little bit here, because we had a question for you, which comes up for me reading your book, and then kind of comparing it to the work of Alan Francis, who worked on earlier versions of the DSM. And he's published work on psychiatry, which is something we haven't quite touched on yet. But you know, in the same kind of general area of interest and research, Alan Francis talks about how the economics surrounding psychiatry and academic psychology and the sort of forces acting on people you know, from career ism to the pay to play academic journals, and other kind of ugly features of the markets at work in the knowledge economy, the institutionalization of psychiatry and psychotherapy and how they're all these international organizations. Now, they get together every year and they help each other build careers and they coined new terms that trickle down into the public. So his work is also very concerned with what you've described as the the medicalization of life, the medicalization of the human experience. And I wanted to even take that a little bit further, because it's not only these institutions and practitioners now but it seems to me in my everyday life that my millennial age cohort, have all kind of self anointed themselves as therapists or amateur therapists. Everybody seems to think they know something about how to diagnose someone else. And I'm starting to see medical language stand in for the ways that humans used to just interact without this medicalized jargon. So you don't like something your friend believes or you disagree with your friend, you call them toxic, you give them this kind of vague, meaningless medical sounding description of oh, this is a toxic behavior. This is a toxic person, or we're very quick to call somebody, a narcissist. And that's actually an extremely rare disorder with very narrow diagnostic criteria. And yet, anyone we don't like now is a narcissist or a sociopath or a psychopath. And this is not just happening at the professional level, we are now using this language to describe our friends, our family, it's affecting the way that we interact with each other. And that strikes me as very dangerous. That strikes me as potentially eroding our social lives, our family lives.

Danielle:
51:00
And it's a double whammy. Because if we are not able to, or we're not able, as much as we used to, to depend upon our friends and our communities, for the type of social comforting and validation, we're outsourcing that to therapists. And now when we are interacting with our friends in our communities, they are borrowing these medicalized terms and the framework of therapists, then it's just like, we have a vanishingly small direction to turn to there's a sort of vicious cycle here.

Unknown:
51:31
So going back to the points, I think you have specifically opened that question with Alan Francis, I believe, you know, he makes a lot of relatively valid claims and in his criticisms of the DSM, okay, so I think the best way, or the easiest way to describe this is the DSM is a relatively old, but updated now it's been updated for the five times, I think it's a book with diagnostic criteria for conditions related to, to our mental well being, and I think the DSM, so the handbook of diagnostic codes, is is far from perfect. And we do spend in our book as well, quite a lot of time, giving an overview of how it came to be, and the criticism related to what it contains today. It's not perfect, but there's nothing else available. We talked in conversation earlier, that there is generally a problem with establishing a diagnosis, or the reason for which the therapy is conducted. And sometimes it's even impossible to find a solid biological markers of mental health dysfunctions. It is possible now for some conditions, but it's impossible for others. Now, the good way to think about this, is this, imagine you suddenly started singing or the things or hearing voices, are you ill, but what time does your inner voice or the inner dialogue that you might be having with yourself becomes a problem? It's really difficult to diagnose, it's really difficult to draw the line, you know, when do you need treatment? If the inner voice or even if it's someone else's voice that you might be hearing in your head, you know, tells you to do something good, you know, be good to your neighbors, and you know, help your your, you know, the other fellow humans? Is that bad or good?

Brendan Lewis:
53:27
Oh, no, that's the Divine is, that's God speaking through you

