Dr. Paul Conti: How to Improve Your Mental Health | Huberman Lab Guest Series

1. 0:00 – 2:19

   Improve Mental Health

   1. AHAndrew Huberman0:00

      (rock music) Welcome to the Huberman Lab Guest Series, where I and an expert guest discuss science and science-based tools for everyday life. I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. Today's episode marks the second episode in our four-episode series with Dr. Paul Conti about mental health. The first episode in the series dealt with how to understand and assess your level of mental health. Today's episode is about how to improve your mental health. I do want to emphasize that you do not need to have heard or seen the first episode in order to understand or glean important information from today's episode about how to improve your mental health. But I do encourage you to go and listen to the first episode at some point if you have not already. Today's episode deals with several topics important to all of us, as well as protocols to improve one's mental health. For instance, you will learn how to guide yourself through a process of self-inquiry in which you address certain key questions about your drives, your level of aggressive drive, pleasure drive, and the so-called generative drive. These are essential things to understand about oneself if you want to guide yourself toward your aspirations and if you want to understand how your subconscious processing is influencing your thoughts, and your behaviors, and your feelings in ways that sometimes serve your aspirations and in other ways that can hinder your aspirations. Dr. Conti shares with us a way of assessing our internal narratives as well as a way of creating a constructive self-awareness and an understanding of where those narratives and that self-awareness stem from in our childhood so that we can navigate forward with the greatest sense of agency. We also talk about how to move past common hindrances to improving one's mental health, such as overcoming intrusive thoughts. And perhaps most importantly, today's episode provides information and protocols that anyone can use to cultivate their generative drive, which is a hallmark of mental health. Just a reminder that Dr. Paul Conti has generously provided a few diagrams that we include as PDFs in the show note captions. They are completely zero cost to access and they can help you understand some of the material that was discussed in the first episode of this series as well as the current episode about how to improve your mental health. And while those simple PDF diagrams are certainly not necessary in order to understand the material in today's discussion or in the other discussions of this series, many people find them useful. So I encourage you to check out those links in the show

2. 2:19 – 5:26

   Sponsors: BetterHelp & Waking Up App

   1. AHAndrew Huberman2:19

      note captions. Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford. It is, however, part of my desire and effort to bring zero-cost-to-consumer information about science and science-related tools to the general public. In keeping with that theme, I'd like to thank the sponsors of today's podcast. Our first sponsor is BetterHelp. BetterHelp offers professional therapy with a licensed therapist carried out online. I personally have been doing weekly therapy for more than 30 years. And while that weekly therapy was initiated not by my own request, it was in fact a requirement for me to, uh, remain in high school, over time I really came to appreciate just how valuable doing quality therapy is. In fact, I look at doing quality therapy much in the same way that I look at going to the gym or doing cardiovascular training such as running as ways to enhance my physical health. I see therapy as a vital way to enhance one's mental health. The beauty of BetterHelp is that they make it very easy to find an excellent therapist. An excellent therapist can be defined as somebody who is going to be very supportive of you in an objective way, with whom you have excellent rapport with, and who can help you arrive at key insights that you wouldn't have otherwise been able to find. And because BetterHelp Therapy is conducted entirely online, it's extremely convenient and easy to incorporate into the rest of your life. So if you're interested in BetterHelp, go to betterhelp.com/huberman to get 10% off your first month. That's BetterHelp, spelled H-E-L-P, .com/huberman. Today's episode is also brought to us by Waking Up. Waking Up is a meditation app that offers dozens of guided meditation sessions, mindfulness trainings, yoga nidra sessions, and more. By now, there's an abundance of data showing that even short daily meditations can greatly improve our mood, reduce anxiety, improve our ability to focus, and can improve our memory. And while there are many different forms of meditation, most people find it difficult to find and stick to a meditation practice in a way that is most beneficial for them. The Waking Up app makes it extremely easy to learn how to meditate and to carry out your daily meditation practice in a way that's going to be most effective and efficient for you. It includes a variety of different types of meditations of different duration, as well as things like yoga nidra, which place the brain and body into a sort of pseudo sleep that allows you to emerge feeling incredibly mentally refreshed. In fact, the science around yoga nidra is really impressive, showing that after a yoga nidra session, levels of dopamine in certain areas of the brain are enhanced by up to 60%, which places the brain and body into a state of enhanced readiness for mental work and for physical work. Another thing I really like about the Waking Up app is that it provides a 30-day introduction course. So for those of you that have not meditated before or are getting back to a meditation practice, that's fantastic. Or if you're somebody who's already a skilled and regular meditator, Waking Up has more advanced meditations and yoga nidra sessions for you as well. If you'd like to try the Waking Up app, you can go to wakingup.com/huberman and access a free 30-day trial. Again, that's wakingup.com/huberman. And now for my discussion about mental health with Dr. Paul

3. 5:26 – 16:25

   Structure & Function of Healthy Self

   1. AHAndrew Huberman5:26

      Conti. Dr. Conti, welcome back. Thank you. In the first episode of this series, you laid out for us in a very structured way, you know, what true mental health looks like, essentially what we should all be aspiring to. And you touched on these themes of agency and gratitude as, uh, verb states, really ways of being in the world- Yes. ... that allow everybody to have some sense of well-being, to have some sense of themselves in a way that is kind to themselves and to others, and really to feel good and do good in their life. And I- And without question, this is what people want.You also spelled out for us these two pillars: the structure of self and the function of self that consist of a number of different things that, from which geyser up, or kind of, you know, give rise to these feelings of empowerment, humility, agency, and gratitude, and reminded us several times that when we are challenged, when we're not doing as well as we would like, that we need to look back to the structure of self and the function of self and ask specific questions in order to arrive or re-arrive at this sense of agency and gratitude.

   2. PCDr. Paul Conti6:38

      Mm-hmm. Yes.

   3. AHAndrew Huberman6:39

      I think it would be wonderful for us if you could just sort of recap the overall model, um, because it has the components that I just mentioned, but there's some subtlety and some really key aspects of these pillars, structure of self and function of self, and I think if people keep in mind for today's episode, which is about challenges that people commonly face, and even, uh, if you will, phenotypes that we see commonly out there. For people that haven't heard of phenotypes, phenotypes are, um, the typical appearance of something. So, uh, there is the phenotype of the anxious person, the phenotype of the person who just can't seem to get out of a rut. There's the phenotype of the traum- traumatized person. And- and these things play out differently in- in different individuals, men and women, boys and girls. But we're going to visit, uh, many of the most common phenotypes out there and think about how to do better, be better, feel better through the lens of the model that, uh, we spelled out in episode one. And of course, if people have not seen or heard episode one, today's discussion will still be entirely accessible to them. So, in keeping with that, if you could just, um, give us an overview of- of what this, uh, structure of the healthy self looks like, as a roadmap for, uh, where we're all headed today.

