Dr. Paul Conti: How to Understand & Assess Your Mental Health | Huberman Lab Guest Series

1. 0:00 – 3:46

   Dr. Paul Conti

   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 first in a four-episode series all about mental health. The expert guest for this series is Dr. Paul Conti. Dr. Paul Conti is a medical doctor and psychiatrist who completed his medical training at Stanford University School of Medicine, and then went on to become Chief Resident of Psychiatry at Harvard Medical School. He then went on to found the Pacific Premier Group, which is a collection of psychiatrists and therapists who are expert in treating all types of psychiatric disorders and life stressors. Across the four episodes of this series on mental health, Dr. Conti teaches us about the structure of our own minds and how to think about our own minds as a way to enhance our mental health. He explains how our subconscious mind and our conscious mind interact to drive our emotions, our decision-making, and our behavior. And while any series about mental health requires that from time to time we discuss personality disorders and psychiatric challenges, the main discussion in today's episode, and in fact all four episodes in this series, are about what it means to be mentally healthy and how to build one's mental health through specific practices, either done alone or with a therapist. Today's episode addresses several key questions as well as provides protocols for you to address questions about your own mental health. For instance, you will learn what constitutes the most mentally healthy version of yourself. You will learn to assess and indeed you will learn protocols for addressing levels of anxiety, levels of your confidence, how to think about your beliefs and internal narratives, how to think about your self-talk and restructure your self-talk. We discuss common challenges such as overthinking, we talk about the role of defense mechanisms and other aspects of the conscious and unconscious mind interactions that can lead us toward or away from the healthiest versions of ourselves. You'll notice that during the first five minutes or so of today's discussion, Dr. Conti describes a framework of what he refers to as the structure of self and the function of self, and he describes several pillars for understanding what those are. I'd like to highlight that while that short portion of our discussion does bring up a number of terms that are likely to be novel to you, they certainly were novel to me, that as our conversation proceeds, you will really come to appreciate just how simple and yet powerful that framework is. It will help you understand, for instance, the relationship between your conscious mind and your subconscious mind in ways that you can really apply toward enhancing your mental health. In addition to that, Dr. Conti has generously provided a few PDFs which illustrate that framework for you and that are available completely zero cost by going to the links in the show note captions. So you have the option to download those PDFs and to look them over, either prior to or during or perhaps after you listen to these four podcast episodes. As a final note before beginning today's discussion, I just want to emphasize my sentiment, which I'm confident will soon be your sentiment as well, which is that Dr. Paul Conti shares with us immensely powerful tools for enhancing mental health that, at least to my knowledge, have never been shared publicly before. In fact, as somebody who has done more than three decades of therapy, I've never before been exposed to a conversation about the structure of the mind and the subconscious mind as well as tools and protocols for enhancing mental health as powerful as these. For me, the information was absolutely transformative in terms of reshaping my thought patterns, my emotional patterns, and indeed several of my behavioral patterns, and I'm confident that the information that you'll glean from today's episode and throughout the series will be positively transformative for you as well. Before

2. 3:46 – 6:55

   Sponsors: BetterHelp & Waking Up

   1. AHAndrew Huberman3:46

      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 how to understand and assess your level of mental health with Dr. Paul Conti.

3. 6:55 – 10:41

   What is a Healthy Self?

   1. AHAndrew Huberman6:55

      Dr. Paul Conti, welcome.

   2. PCDr. Paul Conti6:56

      Thank you.

   3. AHAndrew Huberman6:57

      I'm very excited for today's episode and for this series because I, like so many other people out there, have a lot of questions about myself and themselves, and not just about ourselves, but how the different personality types out there, the healthy types, the narcissists, the, you know, all the things that we hear about these days-

   4. PCDr. Paul Conti7:19

      Right.

   5. AHAndrew Huberman7:19

      ... gaslighting, all these sorts of things, what all of that really is. Um, perhaps we can dispel some of the myths that exist during the course of this series. I'm sure we will. I'm sure you will.

   6. PCDr. Paul Conti7:30

      Thank you.

   7. AHAndrew Huberman7:31

      And also raise certain important questions that we should all ask ourselves in terms of trying to understand who we are and how we can be the best versions of ourselves, how we can experience the most happiness, also the, the most richness in life, because, of course, life isn't just all about being happy. So, to start off this question, I, I want to raise a parallel with something I think for most people is, is more concrete, which is physical health.

   8. PCDr. Paul Conti7:56

      Mm-hmm.

   9. AHAndrew Huberman7:56

      You know? Um, while there isn't an ideal physical self that's been defined by the medical community, we know, for instance, that there is a range of blood pressures that are considered healthy.

   10. PCDr. Paul Conti8:08

       Mm-hmm.

   11. AHAndrew Huberman8:08

       (laughs) And there's a, a range of body mass index that's considered healthy, although that's a little controversial because it depends on how much muscle, how lean people are, et cetera. But, you know, I think it's reasonable to say that the healthy individual is not going to, going to get exhausted walking up a flight of stairs, that they could bend down and lift an object without hurting themselves. They might even have some additional strength or endurance, et cetera. Within the physical health domain, all of that is fairly well scripted, and there are protocols that people can follow to improve their physical health. We've covered many of them on this podcast before. When it comes to mental health, when it comes to concepts of the self, things become much more abstract for people. In fact, I think most people, including myself, are kind of wandering around in the dark wondering whether or not we are the best versions of ourselves-

   12. PCDr. Paul Conti8:56

       Mm-hmm.

   13. AHAndrew Huberman8:56

       ... whether or not we're thinking about ourselves and the world around us in the best ways. So to start things off, could you tell us, what is the healthy version of self? I mean, what, what, what should we all be aspiring to? You've worked with people who, uh, presumably are healthy and people who have severe pathologies of different psychiatric types, right? Bipolar, narcissistic, sociopathic, uh, and everything in between. So for me and for the listeners, what is a healthy self? What should we be striving for?

   14. PCDr. Paul Conti9:27

       A healthy self approaches life through the lens of agency and gratitude. If you look at happy people, you know, people who like their lives, right, no matter what stage of life they're at, right, no matter what their socioeconomic status is, you know, race, religion, there's so many things that we, we think matters, right? And, and, and they matter to a lot of things. Do they matter to, is someone happy or not, right? They, they are not factors, right? The factors that tell us, is this person enjoying life, are they going to take care of themselves, are they happy they're here, are they engaged productively in the world, is agency and gratitude. And if we have those two things, then it's interesting, you almost never see someone go wrong, right? And even if, if there are difficulties, even if there are... if things happen in life that, that can make some unhappiness, right, it doesn't take away the person's engagement in life, the person's enthusiasm for life. And I think if you look at even traditions of understanding how are people happy, whether it's in psychiatry or it's through literature or through a religious lens, it is always people who approach life through the lens of agency and gratitude.

   15. AHAndrew Huberman10:40

       Could we go

4. 10:41 – 16:13

   Agency & Gratitude; Empowerment & Humility

   1. AHAndrew Huberman10:41

      a little bit deeper on agency and gratitude?

