Komisar: Why early presence shapes lifelong mental health

1. 0:00 – 2:16

   Intro

   1. EKErica Komisar0:00

      One in five children will not leave childhood without developing a serious mental illness. Anxiety, depression, ADHD, behavioral problems. And what pisses me off, it's that we're not really educating or telling parents the truth as to why.

   2. SBSteven Bartlett0:14

      Why is it that what you say is so troubling for some people?

   3. EKErica Komisar0:17

      Sometimes facts are an inconvenient truth. But everything I'm gonna say is supported by research.

   4. SBSteven Bartlett0:23

      Erika Komisa is a parenting expert and psychoanalyst.

   5. EKErica Komisar0:26

      Who uses over 30 years of research...

   6. SBSteven Bartlett0:28

      To challenge the societal norms on parenting and early child development.

   7. EKErica Komisar0:32

      There's some myths that really have to be debunked about how to raise a healthy child, and the first is, daycare is good for children for socialization. No. It's so bad for their brain, and it's been known to increase aggression, behavioral problems, attachment disorders, because babies need their mothers in the first three years for emotional security.

   8. SBSteven Bartlett0:50

      Can a father do that?

   9. EKErica Komisar0:51

      So, fathers are important in a different way, and I'll go through all of that. But they're both critical, because if you're raised without one, you are missing a piece. And then there's quality versus quantity time. Myth. You need to be there a quality of time as well as a quantity of time. You can't have a fabulous career and then come home and be present for your child on your time. It needs to be on their time. And there's more.

   10. SBSteven Bartlett1:14

       And we're gonna go through all of them, but are there any areas of privilege that you need to acknowledge? Maybe someone who doesn't have a partner there, or someone who is in an extremely difficult economic situation?

   11. EKErica Komisar1:23

       I do. But there are ways to creatively deal with it, and I'll go through each of them. So there's...

   12. SBSteven Bartlett1:30

       This has always blown my mind a little bit. 53% of you that listen to this show regularly haven't yet subscribed to this show. So could I ask you for a favor before we start? If you like this show and you like what we do here and you wanna support us, the free simple way that you can do just that is by hitting the subscribe button. And my commitment to you is if you do that, then I'll do everything in my power, me and my team, to make sure that this show is better for you every single week. We'll listen to your feedback, we'll find the guests that you want me to speak to, and we'll continue to do what we do. Thank you so much. Erica, you're clearly on a mission, and I get that energy from you that there's really an idea that you believe that much of the world doesn't believe or is struggling to accept

2. 2:16 – 5:17

   Erica's Mission

   1. SBSteven Bartlett2:16

      in some way, but it's an important idea. What is the mission that you're on?

   2. EKErica Komisar2:22

      I like to think of it as three Ps, presence, prioritization, and prevention. And I'll go through each of them. Um, my mission is to educate parents and, uh, policymakers and clinicians and educators about the, the fact that for children to be mentally healthy in the future, you have to be physically and emotionally present for them throughout ch- childhood, but particularly in the two critical periods of brain development, which are zero to three and nine to 25, which is adolescence. So in those two critical periods of brain development, uh, particularly zero to three, um, much of a child's development depends on their environment, and you are their environment. So, I run around the world talking about the importance of physical and emotional presence, attachment security. Attachment security is the foundation for future mental health. Prioritization. We prioritize everything today other than our children. We prioritize our work, our careers, uh, our material success, our personal desires and pleasures. But what we're not prioritizing is children. Um, and, you know, that's a problem because if we don't prioritize them, they break down. They may break down at three, they may break down at eight, or they may not break down till they're in adolescence, but eventually they break down. And prevention, there's so much that we can do. We have a mental health crisis now in the world. It varies to a certain degree in America. One in five children will not leave childhood without breaking down at some point, without developing a serious mental illness. Anxiety, depression, ADHD, behavioral problems, um, suicidal thoughts. So, uh, we have a problem. In the UK it's one in six, in America it's one in five. Uh, it's, around the world it's about one in five. That is a shocking figure, and so... And the, and the truth is we can do a great deal to prevent that. The idea that we are trying to put out fires without talking about what is the origin of these issues. The way that the mental health care system works now, it's like what I call cutting the grass. Uh, children are medicated, which is basically just pain management. Um, they're given CBT therapy, which again, is just pain management. But why aren't we asking the important questions, which is where does emotional regulation originate? Where does it come from? When does it start? How do we foster development in children from a very young age to promote resilience to stress and adversity in the future? And so those are my three missions.

   3. SBSteven Bartlett5:13

      And for someone who doesn't know your work and doesn't, isn't aware

3. 5:17 – 8:26

   Erica's Background

   1. SBSteven Bartlett5:17

      of you, they might be thinking, how would you know, Erica? How would you know the answer?

   2. EKErica Komisar5:24

      So I'm a psychoanalyst. Um, I'm also a social worker. I started out as a social worker and then became a psychoanalyst. I'm also an author of books on parent guidance and parents' education. Um, and I've been in practice seeing patients, so the majority of my work is still seeing patients. I have a full-time job of seeing patients and, uh, as someone who is also a parent, I have three children of my own. Um, and so as a parent, as a clinician, uh, as an author who has for the past...... 20 years been researching. And what I did is I collected research in epigenetics and attachment theory and neuroscience and, uh, wrote my first book being there. Because what, what happened is, I was seeing this uptick in mental illness in children, and this is really how I got into it. Um, about 30 years ago, I started practicing about 36 years ago, but I was probably five years into my practice and I was seeing that the families that were coming to see me had younger and younger children that were being diagnosed with very serious mental illnesses and being medicated at a very young age, basically silencing their pain. And what I was observing, in my practice, is that those children who were doing the least well were the ones whose mothers were the least present in their lives. So, their primary attachment figures were the least present in their lives. And so then I started looking at the research. I looked at all the neuroscience research since the '90s and all of the new, new research that had come out. Um, I looked at the old attachment theories which had been around since the '60s and I looked at the epigenetic research which was rather new too. And I saw this trend. I, I saw that we were abandoning our children for our own desires, for our careers, for material success. Um, and there was a great deal of misunderstanding about the irreducible emotional needs of children.

   3. SBSteven Bartlett7:32

      We're gonna go through all of that today.

   4. EKErica Komisar7:34

      Yeah.

   5. SBSteven Bartlett7:34

      I'm very excited to learn more about all of this. I'm not a parent myself. Um, from all the investigative research we've done, you have three very well-adjusted children. Um, so congratulations for that. And I hope to have successful children myself one day. But I'm also just really interested in understanding myself through the work that you've done and the work that you continue to do because we're all, at one point, children, and much of the fingerprints of that early experience still exist in us today. So I'm keen to understand how things that might have happened to me or anyone listening today when we were younger may have shaped us in pro-social, antisocial ways, or productive, unproductive ways. You mentioned that you still see clients and patients today. What kind of patients do you see? What are they struggling with and who are they? Are you seeing the parents, the kids, both?

   6. EKErica Komisar8:24

      Well, I have a very large parent

4. 8:26 – 9:49

   Who Are Erica's Patients?

   1. EKErica Komisar8:26

      guidance practice because of the books that I write, um, and the articles I write. I also write for the Wall Street Journal and other newspapers. So I, um, you know, people find me through my writing, um, and then they reach out for help. Um, and, and so I have... The parent guidance basically means people come to see me, either both parents or one parent, because they have questions about their child's development or something's going wrong. Their child's starting to, to develop symptoms, um, and they don't want to medicate them, and they want to understand what's really at the root cause of, of, of the issue. And so that's a, a good portion of my practice, but I also see individual patients for depression and anxiety, and I see couples. And, you know, the joke about psychoanalysts is we're all specialists in depression and anxiety. (laughs)

   2. SBSteven Bartlett9:15

      (laughs)

   3. EKErica Komisar9:15

      But, um, yeah, so I see individuals and couples, but a lot of parent guidance work.

   4. SBSteven Bartlett9:20

      And they come to you typically because there's, they're noticing something is not right with their child.

   5. EKErica Komisar9:25

      Sometimes they'll come preventatively because they want to raise a healthy child, and there's so much white noise in society. There's so much of misinformation. Our instincts are to lean into our children. Our evolutionary drive is to create a feeling of safety and security for our children and to be as present as possible and to soothe them when they're in distress

5. 9:49 – 13:14

   How Have Social Changes Influenced Parenting?

   1. EKErica Komisar9:49

      and to be there to teach them our values. And... But society, um, took a turn. It took a turn in the... I suppose you could say going back to the Industrial Revolution. If I really want to go back, I'll say the Industrial Revolution was a time when women were forced into the workplace, into factories in cities, you know. They were separated from children for the first time. But really the turn that society took that, that I think has a lot to do with what's happening today is the Me movement of the '60s and also the feminist movement. Both of those movements, which had a tremendously positive impact on society in one way also had a tremendously negative impact (laughs) on society. Um, when women decided that it was cool to go to work and to work full time out of the home, you know, everybody cheered and said, "Great. You know, women have the same rights as men and now everybody can be in the workforce and be independent and make money and do their own thing. Me, me, me, me, me." The problem is that children were dropped. Mm-hmm. They were abandoned. And their needs, which are not needs that are going to shift because society shifts, because they have irreducible, uh, neurological emotional needs. So we know that babies are born neurologically and emotionally fragile, and so what that means is they're not born resilient. And today, what's being projected onto babies is they can handle a lot. They can handle stress, they can handle separation, um, they can handle you going back to work after six weeks or three months and leaving them in daycare with strangers or, you know... And fr- from an evolutionary perspective, babies have always needed the physical skin-to-skin contact with their mothers for the first year. Most parts of the world, babies are worn on their mothers' bodies because mothers perform a number of really important functions for babies that are biological functions based on our evolutionary need....to provide our babies with what we call attachment security. Um, so, you know, society took a turn and it's, it's, um, it's caused a lot of damage. I mean, this mental health crisis in children, I saw coming 30 years ago and it was already, you know, so, um, you know, I have, uh, friends and colleagues like Jonathan Haidt who says, "Oh, well it didn't start till social media." And that's false, because I was seeing this uptick. And if you really look, there was an uptick in mental illness in children, um, going back decades and it had everything to do with the shift in society towards, I- self-centeredness, towards narcissism, towards individualism, towards me, me, me. And so, you know, and I always say that you don't have to have children, period, to have a satisfying life, but if you're going to have children, you need to be equipped to care for them. Because having children alone without really understanding what it means to care for them and being prepared to take on that responsibility, uh, is causing our children to break down.