Unknown:
53:31
need to be treated? Or is it completely acceptable? You know, what, if you see people you know, and they do tell you the same thing is that bad? Maybe the voices are annoying, right? Maybe this is when it becomes bad. Or maybe they're pushing you to harm yourself or harm someone else. Right? We can clearly see the escalation of the gradation of something of that is a fairly normal thing for most of us to have some kind of an inner dialogue. But it clearly at some point becomes a mis adaptation to our everyday life. Yet, it's very difficult to define in terms of objective diagnostic criteria, we do not have at the moment, diagnostic tools or biological markers that allow you to establish this as a fact, right? We know this today with diabetes, which wasn't the case, you know, 200 years ago, we can measure your levels of insulin and blood sugar in your blood, and we can adjust the treatments appropriately. And that's why people with diabetes live relatively normal lives today. But it wasn't the case in the past to similar thing that we have with mental health. We just do not have tools that are good enough. And going back to the lack of the ability that we have to objectively measure things, and not knowing when the line is being crossed. How do we choose when and what treatment is appropriate? So we need to define the disability and all the DSM isn't perfect. It's a step towards that space. It's necessary to have something that will allow us to objectively do that and do Time is the only one not perfect, but it's the only thing that we have at the moment for many conditions, it evolves as well. But it's odd that, you know, we've written it down, you know, 5060 years ago, and it's just left and sits there and just causes harm. It seems to evolve as we learn more, and as we get new evidence. Now, we tend to believe that something requires an intervention, generally speaking, and medical practice, when it results or at least to some sort of a modification to the current environment. Right. So the voices that tell you to be kind to others, you know, for example, in a devout Christian, you know, telling someone to donate to charities. That's how the problem right there, as you said, it can be a divine thing. And people may be really happy when that happens. Well, if the US president, you know, the commander in chief is hearing voices, it's probably a different story. Another example, so fidgeting children, right? Imagine you're living in a 17th century rural Britain, and you have a kid that is fidgety, right, and talks to himself when he helps in a field, right, or in a coal mine or on a farm or, you know, hardly a problem. Now, it's a very different situation where he is in a highly organized office environment or an educational placements, where those types of problems become challenging. When you lose your leg, is it a disability? It probably depends, all depends. And I'm just deliberately trying to make a certain leap forwards in the future. Imagine that if we if we live in some sort of a matrix society that we're just, you know, brains plugged into the Internet, you know, that wouldn't even be a question we would need legs and being kind of having no limb wouldn't be a significant problem, right? So you can you can translate those concepts that are in a wider, easy, easy to imagine that what or something is or isn't a disability, in a large amount of cases, in certain amount of cases, that means that is contextual and dependent on the situation, right, if I lose my voice, and I can no longer be opera singer, because of the throat infection, it's only a problem if I was an opera singer before, and I no longer can, you know, perform deliver or, or, you know, make a living, that it's very different, if I just, you know, have a slightly hoarse voice, and nobody really noticed it sort of, or it doesn't affect my life in any way. So there is this elements, that whether something is or isn't a mess, adaptation, or alteration, or, or, or a condition that requires attention is dependent on the situation we find ourselves in. And those tend to evolve for individuals, but they also tend to evolve over time. Now, there's a second side of this coin, that I think it's important, because if we don't have clear biological markers, it's also hard to develop clearly effective medicines and treatment, how do we target the pathology, when the pathology itself hasn't been defined? And that's a common challenge in pharmaceutical sciences, when we're trying to develop effective treatments? Well, it doesn't mean that we shouldn't be treating mental illness right. And and because that's, that's definitely not what I'm trying to say. And no one's saying what actually would I'm just trying to kind of make a point here that classification as an attempt to create a meaningful diagnostic criteria itself is not a bad idea. I think it's actually necessary to do it, well, we still have a long way to go. And that's what I fully agree with. With Francis here, we do have a long way to go. And there's plenty of things we can improve.

Brendan Lewis:
58:26
At the very least, we should probably say that maybe we need kind of humility, especially with millennials and younger, we need the humility to stop ourselves from diagnosing our friends and family with disorders on the DSM.

Unknown:
58:42
We have this tendency to medicalize our normal everyday, you know, feelings and experiences, and if they're inconvenient, are not what we imagined them to be. We tend to label them as a problem. I think this is where things start to fall apart. For that reason, I believe it's harmful because we are Miss labeling normal experiences by incorrectly diagnosing them as conditions that need to be treated, there will be later may be seeking help when it's absolutely not necessary. And when we talked about this, I've introduced this concept when it comes to therapeutics of risk benefit, right? There's no such thing as a good or bad medicine, there is a medicine whether positive benefit to risk ratio for certain conditions in certain patients. And the medicine needs to be applied in an appropriate context to an appropriate person to achieve a beneficial result otherwise, it's most likely harmful. Once we combine the kind of the perfect storm I would say you know we do not have a clear diagnostic criteria. We do not have appropriately trained and up to date professionals in that space. We have a medical language creeping in into everyday language with prompts people to think about themselves as Miss adapting Because the reality doesn't meet their expectations, and they started to seek help from those very professionals who kind of embedded those ideas in their heads in the first place, and started undergoing, you know, treatments and therapies that they don't need. That's where the harms start.