   2. PCDr. Paul Conti10:43

      Sure.

   3. AHAndrew Huberman10:44

      When I hear the words "agency and gratitude," I think agency and ability to affect the world around me in the ways that I want, and I think gratitude, being thankful. And, uh, we did an entire episode all about gratitude practices and some of the neuroscience and neuroimaging and neurochemical changes that occur in the brain and body when people exert a gratitude practice. But I have a feeling that when you talk about agency and gratitude, you might be talking about something slightly or maybe even quite a bit different than the way that I'm defining it.

   4. PCDr. Paul Conti11:14

      Yeah. I, I would say agency and gratitude are these amazing rewards, right? That sit on top of the highly complex brain function inside of us and the highly complex psychology in all of us. So i- if we think about, uh, uh, a self, right, that I identify, uh, uh, a self, right? I'm an I, right? I- if I'm going to approach the world with agency and gratitude, that's sitting on top of a lot of healthy things, right? And the idea that, okay, there are ways in which we can be mentally unhealthy, right? But to start with, like, what is going on inside of us, right? And what does it look like when we're healthy? So there's a structure of the self, right? There's function of the self. And if we look at the structure and the function and the parts, the components of structure and function, we can come to understand, okay, what is going on in us? What might we change for the better?How do we build empowerment, right? Because empowerment is, is the, the, the ability to navigate the world around us and to bring myself to bear in ways that are effective, and from empowerment arises the sense of agency, right? I have agency because I am empowered, right? And also from a healthy structure of self and function of self, we end up with humility, right? We come through that with a sense of our, our place in the world and our power in the world to, to navigate as we choose, but also a sense of the world around us that's far more complicated, right? Than just we are. Extends beyond us to other people, to the climate around us, to the health of the whole planet, right? We, we feel a sense of humility that I'm here and I can do good things. I'm fortunate to be here, and I'm part of this bigger ecosystem, right? All the way up to the scale of the ecosystem of Earth, right? And if we feel that humility, then we approach the world through the lens of gratitude. So the idea that a healthy structure of self and a healthy function of self leads to empowerment and humility, and then upon that, we are, we are sort of imbued with agency and gratitude, and that leads us forth to happy lives.

   5. AHAndrew Huberman13:32

      Okay. So it's clear to me why having agency and gratitude would be wonderful, perhaps even the goal state that we should all be seeking to achieve, and it also makes sense to me as to why empowerment and humility are important components that feed into our ability to have agency and gratitude.

   6. PCDr. Paul Conti13:51

      Yes.

   7. AHAndrew Huberman13:52

      Right? Because all of that, at least to my mind, sums to, uh, uh, a very clear statement about having agency and gratitude is the best way to approach life. That all makes perfect sense to me, and yet I've never really thought about it that way, and I think most people haven't ever been told this, right? I mean, what should we be seeking? Agency and gratitude.

   8. PCDr. Paul Conti14:12

      Yes.

   9. AHAndrew Huberman14:12

      You know, we've heard endless number of podcasts, including this podcast, about physical health, and we've been told by physicians and everybody else that, you know, we should seek to have a relatively low blood pressure, we should seek to have a relatively low heart rate, that our cholesterol should be at a certain level, et cetera. So within the physical health domain, you know, w- there are strong, clear messages about what we should all be striving toward, and in a similar way to how we're discussing the self in psychology, you know, I don't think anyone seeks to have low blood pressure or low heart rate because that's what they want per se. They want those things along with some capacity for endurance, the ability to, to, you know, lift an object, so some strength, et cetera, because of the way that those metrics of health allow them to move through the world in the best possible way. In other words, having some degree of endurance allows you to walk down the block maybe a lot further, or to walk up several flights of stairs, or to have some strength allows you to pick up objects and ef- effectively move through life.

   10. PCDr. Paul Conti15:14

       Right.

   11. AHAndrew Huberman15:15

       You're telling us that having a sense of agency and gratitude and that agency and gratitude are undergirded by empowerment and humility, and that's the best way to move through life, the most effective, happiest, if you will, way to move through life? Well, then I think we have to ask ourselves the same thing we would ask about physical fitness, which is, what goes into creating a sense of agency and gratitude, empowerment and humility? You know, what are the action steps? Because if I want more endurance, I know to get on an exercise bike or, or a treadmill or go out for a run a few times a week or more. If I want to get stronger, I'm going to lift objects that are difficult to lift until they're easier to lift. I mean, it's all pretty straightforward in the physical domain, but in the, in the mental health domain, in the psychological domain, it does become a bit more abstract, I think in part because no one's ever told us, certainly no one's ever told me, what you really need in, is agency and gratitude in order to have the best possible life. So I very much appreciate that you're telling us this, and I'd

5. 16:13 – 20:21

   Physical Health & Mental Health Parallels

   1. AHAndrew Huberman16:13

      love for you to tell us what are the action steps that go into creating these things that we're calling agency, gratitude, empowerment, and humility?

   2. PCDr. Paul Conti16:21

      You know, there's actually quite a strong parallel between the physical health dimension and the mental health dimension, so, so as you're saying, like, why do you put in the time, the energy, the learning, right? To be physically healthy, right? It's a lot of effort, and, and we put so much of ourselves towards it if we decide that we value that, right? Why do we do it, right? Because as you said, it's the best way to approach life. Like, there may be something that I want to do. I, I want to run a race, right? Or I, you know, I want to climb a mountain, right? But ultimately, we take care of ourselves physically because we don't know what's coming next in life, and we want to be prepared for it, good, bad, and otherwise, right? And the same thing is true of mental health. So I can feel grateful for something. I can feel grateful that I'm still breathing right now, right? I can exercise agency. I can pick up that cup and take a drink, right? But that doesn't mean that I'm living life through the lens of agency and gratitude, which is consistent with every opinion. If you look psychologically, through the lens of literature, through the lens of s- of sociology and psychology, agency and gratitude make happiness, right? They're ways of approaching life. And just like physical health is undergirded by, uh, by cardiovascular health, heart health, muscle strength, right? The, there's an undergirding of agency and gratitude, and empowerment and humility are ways of describing, okay, what arises, right? From understanding ourselves, taking care of ourselves, that then gives us the agency and gratitude. So we have empowerment. We have humility. But where does it all come from, right? So just like we have to understand the physical body and what to do to it in order to be healthy, right? We also have to understand the mind, right? The self that wants to be healthier, and that comes through understanding the structure of the self. And we have enough science through the lens of neurobiology and psychiatry to understand the structure of self and then the function of self, right? Is how we work, right? How we interface with the world. So it's actually not...... more complicated than physical health. It's just that we don't spell it out that way, right? We come at it through the lens of pathology, of what's wrong and who has some diagnosis. And, you know, we're, we're looking for the problematic instead of saying, like, "What do we look like when we're happy?" Right? And then going and digging down into the mechanics of it all, right? And if we're not in that state, right, to go and look at that and to make changes, just as if you were very, very physically healthy, right, but, you know, your heart rate couldn't go up that much without you feeling very, very fatigued. We'd say, "Well, look, you're doing a lot of the right things, right? But let's work more on, on your heart," right? We would go look at the specifics of it because that's how we understand it. And we just don't apply the same science, logic, common sense to mental health as we do to physical health, but it's time for that to change because we have the knowledge and ability to do just that.