   4. PCDr. Paul Conti7:52

      Thank you. Thanks very much. Um, revisiting the- the pillars is- is I think the best place to start, because there really are routes to understanding, and if we understand, then we can strategize, we can make change, right? We can make things better. So the- the- the first pillar of the structure of self starts with the unconscious mind, right? This incredibly complicated biological super computer that's firing a mile a minute, right, underneath the surface in us and is throwing up to the surface all sorts of thoughts and ideas and states that then the conscious mind apprehends. Then our awareness comes into play. And then we have defense mechanisms that sort of rise up from the unconscious mind, and they- they circle and sort of gird themselves around the conscious mind, which they can do in an unhealthy way or in a healthy way or a- any- anything in between. And then the- the character structure is sort of the nest around all of that, and it's from the character structure that we- that we are engaging in the world in the ways that we're engaging, right? It's our active engagement with the world around us. And the idea is that the self grows out of that. It grows out of that nest sitting on top of the unconscious mind to the conscious mind rising above, the defense mechanisms and the character structure, and- and if we go back to that when we're trying to understand ourselves, you know, if we're trying to understand states of health as well as states of unhappiness or- or states that aren't healthy, right? By- by going back and looking at the structure, we can learn a tremendous amount. And the other side, the- the- the other pillar is the- the function of self, and it really starts with the self awareness, right?The awareness that, hey, there is an I, right? I am in the world, right? This is 24 hours in the day are gonna pass today, and I'm gonna be doing one thing or another. I'm- I- I'm- so I'm, to some very significant extent, deciding how am I gonna engage in the world around me during that time, right? So on top of that are the defense mechanisms in action. So defense mechanisms, remember, are unconscious, so there's a lot then going on inside of us that's determining sort of the field set of options, right? There may be a lot of automaticity that narrows down the set of options of what we may entertain, what we may be aware of, what we may decide, and that could happen for better or for worse depending upon the health of the defense mechanisms. But on top of that lies salience, so the idea then we would next visit, okay, what are we paying attention to, right? What- what's coming from inside? What's coming from outside? And we have to not pay attention to many, many, many, many things in order to pay attention to whatever our attention is alighted on at the moment. So it's a complex process, uh, and it's worth looking at very closely if we want to understand ourselves. So after thinking about the- the defense mechanisms in action, right? The unconscious aspects of how we're engaging with the world, then next to consider is salience, which is sort of where does the mind arrive at at rest, right? Where does the mind trend towards? Is it something internal? Is it something external? What are all the things we're not paying attention to in order to pay attention to something, uh, and is that thing healthy? Is it not healthy? Is it serving us well? So there's so much to understand about salience, and then the next step beyond that is understanding behavior, right? How are we engaging with the world around us? What are our behavioral choices? What are our automatic behaviors? And then sitting on top of all of that are our strivings. So we- we have a sense of wanting something in the world around us, like, what is that and how are we trying to get to it and how does it make us feel? So if we look at the- the 10 elements, right? The five under the structure of self and the five under the function of self, then what we're really looking at is- is sort of like looking at 10 cabinets, right? And if we're trying to understand ourselves, whether we're trying to just generally understand ourselves or we're trying to get at a problem, right? Then looking at all 10 of those cabinets makes sense, right? Some of them will be bare, meaning that they may seem to have very little to do with the problem we're bringing, and we kind of maintain an open mind, right? We may be led back to that cabinet, and there may be something there, but what usually happens is if we look in all 10 places, we find a couple where there's- there's some rich material to explore, sort of the X marks the spot, and then we go and we- we dig there, to sort of mix metaphors. We- we dig in the cabinet where we're gonna find something, right? And then it leads forward a process of...... understanding. And if we're bringing those things into line, where we have a healthy structure of self and a healthy function of self, and we're aware of all this and we're working on it, we're self-aware, and we're paying attention to everything built on top of that, then what we end up with is a sense of humility. Because one cannot be anything but respectful, compassionate, understanding the complexity of, of all of this, and understanding how does it manifest itself in us and, and just the very fact that we can make our ways in the world, right? Is so, just, is so impressive and in a way I think it brings to us a respect. Just a respect for being here, navigating the world, and I think of that respect is born humility. The complexity of us. The fact that millions of things are going on underneath the surface. Millions of, of, uh, neurotransmission and endocrinological function. All this is going on under the surface. I'm not even aware of it and then it kicks up to the surface, generates a tremendous amount of respect for the complexity and also the diligence and perseverance it takes us to navigate through the world. And I think built upon that understanding is a sense of humility and a sense of empowerment. And the humility and empowerment in action, right? So, so expressed, right? Become agency and gratitude. And agency and gratitude, as you said at the beginning, w- we're seeing as verbs, right? That's like how we're living life. It's, it's through the lens, so to speak, of agency and gratitude that we're actively living. A- and again, I would put forth that when we look at measures of human happiness, right? A- across disciplines and across time, this is always what we see, is, is some way of describing how agency and gratitude together as verbs manifest and then create happiness. It's the state that we're seeking to be in, right? Because from that state of active agency and active gratitude, we achieve what it is that I think we're really searching for. And, you know, there are by infinite words, uh, throughout human history to describe what that is. We might choose to use words like peacefulness, right? A sense of peace, a sense of contentment, uh, being delighted by things. Like just being amazed and impressed by things in the world around us. Like, this is a state that we are striving for, and I think when people talk about happiness and what we're really trying to get to, it's this, right? But i- it's not that these things are passive, right? These things are coming from the active agency, the active gratitude, and they're then interacting with a generative drive within us. We have an aggressive drive. We have a pleasure drive. Like this has been thought about now for a long, long time within mental health and validated in a lot of ways, but what hasn't been validated is that they're the only things, right? We see human beings striving. We see human beings wanting better for themselves and for the world around them. We see acts of kindness th- that seem to be rooted to nothing other than the act of kindness. We have within us a drive to know, to understand, to learn, to make better, and that has been described as many, many things across human history. But I think the words we might choose are generative drive, a drive to create and to make better, and it's the, the generative drive as something active within us, right? That is then aligning with agency and gratitude, right? The active ways in which we express ourselves and then that all together brings us the peace, the contentment, the sense of delight. Sometimes that may exist in us in a state of rest, right? But very often it's in, it's existing in us in a state of activity, right? And that's why people find, you know, the quote unquote happiness, like what people are seeking, not just in, you know, meditation. Sometimes we can find it there, but people also find it in, in action, right? They find it in doing that thing that they love to do or taking care of someone and learning something. So when we look at all of this, w- we can then, we can then have a route of understanding what is going on inside of us and how we can make the changes that let us be in this state, which is really the state that we're seeking.

4. 16:25 – 21:14

   Agency & Gratitude

   1. PCDr. Paul Conti16:25

   2. AHAndrew Huberman16:25

      I really appreciate that you highlight that agency and gratitude are verb states, uh, from which peace, contentment, and delight emerge, and also the way that you explain the generative drive that, um, is distinct from aggressive drives and pleasure drives that exist in all of us. Um, you know, I th- I am smiling because a number of examples of, uh, peace, contentment, and delight while in action come to mind. I mean, for me, podcasting and in particular preparing for a podcast, kind of mine the literature and figure out, you know, where the gems reside and where the confusion could, could emerge, and, uh, all of that brings about such peace, contentment, and delight for me, but is, it's anything but passive. It's, um, uh, likewise, uh, y- yesterday I, uh, had the experience of running into a, a puppy. It's been awhile since I've owned a dog, and, um, dogs are delightful. Puppies are particularly delightful.

   3. PCDr. Paul Conti17:19

      I had the experience of seeing you light up-

   4. AHAndrew Huberman17:21

      (laughs)

   5. PCDr. Paul Conti17:21

      ... when you ran into the puppy.

   6. AHAndrew Huberman17:23

      You know, I... And, uh, you did, and, um, and I'm still buzzing from that short interaction with the puppy downstairs, the Weimaraner puppy. Um, it's just that I don't know why but I just delight in, in animals of, of most all kinds. Not a fan of reptiles, sorry reptile fans, uh, so much. But I just derive so much energy from it and it felt like life energy and the, the way the animal is sort of attentionally scattered is amusing to me a- as compared to the dog that he will eventually be which is going to be more linear in his thinking. Like, it encapsulates so much of the other things I love like brain development, et cetera. Anyway, I highlight those as examples because, um, there's nothing passive about it. It's pure delight and joy for me, um, and it intersects with other delights and joys. And I think that, um, as you describe agency and gratitude, peace, contentment, and delight, and these generative forces.Um, as well as other forces that exist in us. I think it's really, uh, critical that, uh, people understand that, you know, these are not states that you sit down and, and place yourself into, although perhaps one could through, uh, reflection or meditation or waking up from a really great night's sleep, things of that sort. But that, um, these are things that we can find ourselves awash in if we are doing the right things, and those things can oftentimes be very challenging. Um, so assuming I understand, uh, the way the model is spelled out correctly, um, I'm more and more delighted a- at the fact that this is not just accessible in one domain but is accessible in many, many different domains for everybody, right?

   7. PCDr. Paul Conti18:57

      Yeah.

   8. AHAndrew Huberman18:57

      This is not something unique to my experience, even though I give examples, uh, uh, from my own life. But, um, that we really all do have access to this if we're looking in those cupboards, those 10 cupboards and asking the right questions.

   9. PCDr. Paul Conti19:11

      Yes. And, and to maybe comment even a little further on the experience of, of you and the dog, right? So, so it was a, a, uh, an experience of delight, right? And, and you enjoyed it and brought a sense of peace and contentment, like, all of that happens, right? But think about what that's linked to, like, the, I, I believe there's a strong sense of agency in you that you are enacting, there's a strong gratitude in you that you're enacting. You're, you're handling your life in a way... And, and also for all of us, good things always come with good fortune but, but it comes with our strivings and our achievements that you're in a place to delight in that, right? If you are unhappy, like, "I don't like what I'm doing. I'm, I'm angry, I'm frustrated," right? Then there's no room in you to, to find the delight, right? And the delight that you find is also very much linked to the generative drive, right? That it makes me think of how you, you loved and nurtured Costello, right? So you have it in you to love and nurture a dog, and you have done that in a really wonderful way, and that generative drive is part and parcel of the delight you feel when you see a dog, because you love dogs and you think about nurturing and it all comes together. The, the, uh, the agency and the gratitude expressed as verbs puts you in a position to have that sense of delight which is so intertwined with your generative drive, with a sense of care-taking, a sense of creating the, the beyond self. Because although you enjoyed and loved Costello, you enjoyed and loved his happiness, right? So it all comes together, and I think it's interesting because in some ways it's a simple example, but, like, that's life, you know? Life has its, its big moments, but so much of our lives are the smaller moments that link together, and I think that smaller moment becomes a big example.