Brendan Lewis:
1:00:17
This is a great opportunity before we get into our last two questions to highlight something that I really wanted to highlight for the listener, because it occurred to me that we have all read the same books, we have access to the same information. But I remember what it was like to kind of have an awakening or realization as I read into the history of psychology and psychotherapy. And more importantly, when I found books like yours and House of Cards by Robin Dawes, these books go into the actual research on the efficacy of therapy and psychotherapy. And we've already touched on this, but I think it really bears repeating and kind of drawing out and highlighting for the listener, because people really may not be aware, and as we said, At the onset of the discussion may be taking for granted that these therapies are effective. But there's actually been research done on the efficacy of these therapies. And the meta analysis really doesn't look good. Can you talk a little bit about the the meta analysis and how kind of abysmal it actually turns out to be?

Unknown:
1:01:17
You're absolutely right, that the common conceptions that people hold about psychology or the things that they might be remember, have been long disproven, but somehow do not make it into the public minds. You know, they were started writing the book at the verge of 2010. I think it was published in English language in 2015. And, you know, by now there's a updated version of the book. And there's also a new one with a new title, called psychology led astray. Because even in the five years since the publication of the book, there's so many things have changed in that space. You're absolutely right. When you look at the robust meta analysis of many studies in psychology, most of them do not hold to scrutiny, the vast majority of the experiments are completely unable to be replicated. This is a an interesting phenomenon that we're dealing with. Because a lot of people have heard something probably in the past about the you know, the famous prison experiment, or, you know, Zimbardo his experiments, those are popular constructs and truths taken for granted. But we now know that the vast majority vast majority of the psychological research is completely impossible to replicate that the end repeated experiments, the results show, sometimes completely opposite results. Meta Analysis of therapies, and for the vast majority of the modalities doesn't leave a shadow of a doubt that the vast majority of them for the vast majority of patients are completely ineffective. And sometimes you will encounter effective by which I mean that they bring harm, rather than help. I think a great example here is the fact that we've probably seen in a popular culture in movies, you know, every time there's a disaster, or an earthquake plane crash psychologist has been deployed to help the victims to deal with trauma, right? There's plenty of evidence right now. And this is beyond a shadow of a doubt that this is actually the worst thing that we can do to the victims of a sudden event, right? We know that this type of intervention, even though it's very embedded in the popular culture, makes it more difficult for people to recover from traumatic events, just the last thing we should be doing. And this can be said about the vast majority of the popular interventions in psychology.

Brendan Lewis:
1:03:22
Thanks for highlighting that with me, it's point that I really wanted to drive home to the listeners, because it's easy for us to take for granted what we've already read, and what we've already did the research that we've already seen.

Danielle:
1:03:31
Yeah, so I'll transition to asking my last question. My colleagues in the developmental sciences are demonstrating the many ways in which our genes experiences and social worlds shape who we are. And in an earlier podcast, Brendan, and I spoke to Dr. Bruce Hood, the author of the self illusion about exactly this, his comprehensive review of evidence points to the idea that humans don't actually have selves in the way that we think that we do. There's no static inner essence or a monkey list inside our brains that contains the constant characteristics that define us. Rather, how an individual behaves is highly context dependent. And you've been using this idea of context dependence in a lot of your answers previously. So our behavior is not determined by some rational, stable internal entity making executive decisions, but instead reflects dynamic interactions between our environments or embodiments, our cultures and each other, each of which in turn entails strategies that have evolved over hundreds of 1000s or even millions of years. And all of this means that there's no, quote, true self to discover or express, and certainly not to take the helm of our behavior. So I'm curious whether this characterization of the self or more accurately the self illusion resonates with you, how do you think about the self?