   3. AHAndrew Huberman19:29

      Mm-hmm. When we had Dr. Andy Galpin on this podcast to do a series on physical health and, uh, fitness essentially, uh, he said something that really stuck with me, which was that, you know, the, the number of different workouts that people can do out there, body weight workouts, wo- work with weights, with machines, you can run far, you can run shorter distances more quickly, (laughs) you know, you can do planks, you know, sit-ups, so many variations on exercise routines. But what he very clearly stated was that there are only a few core adaptations that the body can undergo that lead to these byproducts that we call lower blood pressure, enhanced endurance, improved strength-

   4. PCDr. Paul Conti20:10

      Right.

   5. AHAndrew Huberman20:10

      ... improved, uh, neuromuscular function, improved brain function for that matter. It sounds to me like there are a lot of parallels in creating the healthy psychological self.

   6. PCDr. Paul Conti20:20

      Right.

   7. AHAndrew Huberman20:20

      So

6. 20:21 – 26:15

   Structure of Self; Unconscious vs. Conscious Mind; “Iceberg”

   1. AHAndrew Huberman20:21

      what are the core components that I and others should think about in terms of understanding, I think you described them as the structure of the self and the functions of the self? Again, just to draw a parallel, if we were talking about physical health, we'd say, okay, there's connections between nerves and muscle that allows us to move our limbs. If you apply a certain amount of resistance, you get a certain adaptation, which is the, the neuromuscular connection gets stronger, the muscle might get bigger or just stronger, et cetera. Flexibility, you know, you just push your range of motion just a little bit into discomfort, you do that, we- it so happens to be the case that you do that for just a couple of minutes each day over the course of about a week or so, you get a significant increase in flexibility. Okay, so it's all very clear in the physical domain. In the psychological domain, I hear you telling us that the action steps that we all should be taking in order to be the happiest version of ourselves by achieving agency and gratitude is to explore the structure of self and the function of self. So if you could tell us about what is the structure of self, like what goes into Andrew being Andrew and Paul being Paul and whoever the listener is into being who they are. What is that? And what is the function of self? How, how does a psychiatrist think about that? How should we think about that?

   2. PCDr. Paul Conti21:31

      Okay. I- if I could start maybe to set the stage for that, right, by pointing out that as we go up the hierarchy, right, of health, right, everything should get simpler, right? Not more complicated, right? If you think about physical health, right, there's so much complexity on the initial levels, right? So we think about, you know, your physical health status versus mine, right? It's going to be different, right? We're going to have different cardiac function and muscle function and pulmonary function. And if we're going to be healthy, we could do a lot of different things, right? There might be a whole set of choices that would work well for you, different choices that would work for me, and we can gauge intensity, timing, frequency, right? It's very complicated when we're on the, the lower levels of the hierarchy. As we get higher up, let's say you and I both do the right things, right, then what happens? We both have endurance, right? We both have some strength. We're both robust, right? Things are getting simpler because we're, we're, we're approaching the unique idiosyncrasies in all of us, right? And we have to look at that and look at that in a very specific way. But what we're trying to get to is, is something that's common for all of us. So stamina, for example, in physical health and endurance, right, and agency and gratitude in mental health, right? So then if we go and we look, uh, and we look at the structure of the self and the function of self, we find that there's more complexity, but that it is also understandable. I mean, there's tremendous complexity in the body just as there's tremendous complexity in the mind, and we can understand what is the structure of self, what is the function of self, and we can look at that and assess that in the same way we would physical health parameters so that we arrive at the place we want to be, be it endurance or agency or gratitude. So structure of self, right? We all have an unconscious mind.Right? And we pay so little attention to this part of us that really is the biological supercomputer, right? So millions of things are going on all the time, like in every split second. So for example, I can say these words, right? And you can listen to the words, and you can say things back, and I can listen, right? There are millions and millions of things going on under the surface, much of which comes from either biological predispositions, right, or habits over time, right? Thought processes, patterns, right? So this unconscious mind, this supercomputer is doing all of these things like, you know, at the speed of light, right? There are electrical and chemical signals and, you know, multiple pathways as common, as complicated as superhighway systems that then get consolidated and communicate with others, right? And then what comes up from all of that is the conscious mind. So imagine an iceberg, right? And it's a really, really big iceberg, right? And, and we see the part above the surface, right? That's the conscious mind, right? But there's a huge part of this iceberg, maybe 95% of it that's underneath the water, right? There, there's this hulking mass that we don't see. That's the unconscious mind, right? And it's feeding up to the conscious mind, which is a much smaller part of our brain function, right? But it's the part that we're aware of, right? It's sitting on top of all the unconscious things which are extremely important, but then we become aware so that we can engage in the real world. In order for us to have this conversation, the millions of things per second have to be going on underneath the surface so that you and I, as conscious I's, right, as conscious selves, can ride along on top of it. So that's the part of the iceberg that's above the water. It's the conscious self. Then imagine that the conscious self is girded by, by, uh, uh, a s- a set of, um, you know, long, uh, tendrils that come out from under the water, right? That there are defense mechanisms that are unconscious to us that sort of gird the conscious mind. So do we rationalize automatically? Do we avoid automatically? Do we act out automatically? Are these things in us in ways that we can observe and change, but that are there to try and protect the conscious mind from the, the slings and arrows of the world around us, right? So if you imagine there's the big part of the iceberg under the water, the unconscious mind. The conscious mind is riding on top of it, but the conscious mind, that part sticking out of the water, is vulnerable, right? So imagine that there's a defensive structure then that arises from the part of the iceberg that's underwater that is there to defend and protect the conscious mind.

7. 26:15 – 31:27

   Defense Mechanisms; Character Structure “Nest”, Sense of Self

   1. PCDr. Paul Conti26:15

   2. AHAndrew Huberman26:15

      So when you say to defend and protect, when you say that the conscious mind is vulnerable, what do you mean? Do you mean that it's vulnerable to physical attack or that it's vulnerable to us realizing that we're just a bunch of neurons that are clicking away underneath? Like, in other words, where does the vulnerability of the conscious mind really reside? Um, not physically where does it reside, but, you know, what am I so worried about, uh, in, in terms of my safety? I mean, right now we're in a room, I feel pretty safe. Um, I don't think you're gonna attack me verbally or physically. I suppose it's possible that could happen, but it seems like a very distant possibility. So when you say that these defenses are there to protect us from some sort of awareness, what awareness are we trying to avoid?