   2. SBSteven Bartlett13:07

      Why do you mention mothers and not fathers in that? Because you've, you seem to have an emphasis on the role that a mother plays and it seems to be

6. 13:14 – 16:44

   Is the Role of a Mother More Important Than That of a Father?

   1. SBSteven Bartlett13:14

      more important in your view than the role that a father plays or maybe even that a nanny or some other caregiver could play. And I noticed that on your first book, which was written in 2017, Being There, on the cover it says, "Why prioritizing motherhood," in bigger letters, "in the first three years matters." Scientifically, evolutionarily, with studies and research, how can you make the case to me to make me believe that the role of the mother in particular is essential versus a father or other caregiver?

   2. EKErica Komisar13:44

      So in fact, in the book, it talks about the difference between mothers and fathers, 'cause that's an important question. Um, and the reason I wrote about mothers is not because fathers are unimportant, but fathers are important in a different way. So there's a whole debate in society about this kind of idea of gender neutrality, that mothers and fathers are interchangeable. But actually from an evolutionary perspective as mammals, they're not interchangeable. They serve different functions, and those roles and those behaviors are connected to nurturing hormones. So mothers, um, are really important for what we call sensitive empathic nurturing when children are infants and toddlers. That means that when children are in distress, mothers soothe babies and therefore regulate their emotions from moment to moment. Every time a mother soothes a baby, uh, with skin to skin contact and eye contact and the soothing tone of her voice, she's leaning into that baby's pain and she is regulating that baby's emotions. And the way I like to think about it is that, you know, when babies are born, they're born emotionally disjointed. Think about sailing in the Atlantic. This is how babies' emotions go. They'll go from 0 to 60 in 3 seconds with their emotions. Um, and where we want to get babies is to sailing in the Caribbean. Not flatlining, but we want them to be able to regulate their emotions, but they're not born that way. And so mothers, w- because they soothe the baby from moment to moment when they're physically and emotionally present enough in the first three years, they help a baby to learn how to regulate their emotions, so by three years of age, 85% of the right brain is developed. And by three years of age, babies can then start to internalize the ability to regulate their own emotions. Now, if mothers aren't present as the primary attachment figures to do that mirroring of emotion, to do that soothing of, of their emotions, then babies don't learn how to regulate their emotions. The other thing that's important that mothers do is they buffer babies from stress by wearing them on their body for the first year, and then by being as present as possible for three years, they actually protect babies' brains from cortisol, the stress hormone. So there is a, a hormone called oxytocin. It's the love hormone, and it is protective against cortisol. The more a mother nurtures with sensitive empathic nurturing, meaning when the baby cries, the mother goes, "Oh, sweetheart," you know, "let me see the boo-boo. Let me kiss the boo-boo," that actually raises the oxytocin in the baby's brain which then protects the baby from cortisol.

   3. SBSteven Bartlett16:36

      Can a father do that?

   4. EKErica Komisar16:37

      So now, fathers. Why are fathers important? So fathers also produce

7. 16:44 – 21:07

   Why Are Fathers Important From a Biological Level?

   1. EKErica Komisar16:44

      oxytocin, but it has a different effect on their brains. So for mothers, oxytocin makes mothers sensitive empathic nurturers, very vigilant to the baby's distress. When fathers produce oxytocin, it comes from a different part of their brain and it makes them more what we call playful tactile stimulators of babies. What does that sound like to you?

   2. SBSteven Bartlett17:05

      Playful tactful stimulators of babies?

   3. EKErica Komisar17:08

      Throwing the baby up in the air and tickling the baby-

   4. SBSteven Bartlett17:10

      Okay, yeah, messing around.

   5. EKErica Komisar17:11

      ...and running after the baby and roughhousing. And so that's important for a variety of reasons. Um, first, it encourages things like exploration and risk-taking. It encourages separation. And fathers do this really important thing which is they help the baby to learn to regulate certain emotions. So mothers help to regulate sadness, fear, distress. Fathers help to regulate excitement and aggression. So when fathers aren't in the house, when there are single mothers raising children without a father, often little boys develop behavioral problems is what we're seeing, that they can't regulate their aggression, because fathers help little boys in particular, but little girls too, to regulate aggression. So when fathers aren't around, you'll often see little boys who are more impulsive, who are more aggressive. Um, so the answer is fathers and mothers are both critical to the development of children, which is a very controversial thing to say today, because if you're raised without one, you are missing a piece. But they're not the same.... and they're not the same because our hormones dictate they're not the same. So, fathers produce a hormone in great quantities called vasopressin. Vasopressin is the protective aggressive hormone. And what does it do? It helps fathers to protect their family. There was a study that was done where mothers and fathers lay in bed and the baby cries. Uh, it was out of the UK, this study. The baby cries and the fathers sleep through the baby's distressed cries, but the mothers wake up right away. Okay? But with the rustling of leaves outside the window, the mothers sleep through it, and the fathers wake up right away because the fathers are attuned to predatorial threat. So, our nurturing hormones make us different. I mean, the fact that we can say that there are many things that are similar between women and men, of course. We're both intelligent. We can both be ambitious. Um, but I think the idea that we want to kind of make everything the same when it's just not factual. It is the inconvenient truth that mothers' and fathers' nurturing hormones dictate that if they are healthy and they've been raised in a healthy environment, they are different. Now, does that mean that a father can't raise a child and be a sensitive, empathic nurturer? It, it doesn't mean he can't take on that role, but if, as a society, we can't acknowledge the differences, then a father can't learn to be a sensitive, empathic nurturer. Meaning, these are instinctual behaviors, and so that infant, if that father is gonna stay home with that baby, acknowledging the differences allows that father then to become a sensitive, empathic nurturer.

   6. SBSteven Bartlett20:10

      So interesting because these aren't the ideas that are socially accepted, or at least the ideas you see on social media. And funny enough, as you were speaking, I recorded everything you said and I ran it through AI, and AI said the core ideas that you shared, um, are well supported by evolutionary psychology and neuroscience. Which is quite surprising 'cause usually-

   7. EKErica Komisar20:29

      Yeah.

   8. SBSteven Bartlett20:30

      ... AI argues with people.

   9. EKErica Komisar20:31

      I mean, so, so the thing is none of the books I write are based on opinion. So, I'm, I'm very skittish about saying anything that isn't backed up with research. Um, so it's... Everything that I write about and speak about is, is supported by research.

   10. SBSteven Bartlett20:49

       Why is it that what you say is so troubling for some people? Have y- you know why, right? 'Cause it, 'cause it makes us confront a set of realities that-

   11. EKErica Komisar20:57

       It's an inconvenient truth-

   12. SBSteven Bartlett20:59

       ... are inconvenient.

   13. EKErica Komisar20:59

       ... to quote Al Gore (laughs) .

   14. SBSteven Bartlett21:00

       Yeah. Exactly.

   15. EKErica Komisar21:00

       It's an inconvenient truth. Um, sometimes facts are an inconvenient truth just like, you know, climate change

8. 21:07 – 23:34

   Is Guilt a Bad Thing?

   1. EKErica Komisar21:07

      is an inconvenient truth. Um, this is an inconvenient truth. It inconveniences people. It also makes people feel guilty. So, I don't believe that guilt is a bad feeling. I don't believe that guilt is a bad thing. Guilt is a sign that your ego is functioning. It's a sign that the part of you, the part of your ego called the superego can identify something that feels right and wrong. So, if you look at a baby who's crying, who's your baby and you feel nothing, that means that there's a part of you that is dead inside. There's a part of you that is unempathic towards your own young. And we would say that that doesn't make that person a bad person. It makes that person someone who probably had some early trauma themselves, right? It means that they probably have some kind of attachment disorder where they can't be attuned to their, their baby's pain, right? So, when you are guilty, it means you have internal conflict. It means two parts of you are struggling with each other.

   2. SBSteven Bartlett22:11

      Mm-hmm.

   3. EKErica Komisar22:12

      The part of you that wants to do whatever you wanna do, "I wanna go out to work. I wanna make money. I wanna be free." (laughs) You know, and the other part of you that says, "Wait a second. But my baby, my baby needs me. Look at my vulnerable baby. Look how sad, look at the distress that my absence is causing that baby." So, if we don't feel guilt, then our species is lost. We're lost. Now, excessive guilt is another thing. If you're a good enough mother or a good enough father and you still feel guilty, then we call it anxiety. But for the most part, what I say makes a lot of women and men feel guilty. And again, I don't see that as a bad thing, and I think when we tell parents to turn away from their guilt instead of turning toward it, when we turn towards our internal conflicts, we tend to make better decisions for ourselves, for our children, for our families. Um, but when we turn away from those conflicts, we tend not to make good decisions, and those tend to have long-term consequences.

   4. SBSteven Bartlett23:20

      What exactly are you inconveniencing with your truth? What are the ideas that you're...