   10. AHAndrew Huberman20:55

       I appreciate that you mentioned Costello. For listeners of this podcast that have, um, tuned into early episodes, uh, Costello was the source of the, the background snoring. For those of you that haven't, you can go check. He's a, was a 90 pound English bulldog mastiff who, um, who had many skills, um, the best of which was snoring (laughs) .

   11. PCDr. Paul Conti21:12

       (laughs)

   12. AHAndrew Huberman21:13

       Um,

5. 21:14 – 30:00

   Aggressive Drive, Pleasure Drive, Generative Drive

   1. AHAndrew Huberman21:14

      so in addition to the generative drive, which is something that we certainly want to, um, talk more about today, uh, you mentioned these other drives; aggressive drives and pleasure drives. And much of what we're talking about today is going to be where people can go wrong or where people struggle. We are also, of course, going to go deeply into where people succeed, and in particular where people can ask questions of themselves, um, in particular, what is working for them and why, as a route to understanding how to sift through those cupboards and understand what's not working and why, and come up with real actionable answers-

   2. PCDr. Paul Conti21:54

      Yes.

   3. AHAndrew Huberman21:54

      ... and, and then the ability to move forward. Um, so if, if you would, could you tell us a little bit more about drives generally? Like, like, you know, when I hear drives I, I can't help as a neuroscientist but default to, okay, the dopamine circuit or the, the endogenous opioid circuit or the, uh, serotonergic circuit. But, you know, how do you conceptualize drives within us? And, and then perhaps you could tell us what the nature of aggressive drives and pleasure drives and generative drives...

   4. PCDr. Paul Conti22:26

      So the, the concept of a drive, the definition of a drive is, is something that's intrinsic to humans. So w- we could look at it as a motivation, right? I mean, w- we don't just lie on the ground and do nothing until we passively die, right? So something is going on inside of us that is driving us to do something other than that. And historically, the thinking in the field arising from early psychodynamic principles, the, the, the, the theory in the field, uh, that has really dominated the field either directly or indirectly in so many ways has been that there are two drives within us, that there, there's aggression and pleasure. And again, these are just words, right? So we could put, pl- apply many, many words, which is why of course we want to define what that means, right? So aggression, even though we're, we're using that word for it because the word for it is commonly used, right? But it means, it means sort of forward active engagement, right? So, so a, a good healthy amount of aggression, using that word for the drive, would be a strong sense of agency, right? So, so too little aggression can be a problem, right? When the person isn't bringing themselves to bear, right? So there's too little in the way of self-determination, um, forward movement, eh, empowerment, agency, right? And, and in the same way, too much of this drive becomes actual aggression. So, you know, the idea that I want more and if I can't get it in, in certain ways, I'll just take it, right? So, so then, so it starts to become, you know, what we more map to the word aggression, which, which would be something negative in most cases.

   5. AHAndrew Huberman24:10

      Like, like a desire or a tendency to harm. Is that-

   6. PCDr. Paul Conti24:14

      Sure, we... As, as aggressive drives get higher, which you see why they're in us, because let's say we're defending ourselves or, or, or you're defending a family member, right? Or, or like an entire family, right? Then-... it, it makes sense to have high levels of aggression if, like, your family is threatened, right? So, so those drives are in us with, with, at potentially those high levels for a reason. But we, we certainly access very high (laughs) levels of aggression without the, the indication of preservation of life or preservation of safety. So, so the, the thought is that's a drive in us, and that gets us up and off the ground, so to speak, right? And that the other drive then is pleasure, w- which, again, doesn't just mean that, like, we, we all want to be hedonists, right? So, so pleasure could be even the pleasure of relief and safety, right? Like, we're like, you know, we're all back in the cave together and w- and we roll the stone in front of the door. Ah, we're safe, you know? Through- through- throughout human development, you know, p- pleasure comes in a lot of ways. It can come through the pleasure of food or o- other people, you know, friendship, romance, sex. There are a lot of ways we can achieve pleasure. It can be relief of things that are unpleasant, you know, relief of pain. But there, there's a drive towards this in humans, which, again, really does make sense. And, and too little of it, again, can be problematic, 'cause th- the person then isn't motivated to sort of seek things because they're, they're not anticipating or don't receive gratification, and too much of a drive for pleasure can also create problems. So, so we can kind of see how these two drives, like, okay, they get us up and off the ground, so to speak. But the, the question is do they explain everything, right? And it's a very important question, because if they explain everything, then there's not really... There's not room for behaviors and choices that are beyond the self, right? There's not an explanation for the person who... I'll, I'll, I'll give you an, an example of, uh, a person I've taken care of who's just a very strong swimmer, you know, knows how to swim, has swam throughout his life, who was in a place, I saw a video of it, where there'd been a hurricane and the waves were so frightening, you know? They were just hu- this huge surf, and there were people who, who had gotten dragged out, and then you just see him, he runs into the water, right? He runs in and he goes and, and he was really at risk. He needed to be saved himself. But he saved them. And I do not believe you can explain that thr- through these drives. I don't think you can say, "Well, that was... He was aggressive. He, he wanted to go and do something, you know, that was imposing himself on the world," or he got pleasure in thinking, "Ah, I'm strong enough to go do this." I mean, I think we're really gyrating, you know? We're contorting ourselves, right? In order, I have to explain it that way. I- if we think there's a goodness in that man's heart, like, I know there's a goodness in that man's heart. I know him, right? And, and, and that goodness seizes him in the moment and, you know, he knows that maybe he can save them. Maybe he can't. He's not sure. But maybe he can. So the next thing you know, he's in the water. And I think things like love and nurturing of, of other people, you know, of children, love and nurturing of animals, of plants, right? Like, th- there are things inside of us that we can't explain with those two drives. And, and I think they l- have led to a very sort of darker way of just conceiving of humans, you know? Ah, ah, I think it's a reason why now, you know, you look at us in the, in the modern day and age, we come at humans through the lens of pathology, right? I mean, there's a- there's a very, very thick book that if, if, uh, a person is assessing another person, you know, is thinking about like, okay, what, what numbers in the- that book apply, right? Which is like, that's not the way to go about understanding humans. And I think if we just think there are those two drives, we're not doing justice to, to humans, right? One, I think it's not true. I think it's evident that it's not true. And then if we're framing it in a way that's not true, we are not appropriately respectful of humans. And if we come from what I believe to be the truth, that there is a generative drive in us, a drive for the beyond self, a drive to make things better, whether it has anything really directly to do with me or not. And as with the other drives, you know, there can be more or less in people, you know, a combination of nature and nurture. You know, what, what genetically is in us, a predisposition, you know, based upon the genetic lineage that comes down to us and the recombination, and now we're a unique person with a unique set of drives. But they are impacted by the genetics, and then they're impacted by life experience, so more strongly formative life experience, right? So the younger the person, the, the sort of deeper the impact of events. They have nurturing versus abuse, right? On the, the array, on the relative weighting of drives within people. But ultimately, w- we get to these three drives and how they're functioning in a person being a way of understanding and assessing like how healthy or not healthy the person is. And then we look back to those 10 cupboards, right? For the answers. If we're finding things that we don't like, these- those drives are out of balance and they're... And here are the problems they're causing. So very, very concrete issues, right? Of problems in people's lives. We can look and see where is that out of balance? And if it's out of balance, there's something in those pillars that are not in the right place. We can then go back and look in all those cupboards for like, oh, where do we dig to find the answer, right? We learn things. We, we bring things more into balance, right? So, so the pillars are in a healthier place, and then what sits on top of it as you use the word geyser, right? The geyser that then comes up and floats everything on top of it can do that in a, in a healthy way.

6. 30:00 – 37:05

   Physical & Mental Health Similarities, Verb States

   1. PCDr. Paul Conti30:00

   2. AHAndrew Huberman30:00

      Yeah. During episode one, we touched on some of the similarities between understanding the self and, um, building towards a healthy or healthiest version of self-

   3. PCDr. Paul Conti30:10

      Yes.