   3. PCDr. Paul Conti26:58

      So the, the vulnerability of the, of the conscious mind is to fear, confusion, despair, right? There's so many things that, that we can fear, right? Some people are afraid of snakes or spiders. Some people are afraid of death. Some people are afraid of health issues that could come to them or to people they love. We can get confused and not know what decisions to make and how to navigate the world and how to be who we want to be to ourselves and to others, right? We can feel tremendously vulnerable and despairing if we lose others or, we know, we start to see things happening in the world around us that, that, that we don't like, right? We start to feel like what will happen to the planet we live on? Will there be war where I live? Will my children be safe, right? There's so much that we need to protect ourselves against. So that vulnerable part of, of us, right, the part of the iceberg sticking out above the water needs a defensive structure around it to protect it against the vulnerability of fear, confusion, despair, right? And because the conscious mind is, is sticking out of the water with a defensive structure around it, right, it is the, the raw material from which we create our character structure. So the character structure is all of that, the part under the water, the part above the water, the defensive structure. So imagine like a nest around all of that, and that's the character structure that we utilize to interface with the world, right? So the character structure is like the thing that I'm using, right? It's like if you're driving somewhere in a car, right, the car is the thing that you're using to go there, right? The character structure is the thing that we're using to interface with the world. So for example, how trusting am I versus suspicious, right? How readily do I come to make friends with people, right? How, uh, how much do I act out if I'm frustrated, right? How much do I, um, you know, exclaim something negative, right, as opposed to holding it inside of me? How much do I rationalize? If something isn't going well, do I want to look at it and maybe see that it is so that I don't have to face it, right? How much do I avoid problems in the world around me? How much do I exercise altruism, right? Th- these are all the ways in which we're engaging with the world around us, and this determines the self. Imagine that the self then grows out of this nest from the, the character structure that we use to interface with the world and the decisions that we make. So if our character structure is, is the thing through which we engage with the world, then we're enacting, what, what is inside of us, right, what we've determined through our unconscious mind, our conscious mind, our defense mechanism. There's a certain us that, that comes at the world in a certain way. And if we're more or less trusting, more or less avoidant, we rationalize more or less, these are the factors that determine, like, where do, where do our lives go?... right? Because on top of all of this, imagine that the nest of the character structure around all of this grows from it the self, right? The product of the feelings inside, the things that we know about ourselves and don't know about ourselves, the decisions that all of it leads to. So I may choose to be, for example, more trusting, and that may bring an opportunity to me that I wouldn't have otherwise had, right? I may choose to be more trusting, and it may bring risk to me that I wouldn't otherwise have had. So we want to be as healthy as we can, as knowledgeable of ourselves and the world around us so that it's safe for us to have a healthy character structure through which we can engage in the world around us with a sense of prudence, right? Taking reasonable risks, right? Not too little so that we shut ourselves down and maybe end up despairing, not so much that, that scary things can happen to us and we end up fearful, right? But the idea that if we know ourselves well, the character structure is healthy, right? Because it's built upon a structure of self and a function of self that are healthy, and out of it is coming empowerment, right? And empowerment and humility, right, that then lead us to agency and gratitude, right? The idea here is that this is the character structure that we create that can then interface with the world in a way that's good for us and good for the world around us, that leads us to be able to live in much more harmony inside of ourselves and outside of ourselves.

   4. AHAndrew Huberman31:26

      So if I understand

8. 31:27 – 36:01

   Predispositions & Character Structure

   1. AHAndrew Huberman31:27

      correctly, defense mechanisms that grow up out of this portion of the iceberg that we're calling the unconscious mind, they protect our conscious self in ways that can be adaptive or that can be maladaptive.

   2. PCDr. Paul Conti31:42

      Mm-hmm.

   3. AHAndrew Huberman31:42

      In other words, defenses can be healthy or they can be unhealthy.

   4. PCDr. Paul Conti31:45

      Yes. Yes.

   5. AHAndrew Huberman31:46

      And, uh, perhaps in a, in a few minutes, we can get into what a healthy versus an unhealthy defense looks like. But the way you described character structure sounds to me like an array of contextual dispositions. I don't want to add unnecessarily, um, complex language, but it sounds to me like a bunch of dispositions. Like, like, if I'm walking into the office where I know everybody and I see familiar faces, there's no reason for me to be on guard...

   6. PCDr. Paul Conti32:14

      Mm-hmm.

   7. AHAndrew Huberman32:14

      ... if I trust those people. But if I'm walking down a, a, a street at night that I'm not familiar with and, and I'm starting to get the sense that, you know, this neighborhood might not be the best, it makes sense for me to be on relatively high alert. So different dispositions depending on different conditions. I can't help but mention my, uh, bulldog, Costello, who had basically three dispositions. He was asleep, (laughs) but in all seriousness. The second one was, um, kind of bored. The bulldog face was kind of bored. Or if something was given to him that he liked or if we were doing something he liked, delight. He basically had three dispositions as far as I could tell. Um, I think one of the reasons we like dogs so much, or that many of us like dogs so much, is that their decisions are very predictable. Take him to the park, he's happy, unless he happened to be ill that day, which was rare. Um, you know, feed him, he's happy, right? There, there wasn't a lot of, uh, "I don't like this particular meal," or, "I don't like this particular park, or this Bichon Frise doesn't smell so good to me."

   8. PCDr. Paul Conti33:12

      Right, right.

   9. AHAndrew Huberman33:12

      You know, there's a, it was so simple.

   10. PCDr. Paul Conti33:15

       Mm-hmm.

   11. AHAndrew Huberman33:15

       And yet people are very complex, right? I, I, I can look at myself and say, "Okay, what, like, what is my character structure?" My character structure is certain things I like, certain things I dislike, certain things really irritate me, certain environments and people I just delight in. Okay, so is the definition of a healthy character structure one in which the dispositions match the context perfectly? I mean, I don't know how any of us could be like that, but is, is that sort of the ideal? Much in the same way that, um, you know, we could probably arrive at, at an ideal degree of stamina that one could have? I mean, some people want, run ultra-marathons, you know, 100 miles or more. Some people want to run a marathon. Some people like me don't really desire to run a marathon, but I want to be able to run a mile if I need to...

   12. PCDr. Paul Conti34:00

       Mm-hmm.

   13. AHAndrew Huberman34:01

       ... without being completely exhausted and injured. So, you- you know, when we, when we ask ourselves about character structure, are we asking ourselves about context-driven dispositions, and, you know, how do we start to evaluate that for ourselves?

   14. PCDr. Paul Conti34:14

       Right. I think because we're more complicated, I think it's not dispositions as much as it's predispositions, right?

   15. AHAndrew Huberman34:20

       Mm-hmm.

   16. PCDr. Paul Conti34:21

       So, so in the example that you gave, right, you have a certain predisposition to be either trusting or wary, right?

   17. AHAndrew Huberman34:28

       Right.