   5. EKErica Komisar23:26

      That you have to sacrifice time and money and freedom. That if you want

9. 23:34 – 25:31

   Erica's Unpopular Ideas About Parenting

   1. EKErica Komisar23:34

      to raise healthy children, it's going to require discomfort and frustration and sacrifice. And what's interesting is that what's also happened is because we're raising our children in such a selfish, self-centered environment, um, young people are more fragile. They are more emotionally fragile. More of them have attachment disorders. They can't bear frustration. They can't bear pain. They can't bear sleeplessness. You know, the idea that you have to get a baby nurse because you can't get up in the middle of the night with your own baby, and that's become the norm in certain socioeconomic circles. I mean, uh, so women and men always raised children in, in history in extended family circles.... right? Um, they weren't isolated. And today parents are very isolated, so you would have your mother staying with you, or you'd have your sister staying with you, or you'd live in a big house and there'd be people to support you. Um, I started a non-profit, uh, recently because I found that so many mothers, it's called Attachment Circle, so many mothers feel so isolated that dealing with the pain and the discomfort of mothering alone is too much for them. So there is that. So we live in a very strange society where people are separate from one another in their own houses and apartments, and they don't depend on one another 'cause dependency is a bad word and... But there, there is also this issue of how are we producing such frag- fragile youth that even the discomfort and the frustration of raising children is too much for them?

   2. SBSteven Bartlett25:22

      There's a, a big economic component to this as well, right? Because if you're raising children in isolation, the probability that you have disposable

10. 25:31 – 27:45

    Family Diaspora: Raising Children Without Extended Family

    1. SBSteven Bartlett25:31

       income or at least enough money to be able to just stay at home and raise the kids and still maintain any standard of, quality standard of life is lower if you're not doing it with a big extended family that can support and, and pay for some of those costs.

    2. EKErica Komisar25:48

       Interestingly, yes and no to your question. Um, people who have less economic resources are, in general, less isolated, but they are also isolated today. You have a lot of single mothers raising children not in an apartment with other family members, who've had to move to other cities or countries to make a living, um, who are really isolated. Uh, uh, you know, again, it, I, I think it crosses socioeconomic lines, um, but with wealthier people, more affluent people, um, they're opting for isolation, (laughs) many of them. They're buying big houses, they're living in the suburbs or, or they're not wanting to lean on anyone, right? So we have what I call a family diaspora. It's really what it, it is, um, which is that people will move away from their families of origin when they (laughs) have children, which is very bizarre and anti-instinctual. So the world's become a global place and we can move wherever we want, but doesn't it make common sense, isn't it a reasonable clause that you would want to move closer to your extended family, even if they're a pain in the neck unless they're abusive, um, because it provides you with support. It provides you with extended family support. But that's not what's happening. People are choosing to live geographically distant from their families of origin, and so it's making it harder for families. It's making it harder for women. It's making them feel more isolated. Um-

    3. SBSteven Bartlett27:32

       But what if they, they want a... They've got their own career, they've got their own passions, there are things that they love doing and that means that they have to be working in a major city or they have to be traveling to pursue those things?

    4. EKErica Komisar27:44

       Mm,

11. 27:45 – 28:44

    Can Raising Children Away From Extended Family Be Justified?

    1. EKErica Komisar27:45

       you just said it. What if they have passions?

    2. SBSteven Bartlett27:48

       Right.

    3. EKErica Komisar27:48

       What if they have a career? The problem is children do best in extended family situations so, you know, you can have a fabulous career and move far away from your family and when you're young and single and... I, I even call it single when you're married but don't have children. You're still really single. (laughs)

    4. SBSteven Bartlett28:06

       (laughs)

    5. EKErica Komisar28:07

       Um, you know what I say to parents is that your life won't be so fabulous if you have children and you're not present for them physically and emotionally, particularly in the early years, because what happens is they break down, and the expression goes that a parent is only as happy as their least happy child. And so there is no fabulous life if your children are breaking down. And that's what families are learning is that, you know, all of that freedom and all that fabulous me time comes at a cost if you have children.

12. 28:44 – 29:39

    Voluntary Childlessness

    1. EKErica Komisar28:44

    2. SBSteven Bartlett28:44

       So one would say then, "Well, I just won't have children then."

    3. EKErica Komisar28:47

       And that would be fine. And so there are a lot of people that are saying today, "I don't see the value in being responsible for another human being," and what they're missing out on is the deep and rewarding emotional connection to your children. It's a love like no other love. But if you've had... If you've had trauma as a child, if you've had parents who were narcissistic or resented parenting or, uh, you know, uh, were distracted or mentally ill, you know, uh, you may already have had that trauma that, that implies that later it's harder to connect, right? So those attachment disorders that I was referring to earlier. There's three kinds of attachment disorders.

13. 29:39 – 33:54

    Attachment Disorders

    1. EKErica Komisar29:39

       There's the avoidant attachment disorder. So what does that mean? So a healthy attachment looks like this. Um, when you return home, your child feels so securely attached to you, meaning you've gone out for a- an hour or two for dinner with your spouse. You come home and your baby is happy to see you and the reunion, what we call the reunion, is a beautiful reunion. The baby is joyful and happy and, you know, that's healthy attachment. It means that you've made your baby feel so safe and secure because you are there primarily and have prioritized them the majority of the time as the primary attachment figure that when you come home, your baby welcomes it.... but what we seeing is more and more children developing attachment disorders because their parents are pushing the limits of how much they can leave those babies, and putting them in things like institutional care, and leaving them for long hours at a time, and traveling for their fabulous careers (laughs) and their fabulous lives at ages when babies really can't tolerate that kind of separation. When a parent comes, when the primary attachment figure, usually the mother, comes home and the baby turns away from you and turns toward the babysitter or towa- or just turns away, that baby has the beginning of what's called an avoidant attachment disorder. Now, that's correlated later on with things like depression and difficulty forming attachments later on. The next kind of, uh, attachment disorder is called an ambivalent attachment disorder, and the mother then comes home and the baby clings to the mother for dear life. Because the internal voice in that baby is, "My mommy's gonna leave me again, so I have to hold on to her." Now, that baby is fractious and can't be soothed, and will not let go of that mother, you know, holding on for dear life, what I call like the rhesus monkeys did to the wire cages, right? And that's correlated later on with anxiety in youth. The disorganized attachment disorder is different than the other two in that the other two have a strategy. So think of an attachment disorder as a strategy. A child who's left for too many hours by their parent or whose parent is physically present but emotionally checked out, that baby has to f- cope, has to have a strategy. Turning away from the mother is a strategy, and the internal narrative is, "My mommy isn't present for me, can't, isn't, isn't here for me, won't, won't be there for me. I can't trust my environment." And that baby says, "And I'm gonna have to, uh, cope on my own," what we call learned helplessness. Um, the ambivalent attachment disorder, you know, that baby is, the strategy is, you know, "I'm gonna hold on because if I don't hold on, she's gonna leave again." Disorganized attachment disorder is the hardest to treat, um, because the baby has no strategy, so the baby cycles through many strategies. The baby will go from clinging, to avoiding, to being enraged and even slapping or hitting the mother, and then cycling through again. Um, and that baby that develops a disorganized attachment disorder, those are more, those babies, it's correlated later with borderline personality disorder. And we're seeing a huge rise in borderline personality disorders, and those are the kids who are cutting themselves, who are trying to commit suicide. Um, we have a, a mental illness crisis, the likes of which we've never seen in history, and it has everything to do with how we're raising our children.

    2. SBSteven Bartlett33:23

       You seem pissed off under that calm demeanor.

    3. EKErica Komisar33:26

       Pissed off? Yes, I suppose I am. I'm not pissed off at the people. I'm pissed off at a society that is lying. We're not really educating or telling parents the truth.

    4. SBSteven Bartlett33:40

       So there's four attachment disorders: avoidant, secure, ambivalent, disorganized.

    5. EKErica Komisar33:46

       Well, one, secure isn't a disorder, so there's-

    6. SBSteven Bartlett33:48

       Okay, secure is its own.

    7. EKErica Komisar33:49

       ... secure, and then there's three attachment disorders, yeah.

    8. SBSteven Bartlett33:51

       Avoidant, ambivalent, disorganized.

    9. EKErica Komisar33:53

       Yes.

14. 33:54 – 35:08

    How Do Attachment Disorders Manifest in Adulthood?

    1. EKErica Komisar33:54

    2. SBSteven Bartlett33:54

       How does that manifest when you're an adult? So how would I know? 'Cause, you know, I can relate to some of these, and I'm wondering how that would then manifest in my relationships or my life as an adult outside of the obvious mental health, you know, s- situations.

    3. EKErica Komisar34:07

       So avoidant, th- uh, an avoidant attachment disorder would be someone who, um, can't form meaningful and deep connections, can't commit, has difficulty committing, has difficulty trusting in the intimacy and the, the depth of intimacy in a relationship. An ambivalent attachment disorder would, would be someone who's highly, highly anxious, um, someone who clings to you, uh, calls you. Maybe, uh, a woman you've dated in the past who called you five times a day to check on you and was worried that you'd be the little fish that swam away, um, and suffocate. They suffocate the people they love because they're afraid to let go. Um, disorganized attachment, borderline personality disorders, they tend to be very emotionally volatile. Um, there's a lot of anger there, and, um, and there's a lot of self-harm, self-harming behavior there.

    4. SBSteven Bartlett35:05

       Do they end up attracting

15. 35:08 – 36:34

    Choosing a Partner Based on Attachment Styles

    1. SBSteven Bartlett35:08

       a certain attachment style? So if I'm an avoidant, do I then end up attracting avoidants, or do I, uh, i- is there any research on that, on how we then date? I'm guessing secures go for secures.