Unknown:
1:04:47
Thank you, Danny. We're fearing further away from my expertise as a as a physician, and the author of psychology gone wrong, but it's an amazingly interesting question to ask. So I assume a couple of my thoughts. But from a non expert point of view, I'm fairly confident that our behavior is context dependent. And I also believe this is relatively well confirmed in an experimental research, I think a good way or intuitive way to understand this is if you look, someone in prison, right, for a person who, you know, was living a perfect life, never told a lie, you know, never harmed anyone, I'm pretty confident that a significant amount of those people would start to, you know, lie, fight and harm other people to survive if they have to, which is one example of a context dependent behavior. And another one that you have, I think, touched upon is that, you know, the to large degree, we are shaped by our genetics as well. Right? You it's difficult to say why certain people do and react in certain ways. Why is it that you can try to force me to play a piano, but you know, I will probably never wear any contest, even if I learn some basics, because you will make me work hard and practice every day. But you know, but they also people, when they, you know, when you lock them up in a in an empty cell, they will find something to play on. Right? There are certain things that were probably born with or certain predispositions that we're born with that shape and define why we do what we choose to do, and how we, how we live our lives. Now, the existence of self and kind of more, I think, philosophical conversation here. The current evidence suggests that, you know, both self and freewill are largely illusions, that the fact that our behavior is gene and context or environment dependent, means that we need to be able to have a proper understanding of objective reality in order to drive an appropriate debate again, based on that objective reality that will allow us to create you know, systems and institutions that can maximize their well being and our chances in society. A great book that I have personally found in citing is the book called blueprints written by Professor Robert plomin is a professor at King's College in London. And in that book, he has discussed the impacts of genes on ourselves and our behavior and our preferences. And I think it's also important because it does help to understand certain of the concepts and of self, from the kind of the genetic lottery that we all receive at the time when we are born. And it can definitely change the way how many of us think about ourselves, and how do we understand, you know, what we're doing and how we're going through life, and maybe even help people realize that sometimes we have to let certain things go, because it's gonna make our lives easier. But I fully agree with you when it comes to our ability to make decisions. This is context dependent. And when it comes to, you know, the intuitive understanding of this, I think it's also clear that even when we ask people you know, to define what what they are, you know, what the self is, they will give you a different explanations depending on a different context, right? They people often say, oh, you know, I'm this person, I work and I am someone else at home. We behave differently in different situations, we're always forced by life, to find ourselves in a radically different circumstances, for example, like it would be in a case of a war. But I do strongly believe that we do have different selves, which means we react, respond and act differently, depending on the context we find ourselves in.

Brendan Lewis:
1:08:14
Yeah, your example of the prison reminds me of a conversation I had the other day where a friend of mine had sent me an article to read that was trying to kind of knock down some of these ideas about human nature that come from people like Steven Pinker, and folks of his ilk. Some of these ideas in cognitive science and human behavior being context dependent are sort of inconvenient to political ideologies that want to believe something a little bit more black and white, like humans are generally cooperative, or humans are generally aggressive and taking advantage of each other. And it turns out, it's, it's more context dependent. It's somewhere in between. And so this article had brought up the Tonkin children who were stranded on an island and they were all very cooperative, which, you know, they compare with William Golding's Lord of the Flies. It's this book that a lot of us read in grade school, about these kids who are stranded on an island and they all start to kill each other and go mad, and they form gangs and things. But it turns out, there's an example where some children from Tonga were stranded on an island and they cooperated and they were peaceful. But you know, it turns out, they were able to fish they had food. Now compare that with the South American soccer team that crashed into a snowy mountain and did not have food, and then they ate each other. So I pointed that out to my friend, when I read the article with some kind of skepticism that humans are context dependent. If you're able to fish then you're able to cooperate. If there's no food, then you might eat each other, or you might fight for what little food is available to you.