   18. PCDr. Paul Conti34:28

       And, and you're, and that's healthy in you, right? So when you come into a setting where there's not a, a good reason to feel mistrustful, to feel anxious, to feel vulnerable, right, then you feel at ease, right? So you walk into the work setting, there are people you know, there are people you like. Everything is okay, right? You have a different pre- predisposition when the context is different, right? So if the context could bring a lack of safety, then you'll respond accordingly with a lack of safety, right? But, but it's possible, certainly, those predispositions can be in unhealthy places, right? So for example, y- you might have been traumatized in a certain way, or you might approach the world in a certain way because of prior experience, that you may not register a- as trauma, but it may be that within you is a predisposition to be mistrustful. So you could walk into a room of people that you know, of people who've never met you any harm, and still feel unsafe, right? Now, this happens most often after trauma, but there are other ways people can get to that where the predisposition isn't so healthy. The converse is true too, right? There are people who can have too much of what's called an omnipotence defense, and then they don't recognize danger when danger is around them. So the idea of the character structure, that nest, right, that's built around a defensive structure and the conscious mind that's sitting on top of the part of the iceberg, the unconscious mind underwater, right? It's that nest that is interfacing with the world through a whole set of predispositions.

   19. AHAndrew Huberman36:00

       I'd like

9. 36:01 – 37:27

   Sponsor: AG1

   1. AHAndrew Huberman36:01

      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's supply of vitamin D3K2. Again, that's drinkag1.com/huberman to claim this special offer.

10. 37:27 – 46:20

    Character Structure & Action States; Physical Health Parallels

    1. AHAndrew Huberman37:27

       I think most of us are familiar with assessing and assigning names to the character structures of others. And at least for most of us, we do that with no professional training or authority, right?

    2. PCDr. Paul Conti37:38

       Mm-hmm.

    3. AHAndrew Huberman37:38

       We say, "That person is great. They're super nice. That person's a jerk. Uh, they're like weird." You know, et cetera, et cetera. I think very few of us are familiar with assessing our own character structure.

    4. PCDr. Paul Conti37:52

       Right.

    5. AHAndrew Huberman37:53

       Right? And I have to presume that some of what happens when somebody comes to you as a psychiatrist or to a psychologist is that certain questions are asked and certain narratives are told that start to reveal to the clinician the character structure, and perhaps from there, some of the possible defense mechanisms and, uh, you know, structure of the person's unconscious mind and conscious mind that obviously are unaware to them-

    6. PCDr. Paul Conti38:16

       Yeah.

    7. AHAndrew Huberman38:16

       ... but would be clear to the clinician.

    8. PCDr. Paul Conti38:19

       Right.

    9. AHAndrew Huberman38:19

       Much in the same way that if somebody goes into the doctor and says, "You know, I don't feel well," they're gonna start probing with questions, or they're gonna put, you know, take a, take a re- listen to their breathing-

    10. PCDr. Paul Conti38:29

        Right.

    11. AHAndrew Huberman38:29

        ... listen to their heart, right? I mean, these are the-

    12. PCDr. Paul Conti38:30

        Get out the stethoscope and figure it out.

    13. AHAndrew Huberman38:31

        These are the probes-

    14. PCDr. Paul Conti38:32

        Yep.

    15. AHAndrew Huberman38:32

        ... whereas the, the psychiatrist or psychologist uses words and language-

    16. PCDr. Paul Conti38:36

        Yes.

    17. AHAndrew Huberman38:36

        ... to probe.

    18. PCDr. Paul Conti38:36

        Yes.

    19. AHAndrew Huberman38:37

        So what are the sorts of aspects of character structure that we can be aware of in ourselves? You know, I mean, in other words, um, should we be asking what type of character do I have depending on one circumstance or another? Um, should we ask ourselves what sorts of defenses we have? And, and maybe this would be a good opportunity to, um, address this issue of what are healthy versus unhealthy defenses. Um, because it sounds to me, if I understand correctly, that the defense mechanisms are a very strong component in determining what our character structure is.

    20. PCDr. Paul Conti39:12

        Mm-hmm. Mm-hmm. Right, because the defense mechanisms are unconscious, right? The character structure, that nest around the defenses and the conscious mind through which we interface with the world, right? Is very, very complicated. So there are as many character structures as there are human beings, right? So it's very, very complicated, but there are factors that are consistently relevant across people and get identified as such. So, so one example would be isolation versus affiliation, right? So d- does a person tend to group with others, right? Or does the person tend to avoid grouping, right? And, and go about, uh, thoughts, tasks, approaches to life in a, in a more singular manner, right? So it's just one element. I'm making value judgment about it 'cause it can be good or bad on either end of the spectrum, right? So we're just saying what are the factors? So am I more affiliative or do I tend to isolate and be more singular? That's just one example, right? Another example could be things like, for example, use of humor, right? Uh, does a person use humor and in what way, right? Does a person use hum- humor to deflect, uh, discomfort in negative situations? Does a person use humor in order to belittle others or to belittle themselves? Or does a person not use humor, right? So there are these aspects of character structure, and so much research has been done on this over the years to determine what is most salient, right? In, in this, this thing that we use in order to interface with the world around us, up out of which grows our self.

    21. AHAndrew Huberman40:46

        That makes good sense and, and it makes me want to revise a little bit m- what I asked about before, which is I said that, uh, when it comes to an exam of physical health, we measure blood pressure, measure, um, uh, breathing, et cetera, maybe even a blood test, look at some biomarkers. But what you're describing is a little bit more analogous to, um, the physician, uh, addressing a patient who's having some physical discomfort or malaise and saying, "Tell me about your day." You know? What do you do when you get up in the morning? If the person says, "Well, you know, I, I drink a, you know, a quarter pint of vodka," see, it's a very different answer than, you know, "I go outside and get sunlight in my eyes, drink a glass of water, and maybe have a cup of coffee," right?

    22. PCDr. Paul Conti41:26

        Right.

    23. AHAndrew Huberman41:26

        You know? Um, or if somebody says, "I have si- six espresso," if I understand correctly, the character structure is better revealed by exploring the action states-

    24. PCDr. Paul Conti41:36

        Yeah. It comes to life.

    25. AHAndrew Huberman41:37

        ... that someone engages in, isolation versus engagement, um, as opposed to a read of one specific biomarker-

    26. PCDr. Paul Conti41:44

        Yes.

    27. AHAndrew Huberman41:44

        ... um, so to speak.

    28. PCDr. Paul Conti41:45

        It's character structure brought to life.

    29. AHAndrew Huberman41:47

        Right. Yes. I immediately am thinking about movies and books where we learn so much about somebody through observing the way that they interact with people in, in very, um, very potent ways. So for instance, I can think of...

    30. ... countless movies where, uh, you learn a ton about somebody in the first scene simply because of the way they react to somebody who, you know, cuts them off on, in traffic. They just explode. Okay, well then we think of that person as reactive from that point on, unless there's a significant amount of material to revise that. But it's in the action of, of, of getting explosive and cursing, et cetera, r- as opposed to if they just kind of la- laugh it off or laugh at themselves, or blame someone within their own vehicle or something like that.
11. 46:20 – 53:12

    Anxiety; Understanding Excessive Anxiety

    1. PCDr. Paul Conti46:20

       about the role of anxiety in all of this. The reason I ask about anxiety is that you said that so much of character structure is, uh, determined by a set of predispositions and potentialities. Mm-hmm.