   4. AHAndrew Huberman30:10

      ... where agency and gratitude are the states that are being expressed. And one of the themes there was this idea, you know, people perhaps want to be healthy so that they live a long time. But presumably, they also want to be healthy so that they can walk up flights of stairs, pick up their kids and move objects, not get injured. Perhaps even do sport or, um, and of...... course, some people want to be healthy for aesthetic reasons as well. And if we were having a discussion about physical health, we could address the major pillars there, which were, were, um, items within the cupboard, like, um, you know, most people want, uh, some ability to have endurance or stamina to walk some distance or maybe even run some distance. Uh, as I mentioned before, walk up a flight of stairs, have some strength, some degree of flexibility, certainly some mobility, um, maybe even dynamic mobility, et cetera. And in order to address those or improve upon those, they could look in those cupboards and say, "Well, how much, you know, running, swimming, you know, long form cardiovascular exercise am I doing per week? How many steps am I taking per day? Uh, how many times a week do I lift objects that are slightly heavier than is comfortable for me to lift?" Et cetera. It, it's very tangible, very concrete. Um, here you're making the, the psyche and the, and, and the self and mental health, uh, very much concrete in some of the same ways, saying there are 10 cupboards that one can look in. And these drives, as you refer to them, as, uh, generative drive, aggressive drive and pleasure drive, um, uh, you'll probably tell us in a few minutes, um, can be expressed to varying degrees in different people and how that shows up and what that looks like. And I just want to frame this in people's minds as very similar to addressing whether or not, okay, if somebody can run very long distances, but they're always a- you know, uh, having aches and pains or they, they feel weak or they are weak, you know? There are good reasons for that. They're overemphasizing one form of, uh, exercise. The expression is more along the lines of endurance and stamina, not strength. Um, or vice versa, the, the power lifter who can, you know, lift, you know, 750 pounds from the floor in a deadlift, but walks up two flights of stairs and is, you know, belly breathing and has to stop at the top of the stairs. Uh, you know, it's, it's obvious in the physical realm, it's slightly, um, more cryptic, or more cryptic in the psychological realm, but here it's becoming concrete for us. So-

   5. PCDr. Paul Conti32:31

      I think it's, it's very interesting and very ironic, right? So the field that I'm in, the field of psychiatry has historically w- wanted to be sort of part of the rest of medicine or like the rest of medicine. And, and what I believe it's ended up doing is glorifying a taxonomy, right? Glorifying a, a, a category, uh, mechanism of understanding human beings. So in the way that, that if, okay, if I'm a, uh, practicing general medicine and you come in and you're congested and, and I determine like, oh, you have, you have bacterial sinusitis, right? So, so now I've, I've made a diagnosis and now the... I know what I'm going to do about that, right? So, so the... okay, I'm going to prescribe an antibiotic. Now the thought comes in of like what antibiotic, right? But the identify sinusitis, now you need an antibiotic is like kind of how medicine works, right? So the thought was psychiatry is going to categorize everything, right? So we'd say, "Okay, I've listened to you like, ah, I know your number or your numbers," right? "And then once I've given you the numbers, now I know what to do. I, I prescribe this medicine, that medicine, these many sessions of a certain kind of psychotherapy." And like that doesn't work, right? It doesn't work in mental health. It may... I mean, it's just, it's not that it never works, but if you're going to try and understand people, like it's different, the problem of self. Like if I have a lack of confidence in one area of life and not in others, right? That's a significant issue. It is not like bacterial sinusitis where then, you know, okay, arrow goes to prescribe antibiotic. And I think what is ironic is that this route of approach, right? Actually does bring psychiatry, mental health into line with the rest of medicine, right? Which is why you, you can make that parallel and you know, it fits well, right? When you're making the parallel to physical health and to I want to be healthy. Okay, what are the components of that? What am I doing to achieve that? If something's not the way I want, let me go back and look at those components. I mean, it may be because it's more tangible, it's sort of e- essentially easier, a- a- to comprehend, right? Because it's more, it's more concrete, but, but I don't in a sense see it as cryptic, just less obvious, right? But if we go and we look at it and we say-

   6. AHAndrew Huberman34:49

      (laughs)

   7. PCDr. Paul Conti34:49

      ... "Oh, that really makes sense," right? And, and i- in a sense, it makes sense that it makes sense, right? If there's a mechanism of understanding that applies to lots and lots of things that are more concrete, why would a similar kind of mechanism, like understand what the components are, understand what's built on top of them. Like this, I believe is how psychiatry actually fits with the rest of medicine, not by glorifying a taxonomy, but by coming through the lens of understanding.

   8. AHAndrew Huberman35:19

      Yeah, I couldn't agree more, and I, I think that, uh, what's so reassuring is that both in terms of creating physical health across the various domains of, you know, heart health, lung health, endurance, strength, et cetera, cognitive health, as well as mental health is verbs. You know, it comes back to action items that we each and all should engage in in order to arrive at the states and you know, ways of being that we all want to be in.

   9. PCDr. Paul Conti35:46

      Mm-hmm.

   10. AHAndrew Huberman35:47

       Right? We want to feel healthy, look healthy, you know, et cetera. We want to, um, be happy, right? I, I know very few people who don't want to be happy. I mean, certainly there are people who give up, but, uh, we'll talk about that today and, and routes out of that. But at the end of the day, it's all about looking in those bins, asking specific questions, and then moving forward in specific actions to get to the place of empowerment, humility, agency, gratitude, peace, contentment and delight, et cetera. Um, as opposed to, um, simply using words and understanding to arrive at insight and then stopping there and expecting everything to change. And I think that's where a lot of people are confused about psychology, therapy and psychiatry. And, um, and as you mentioned, psychiatry has its own, um, uh-... shadows, if you will, within it, where the, the use of, of drugs, which cer- certainly can be very useful-

   11. PCDr. Paul Conti36:39

       Mm-hmm.

   12. AHAndrew Huberman36:40

       ... even lifesaving-

   13. PCDr. Paul Conti36:40

       Absolutely.

   14. AHAndrew Huberman36:41

       ... oftentimes is, is seen as a, um, a fix-all that, um, somehow could reorder everything within the cupboards and, and make the recipe just right, when, in fact, as we'll talk about today, that that is, um, generally not the best route.

   15. PCDr. Paul Conti36:54

       Yes.

   16. AHAndrew Huberman36:55

       But again, with the understanding that drugs can be very powerful tools.

   17. PCDr. Paul Conti36:58

       Yes, they can play a role.

   18. AHAndrew Huberman36:59

       Yeah.

   19. PCDr. Paul Conti36:59

       Right? But it's important we understand what role is appropriate for them, and that's where we often go astray.

   20. AHAndrew Huberman37:04

       Mm-hmm.

7. 37:05 – 38:32

   Sponsor: AG1

   1. AHAndrew Huberman37:06

      I'd like to take a brief break and acknowledge one of our sponsors, AG1. AG1 is a vitamin mineral probiotic drink that meets all of your foundational nutrition needs. I started taking AG1 way back in 2012, so I'm delighted that they're sponsoring the podcast. The reason I started taking AG1 and the reason I still take AG1 once or generally twice per day is that it's the easiest way for me to ensure that I'm getting all of the vitamins, minerals, probiotics, and fiber that I need in my diet. Now, of course, it's essential to get proper nutrition from whole foods. But most people, including myself, find it hard to get enough servings of fruits and vegetables each day, and especially to get enough prebiotics and probiotics to ensure gut health. As you may know, your gut contains trillions of little microbiota, the so-called gut microbiome, which establishes critical connections with other organs of your body to enhance brain health, as well as to support your immune system and other aspects that relate to mental and physical health. One of the most common questions I get is, if you were to take just one supplement, which supplement would that be? And my answer is always AG1, because by taking AG1, I'm able to ensure that I'm getting all of the vitamins, minerals, and probiotics that I need to enhance my mental health, physical health, and performance. If you'd like to try AG1, go to drinkag1.com/huberman to claim a special offer. They'll give you five free travel packs, and they'll give you a year supply of vitamin D3 K2. Again, that's drinkag1.com/huberman to claim this special offer.