Unknown:
1:09:44
I think you're absolutely right. And I think that it's grossly inappropriate for us to predict how we would behave in certain situations. As I said, you know, I'm a physician by training I spend my life training how to save people life or how to improve their well being. And for me, it's extremely difficult To even predict how I will behave in an extreme situation like this. But I'm reasonably confident that if my survival will be kind of a threatened, it's very likely that I will do or at least consider doing things that I consider to be unimaginable right now, right? I genuinely do not do not know how I would behave. And a lot of people do extrapolate their daily experience into those extreme circumstances. And I don't think that's the correct or the right thing to do.

Brendan Lewis:
1:10:30
Great. So I'm going to take us into our last question here, we're going to wrap up by going even broader still. So maybe even farther away from your particular expertise here, but this is what we'd like to do on the podcast. We'd like to kind of take foundational ideas that we think everybody should know about and see how broadly we can take them and where we can go with them, even if it's just kind of hypothetical or experimental and thinking. So we're living in an age where the messaging we receive about what is quote, good for us, and even good for society is all very self oriented. So coming off of Danielle's question about the self, you hear this kind of banal sloganeering about loving yourself before all else doing you being your true self, no matter what anyone thinks, setting strict and uncompromising boundaries around your personal and your emotional needs, cutting allegedly toxic people out of your life and myriad other platitudes of this kind. And this is all very therapeutic language. But it occurs to me if you really stop and think about what a society built on this kind of behavior would look like where everyone acts like an island governed by their own emotional whims and their evanescent self concepts. It becomes obvious how selfish and immature this society would be. The slogans offer terrible advice for at least two reasons. The first as we just discussed, as Danielle brought up is that they're patently wrong. There's no true self to go looking forward to to actualize we're kind of chasing an illusion, the self is very context dependent, we could be a completely different person waking up on the wrong side of the bed than we were yesterday. We act differently with our friends than we do with our family and our co workers and so on. The second is that maturity in the human experience, it arises from a long life of realizing that we are not omnipotent. We're not all powerful. We must often make sacrifices, work hard, pay our dues, follow rules, defer enjoyment, take a few blows kiss up to people we don't particularly like, and approach close relationships with forgiveness with grace with humility and compromises. A society that centers around a self and its emotional needs and boundaries, a society in which we're quick to label anyone with conflicting perspectives as toxic or narcissistic or somehow disordered. A society that insists we all act out of whatever a true self is, seems to be not only astonishingly immature, but maybe even delusional, and also frighteningly dysfunctional. These are terrible ways to approach friendships, family, romances, our careers. And perhaps that's partly why we're seeing what we are with identity politics and interest groups and political parties swinging back and forth and being rather ineffective, the increasingly obstructionist tactics in our legislative bodies. So to get to my question, are these over medicalized? And over psychologize frameworks that we're using to determine how to live actually somewhat pathological? Are they getting in the way of our ability to have normal human relationships, but also as society to address large scale problems, such as poverty and climate change, and things that need a certain amount of sacrifice and forgiveness and understanding of people with conflicting views from our own?