    2. AHAndrew Huberman46:34

       And earlier we were talking about an example of either being afraid or unafraid in particular environments, or feeling like we can walk into a classroom and learn, or whether or not we're overly concerned about what people think about us, or both, right? It could be a mix. Um, whether or not we can embrace novel environments in safe and adaptive ways.

    3. PCDr. Paul Conti46:53

       Mm-hmm.

    4. AHAndrew Huberman46:53

       Whether or not we can grow from them as opposed to whether or not we can be overtaken by them or perhaps even injured, harmed psychologically, physically, or both. Anxiety to me is, is a very basic function. I think about it in terms of the autonomic nervous system and degrees of excitability and et cetera, an ability to sleep at night, an ability to wake up feeling reasonably good but not have a panic attack. But anxiety to me does seem like a key node in all of this, meaning, you know, I, most people, including myself, I don't walk around thinking about my character structure. I don't walk around thinking about how I'm going to behave in a bunch of hypothetical environments. I think about the fact that most mornings I wake up and I feel pretty good, uh, to be quite honest, not as good as I would like to feel, and not necessarily because anything's wrong but because I think I'm wired to be a little bit more on the anxious side and to predict what's going to happen next and what needs to be done. And so until I'm actually engaging in certain behaviors, that anxiety hums a little bit high for me.

    5. PCDr. Paul Conti47:54

       Mm-hmm.

    6. AHAndrew Huberman47:54

       The gears turn a little bit faster perhaps than I would like when I wake up in the morning. But once I engage, I feel like the, the speed of that gear turning, uh, matches the demands of life-

    7. PCDr. Paul Conti48:04

       Mm-hmm.

    8. AHAndrew Huberman48:04

       ... pretty well.

    9. PCDr. Paul Conti48:05

       Mm-hmm.

    10. AHAndrew Huberman48:05

        And I feel, um, agency.

    11. PCDr. Paul Conti48:07

        Mm-hmm.

    12. AHAndrew Huberman48:08

        Okay? Um...

    13. So if you don't mind, uh, could we explore this, this feeling of anxiety or lack of anxiety that I think people are pretty familiar with within themselves at different times of day and under different conditions? Because to me it seems like a, um, an interesting lens to, to explore this notion of character, structure, and defenses. Is anxiety a healthy defense or an unhealthy defense, or does it simply depend on the circumstances?

    14. PCDr. Paul Conti48:32

        Mm-hmm. Mm-hmm. Well, we all have some degree of anxiety in us, right? We, we all have some awareness that, like, we're navigating the world and, like, not everything is, is perfect, right? This is not nirvana, so there's some anxiety within us. And the thought is that that anxiety can keep us vigilant about the things we should be vigilant about. You know, health and safety, right? But that too much anxiety then becomes counterproductive. And we can look at this in a very regimented way, right? So, so some anxiety makes sense, right? It keeps us being careful. It keeps you, keeps you being careful as you're pulling out of a driveway, for example, right? So, okay, it can be, it can be absolutely fine. But let's say you bring something to clinical attention that isn't absolutely fine, right? Let's say I didn't know you and you come in, we have the example that, that we, that you used before where, where you, you walk into work and there's a group of people that you, that you know well and like, right? Let's say you told me, "When I walk in there, I, I feel very anxious," right? "I don't feel like things are okay," right? So then we would go through, we say, "That's not good," right? Maybe it's impacting your professional life, things are not going well. Like, you really want this to change 'cause it's impacting your life in a negative way. And we say, "Okay, let's look at that from the perspective of structure of self," right? So first, unconscious, right? Is it that just genetically are you built with just higher levels of anxiety, right? So we could learn, okay, have you always been anxious like this? Is this, has this always been in your life since you were a little kid no matter what? So we're looking for biological nature, so to speak, variables. We might also look for things that have happened to you that are lodged in your unconscious mind, right? Is there trauma that you haven't processed, right, that now is underneath the surface but is spinning off more anxiety, right? Is, is, let, let's say you tell me, "Oh, it wasn't that long ago you started being anxious." Ah, did something happen? Like, did you walk into a group of people and, I don't know, you tripped and you felt bad about something, right? And then, and then you get more anxious, right? So are there things going on underneath the surface that are impacting you? Like, let's, let's look into that, right? Because that's the biggest part of the iceberg, right? Then your conscious mind, we could start thinking about, okay, what, what's going on? What are you actively thinking about, right? So this is where sometimes cognitive behavioral techniques can, can come into mind, like are you thinking like, "Oh no, I'm scared. It isn't gonna go well," right? Like, are you having thoughts? Are the thoughts then making you more anxious, right? What's going on in your conscious mind, right? I would also be very interested in the defenses around you. So for example, do you tend to avoid, right? Has this been getting worse for three months but, but you just, your mind wouldn't acknowledge it, right? And by the time you have to acknowledge it, now it's really bad, right? Or do you not avoid and like this started, just started happening and you want to nip it in the bud, right? So I would be interested in the defense mechanisms, right? That are girding your conscious self, and I would be interested in the character structure. What decisions are you then making? Like, are you going anyway, right? Are you having trouble, so sometimes you avoid? Are you then making decisions that make you late and that causes problems? How does it impact you once you're there? Are you engaging differently with people, doing your work differently? So I want to understand the character structure and ultimately you understand all of this by probing the self that's riding along on top of it. And then what is the experience of that self? Like, do you see that, "Okay, this is a problem and I want to address it, but like, look, I know that I'm good at what I do and, you know, I mean, this isn't some like awful thing about me, I just have to deal with it," right? Or i- is your self impacted where you start thinking, "Maybe I can't do this anymore. I'm not good enough," or, you know, we want to understand what's the experience of the self, right? And if we do all of that, how is it that we don't get to a place where we can understand that anxiety, right, and we can make things better? So just like in physical health, okay, maybe we can't, but that is a dramatic outlier. If we bring ourselves to bear, we would say, "You should not have to have this in you, right, because it is something negative. It is making unhappiness for you. It is taking away from empowerment, right?" And it's also taking away from humility, right? Because if someone's beating up on themselves, you're beating up on yourself about it, then that's not humility, right? Then that, that's being s- falsely persecutory, right? There's just not an honest humility to that. It leads us away from health, so, so like, we don't want it to be this way, right? Because that is working against agency and gratitude so we can understand it and we can go after it and make it better.

    15. AHAndrew Huberman53:11

        One of the

12. 53:12 – 59:44

    Improving Confidence: State Dependence & Phenomenology; Narcissism

    1. AHAndrew Huberman53:12

       most common questions I get on the internet, and I get a lot of questions, is what can be done to improve confidence.

    2. PCDr. Paul Conti53:20

       Mm-hmm.