8. 38:32 – 43:06

   Lack of Motivation, Drives

   1. AHAndrew Huberman38:32

      So, uh, as we move forward here in defining and, and helping people gain, uh, for lack of a better word, agency over their own mental health and, and self-understanding, and defining for them what, what action items to take, you know, I think I'd like to ask you about some of the things that I observe in the world and hear a lot about, and particularly from the audience of this podcast. You know, um, it's obvious to me that people vary in terms of their level of aggressive drive, pleasure drive, and presumably generative drive as well. Um, one common question is, how do I become more motivated, right? You know, um, and, of course, that opens up a bunch of other questions like, are people afraid of failure and that's why they're not motivated? Are people afraid of success, is that why they're not motivated? Is there some underlying childhood trauma or unconscious process, uh, that's driving that fear, um, and so on? But if we were to take the psychiatrist perspective, your perspective, if someone comes to you and says, "You know, I, uh, you know, I just don't really feel like trying. It's, you know, school's hard. School loans are, you know, are excessive," which is true by the way. (laughs) Um, "You know, it's not even clear that with a degree I can do much, you know?" Or, uh, "I had a series of failures in, in the work domain or in the relationship domain." And, and they're just feeling w- weighed down, as if it's not worth trying. Um, you know, what does that tell you in terms of where to look, and, and what does that tell you in terms of their drives? I mean, do we conclude something about their innate level of aggressive drive, um, or their pleasure drive, or their generative drive? I mean, I think there are many such people out there, and then we'll consider some other, um, kind of phenotypic examples.

   2. PCDr. Paul Conti40:21

      Right. So it's a great example, because sort of like any good clinician, right, could, could hear that story and then, and have thoughts about it, right, that, that could and would hopefully be helpful, right? Without necessarily referring to drives, right? So, so I think you can anchor any set of assessments, any evaluation, any attempted understanding to drives, right? But, but it doesn't have to be that way. So for example, you might ask that person more questions about what they're doing, how they spend their time, because y- you're telling me about someone who's not enj- getting enjoyment or gratification out of anything, right? And, and that then becomes of interest to me, right? Is, is there, is there something this person does enjoy, right? Or something they'd rather be doing? Like, did they, did they go to college and take on a bunch of loans because they thought that was better, because they thought they were gonna do something that now they actually don't want to do, right? Or that opportunity isn't there and now they're frustrated. Like, what is inside this person that might seem different than that? And, and again, the answers could be complicated. It could be maybe that person enjoys what they're doing, but the cost of living where they are is so high that they still feel miserable. There's a sense of privation, and then that gets back mapped to like I don't... I'm not getting any pleasure out of anything, right? So the answer could be as simple as you strategize with the person of, you know, for example, does a person like that move, you know, or move to a different area? So, so like there's so many ways of looking at this and so many ways of understanding this. But you're describing someone to me who, who i- is kind of really complaining that nothing is feeling good, right? Nothing's providing a, a sense of, uh, of enjoyment or of pleasure, right? So I, I would probably be interested in that first and think maybe the, the pleasure drive is higher than what's being fulfilled, right? Maybe the pleasure drive is, is low, and that's an issue in and of itself. We sort of learn those things, right? Maybe the aggressive drive is low, and, you know, if that person just put a little more energy into it, right, like they could be in a different place, right? So you try and help the person understand themselves so that you can make change. And again, that understanding doesn't have to be anchored to, to the drives. But I do believe the drives are at the root of all understanding, because if you sit with that person and you talk to that person, then you're gonna be able to understand what is.... out of balance, right? Either in, uh, the, the actual array of the drives or in how they're being, being experienced. Because again, if you have a high pleasure drive to, for example, and it's not gratified, right, like, that represents a problem,

9. 43:06 – 51:46

   Video Games/Social Media & Distraction, Generative Drive

   1. PCDr. Paul Conti43:06

      right?

   2. AHAndrew Huberman43:06

      Yeah. What, what about people who, um, can experience some pleasure or can keep busy, say for instance, on social media or playing video games, and I should also say perhaps it's bringing them to a place of peace, contentment, and delight, but in some sense it's not really generative, right? It, you know, I'm not going to cast judgment and say that video games and social media are all a waste of time. I mean, I'm on social media trying to provide value to people and learnings and, um, and I derive value and learnings from other accounts as well. But, you know, there are these, um, milestones, if you will, in life. I mean, not that everyone has to, you know, go to college and, and get married and ha- have a family. I mean, there are a lot of different paths through life that I would consider successful. But in some sense, we, you know, there are milestones, like we want to move forward. There's this phenomenon nowadays of a lot of, um, young people, um, so-called failure to launch. Like, they, they're not leaving home or, uh, they're not finding a vocation, they're not, they're not feeling as if they're good at anything, um, or, or they have the sense that unless you're going to be a prof- you know, like top 1% in something, it's not worth trying. But they can still find, uh, you know, what most people would describe as pleasures, like they might, yeah, they enjoy food, um, maybe a little too much. Uh, they enjoy, uh, alcohol maybe a little too much. They enjoy social media or video games maybe a little too much. And I say a little too much because it, it's providing more or less a, uh, a sink or a, or a reservoir for their aggressive and pleasure drives that's not moving them forward in the standard milestones of life.

   3. PCDr. Paul Conti44:39

      Mm-hmm. Mm-hmm.

   4. AHAndrew Huberman44:40

      Um, I, I hear about that a lot. I, I see that a lot. Um, you know, so it's a slightly more, um, complex, uh, phenotype than what I described before as just simply the amotivated or non-motivated person, but, you know, w- what does one, you know, what do you think of, of that, uh, of the phenotype I just described?

   5. PCDr. Paul Conti45:00

      Again, because w- we're unique, right? E- each person is unique, although we fit categories, right? So there are categories a, a person there could fit that could be different from what I'm saying, right? But I think most people, let's say on balance, right, what's, what is most prominent, right? And I think w- what is most prominent in that situation is there's something a- out of balance i- in the generative drive, right? And what you see a lot of times is the person has a generative drive in them that's higher than their ability to, to realize that drive. The generative drive then is frustrated. So I'll give a- an example. It's a r- a real true story of a person who had worked very, very hard, gone to school for a long time, and had achieved a very high paying job. And like that was the goal, right? Uh, it's a prestigious job, it's a high paying job, and the person for a while w- was doing quite well at it. And, you know, things went, well, relatively rapidly in a negative direction, so maybe for a little while the person's doing okay. Then the person becomes very negligent of themselves and their environment when they're not at the job. So the, you know, the, the house is a mess, things are dirty, the person is wasting time with things. So this is a person who enjoys... It wasn't exactly video games, but say... Let's say, it could have been, right? Well, enjoys them to a c- certain degree and can really gain pleasure and feel good a- about the time spent, right? But starts spending too much time, right? Now what was pleasurable starts becoming a distraction mechanism, right? And then what that transitioned to was overuse of alcohol, right? So now you have either something that is actually destructive and was negative to job performance, right, towards the person... This wasn't a person who was drinking a lot before, and this is a person who was miserable when they were drinking, or they were sort of wasting their time, right? And we're aware of all of this. Well, there's a very clear problem, which is that that person had no interest in what they were doing. None whatsoever. It felt like the majority of waking hours were spent i- in an automaton-like way, but being awake and aware of the tedium of it, the frustration of it. An-

   6. AHAndrew Huberman47:17

      The professional side. So they, they essentially-

   7. PCDr. Paul Conti47:19

      Yes.

   8. AHAndrew Huberman47:19

      ... had very little, uh, intrinsic curiosity or desire to do the job that they were successfully doing.