    2. EKErica Komisar35:19

       Yeah, secures... Well, if you're healthy, you're attracted to reciprocally healthy relationships, and you trust your environment, so you trust in loving relationships. And, um, avoidants sometimes are attracted to avoidant people because there's no conflict there, so in other words, someone who can't commit with someone also who can't commit. Um, that can break down, though, so at some point... So remember that these are pathological defenses, so, you know, we use the word defense because it means to protect one, right? And, and defenses help us until they no longer help us, and so we say attachment disorders are pathological defenses, meaning they don't usually last a lifetime. They break down at some point. And so you might be with another avoidant attachment disordered person, but at some point, one of you breaks down and then realizes that you need the other (laughs) and then, you know, then you're with, in a relationship with someone who can't give back (laughs) .So, yeah. As we say, like levels of water meet, so people will be attracted to one another often of the same ilk, but, but it isn't necessarily a healthy relationship.

16. 36:34 – 38:07

    Predicting Relationship Success Based on Attachment Styles

    1. SBSteven Bartlett36:34

       And of all these four attachment styles, who do you think, which attachment style from, in your opinion and from your observations and the people that you've seen, is most likely to have a successful and then also unsuccessful relationship?

    2. EKErica Komisar36:47

       Oh. Well, secure attachment will have a successful, I mean, secure, people with secure attachment, uh, will be drawn to healthy reciprocal loving, um, deep connections, because they've had a deep and loving connection with their mother. So remember I said that you, it's only after three years of age that you internalize the feeling of security, and where you internalize the feeling that the world is a safe place and you can trust the people in it, and you can trust to love another person. And so, you know, we, we throw that word trust around, but we don't realize that it comes from the very beginnings of our development. When we don't trust others, it's generally because we couldn't trust those that we were to depend upon when we were at our most vulnerable stage.

    3. SBSteven Bartlett37:40

       And what about the other, the alternative? So if, which of these attachment styles is least likely to have successful relationships with-

    4. EKErica Komisar37:48

       That's disorganized, yeah.

    5. SBSteven Bartlett37:49

       Okay.

    6. EKErica Komisar37:49

       They have a very hard time forming relationships, holding on to relationships. Um, yeah, I would say it's, it's they're the most complicated to treat, and they're also the most complicated in terms of, you know, being able to have successful relationships in the future.

17. 38:07 – 39:33

    Does Having More Children Correlate With Neglect?

    1. EKErica Komisar38:07

    2. SBSteven Bartlett38:07

       Uh, I was wondering as you were speaking whether if I have more kids, so if I have 10 young kids-

    3. EKErica Komisar38:12

       Yeah.

    4. SBSteven Bartlett38:13

       ... is there a higher probability that, of neglect in those kids? Because I j- if, if I'm a mother, I just don't have time for all of these kids at the same time. They can't all be on my chest at the same time.

    5. EKErica Komisar38:23

       Yeah. It's, it's a good question. Well, there's something in the developing world called maternal depletion syndrome, which is that mothers can actually die in the developing world of having too many children in too short a period of time. Uh, they get depleted physically, but they also get depleted emotionally. I'm gonna say it right now so everybody can hear it who's watching this, having children is stressful. It is frustrating. It does require that you are sleepless for the first five years. It requires that you can tolerate a lot of discomfort and frustration. So if there was a job description, first it would say, "The most joyful, uh, enriching thing you can do in your entire life, but what comes with that to foster healthy development is frustration, lack of sleep, stress, uh, d- discomfort." And so that should be part of the job description.

    6. SBSteven Bartlett39:20

       Yeah. It seems to be such an important principle for life generally that everything has a, uh, a trade-off. And I think, uh, was it Einstein that said, "E- for every force there's like an equal and opposite counterforce," or something to, to, to that effect,

18. 39:33 – 41:36

    Decline in Birth Rates

    1. SBSteven Bartlett39:33

       and a lot of people are choosing not to make the decision to have kids. I was looking at some stats around this. The European Union witnessed only 3.8 million births in 2022-

    2. EKErica Komisar39:43

       Yep.

    3. SBSteven Bartlett39:43

       ... nearly half the number recorded six decades ago, marking one of the lowest birth rates in history. France, for example, known for its robust family policies, has seen a decrease from 830,000 children born in 2010 to just 670,000 in 2023, the lowest since World War II. And this is a huge global trend across especially-

    4. EKErica Komisar40:08

       It is.

    5. SBSteven Bartlett40:09

       ... countries that have a lot of money.

    6. EKErica Komisar40:10

       It is. So I speak at a big conference called the Alliance for Responsible Citizenship, and they talk about a lot of these alarming dropping birth rates. The truth is though that, uh, as countries become more developed, birth rates do decline to a certain degree. That has to do with economics, some of it, but there's a trend that's happening that's worse than this, which is people, it's not that they're having less children, which actually, you know, everybody has their own limits in terms of their capacity to give and to love. And so for some people, maybe one child is enough. For other people, five children isn't enough, meaning they have so much inside of them to give, right? Um, but the alarming thing for me isn't the dropping birth rates due to economics, you know, so maybe people aren't having 10 children-

    7. SBSteven Bartlett41:04

       Yeah.

    8. EKErica Komisar41:04

       ... like they used to. They're having three children or two children, right? The alarming thing for me is that people are not having children. That's more alarming to me, because that's more a sign not of a country developing, but of a country and a society, of a modern society which does not see the value in, in raising children and having deep and loving relationships be a priority in your life.

19. 41:36 – 43:25

    What Is Unique About Relationships With Your Own Children?

    1. EKErica Komisar41:37

    2. SBSteven Bartlett41:37

       Those people would say, "I have deep and loving relationships with my partner, with my dog, with my uncle, auntie, friends, et cetera."

    3. EKErica Komisar41:44

       It's different. And why is it different? It's a good question. It's different because, um, in the end, your relationship with your partner or with your auntie or with your dog isn't the same level of dependency. The ability to care for another human being, uh, to allow another human being to be dependent on you, to devote to that human being, is a growing, transforming experience for human beings. One would say that, not sure I completely buy this fully because, but Jordan Peterson, I think, has said, I think it was Jordan who said that you can't fully become an adult if you don't have a child. Now, I'm not sure I would go that far because there's some people who can't have children, but I do think that there is something-... in terms of developmentally on an adult development level, that transforms you, that is meant to, to transform you in being generative and having children. Again, it's not for everyone, and I do say this, that, um, I'm not part of the pro-natality movement where I say everybody should have children. I don't think everybody should have children. But I do think that if you're going to have children, then you need to look deeply at your own upbringing and your own losses and your own early traumas before you bring them into this world so you can repair whatever it is you need to repair and not, uh, create what we call generational expression of things like attachment disorders and mental illness, and...

20. 43:25 – 46:59

    What Contributes to Growing Infertility Among People?

    1. EKErica Komisar43:25

    2. SBSteven Bartlett43:25

       'Cause a lot of people are struggling now to have kids, even those that want to.

    3. EKErica Komisar43:28

       Yeah.

    4. SBSteven Bartlett43:29

       Um, I was looking at some stats, and there's a global prevalence of infertility. Approximately 18% of w- adults worldwide, about one in six e- experience infertility at some point in their lives.

    5. EKErica Komisar43:39

       Yeah.

    6. SBSteven Bartlett43:40

       Between 2015 and 2019, about roughly 15% of US women aged 15 to 49 experienced impaired fertility. And in the UK, research indicates that one in eight women listening to this now and one in 10 men aged 16 to 74 have experienced infertility, which is defined as unsuccessfully attempting pregnancy for a year or longer. And I've spoken to a lot of people actually that have tried to have kids-

    7. EKErica Komisar44:04

       Yeah.

    8. SBSteven Bartlett44:05

       ... for years, two years.

    9. EKErica Komisar44:06

       It's very sad. It's very sad. When people want children and they can't have children, it is incredibly sad.

    10. SBSteven Bartlett44:11

        When you think about what's contributing to that, what, how do you diagnose that infertility challenge for people?

    11. EKErica Komisar44:16

        There are a lot of theories. Some are environmental. Some are the fact that we're delaying having children. Uh, we're lying to women and to men. We're telling them, "Freeze your eggs." In fact, this is a little disturbing. (laughs) I'll tell you about this. That law firms now are, um, paying for the freezing of their young female associates' eggs. I find that disturbing. Um, saying, "Freeze your eggs. Work really hard for us. Yeah, you can have children later." And the truth is, a lot of them can't, because when you freeze eggs, it's not a guarantee of fertility. It's not a guarantee that those eggs will turn into embryos. It's not a guarantee that those embryos will turn into babies. So there's the age piece. Um, there is also... and there's the environmental piece. There is also the stress piece, which we are not talking about. Um, there's a component to getting pregnant that is about stress. We have more stress on both men and women. You know, it used to be that men died sooner because they had more stress. But now I think it's evened out the odds. I think women may die sooner (laughs) because they have the stress of working and raising children, for the most part. Um, but the point is that, that, uh, the stress that young adults face because they're trying to, you know... Uh, w- we should talk about some of the other myths. What's another myth? We'll weave it through this talk. Another myth is you can do everything all at the same time and do it well. Myth. That's a big myth. You can't. You can't have a fabulous career working full-time and traveling and being fabulous and raise healthy children. The good news is life is long. You may live 'til 120 like Moses, and I think of your generation, you're younger than me, but, um, I think you probably will live well over 100. Um, and so what that means is you have many, many, many, many, many, many years to have a fabulous career when your children don't need you so much. But you have a very small window to create that emotional security for your children that will be the core of them. You know, we talk a lot about your physical core and core training. This is your emotional core. This is the emotional core of human beings, attachment, security, and a feeling of safety that you can rely on the people who you need most in the world to be there when you need them. That is your emotional core.

21. 46:59 – 49:02

    How Did Erica Manage to Balance Work and Motherhood?

    1. EKErica Komisar46:59

    2. SBSteven Bartlett46:59

       How did you manage? You're a mother of three. You've raised three very wonderful, well-adjusted children.