    3. AHAndrew Huberman53:21

       You know, and I've thought a lot about that question and, you know, what is confidence? In the context of what we're talking about now, is one reasonable definition of confidence our ability to trust our predispositions and our potentialities enough that were we to encounter scenarios A through Z we feel pretty good that we would respond the right way, in a way that, um, wouldn't threaten our conscious mind at a core level, right? You know, that, that we wouldn't... Um, I, I used to use the term and, and joke a lot in my laboratory, uh, with the, you know, phrase, "Dissolve into a puddle of our own tears," right?

    4. PCDr. Paul Conti54:00

       Mm-hmm. Mm-hmm.

    5. AHAndrew Huberman54:00

       It's kind of this like hyperbolic-

    6. PCDr. Paul Conti54:01

       Right.

    7. AHAndrew Huberman54:02

       ... explanation of, of what I think many people fear, like they're gonna be called upon to answer a question publicly or give a speech or they're gonna be in a critical moment in a rel- relationship or something and they're, and just everything is just gonna go so badly wrong that it's just gonna dissolve them as a person.... impossible, right? Dissolve in a puddle of our, of our own tears is impossible. But I think that's a fear that a lot of people live with because, and we can get into this a little bit later and we will, I'm sure you know that this notion of like protecting one's ego is, seems really vital to, to being a human being at some level. Like, we don't, we don't want to dissolve into a puddle of our own tears. So, is confidence the ability to trust ourselves in a bunch of different contexts? Um, and at the same time, I, I do have to raise the, this notion of narcissism. I think, um-

    8. PCDr. Paul Conti54:50

       Mm-hmm.

    9. AHAndrew Huberman54:52

       ... you know, this word gets thrown around a lot lately. But it seems to me that any, um, truly psychologically healthy person would also not want to be the idiot that thinks that they're better than they-

    10. PCDr. Paul Conti55:02

        Mm-hmm.

    11. AHAndrew Huberman55:02

        ... actually are.

    12. PCDr. Paul Conti55:03

        Mm-hmm.

    13. AHAndrew Huberman55:03

        That's, uh ...

    14. PCDr. Paul Conti55:04

        Mm-hmm.

    15. AHAndrew Huberman55:05

        What are your thoughts on this?

    16. PCDr. Paul Conti55:07

        Well, I agree with the things that you, that you said about confidence, except I would add two factors that I think are like really big, big factors, right? Right? One being state dependence and the other being phenomenology, right? So think about the state dependence first, right? When we're talking about confidence, it's, it's not uniform, right? Or it's not automatically uniform, right? So if, so if you were to tell me, "Oh, oh, I lack confidence," right? Then I, I want to understand, is that across the board? Is like, is that a way that you feel about yourself that like, I, why I'm not good enough at anything, for example, right? Or do you lack confidence in a specific area, right? And this is often the case, right? And it's, it's a huge difference, right? It says that person has the machinery of confidence, so to speak, right? They have the potentialities and the predispositions for confidence, right? When that character structure that's self-built upon it is e- engaging with the world, right? But they're not able to bring it to bear in certain, i- in a certain special situation, so to speak. So for some people, for example, the, the way we most often see this is like the carve out of romance, right? Where because it's so emotionally laden, right? And like rejection can feel so bad, right? That we can see people who are very confident in many, many aspects of life but they are very diffident about romance. And they'll say diffident, "Oh, it never works out for me," or, "No one will ever like me," right? And, and you see like, that's not how that person actually feels, right? About themselves as a whole human being, right? Which, which i- is, then we are coming at how to make that better in a way that's very robust, right? We might say something like, "Hey, here's the good news, is you have the tools and the machinery that you need," right? "You're confident in so many ways," right? "In fact, maybe in all ways except this one. So let's go take a look at like, why is that special," right? And then, and that, where are we? We're back to, is it something in the unconscious mind? Is it, you know, something in the, in the conscious mind about how that person is engaging, right? So we, we have to understand what the state is and if the lack of confidence is state dependent. If the person is not confident across the board, then again we go back to the same, we always go back to the same places to look, right? But then you might more think, okay, is, is there an impact of childhood trauma or early life trauma that w- that took away from that person, you know, their, their ability to, to gain confidence, right? 'Cause if you have no confidence across the board, there's a deeper problem, right? Because there would be s- something anyone can be good about, and feel confident in, right? So, the state dependence is very important as is phenomenology. So, what is your experience of being confident? If you tell me, well, I'm ... Let's say in a different version of this example, you say, "You know, actually, I'm, I'm quite, I feel quite confident when I, when I walk into a room of, of people." I say, "Okay, oh, I want to understand more about that too," right? Because if I ask questions about that and you say, "Well, I feel confident because, you know, look, I'm a, I'm a pretty smart person. I can think on my feet. I can, I can deal well with, with people. If something doesn't go right, I can recover from it." Like, "I've got ..." You know, that's why I feel confident, you know? And say, "Okay, that sounds pretty good." If you say, "Well, I feel confident because I know that I'm better than everybody," right? Well, now we have a problem, right? Right? Like, that's not gonna go well in other, you know, in other, uh, aspects of life and engagement. Like, there's, you know, it's not gonna lead to humility and gratitude. Like, so, so where's that coming from? And again, maybe there's a deeper problem, right? As you, it's sort of narcissism, right? Which can be a, a, a reaction, right? Which is a reaction to vulnerability, right? So then there's, uh, what's called a reaction formation. And now the person, uh, is actually deeply diffident, right? But presents as very, very confident and with a sense of superiority, and th- that, that's not a recipe for, for happiness, right? So, so in the, in approaching it, we, we do want to understand all the things that you said. What are the factors and the, the set of predispositions and the set of potentialities? But then what's the real world experience of that across situations and what is the person's experience of that inside? Which is why if we're gonna understand and help people, like, that's the understand part, right? You know, it, it's why the conveyor belt medicine, you know, it doesn't work, right? In situations w- where we're dealing with human beings like mental health, right? We have to understand something about people to understand whatever they're telling us means. Otherwise, you have no context, so you have no knowledge.

    17. AHAndrew Huberman59:43

        Another

13. 59:44 – 1:06:04

    Changing Beliefs & Internal Narratives

    1. AHAndrew Huberman59:44

       very common set of questions that I get that I believe is very directly related to this is about beliefs and internal narratives.

    2. PCDr. Paul Conti59:51

       Mm-hmm.

    3. AHAndrew Huberman59:52

       You know, people ask me all the time, "How can I change what I believe about myself?" And they also ask, "How can I change the script in my head?" How do I ... Typically it's, "How do I shut down a particular narrative in my head?"

    4. PCDr. Paul Conti1:00:07

       Mm-hmm.

    5. AHAndrew Huberman1:00:07

       This seems to fit very well in thinking about structure of self, because as you pointed out, you know, the, the self or the structure of self includes the unconscious mind, you know, what's going on below the surface of the water in this iceberg model, what's going on in the conscious mind that the conscious mind is-... protected by these defense mechanisms that grow up from the unconscious mind, from that, what was it, character structure and then this thing that we call the self.