   9. PCDr. Paul Conti47:26

      Right, right, which comes out only after exploration, because it seems, well, what's going on with this person? Like, this person has a good job and their life was going really, really well and, and they're doing well financially and, you know, is this person trying to now, you know, overly indulge themselves, right? Like, is that why they're drinking? What's going on, right? And what you, you feel is that this person had a strong generative drive, and it wasn't met one little bit by what he was doing, which was creating such frustration inside that the person was either taking himself online or doing something that was punitive and self-injurious. And like, this is a real story. The, the, the person exchanged that job for a job that paid a tenth of what the job they had paid, and the change in the person's life was amazing. Like, I didn't know this guy could smile, right? He became happy. He loved what he was doing. He sold the larger house, bought a smaller house, kept it beautifully. Like, he was happy, right? That's what he needed to be happy, because then the generative drive in him, he loved what he was doing, where it gets enacted, it gets expressed, and then oth- other things can come then into line, right? He's not being overaggressive towards himself and drinking too much, you know, because he's saying, "Oh, to hell with you," to the world around him and to himself, right? He's not taking something that serves a purpose in his life. Like, again, if the example had been video games, it would be like, yeah, great. You enjoy doing that X amount of time, and like, go do that and get gratification from it, as opposed to then over-relying on it, and then it's not providing gratification, it becomes a distraction. So those things came back into balance by...... in his life. But there had to be the understanding, and I think there's a lot of that in people who have regenerative drive in them that they feel is frustrated by a world around them that isn't cooperating. Now, do I think we can understand that and change that in the vast majority of people who are in that place? Yes. But it has to be looked at first, right? Because when, it's not always that, it's just that a lot of the time, right? So it has to be understood. What is it in that person? And then how do you go back to those pillars and look at what's going on that that person is in that place? Because the world can bring us a lot of difficulties, right? And that person who now is saddled with a lot more loans than they expected. Like, I have tremendous compassion for that and sympathy for that. Like, that's real, right? So people can be up against a lot of things and that's just one of them, right? But it doesn't mean that life can't be okay, all right? It doesn't mean that. But the person has to feel that there's some way, uh, they have to understand enough, uh, about themselves, say, "Okay, this is what this is and I kind of see what this is and why and how I'm here and from there I can start to plot a route to something that is better." Because yes, we have our difficulties and we can have a lot of them, right? But it's n- it, f- for the vast majority of us, it's not like they're not surmountable. We have to just understand them. And let's say if that person goes and says, "I'm going to get some help." And they go and someone says, "Oh, okay. All right. You get 10 sessions of cognitive behavioral therapy." And you're trying to, like, how can that person think differently, then they'll feel differently? And look, cognitive behavioral therapy has its place, right? But it's not going to solve that, right? Like that person needs to understand something about themselves, not redirect their thoughts to better places, right? So if the person gets a reflex, because that reflex works well for the system, right? A reflex works well for the system that's treating that person, for the medical system, the insurance system. That person isn't helped one bit, right? And maybe a medicine can help, right? Maybe a medicine helps to just take down the anxiety and the tension in the person. Then the person can sort of think more about it and, and truly medicine did help this person because the idea of leaving the job, I'm leaving the prestige, I'm leaving the money, is that okay to do? Like it generated a lot of anxiety and it helped to kind of bring the temperature down a little bit of that so that he could think about it, engage in therapy, ultimately navigate to where he wanted to be, then we could back away from the medicine. So, like, medicine has a role. But i- if he just got medicine, I mean, w- what are the possibility, what are the odds of that helping? Like zero, right? Because it's, it's not going to make the answers unless somehow the person feels a little bit better and figures it out on their own. I mean, it's not how it works, right? So medicine has its place, but a, a, a kind of therapy that recognizes the limitations of medicine in most situations and is designed to really help the person understand, like, that's what we need.

10. 51:46 – 59:10

    Asking Better Questions, Psychiatric Medicine, Physical Health Parallels

    1. PCDr. Paul Conti51:46

    2. AHAndrew Huberman51:46

       You know, the example you gave is a spectacular one because as you mentioned, medication had its place. Uh, perhaps even redirection of thought in some sense had its place-

    3. PCDr. Paul Conti51:56

       Mm-hmm. Yes.

    4. AHAndrew Huberman51:56

       ... because, uh, as I recall, under the pillar of function of self, uh, you know, one of the, the key, uh, items, uh, is salients, you know, what we pay attention to internally or externally, what our internal narratives are. But, um, in staying with the example of this individual, again, as a, as a phenotypic, uh, example for everybody to, to learn something from, the asking of better questions about oneself is really what leads to the understanding, so that like better forms of inquiry, right? The, to me, the- these are the, these better forms of inquiry, uh, better questions are really the, um, cardiovascular exercise, the strength training, the flexibility training, the mobility training, coordination training of physical health just translate to, to mental health.

    5. PCDr. Paul Conti52:47

       Right.

    6. AHAndrew Huberman52:47

       Right?

    7. PCDr. Paul Conti52:47

       It's so, it's so interesting, right? Because if you think about it, in the example I gave, both the th- the therapy part from through the system, right, the CBT had a place, right? And the medicine part also had a place. So both of those things have their role, but if we build the whole story of like this is what this is and this is how you're going to be helped around those things, we don't help that person at all. In fact, we ultimately, if you take on balance, you take all comers, we end up doing harm.

    8. AHAndrew Huberman53:15

       Well, in some ways, if I, we stay with the, um, the analogy of physical health, it would be like the person who wants to get in shape and then they get a, a... I'm not picking on Peloton, um, as a brand, but just a stationary bike and they, they pedal every morning and they lose weight, their blood pressure goes down, they're doing better. But then at some point if... We, we know for cer- with certainty that if you just do the same form of exercise over and over again, like sooner or later, you're going to get overuse injury. So then there's like the lower back pain and another piece and, and you become out of balance, right? There's just... But you know, I guess this is stealing from the Lance Armstrong book, uh, but it's not about the bike, right? (laughs) I mean, uh, you know, it's not about the bike, it's about the elevation of heart rate, it's about the, um, whatever other healthy activities go along with exercising first thing in the morning and the, all the things that you're not doing as a consequence of exercising in the morning. Um, so it, it seems to me that these, these, uh, better lines of inquiry as the path to, um, better mental health, a better life, um, that sit under these pillars of structure of self, function of self are really the key.

    9. PCDr. Paul Conti54:16

       So in this example, right? The parallel that you made is even more dramatic, right? I- it wouldn't be the stationary bike, right? Because a stationary bike is achieving a lot of ends, right? It would be more like telling the person, "You know, you should walk more briskly when you're going up stairs." Right? Like that's a good idea, but that's not going to make the change, right? So the idea that some CBT, some medicine makes sense, it's more like that, right? It's not that walking more briskly up the stairs isn't a good thing, it's that we, we can't build a story around your whole health is going to change based upon that. And then that's, it's a problem then if the person thinks just walk more briskly up the stairs and you'll be healthier, because when it doesn't work, now they've failed....right? And this gets used a lot in mental health, "That person failed this therapy, failed that medicine," right? It, and, and it gets so, also ironic because that's often what the person internalizes. Well, they failed because we set them up 100% for failure, right? Because we took things that have their role, at least potentially have their role, and we built the whole story around them because that story is convenient for the systems that are providing the care. It's pro- it's convenient for the healthcare systems, it's convenient for the insurers. CBT packages very nicely, and you could see how, you know, if you start changing thoughts and how they make you feel, like, you, you know, you can get some movement on the surface even if there's no movement underneath, right? And again, I'm not saying CBT is bad, but to see it a- as the whole answer guarantees failure in so many situations. Same thing with the medicine. If you build the whole story just 'cause it's convenient and, and by and large, medicines are cheaper than people, right? So, so you can prescribe medicines very reflexively. Psychiatrists with 15 minutes with a patient that they can't then see back for a couple of months, like, how does that go well? The answer is, it only goes well the way a broken clock is right a couple of times, you know, twice a, twice a day, right? I mean, some, look, sometimes it goes well where it just somehow it works out and the, that person can do a little bit of therapy in 15 minutes and choose the right medicines, but by and large, we do those things because they're convenient for the systems even though th- that's why, like, people don't get better like, like we think they would. That's why they stay in systems, that's why they come in and out of emergency rooms, that's why they're not able to stop the drugs that end up, you know, only being stopped at, when the person dies. Like, this happens all the time and we don't stop it because we're coming from a perspective that is so limited. It's not saying, "Let's take a step back and look, can we really, like, help someone? Can we really help that person understand? Can we help that person make change?" Which ultimately would be, of course, so much better for the person, and so much better for society, but is also better if we just look at bottom line dollars and cents, right? Because the short term view of it is cheaper today to have a psychiatrist at a 15-minute appointment reflexively prescribe a medicine, that is cheaper today. Is that cheaper across time when that person is utilizing more resources or they're in and out of emergency rooms? It's so shortsighted with, which fits with many ways in how our society works, right? That we want gratification and we want gratification rapidly. That's why a person would accept that their problems could be changed by medicine, right? We're kind of conditioned that way.

    10. AHAndrew Huberman57:43

        Well, and then of course, there's the, the cost we don't see which is that person doesn't get the opportunity to express their generative drive, and so the-

    11. PCDr. Paul Conti57:51

        Right.

    12. AHAndrew Huberman57:51

        ... the, and the, the consequence of that is incalculable.