    3. EKErica Komisar47:05

       Yeah.

    4. SBSteven Bartlett47:05

       But you're also successful.

    5. EKErica Komisar47:07

       Yeah.

    6. SBSteven Bartlett47:07

       You have books. You, you're, you're traveling around the world, you said.

    7. EKErica Komisar47:11

       So I'm a good example. Um, I had a career when I was in my 20s, um, and I got married when I was... I met my husband when I was 27 and I got married when I was just shy of 30, or I was 30. Um, and then we had children in our 30s. Uh, so before we had children, I was working, I was seeing something like 40 hours of patients a week, and I was working into the wee hours of the night. I would work 'til 11 o'clock at night, coming home exhausted. Then we had children, but it was an agreement that we had that when we had babies, I would take a good long period off and then really go back very, very, very minimally. And I had the kind of career, by choice, that I could have control over and be, it could be flexible and I could control it. And so I took six months off with each child, and then after six months, only went back to work an hour and a half a day, five days a week. So just in... We had an agreement, my husband and I, which is, it would be just enough to pay a mother's helper, a nanny. And so, and we did without in those years. We did without vacations. We did without, you know, second homes. We did without fancy clothes. We did without. We, and, and, uh, the other things that many of our peers were getting and traveling and doing, we said, "What's important to us is that we pare down, not expand now." This is... We're expanding as parents, so we wanna pare down materially. Life is long, and you can have a successful career. Some of the women that I interview for my book, uh...... are women who didn't even start their careers until they were in their 40s after they had children that were

22. 49:02 – 51:32

    Should Fathers Be the Stay-at-Home Parent?

    1. EKErica Komisar49:02

       older.

    2. SBSteven Bartlett49:03

       Could it have worked if your husband stayed home instead of you, in your view? Because I'm trying to understand if you're saying that dads don't need to be as there, present, as much as the mother.

    3. EKErica Komisar49:14

       They have to be there in a different way. In the early days, men don't breastfeed, so that's the first thing, unless you can show me a man who has grown breasts and can actually breastfeed. Maybe it's coming (laughs) , I don't know. But for now, um, women's bodies connect them to their babies. They connect them through birth, they connect them through breastfeeding. There is a physical component and a hormonal component to infancy and motherhood, and there really is a difference in the way that mothers respond to babies and fathers respond to babies. Now, when do fathers become really important? It's not that the father isn't important to give the mother a break or to bond with the baby or to bathe the baby, but what that baby needs is that attachment security to that primary attachment figure. So-

    4. SBSteven Bartlett50:08

       The mother.

    5. EKErica Komisar50:08

       The mother, usually the mother. Sometimes it's the father, but usually the mother. Fathers, with their playful tactile stimulation, they become really important when children become mobile. When children start to crawl and toddle, when they're around 18 months to two years old, fathers become incredibly exciting and they're really important. So when fathers aren't around in those days, um, when children are starting to explore the world, those children have a harder time separating from mothers. So it's really important to have what we say, the yin and the yang. What we're doing now is we are, um, not prioritizing attachment security, which is the foundation for then healthy separation. And when healthy separation starts, fathers are critical. When you have another child, a second child, fathers are critical because fathers seduce the older child. They say, "Come on, let's go out and play. Let's go kick the soccer ball. Let's go to the swing set." And they give a space to the mother with the next baby. They help the older children to grow up.

    6. SBSteven Bartlett51:18

       Earlier on, you mentioned a study that I read about when I was studying psychology once upon a time, which is the rhesus, the rhesus monkey study-

    7. EKErica Komisar51:25

       Yes.

    8. SBSteven Bartlett51:25

       ... with the wire mother. For anybody that's never heard about that study, I think it's quite important to understand the profound impact that touch and,

23. 51:32 – 53:52

    Harlow's Study on Rhesus Monkeys

    1. SBSteven Bartlett51:32

       um...

    2. EKErica Komisar51:33

       Well, that was an attachment study.

    3. SBSteven Bartlett51:35

       Yeah, what was it, what's the, what's touch called from a, in a sci- in the science world?

    4. EKErica Komisar51:38

       Skin-to-skin.

    5. SBSteven Bartlett51:39

       Skin to skin. Can you give me an overview of that study and what it showed for people that aren't aware of it?

    6. EKErica Komisar51:46

       Well, they took these baby rhesus monkeys and they, they let some be with the mothers and the mothers nurtured those babies, and those babies became healthily attached and secure and those were the healthy, emotionally healthy babies. Then they gave, um, another s- subset of monkeys, um, a wire mother covered with a piece of cloth or fur or something, and those babies became very neurotic but at least they were clinging. They became like the ambivalent attachment babies because there was no response from the mother but at least they were holding on to this mother, and then they gave ... And these babies became very neurotic. And then they gave this subset of babies nothing, and those babies literally lost their minds. And, um, I mean, there are other studies which are more recent than that. That's quite an old study. There, there is a researcher named Michael Meany. He did a study on licking and grooming, animals who lick and groom their young, meaning are nurturing, skin-to-skin lick and groom. Uh, in human terms that would be holding, touching, loving, skin to skin. Those, uh, if, if a mother licked and groomed her young, that baby would become more resilient to stress in the future. The babies who were not licked and groomed by their mothers become, became less resilient to stress in the future. In addition, the babies who were more resilient to stress, because their mothers had licked and groomed them, passed down generationally the ability to lick and groom the next generation. What happened to the babies who weren't licked and groomed, guess what happened?

    7. SBSteven Bartlett53:30

       They didn't pass it down.

    8. EKErica Komisar53:31

       Right. And that's what's happening to humans today. If we don't lick and groom our babies, I mean, you know, take it, for, for whatever.

    9. SBSteven Bartlett53:39

       Mm-hmm.

    10. EKErica Komisar53:39

        Um, if we don't lick and groom our babies, it, we don't pass on this resilience to stress and adversity, but we also don't pass on the desire to lick and groom your, to have babies.

24. 53:52 – 57:50

    The Challenge of Motherhood in Poor Socioeconomic Conditions

    1. SBSteven Bartlett53:52

       Your story, going back to your story which we were talking about-

    2. EKErica Komisar53:54

       Mm-hmm.

    3. SBSteven Bartlett53:55

       ... are there any areas of privilege that you need to acknowledge that someone else listening to this now goes, "Yeah, but that's all right for you," because, you know, maybe someone who didn't have a partner there or someone who is in a difficult economic situat- extremely difficult economic situation, living in the projects in Harlem or something. I really wanna ... I'm saying this because ...

    4. EKErica Komisar54:21

       Well, it's not the mothers in the projects in Harlem, 'cause I'll tell you, the mothers in the projects in Harlem stay home with their babies. That's what's interesting. Very poor people in America ... So let me just say, I love America. America sucks. And I'll tell you why America sucks from my perspective.

    5. SBSteven Bartlett54:38

       (laughs)

    6. EKErica Komisar54:38

       And I say this internationally. I go around the world saying, "America sucks and I'm gonna tell you why." Um, we are the only country in the world other than Papua New Guinea who does not have a paid parental maternity leave. We do not have paid maternity leave. Nobody cares about children.They care about the GDP and the bottom line, and the people who are out there talking about this stuff are economists, saying, "Women have to work, work, work for the economy." Nobody cares about children. Because if we cared about children, our tax money would be in paid leave, not for three months, not for six months, for at least a year. In Hungary, they have three years. Slovenia, Slovakia, um, Estonia has three years. Hungary, I think, has two years of paid leave. S- Sweden, I have some issues with Sweden, but Sweden has 14 months. Sweden, after 14 months, makes women go back to work full, full, full time and put them in institutional care, and all those babies are breaking down. So 14 months isn't even enough. So, but if we could even get to a civilized place of one year of paid leave in this country, and then the next two years, some way that parents could be complimented so they could work part-time, supplemented so they could work part-time. Um, you know, I'm a, I'm a reasonable, realistic person. I know this country is never gonna go for three years of paid leave, even though I would love them to. I also know that this country isn't going to go for an entitlement called paid leave because that's the kind of country we are. We talk a big game, but we don't wanna put our money where our mouth is. There is the possibility, now that the Republicans are in, of a creative solution, which is potentially using things like Social Security in advance, borrowing from your Social Security. So I'm a mom, and I say, "Ah, to stay home, I can borrow from my Social Security for a year, and then work a year or two longer in my life." Wouldn't you say that most women who wanted to stay home with their babies would say, "I'll work longer so I can stay home with my baby"? There are ways to creatively deal with it. Um, from my perspective, this is what's going on. People on the left will not compromise. They'll only do an entitlement called paid leave, but they only are asking for it for three to six months. After that, they want women back in the workforce and institutional daycare. So I'm not on the left. Um, people on the right talk a lot about family. They're the party of the family now. But they do not want tax dollars to go into paid leave. They, they don't like the entitlements that already exist, and they don't wanna add any more. And so the only way they're gonna give it to women and men is if they put skin in the game.

    7. SBSteven Bartlett57:32

       Mm-hmm.

    8. EKErica Komisar57:33

       This is the country we live in. Again, I'm a realist. I think in any way that we can give families the choice to care for their own children, particularly in the early years, we will create a population of healthier children.

25. 57:50 – 59:24

    Does More Paid Leave Equal Better Childcare?

    1. EKErica Komisar57:50

    2. SBSteven Bartlett57:50

       How do we know that more paid leave equals better children, less strain on the healthcare system in terms of mental health, mortality, whatever it might be? How do you make a statistical or a science or research-backed case that if we had three years of paid leave in the United States or in the UK or Australia, Canada, wherever, that the, it would be a net positive for society outside of it just being an opinion?