Unknown:
1:13:47
Well, you're touching on a multiple topics here and that question, be yourself? Well, I think even in the context of what we have discussed today, right, showing different cells in different situations and contexts is mainly us, you know, cutting toxic people who was toxic, why is it someone you know, is a person who beats up their partner or children or you know, to death? Is that a toxic person? Is it someone who, who has a different opinion, to your opinion on on a certain political issue? You know, I really struggled to understand what that means. You know, a physician in the pharmaceutical sciences toxicity is a very well defined terminology, I'm not really sure how to apply it to humans. I think that humans and consumable doses are not really toxic, apart from maybe the liver, or kidneys. But this is not a practice that most humans kind of embed themselves in. toxicity is a scientific concept. I don't know how to apply this advice in individual circumstances. Those examples conflate recommendations or advice that could be applied in some circumstances, right and generalize this to give the somehow oversimplified general view of or rules for life that are aimed at keeping people who listened to them In a comfort zone, while staying in a comfort zone is the opposite of growing. We didn't know how to ride a bike, let's say we don't know how to ride a bike. And it's really difficult to keep falling. And it's a huge problem, the only thing you can do is step out of your comfort zone and expand and learn and then it becomes easy to you because you've mastered a certain skill. Comfort Zone is not necessarily the place where we want to stay for our entire life is the opposite of our growth of our you know, in this case of the growth of our resilience towards cutting out toxic people. Again, it depends what it refers to. I think if this is just you know, if we're using this to cut out people with different opinions by muting them on Facebook and not talking to people who know something that we might not know, it's actually counterproductive. It's we're doing ourselves harm while growing less resilient. This is a terrible advice. Probably, it's clear now I struggle with the concepts of or the advice of being yourself in every situation. If I go for a heart surgery, do you know do I want to see my surgeon's, true self, whatever he thinks about this, but I don't want to see his best professional self, or you know, the best self during my surgery, I don't really care about, you know, how he feels about himself, or what he does outside of work. At this particular moment, I want him to be the best, the best surgeon that he can be professionally in that iteration of his self, those thoughts. And those considerations make it very hard for me even to grasp the focus of chasing true self, I think the best way to describe it, this is bullshit advice. That doesn't seem to make any sense to me.

Brendan Lewis:
1:16:30
Yeah, at the very least, possibly a stand in for the idea of feeling good, which takes us kind of full circle to where we started the beginning of the conversation that this is the assumption of therapy, that that we're supposed to feel good all the time, not that life is challenging. Life is hard. As you pointed out, we're not really entitled to feel good all the time. Sometimes we just have to keep our heads down and get on with it.

Unknown:
1:16:51
I think that this obsession with focusing on yourself, we used to call it being selfish, it became politically incorrect to call people selfish, especially in public, by taking it to the next level by you know, making it a way of living. I think there's something clearly wrong with this. It's not the right way to go. And as I've said, you know, it's not, it's not good for you, it's good for your relationships, and friendships and family, right? being selfish or self obsessed. How does that help to get you where you want to be? Or how does it help you build, you know, healthy relationships, where you have to deliberately sacrifice things in order to make those those relationships work, right. And such as those things, I think it's just a bad choice to be selfish for most of the things in a modern life. And when we take those things and expand them into the world of politics or institutions, you know, that can become self serving, it becomes a disaster, right, it becomes a self perpetuating stream of things that we should all strive to avoid. And combining this with the fact that each of us feels different. And you know, it's different as an individual, there's growing divisions in society as well. We have an infinite number of ways that we can divide people, right? I don't think this is the right way forward, right? Being yourself is a completely useless concepts and like terrible advice to give people for most of the time, you know, I personally dream to live in a world built on, you know, solid, objective foundations in reality, rather, this is always uncomfortable for us, when we seek commonalities between people, not divisions, and when we set ourselves ambitious goals and step out of the comfort zones. And, you know, and we grow as humans, but also grow as a species, right. And it would be great if our life could be governed by you know, not short term gains, or imagine gains, but but kind of a more by the long term goals, both individually. And as a society, I think climate change is a great example that they can use here. So it seems to me that the focus of on the first on the short term gains, which is, I think, the predominant way that most people choose to live their lives today, we have somehow lost the ability to focus on the on the longer term outlook for us and for the for the society as well. So again, I hope we can someday live in a world where those proportions are reversed. Yeah,

Brendan Lewis:
1:19:03
that's incredibly well said. And I'm glad you were willing to go there with us today. Because I, you know, when I read books like yours, I do see there being a political and civic importance to the information that you've put out into the world. If we can exercise a little bit more skepticism towards therapies that are encouraging us to act out our impulses to be our true selves to always feel entitled to being happy, as opposed to the kinds of sacrifices that make societies function well, the kind of compromises and sacrifices that we have to make to have a functioning society. There is a real political importance here to the work that you've done. And so I want to wrap up by saying thank you for this book. Thank you for the work that you're doing and kind of carrying the torch for in all too rare form of skepticism about these kinds of dubious therapies and frameworks that we are increasingly using to guide our decisions in life possibly to our detriment. Thank you for having me. Thank you so much.