    13. PCDr. Paul Conti57:54

        Right. Yes. And if we take a step back and we look at that, I think that what we will see is that we have, it's not quite, like, painted ourselves into a corner, but it's like, you know, the idea that if there's a, a beautiful tapestry that's the size of the wall, right, that you can see that only standing back from it, right? I mean, this goes back, you know, a couple, I think a couple thousand years, right? This, this sort of thought and idea. But if you come up too close to it, then you kee- can't see what it means anymore. And we're up so close to it that we're thinking, "Well, okay, how could one parameter change?" And, you know, can, can this person get a 15-minute visit sooner rather than later or how about this medicine instead of that? And then it's like our noses are right up against the tapestry and we don't see that we're not doing right by individual people a, a lot of the time, and we're not doing right by society. Which then if you stop and think about it, we're not doing right by us, 'cause any one of us could be in that position, and many of us have been in that position, being on the other side of things and m- really needing help and needing to understand. So any of us can be there. So if we're failing a lot of individual people and we're failing the society, it doesn't matter who we are listening to this, like, ultimately, we're failing ourselves.

11. 59:10 – 1:00:30

    Sponsor: Eight Sleep

    1. PCDr. Paul Conti59:10

    2. AHAndrew Huberman59:10

       I'd like to take a brief break and acknowledge our sponsor, Eight Sleep. Eight Sleep makes smart mattress covers with cooling, heating, and sleep tracking capacity. I've spoken many times before on this podcast and elsewhere about the fact that getting a quality night's sleep on a regular basis is the foundation of mental health, physical health, and performance. When we're sleeping well, everything goes better, and when we are not sleeping well or enough, everything in terms of mental health, physical health, and performance gets far worse very quickly. One of the key things to getting a great night's sleep is to control the temperature of your sleeping environment, and that's because in order to fall and stay deeply asleep, you need your core body temperature to drop by about one to three degrees, and in order to wake up feeling refreshed, you need your core body temperature to increase by about one to three degrees. That all becomes very easy when using an Eight Sleep mattress cover because it allows you to program the temperature of your sleeping environment at the beginning, middle, and towards the end of your night when you wake up. I started sleeping on an Eight Sleep mattress cover over two years ago and it immediately and persistently improved the quality and depth of my sleep. And as a consequence, I wake up feeling far more refreshed. I have enhanced mood, focus, and alertness throughout the day. If you'd like to try Eight Sleep, you can go to EightSleep.com/huberman to save up to $150 off their Pod 3 cover. Eight Sleep currently ships in the USA, Canada, UK, select countries in the EU, and Australia. Again, that's EightSleep.com/huberman.

12. 1:00:30 – 1:08:53

    Self-Reflection & Structure of Self “Cupboards”, Trauma & Agency

    1. AHAndrew Huberman1:00:31

       Let's therefore talk about what does work-

    2. PCDr. Paul Conti1:00:34

       Mm-hmm.

    3. AHAndrew Huberman1:00:34

       ... you know? And again, placing on the shelf the, the fact that medications can help and CBT, cognitive behavioral therapy can help, but it, they are just but two components of a much larger picture. The map that we described briefly at the beginning of today's episode, and that is, by the way, available as a downloadable PDF in the show note captions if people want to look at it visually, and that was described in a lot of detail in episode one, which I hope people will-... take the time to listen to because it's so rich with depth of understanding. And I'm certain everyone will learn a ton about themselves and others simply by listening to y- your words. It, um... I'm absolutely certain of that. That map provides essentially a description of the bins, the cupboards to look in, uh, to arrive at better answers, and, and even the sorts of questions that one might ask. Uh, if we could just talk about that in the context of the example that you gave of this person who made this, uh, really incredible choice to move away from this higher-paying job, um, you know, they were overindulging in, in certain, uh, maladaptive behaviors. And again, it, w- we will use this example, but, um, this example is but one of an infinite number of examples that we could use of a person who's, you know, in a struggle, right? They're doing something that's not working for them, and they're also not doing things that they know they ought to be doing, okay? Um, this is important for people to, to understand, because, um, there are gonna be people out there that are thinking, "Oh, like this poor guy, like, he's making tons of money. Poor him," you know? But, you know, he was experiencing deep-

    4. PCDr. Paul Conti1:02:08

       He was miserable.

    5. AHAndrew Huberman1:02:09

       ... lack of satisfaction. So it could, could have been the reverse example, like the person isn't in a job that, that brings about enough wealth for them to-

    6. PCDr. Paul Conti1:02:16

       Right.

    7. AHAndrew Huberman1:02:16

       ... to thrive, right? Because there are financial realities to life. Um, so it's just-

    8. PCDr. Paul Conti1:02:20

       It's one example, right?

    9. AHAndrew Huberman1:02:21

       Right.

    10. PCDr. Paul Conti1:02:21

        But it's a good one, I think, because the person left the money, right?

    11. AHAndrew Huberman1:02:25

        Right.

    12. PCDr. Paul Conti1:02:25

        So it's like, well, what would make you leave that, right? A- and he says, "Well, what would make you leave that is if you were miserable in the situation with that, and you're happy in the situation without it."

    13. AHAndrew Huberman1:02:34

        Right. So it's about leaving misery and, and finding happiness.

    14. PCDr. Paul Conti1:02:37

        Yes.

    15. AHAndrew Huberman1:02:37

        That's... So if you'd be willing to share with us a little bit of your mindset during those sessions, meaning the sorts of questions you asked him about the structure of his self, or to reveal the structure of his self and the function of his self that allowed the both of you to eventually set him down this, um, far better course, uh, you know? What's better than moving away from frustration and overindulgence and maladaptive behavior to deep satisfaction, peace, contentment and delight, and to become a generative human being?

    16. PCDr. Paul Conti1:03:05

        Right. So we can look in each of those 10 cabinets, right? So let's say we look in the unconscious mind cabinet. There's not much there, all right? When the person was growing up, it was very clear that having more money and having a job that impressed people was, was an important thing. He internalizes some of it, so some of it's unconscious, but by and large, he's aware of it, right?

    17. AHAndrew Huberman1:03:25

        And, and that was revealed to you how? He, you know, you would ask him a question about, um, you know, like tell me about your upbringing. And he would say, "Yeah, like, you know, money was important in my family, but we a- I always felt like we had, you know, enough." Way he wasn't super wealthy, but he had enough. And so when you say there wasn't a lot there, do you mean that there was no kind of like, X marks the spot or like, like blinking red light, like, whoa, there's something really in his unconscious mind that's in his way, is it? Do I have that right?

    18. PCDr. Paul Conti1:03:50

        Well, more because it was conscious, right? So, so he was aware that it was very much, like, beat into him, right? Like, this is the only way to be okay, right? I- is to have a prestigious job that makes a lot of money, right? But he's aware of it. If he weren't aware of it, then we have to bring that to light, right? But he was aware. He's like, "Look, it has a big impact on me. It makes it hard to step away. Like, I know I don't really care that much about the money, but I also kind of do," you know? So, so he's-

    19. AHAndrew Huberman1:04:14

        Sure, money bu- I always say money can't buy happiness, but it certainly can buffer certain stressors in life.

    20. PCDr. Paul Conti1:04:20

        Right.

    21. AHAndrew Huberman1:04:20

        I mean, nobody... You know (laughs) sometimes you hear people who have a lot of money saying like, "Money can't buy happiness," 'cause, you know, there are a lot of miserable rich people, but it's like, you know, uh, it's very different to have a, a two night nurses to take care of a baby than to be the person who has to stay up all night taking care of a kid, especially... Or a single mother versus a, uh, a mother that has a partner who's, who's willing to pitch in, right? (laughs) You know? You just can't compare.

    22. PCDr. Paul Conti1:04:42

        And while that's, that's absolutely true, in this case, we're just looking at money as money, like as an end point, right? The idea that no matter, no matter what, right, how, how secure and safe, like, is more money better, right? And he had an intrinsic overvalue of that, right? So, so it made it harder to step away from it because he, he was overvaluing it. He knew he was overvaluing it just in and of itself, not even for what it gets you, right? But for the psychological meaning of it, right? Then we look at his defensive structures. If we look in that cupboard, you see that they've, they've really shifted, right? They shifted from healthy places. Now they're sort of twisted and distorted, and he's doing a lot of denial, a lot of avoidance, a lot of rationalization, right? There's, he's enacting a lot of aggression towards himself, and he's progres- he's, he's doing a lot of projecting, right? He's, he's harming himself with the alcohol. He's punishing himself, like so his defensive structure, it can be healthy. We know that because it was healthier, right? But then we see that it is so twisted. So we learn a lot from that, right? A lot is conscious in this person. The defensive structure can be healthy because it was healthy, but it's-

    23. AHAndrew Huberman1:05:50

        Eventually it was healthy.