    3. EKErica Komisar58:14

       Well, the research shows, the longitudinal attachment research shows that children who were insecurely attached at 12 months of age, 20 years later, are insecurely... 80% of them are, are insecurely attached and suffer from mental disorders. That's what the longitudinal attachment research says. So we now have decades of basically children were followed from when they were infants. And the ones who were securely attached, 20 years later, are still securely attached and doing great. And the ones who were insecurely attached, most still insecurely attached, and it's tied and correlated to all of these mental illness conditions, right? So there's a lot of research to show what attachment security does for children in the long run. So, you know, th- you're asking a question about, I mean, I suppose you could take your paid leave and go play soccer in the park and go play tennis and, I don't know, like, play cards with your frie- I mean, you know, uh, how can I say how people are gonna use their paid leave? But if your paid leave is being used to be home with your child, then it's going to benefit your child.

26. 59:24 – 1:01:54

    Connection Between Upbringing and Success in Adult Life

    1. EKErica Komisar59:24

    2. SBSteven Bartlett59:24

       So many of the, the guests that I speak to on this podcast, especially those that become incredibly successful, um, athletes, entrepreneurs, whoever, they often have some form of neglect in their past.

    3. EKErica Komisar59:36

       Mm.

    4. SBSteven Bartlett59:37

       Richard Williams, Serena and Venus Williams' father-

    5. EKErica Komisar59:40

       Uh-huh.

    6. SBSteven Bartlett59:41

       ... he, um, he was very intense with them from a very young age, and he's raised two of the greatest tennis players in history. Joe Jackson was strict and oft- often controversial with Michael, who went on to become the King of Pop. Earl Woods, who was Tiger Woods' father, was very, um, intense in his coaching and mentoring style, which led him to become great. And obviously, Beyonce is the other example I gave who Matthew managed, Matthew which is, uh, Matthew and Tina, who are parents to Beyonce, managed Destiny's Child and Beyonce's solo career, meticulously shaping them into a global superstar. So parents think, you know, "I want to raise kids that are superstars. I, I want, I want my kids to be great."

    7. EKErica Komisar1:00:17

       Okay. So I'm gonna say right now, I don't recommend that as a professional. (laughs)

    8. SBSteven Bartlett1:00:22

       Okay.

    9. EKErica Komisar1:00:22

       (laughs) I'm just saying. So I can't comment on a lot of those people because I could get in a lot of trouble for commenting on a lot of those people.

    10. SBSteven Bartlett1:00:30

        Sure.

    11. EKErica Komisar1:00:30

        But I will say that amongst those people, there is controversy, meaning at least one of those parents, and I don't know the history of the others, uh, was abusive. And so you could say that narcissism is abusive to children. When we project our needs and desires and likes and who we are onto our children, we're not letting them authentically be themselves. The greatest gift you can give your child is to see your child as an authentic individual who is...... an individual and themselves, and not to see them as a mini-me. (laughs) Um, when you start architecting their life, there's a good chance you're gonna lose that child emotionally at some point. They're either gonna hate you, they're, they may be successful in their careers, they may have terrible personal lives, they may be narcissistic parents themselves, so I don't recommend that school of thought. What I do recommend is if your child shows promise in something that they also seem to love and have a drive to be good at, then you can support that drive. Just make sure to keep yourself in check along the way to make sure that they are driving it, not

27. 1:01:54 – 1:02:59

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28. 1:02:59 – 1:08:06

    ADHD: Why Has It Risen So Much in the Past Decade?

    1. SBSteven Bartlett1:03:00

       ADHD.

    2. EKErica Komisar1:03:01

       Yeah. Okay.

    3. SBSteven Bartlett1:03:02

       Uh, B- (laughs) I don't feel like I don't even have to ask a question here, but just to set the stage-

    4. EKErica Komisar1:03:06

       Yeah.

    5. SBSteven Bartlett1:03:06

       ... the reason why I'm so compelled by this is just this sh- I have to say it, the shocking rise in-

    6. EKErica Komisar1:03:12

       Yeah.

    7. SBSteven Bartlett1:03:13

       ... diagnosis and prescriptions over the last 10 years. Uh, between twen- 2000 and 2018, ADHD diagnoses in the UK rose approximately twenty-fold.

    8. EKErica Komisar1:03:25

       Yes.

    9. SBSteven Bartlett1:03:26

       Among boys age 10 to 16, diagnoses increased from 1%, roughly, to, um, about 3.5% in 2018. And in men aged 18 to 29, there was a nearly fifty-fold increase in ADHD prescriptions during the same period, and the same applies to the United States where an estimated 15.5 million adults in the US have been diagnosed with ADHD. Approximately one in nine US children have been diagnosed with ADHD at some point, with 10.5% having a current diagnosis. It, I don't know where ADHD was, but the conversation around it, the prescriptions, the diagnoses, seem to have really surged into culture in a really, really big way. What's going on?

    10. EKErica Komisar1:04:06

        So ADHD was one of the factors that drove me to write Right Being there, um, because I was seeing this huge uptick in ADHD diagnosis and children being medicated so, so early. Do you know what the fight or flight reaction is?

    11. SBSteven Bartlett1:04:20

        That's when the sympathetic nervous system starts to kick into action and-

    12. EKErica Komisar1:04:27

        Yes. So, well, it's basically our evolutionary response to, uh, predatorial threat. So, if a saber-toothed tiger was chasing you, you either stood and fought, fight, or you ran for your life, flight. So, when our children are under stress, they go into fight or flight. So one of the first signs that a child is under stress that they cannot manage is when they become aggressive in school, they hit, they bite, they throw chairs, um, they have trouble, you know, socially in daycare or, or at preschool, or even in school. Or they become distracted, which is the flight part of fight or flight. So what's happening is their nervous systems, the stress regulating part of their brain is getting turned on. So we say that the stress regulating part of their brain has to do with a little almond-shaped part of the brain called the amygdala. It's a very primitive part of the brain, very old part of the brain, and it regulates stress throughout our lives. It helps us to manage it. What we know is that part of the brain is supposed to remain offline for the first year to three years, which is why mothers wear babies on their bodies. It's why babies stay close to their mothers in the first three years, to keep the amygdala quiet and only incrementally, incrementally expose children to stress and frustration that they can manage. So imagine taking small bites of it so you can digest it, right? And your mother's there to help you digest the stress. What we're doing now, by separating mothers and babies, by putting babies into daycare with strangers, um, is, by sleep training babies, all these weird things that we're doing to babies, is we're turning the amygdala on. We're making it active precociously, too early. What happens when the amygdala is activated too early is it becomes very active and very large very quickly. The problem is then it shrivels up and burns out also, because it cannot manage that kind of stress so early. When it ceases to be functional, it ceases to be functional for a lifetime.And so, it's very important to protect, you know, what's the expression? The family jewels. It's very ... These are the family jewels in the brain of a baby. This is the jewel, the amygdala. You want to keep the stress to a, an absolute minimum in the first year, which is why sleep training is dangerous. It's why letting babies cry it out, it's why putting babies into daycare, it's why leaving babies for hours on end when they're so, so very fragile, um, is so bad for their brains, because it gets the cortisol flowing, which is the stress hormone. But it makes this part of the brain very active, so it grows, grows, grows and then pfff, and ceases to be functional in the future, like a PTSD response. So, what we know is that these children are in hyper-vigilant states of stress.

    13. SBSteven Bartlett1:07:51

        ADHD children?

    14. EKErica Komisar1:07:51

        ADHD children. Hyper-vigilant states of stress. If you stay in a hyper-vigilant state of stress long enough, you go into a hypo-vigilant state of stress, which then causes depression.

29. 1:08:06 – 1:10:05

    ADHD Kids Are in Hypervigilant Stress Mode

    1. EKErica Komisar1:08:06

       So, what we have now are not disorders. So there was a whole movement to take the D off of ADHD, 'cause it's not a disorder. It is a stress response. And instead of asking the right questions, which are, "Okay, what's causing the stress? How do we make sure that our children are not exposed to this kind of stress because they're going into fight or flight?" So, the nervous system, as you said, the brain has an on switch and an off switch. The on switch to stress is the amygdala. The hippocampus is the off switch. And you'd say the stress response is in a negative feedback loop. It's- it's- it's actually important. Like, in other words, if a saber-toothed tiger is chasing you, very important that you can activate, right?

    2. SBSteven Bartlett1:08:54

       Mm-hmm.

    3. EKErica Komisar1:08:54

       Run or fight. So, the stress response is supposed to be short-term. It's supposed to be not, it's supposed to be acute rather than chronic. So, we can kind of manifest it. We can, uh, activate it. But then it's supposed to be turned off by the turn-off switch, the hippocampus. What we're seeing in children's brains is that the amygdala is growing very precociously large, and the hippocampus, which is the off switch, is very small. So, we have this problem. As we say, "Houston, we have a problem," we have an on switch going full speed, gas, no brakes, and no off switch. And that's causing ADHD, behavioral problems that are hugely rising in children in school, a lot of aggression and violence. And so, that's what's happening. This is a stress response, and again, instead of asking the right questions like, "Where is this coming from? What's causing the stress?" Instead, we silence the children's pain. We tell, we tell parents, "We'll medicate it, and we'll just relieve the symptoms." For me, that's malpractice. The way we treat ADHD

30. 1:10:05 – 1:11:50

    We're Medicating ADHD Wrong

    1. EKErica Komisar1:10:05

       is malpractice. A child develops, goes into fight or flight when they are under stress. It could be psychosocial stressors at home, in the family. It could be at school, it could be with their friends. It could be a learning disability. There are so many things that can cause kids stress. So instead of medicating them, why don't we figure out what's happening to that child deeply that's causing them to go into fight or flight?

    2. SBSteven Bartlett1:10:32

       Isn't that point of view... I've got two questions here. The first is, how do you know that it's stress? And the second is, if it is stress, then that, the problem, or at least the inconvenient truth that that then creates, is that the parent is responsible-

    3. EKErica Komisar1:10:47

       Yes.