    24. PCDr. Paul Conti1:05:52

        Well, it was healthy before.

    25. AHAndrew Huberman1:05:53

        I see.

    26. PCDr. Paul Conti1:05:54

        It was healthy before. So you know that it can be healthy again, right? He has it in him to have healthy defenses. They just started getting away from him as he felt less and less satisfied with his job and more and more angry with himself and more and more miserable.

    27. AHAndrew Huberman1:06:08

        Um, uh, this is a really key point for me and everyone else to understand. You know, throughout the years of high school and college and friends and things of that sort, I would hear this, like, "I used to be really good at fitness," or, "I used to..." You know, if I had a dollar for every time someone said, "You know, you should have seen me in high school," you know? Like, like the person who lets themself go and, and arguably is very busy with, with professional duties and family duties and, you know, you can understand why their time is more compressed, um, than it was when they were in high school. But nonetheless, you know, you hear these sorts of things all the time. Like, "I used to have this sense of, like, I could do things," or that like, "Things could work out," or that, uh, and then it's as if there was a previous version of themself that has completely atrophied.... and the new version of themself, or the, the later version of themselves, rather, just simply, like, doesn't have access to that anymore.

    28. PCDr. Paul Conti1:07:00

        Right. And that-

    29. AHAndrew Huberman1:07:01

        But, but is it-

    30. PCDr. Paul Conti1:07:01

        ... that's the impact of trauma.
13. 1:08:53 – 1:13:58

    Feeling Stuck, Defense Mechanisms & Sublimation, Character

    1. PCDr. Paul Conti1:08:53

       it before. So think about in this man, he, he felt that he couldn't make change. Like now he's stuck, right? Like, I, I, I got a lot of things done. I was able to, to get myself into this school and achieve this and, you know, and then get this job. Like, he could do all of those things, but now he feels like he can't do anything to make himself happy, so like we know he could do that. She had a strong sense of agency. He doesn't now, right? And, and like people often do, they, they feel a sense of loss. Like naturally, I've had this happen in myself. Like it feels like something's cut out of you and there's something hollow. I had that thing and now I don't, right? Hence the I'm broken, I'm hopeless. The things that we hear over and over and over again. So think about the shift in this person to what's actually going on, which isn't that hard to discern. We just pay attention to it. So then if we run up the structure of self, we say, okay, not a lot of it is rooted in the unconscious mind, right? There, there are, are problems of overvaluing certain things, but they're in the conscious mind.

    2. AHAndrew Huberman1:09:51

       He knows, like, in his household over dinner, it was, you know, dad or mom, you know, being proud of, of some dollar amount that he had achieved.

    3. PCDr. Paul Conti1:09:59

       Yeah, he knows.

    4. AHAndrew Huberman1:09:59

       So that narrative exists and, and he's like, "Yeah, like money was a big deal in my family," kind of thing.

    5. PCDr. Paul Conti1:10:04

       Right.

    6. AHAndrew Huberman1:10:05

       Uh, by the way, I'm not speaking about my family, m- rarely were there discussions about money. There were discussions about other things, of course. But in, in this hypothetical person-

    7. PCDr. Paul Conti1:10:11

       Yeah and he knows he over-

    8. AHAndrew Huberman1:10:12

       Oh no, real patient. Sorry.

    9. PCDr. Paul Conti1:10:13

       Right. He knows he overvalues it, right? He, he knows that independent of what money buys and what he needs and all that, he just puts too much importance in money and he knows that, right? So okay, there are conscious mind issues. He's pretty aware of them and they're pretty kind of set in him, like those are the issues and they're there. Okay, we learned that. Then we go look at his defensive structure. Boy, that's very, very helpful to talk about. Wow, like you had a very healthy defensive structure. What were you doing before? A lot of sublimation, right? Take any-

    10. AHAndrew Huberman1:10:40

        Could you explain sublimation?

    11. PCDr. Paul Conti1:10:41

        Yeah. Take anxiety, tension or something, something negative in the self or that could be negative and you channel it towards something positive, right? He channeled that energy towards learning, right? He channeled some of the aggressive drive, right? Into sense of agency that, that got achievement. So you look and he said, right those, you know, the, the, that, um, network, right? Of, of defense mechanisms that comes up out of the unconscious mind was like looking pretty good, right? It was pretty clear. Light was coming through it in a, you know, in a way that wasn't distorted and now we could look at, wow, like that, things are pretty different now, right? As, as he's saying, "No, it's okay. Like what do you, what do you mean I, I spent ten hours of my weekend utterly wasting time?" And what, what's wrong with that, right? Or, you know, he's rationalizing even that he likes to drink when he doesn't because he's so mad at himself. Like the defensive structure now is twisted, right? So we can say, okay, we, that's a big observation, right? And then the character structure when we look at that, we find a person who's pretty good at figuring out and understanding things and coming right up to the precipice of change. But there's a long history of then difficulty making the change, right? I know it and I'm on the verge of it, but I don't, I can't bring myself to do it. Like that's in his character structure.

    12. AHAndrew Huberman1:11:57

        By the way, such a common thing. I mean people that know better know they know better. Sometimes you almost have to wonder whether or not it's like, um, it's like a medication in the pocket, like they could take it if they wanted to, that, that might even give them some comfort, but they just don't do it. They just don't engage in the proper actions to move their life from one place to the next.

    13. PCDr. Paul Conti1:12:20

        Right. And if we look then at the level of strivings, like he does know what he wants. Like he, he wants a feeling of contentment. That's really what he wanted, was a feeling of contentment, a feeling of like, "I'm taking good care of myself. I'm doing something that's of value. I'm enjoying doing it." Like he wanted those things. And even when we talked more, he had ideas of what jobs would do that. In the beginning he said he had no ideas. What he really meant...... that he said to me, but was also saying to himself is, "I have no ideas of jobs that would meet these requirements for me that pay as much as the one I have," right? So he, but, but within him, which we got to, were the, where he knew that there were jobs that would make him happy, he just had to get over that they were lower paying. So think of what we learn about that. There's nothing lost in this man. There's nothing cut out of him, but he's not damaged, he's not hopeless. And now he can understand that, you know, he, he, that he understands himself actually pretty well, right? And, and his conscious mind is, is apprehending pretty well what's going on and where he wants to go. But boy, as he hasn't taken good care of himself, the defensive structure gets sort of warped, and then it makes it a lot harder to take care of yourself. It starts making other problems in life, and he starts, like, feeling lousy about himself, like, "Maybe I can't do much of anything," right? Why? Because work isn't going as well, because he's drinking too much, and his role performance goes down, right? So we can see that, and then, you know, what's of most interest there is that there's a character structure that can come right up to the precipice but not, but not pull the trigger, so to speak, on what the thing, the thing the person wants to do, because now we start getting, okay, an understanding of what's actually going on, right? And

14. 1:13:58 – 1:19:24

    Self-Reflection & Function of Self “Cupboards”, Self-Awareness

    1. PCDr. Paul Conti1:13:58

       then if we look at function of self, let's look in those cabinets too, right? To help him be more aware of there's an I here, like, which he was pretty well aware of but not enough. Like, there's a person here I'm shepherding through 24 hours in the day, right? Like, I am an I and I'm aware of what's going on inside of me, and it can make me happy or it can make me miserable. Like, let's, let's, let's be more aware of that.

    2. AHAndrew Huberman1:14:18

       How did he go about doing that? Because I, I find this, this first step within, uh, addressing the function of self, you know, self-awareness and really understanding that there's a, there's an, uh, there's an I, there's a me, and I'm moving myself through life, I, I find this to be, uh, so interesting and on the one hand kind of obvious, like, okay, there's an I, there's a me, like tangible thing, you look in the mirror, you see yourself. But at the same time it's a bit abstract, I think, to me and to many people out there. Like, how does one go about building up a sense of self in a way that provides positive agency in the world? Is it to tell... you know, like, we hear all the time about these, like, affirmations and I'm sure there are people who look at themselves in the mirror and say, "You are enough," and these, and I'm not making fun of these people, right? I actually have my own internal, um, list that I, uh, tell myself on waking every morning, which has nothing to do with positive affirmation, it's just actually defining the different roles that I play. I don't know why this is useful to me, but I find it incredibly useful to me. Um, it reminds me who I am, it also reminds, uh, or at least reassures me that I don't have, uh, any dementia yet. (laughs) Uh, so, um, I, you know, we'll see going forward. But, um, hopefully not. But, yeah, let Let's talk about this, this line of inquiry within the, the category of self-awareness-

Episode duration: 3:15:18