    4. SBSteven Bartlett1:10:48

       ... for-

    5. EKErica Komisar1:10:48

       That's the, there's the inconvenient truth.

    6. SBSteven Bartlett1:10:50

       ... for their child's ADHD?

    7. EKErica Komisar1:10:51

       Yes. Yes. That's the inconvenient truth. It's not so simple. Sometimes it's the family s- usually it's the family, particularly with small children. But when children get to school, it could be social. As I said, you know, you can't control whether your children are exposed to social issues or bullying or, there's many things that can cause stress in children. But when they're very little, you are their environment, so the inconvenient truth is that when your child gets an ADHD diagnosis, the first thing you should do is go to a therapist who will do parent guidance with you. Don't rush that child to a psychiatrist to medicate them. You go with your partner or spouse and talk to a parent guidance expert about what could be causing this child to feel such stress, and look at the psychosocial stressors. Look at the influences and the dynamics in this child's life that would be causing them to go into a state of stress like

31. 1:11:50 – 1:13:54

    The Top Stressors We're Exposing Our Children To

    1. EKErica Komisar1:11:50

       this.

    2. SBSteven Bartlett1:11:50

       Give me some examples of the type of stresses, the everyday stresses that we're now exposing children to that are leading to ADHD in your opinion.

    3. EKErica Komisar1:11:58

       Well, again, let's start at home. At home, the stresses might be that they were handed over to a daycare center at an early age, um, which turned that amygdala response on, which turned the stress regulating part of their brain on too early. Now, you have that hyper-vigilant reaction, and they can't turn it off, right? Um, it could be a divorce situation. 50% of couples divorce, which means that divor- divorce is an adversity. You know, I have a book coming out in a year about how to divorce and mitigate the impact of the divorce on the child. But no matter what, a divorce is an adversity on a child, and a stress. Um, when parents fight, uh, dramatically in the home, if there's, uh, tremendous sibling rivalry issues in the home, if there's the birth of another child, it's stressful.... right? If you have a sibling, believe it or not, that's a very stressful thing. If parents are sensitive about that, then it can be mitigated. But if parents are insensitive about the birth of a second child and the feelings that your first child may have, that can cause stress. Moving can cause stress. Illness or mental illness in a parent can cause stress. Alcoholism, any kind of addiction can cause stress. A grandparent or uncle or aunt, or even a parent getting sick and dying can cause st- I mean, there are so many things that can cause stress. But the point is that stress can be regulated. But it can only be regulated if parents are introspective and self-aware and willing to look at their part in it. If parents hand a child over to a psychiatrist and say, "Fix my child," of course psychiatrists will cooperate with you and silence your child's pain. But is that really what you wanna be doing? Um, because in the end, you're just putting your finger in a dyke. You're putting your finger in a dam, and eventually that dam is gonna burst.

32. 1:13:54 – 1:17:18

    Is ADHD Hereditary?

    1. SBSteven Bartlett1:13:54

       What'd you say to some of the evidence around there being a link to a hereditary component in twin studies? They found that ADHD is about 74 to 80% heritable, making it one of the most genetically influenced-

    2. EKErica Komisar1:14:06

       Hmm.

    3. SBSteven Bartlett1:14:06

       ... psychiatric conditions.

    4. EKErica Komisar1:14:07

       Let me tell you a different study that will help you to understand that study, which is that (sighs) we know that there is no genetic precursor to mental illness. There is no genetic precursor to ADHD. There is no genetic precursor to depression and no genetic precursor to anxiety.

    5. SBSteven Bartlett1:14:25

       What do you mean by precursor?

    6. EKErica Komisar1:14:27

       Meaning there's no genetic connection. You don't get it in your genes. If your father or your mother were depressed, you get it by something called the inheritance of acquired characteristics. If you're raised by a depressed parent, you're more likely to become depressed. It's the nature-nurture argument, okay? But what they did find... Now, schizophrenia has a genetic connection, bipolar disorder, those have genetic, but the rest do not. Anxiety, depression, ADHD, no genetics. What they did find is a genetic tie to something called the sensitivity gene. It's a short allele on the serotonin receptor, and serotonin, as we know, is used to regulate happy emotions, to regulate emotions, right? So when you have a short allele, it means that you have a harder time picking up the serotonin. But it also means that you are more sensitive to stress. Now, those children who are born with this gene, this short allele on the serotonin receptor gene, they are more prone to mental illness later on because of that sensitivity to stress. What the study shows is if those children who are born with that gene for sensitivity are provided with emotionally and physically present attachment security in the first year, it neutralizes the expression of that gene. So epigenetics means that we're born with genes. Like, you might have a gene for rheumatoid arthritis or you might have a gene for cancer, but it never gets expressed. Well, we all have genes for something, but they don't necessarily get expressed. That's what epigenetics is. It means the environment has to turn on the gene to make it, let's rock and roll, right?

    7. SBSteven Bartlett1:16:16

       Mm-hmm.

    8. EKErica Komisar1:16:17

       Um, what it showed in this study is that the children who were born with this genetic precursor, the sensitivity to stress, if they had sensitive, empathic, nurturing, and present parents in the first year, it neutralized the expression of that gene. So those children could be as healthy as children born without that gene. If, however, children born with that sensitivity gene were neglected, you know, abandoned, not provided with sensitive, empathic, present nurturing, it exacerbated that gene. So, we know that that sensitivity gene is tied and correlated to mental illness later on unless the sensitive, empathic nurturing mitigates that gene.

    9. SBSteven Bartlett1:17:04

       And what'd you say to people that point to MRI scans?

    10. EKErica Komisar1:17:07

        fMRIs and, yeah, there's, there's all kinds of, um, neurological tests now where we can see the brain in action. So it's not a static thing. We can actually

33. 1:17:18 – 1:19:15

    Can MRI Scans Spot ADHD?

    1. EKErica Komisar1:17:18

       see the blood flow to the brain. We can see the electrical activity in the brain. It's am- it's amazing, actually.

    2. SBSteven Bartlett1:17:25

       Some people say that this proves that it's the way your brain is. And lots of my friends that have ADHD, when they talk about their ADHD or the way that they are, they say, "My brain works like this."

    3. EKErica Komisar1:17:35

       No. It's not correct. Their brain is sensitive to stress. Someone with ADHD is more sensitive to stress. So you could ask them questions like this. You could say, "Were you more, are you a more sensitive person? Are you more sensitive to noise, to smells, to touch? When you were a child, did you not like itchy things? Did you cry more? Were you more sensitive when your parents would go out for the night? Were you more sensitive when your mom would go to work or were you more sensitive when you were left at nursery school?" Um, and they're probably gonna say yes.

    4. SBSteven Bartlett1:18:08

       But if they say no and they still have an ADHD diagnosis?

    5. EKErica Komisar1:18:11

       I would guarantee, almost guarantee they wouldn't say no, because people with ADHD are people who are sensitive. Sensitivity is an amazing strength if it's met with sensitivity. If you have a sensitive child... So what does a sensitive child look like? If you have multiple children, then you know, because the first thing I'll do when I give a public talk is I'll say, "Okay, any, everybody here, who has a sensitive child?" And I describe, okay, a sensitive child is a child who cries more, is harder to soothe, um, is more clingy, doesn't like you leaving them, is harder, has a harder time separating, has a harder time going to sleep and being left to sleep on their own, um, is sensitive to things like noise and smells and touch. And...

    6. SBSteven Bartlett1:19:00

       If you grew up in an environment that was stressful, and again, we've, you've identified that stress can come in many forms. It could be arguing parents. It could be a neighbor or whatever.

    7. EKErica Komisar1:19:08

       Yeah.

    8. SBSteven Bartlett1:19:08

       Some environmental factor that caused that stress. You were sensitive. You developed ADHD.

    9. EKErica Komisar1:19:11

       Mm-hmm.

    10. SBSteven Bartlett1:19:12

        You become an adult. You get diagnosed at

34. 1:19:15 – 1:22:06

    What's Wrong With Medicating Children?

    1. SBSteven Bartlett1:19:15

       30 years old as having ADHD.

    2. EKErica Komisar1:19:17

       Yeah.

    3. SBSteven Bartlett1:19:17

       You're offered medication. You take the medication. The medication makes you much more functional in your career, in your relationships, and your life.

    4. EKErica Komisar1:19:25

       It's a stimulant. And so what stimulants do is they cause, they can cause great anxiety. They can cause panic attacks. In, uh, adolescence, uh, they can cause growth issues. So, uh, I have patients who come to me, young men who didn't grow because they were put on stimulants when they were young. So, um, in, i- in, in terms of the consequences of using stimulants, the jury is still out, but we know that they cause growth issues. They cause panic attacks. They cause anxiety disorders. They cause depression. So-

    5. SBSteven Bartlett1:19:58

       They, they're quite life-saving. They're quite life-saving for some people in terms of having a-

    6. EKErica Komisar1:20:02

       The- they can be. They can be. So what I would say is if you have tried everything to uncover what the stress is that's causing you to react this way and you still are feeling that way, then sometimes medication can be a life-saver. The problem is that we turn to medication, uh, in, in adolescence and children and young adults, we, we turn to it as a performance drug, um, because there's so much stress in modern life and there's such a need for people to perform and be successful in their careers and in school and get good grades. There's so much pressure on kids. So, you know, I'm 60 and we didn't have this kind of pressure growing up. And so, so the generations that follow have so much pressure. That pressure makes children literally go off the rails. We could talk about the academic pressure, the competitiveness, the perfectionism. Um, it... So ADHD is a bucket. It's a bucket which you throw people in who have anxiety that has never been treated. And so... And there's different ways of thinking about treatment too. So we are a society that likes superficial quick fixes. We like drugs. We like CBT therapy. The truth is that this is not a quick fix. Figuring out relationally, dynamically what happened to you as a child, what your losses were, what your traumas were, what caused you to feel so anxious, what's caused you to go into fight or flight is hard work. It requires frustration. It requires commitment. It requires going to someone who can think very deeply with you. You know, I, I wanna define what anxiety is because I think it's really important 'cause we rarely define depression and anxiety. Um, depression is preoccupation with past losses.

35. 1:22:06 – 1:23:40

    What Actually Is Anxiety?

    1. EKErica Komisar1:22:07

       Anxiety is preoccupation with future losses that may never occur. What do they have in common?

    2. SBSteven Bartlett1:22:17

       It's all about losses.

    3. EKErica Komisar1:22:18

       All about loss. And you could say the generations now are very preoccupied with loss.

    4. SBSteven Bartlett1:22:29

       Loss of status, achievement. B- because we're also very preoccupied with gain.

    5. EKErica Komisar1:22:38

       Well, we're preoccupied with, uh, what I say the... Uh, you know, I, I don't wanna judge, but I wanna say the unimportant things in life. Um, what are the important things in life? Relationships, love, connection, health, right? You would say objectively, family. These are the important things in life. But we've become very preoccupied with material success, money, uh, career achievements, fame. I think there was a study that interviewed teenagers, um, and it was really discouraging because they said that the thing they wanted more in life than anything was to be famous. And so we're preoccupied with the wrong things.

    6. SBSteven Bartlett1:23:25

       On this point of stress and the link with ADHD, um, looking at some research from the injury.com Research Education Group.

    7. EKErica Komisar1:23:34

       Mm-hmm.

    8. SBSteven Bartlett1:23:34

       Um, it says that children with an ACE score, which is the trauma based score where I think it goes up to 10 different

36. 1:23:40 – 1:24:47

    The Link Between Stress and ADHD

    1. SBSteven Bartlett1:23:40

       sorta questions.

    2. EKErica Komisar1:23:41

       Mm-hmm.

    3. SBSteven Bartlett1:23:41

       With an ACE score of four or more, so four experiences of trauma or more-

    4. EKErica Komisar1:23:44

       Yeah.

    5. SBSteven Bartlett1:23:44

       ... have nearly four times, which is 400% more chance of having parent-reported ADHD compared to children-

    6. EKErica Komisar1:23:52

       That's right.

    7. SBSteven Bartlett1:23:52

       ... with no ACEs.

    8. EKErica Komisar1:23:53

       Yeah.

    9. SBSteven Bartlett1:23:54

       And some of the factors that have big impact is socio- socioeconomic hardship increases your probability of having ADHD by 40%, parental divorce by 35%, familial mental illness or a parent having a mental illness increases it up to almost 60%, 55% I believe, and neighborhood violence f- almost 50%.

    10. EKErica Komisar1:24:12

        Yeah.

    11. SBSteven Bartlett1:24:12

        Familial incarcerations. If a parent goes to prison, then that increases your probability of ADHD by about 40% as well. And that's published by the, I think it's The New England...

    12. EKErica Komisar1:24:25

        Yeah.

    13. SBSteven Bartlett1:24:25

        What is, or the National Library of Medicine, National Center of Biological Information.

    14. EKErica Komisar1:24:28

        Yeah. So remember w- what I said that you can't control everything that happens to your child. Divorces do happen and adversities happen to children. Health, health issues happen to children. What you can control is you can control the first three years and be as present as possible for your child.

37. 1:24:47 – 1:28:19

    What to Do if a Kid Screams in a Supermarket

    1. EKErica Komisar1:24:47

    2. SBSteven Bartlett1:24:47

       So if my kid starts screaming in a supermarket-

    3. EKErica Komisar1:24:50

       Mm-hmm.

    4. SBSteven Bartlett1:24:52

       One of the prevailing pieces of advice says just walk off, or start screaming yourself as the parent to show them. Do... am I supposed to just ignore my child when it's screaming and throwing a tantrum? Am I meant to drop what I'm doing and go and cater to them? What am I meant to do in these situations?

    5. EKErica Komisar1:25:05

       You can have me on speed dial, Steven. (laughs)

    6. SBSteven Bartlett1:25:07

       You be careful-

    7. EKErica Komisar1:25:08

       (laughs)

    8. SBSteven Bartlett1:25:08

       ... because if you make a promise like that-

    9. EKErica Komisar1:25:10

       Yes, I promise.

    10. SBSteven Bartlett1:25:11

        ... I will call-

    11. EKErica Komisar1:25:12

        I promise.

    12. SBSteven Bartlett1:25:12

        ... I will call.

    13. EKErica Komisar1:25:12

        I'll be on speed dial.

    14. SBSteven Bartlett1:25:12

        You really want to drop your career-

    15. EKErica Komisar1:25:14

        Yes, yes, you c-

    16. SBSteven Bartlett1:25:14

        ... and focus on raising my children? (laughs)

    17. EKErica Komisar1:25:15

        No, you can, you can... no, but you can call me.

    18. SBSteven Bartlett1:25:17

        I've got this on video.

    19. EKErica Komisar1:25:18

        You can have me on speed dial.

    20. SBSteven Bartlett1:25:18

        That's legally binding.

    21. EKErica Komisar1:25:19

        No, you can have me on speed dial.

    22. SBSteven Bartlett1:25:21

        How much? (laughs)

    23. EKErica Komisar1:25:21

        Um, yeah, you can as much as you want. So, the deal is, you don't yell at your children. An emotionally regulated parent, a healthy parent produces a healthy child. So, what is a healthy parent? A healthy parent is a parent who feels good about themself, who has authentically good self-esteem. Not grandiosity, but really feels good about themselves, knows their strengths and limitations, and overall as a whole person, feels good about themselves. Um, they have the capacity to regulate their emotions, to keep their emotions from going too high and too low. Remember?

    24. SBSteven Bartlett1:25:55

        Mm-hmm.

    25. EKErica Komisar1:25:55

        Sailing in the Caribbean? Meaning, they can stay calm in a storm. Um, is sensitive and empathic as a nurturer. These are signs of health in a, in a parent.

    26. SBSteven Bartlett1:26:07

        So, if my kid says, "I want that pack of sweets," and I go, "You, you, you can't have that pack of sweets."

    27. EKErica Komisar1:26:13

        Well, first you have to... so before your discipline, you always wanna be empathic first. So, I always say that, that if you are gonna discipline a child, first you have to recognize how they feel. I mean, recognize, recognizing how children feel is important anyway. Meaning, when you recognize a child's feelings, if they're sad, you mirror their sadness. If they're angry, you say, "I can see you're angry." If they're happy, you look happy with them. That kind of reflection is the way that your child knows that you acknowledge them, that they're a person to you, that they're a separate person to you. It's how they feel valuable. So, when you acknowledge their feelings, that's the first critical, you'd say, parenting 101. Acknowledge your child's feelings.

    28. SBSteven Bartlett1:27:02

        So, I would turn to my child and say, "You want sweets? Are you hungry?"

    29. EKErica Komisar1:27:05

        Yeah, you can say, "I can see that you really want that packet of sweets. I can see how hard it is 'cause you really want it, but you know you can't have it before dinner. You know that's the rule."

    30. SBSteven Bartlett1:27:14

        And then they stop screaming and crying.
38. 1:28:19 – 1:31:49

    The Different Types of Trauma

    1. SBSteven Bartlett1:28:19

       Do you think that I'm a traumatized child?

    2. EKErica Komisar1:28:22

       I don't know. I haven't heard about your traumatized background. (laughs) If so, if you have a trauma, I would say-

    3. SBSteven Bartlett1:28:26

       (laughs) .

    4. EKErica Komisar1:28:26

       ... we're all... So, let me say this.

    5. SBSteven Bartlett1:28:29

       This, this-

    6. EKErica Komisar1:28:29

       There's this word trauma is used a lot. Can I just talk about it for a moment?

    7. SBSteven Bartlett1:28:34

       Sure, sure.

    8. EKErica Komisar1:28:34

       There's something called big T trauma, right? Big T trauma's like, I was in a car accident and I lost my legs, or, um, you know, I lost my parents, you know, my mother died of brain cancer or my, my father was an alcoholic and beat me or, you know, there's, there are things that are more concrete that you can like, hold on to.

    9. SBSteven Bartlett1:28:56

       Mm-hmm.

    10. EKErica Komisar1:28:56

        Things that happen to people.

    11. SBSteven Bartlett1:28:58

        Yeah.

    12. EKErica Komisar1:28:58

        Yeah, I was raped or, you know, those are big T trauma. But believe it or not, probably fewer people suffer from big T trauma and more people suffer from little T trauma. And little T trauma is more nuanced. It's, um, it, it requires looking with a, with a finer tooth comb at, at the issues. It's more relational. It's more I was subtly neglected by my mother. My mother wasn't a good listener. My mother loved me, but sh- or my father loved me, but he never understood me. Uh, my parents were narcissistic and very self-centered. Um, they were never around. You know, and so people will come into my office and sit down, individuals for therapy, and they'll say, you know, "I don't know what's wrong with me. I had two parents who stayed together. I had all the material wealth that I could need. I never wanted for stuff. Uh, you know, my parents stayed together and I don't know what's wrong with me." And so I say, "Okay, so you're telling me nothing big and traumatic happened to you in your life. Now, let's talk about the nuance." And we're not very nuanced (laughs) anymore, so we don't want to look at what causes most forms of mental illness, depression, anxiety, uh, even ADHD, are the relational nuances of a family.

    13. SBSteven Bartlett1:30:27

        And what do you mean by the relational nuances? It could be the-

    14. EKErica Komisar1:30:30

        Neglect.

    15. SBSteven Bartlett1:30:31

        ... neglect.

Episode duration: 2:38:36