    6. PCDr. Paul Conti1:00:30

       Right.

    7. AHAndrew Huberman1:00:30

       Right? But when it comes to beliefs and internal narratives, those seem to me things that people are pretty well aware of. In fact, the very example that people are asking me this all the time-

    8. PCDr. Paul Conti1:00:39

       Mm-hmm.

    9. AHAndrew Huberman1:00:39

       ... how to change beliefs, internal narratives, means they are aware of them. It also suggests that for many people out there, their beliefs about themselves and their internal narratives are not healthy or at least they don't feel are serving them well, or that they are intrusive.

    10. PCDr. Paul Conti1:00:53

        Mm-hmm.

    11. AHAndrew Huberman1:00:54

        Uh, I don't know how open people are about their beliefs and internal narratives when they come to you in the, in your clinical practice, but, um, if you could tell us a little bit about beliefs and internal narratives and, uh, whether or not they are important to rewire and, and, and reset.

    12. PCDr. Paul Conti1:01:09

        Mm-hmm. Mm-hmm. Like, this part is extremely important, right? So, imagine, for example, that I'm saying to myself over and over again that I'm a loser, right, or I'm not good enough, right? I mean, imagine trying to go through life and someone else were saying that to you all the time, right? I mean, it's worst when it's inside your own head, right? So what's going on inside of us, our internal dialogue, our internal narratives are extremely important. And here's where we run into a very big problem, is that we live in an era and in a culture that is very attuned to rapid gratification, right? And all of this that we're talking about can change, but it does not change quickly. And it's amazing to me when, you know, you'll, you'll see under, uh, insurance paradigms often, right, no matter what's going on with someone, they have 10 sessions of cognitive behavioral treatment, right? If, if there's something, like we're trying to change beliefs, it's a guarantee of failure, right? Because beliefs don't change that fast, right? So imagine, for example, that we, you know, you and I chose a word, a random word, and we decided to say it 500 times, right? We'd each be saying it tonight, right? Like, it's not gonna be out of our minds by tonight b- because we, what, took a random word and said it 500 times, right? So imagine that there's something that's highly emotionally laden and we've said it thousands and thousands and thousands of times, right? That's not gonna go away quickly, right? But it can go away. And during the process of it atrophying, right, our, our lives can get better, right? This is the opposite of hopeless, right? It's actually very, very encouraging. But in a world that's rapid gratification, right, like, how do we fix this, how do we fix this now, that doesn't acknowledge this, we hear all the time that a person has failed therapy, right? Like, this is said all the time, "That person failed th-" What does failed therapy mean, right? I mean, I think therapy failed that person, right? But we, we label like, oh, a person isn't better, right? But there are things going on inside of us that could take months and months or years to make better. Now, again, that's okay if we're aware of what's going on. Just the very fact that we understand and we're making change, right, helps us feel better a- about ourselves and more confident, right? That we can change all of this. But we have to approach it in the right way. So l- let's say that I'm telling myself over and over again, um, "You're not gonna get there," right? And let's say a place I want to go professionally, right? Or, "No one's ever gonna really want you," right? If, if, if it's, uh, I'm looking for a romantic partner, right? So, so imagine these things are going on and they're going on over and over again. A- and you can imagine now that's it's intruded into the unconscious mind, it's going on in my conscious mind, my defensive structure is shifting in negative ways, I'm becoming more avoidant. Like, nothing about this is good and I want it to change. And I want it to change to something that says like, "You can do it," right? Or, "You're lovable," right? Or, "You can be a good partner to someone." W- so I want to change it, right? So imagine now when I start to make that change, I'm blazing a path, right? And, and I'm blazing a path where there wasn't a path before, right? And I can blaze a path and I can go through that path. But that path is gonna be nothing like maybe the four-lane highway, right, adjacent to me where the thing that I've been telling myself for years and years and years, born of trauma, right, is, is, you know, is going back and forth, right? I mean, it's got a four-lane highway, I'm cutting a path, right? But over time, you cut that path more and more, you tread that path more and more, you take energy towards that path, it becomes better. Now let's imagine like the path is well lit and it's 12 feet wide and maybe we can pave the path so more, more traffic, so to speak, goes down it, and we're taking energy away from that four-lane highway. And maybe it starts to be overgrown a little bit and there are cracks in the road. Like, we can change all of that. But we have to understand what's going on and, and identify it. Like, what is going on inside of me? Uh, what do I make of it, right? How do I understand the process of change? How do I increase my empowerment during the process of change? If we come at it the right way, all of this can be changed. It's not hardwired in us. It's just very, very strongly reinforced. The same way our, our brains are built this way so, like, we don't forget our own names, right? You know, we don't forget where we live, you know, back when we were hunting and gathering. We don't f- we don't forget, you know, where w- where the good fruits are, right? I mean, this goes on in human life now. Like, we have to remember things. It's very, very important if something is, has high emotional valence and we've thought it a lot that we don't forget it. But that mechanism gets hijacked by things that are not good for us. And we can take it back, but not if we don't understand.

    13. AHAndrew Huberman1:06:03

        What are the

14. 1:06:04 – 1:11:21

    Individuality & Addressing Mental Health Challenges

    1. AHAndrew Huberman1:06:04

       tools or the questions that you, uh, give or ask of patients in order to help them along that pathway? Um, because I totally agree that changing beliefs and internal narratives is very, very hard. Uh, just one quick example that meshes with the physical health realm. I have a, a friend and colleague, he's a, a very accomplished scientist who was very overweight for a long period of time. He-... finally made some behavioral changes that allowed him to lose, I think it was in, upwards of 80 pounds.

    2. PCDr. Paul Conti1:06:34

       Oh, yeah.

    3. AHAndrew Huberman1:06:34

       A significant amount of weight. Felt much better, looked much better. He just delighted in his ability to do that, but then started to reveal to me that he was deathly afraid that he was going to lose control and start eating the way he was before and stop exercising in a way that would return him to his previous weight and feelings of malaise.

    4. PCDr. Paul Conti1:06:58

       Mm-hmm.

    5. AHAndrew Huberman1:06:59

       And I said, "Well, all the things you're doing are in the direction of health. None of what you're doing speaks to the possibility of this all crumbling." This was the dissolve into a puddle of my own tears kind of narrative, but at this point coming from him. And he just said, "I know, but despite doing all the right things, I'm still incredibly afraid that it's gonna happen." It was as if that the beliefs and the internal narratives hadn't changed despite the fact that he was engaging in the world differently and more positively. Uh, I haven't checked in with him recently to find out where he's at with this now, several years later. He has he- kept off most of the weight, not all of it. He gained a little bit back, but he's still far healthier than, than he ever was. So hopefully he's experienced some relief. But, you know, what do you tell a patient who, uh, is saying, you know, "I've got this loop in my head that tells me I'm not good enough," or that, "Even when things are going well, they're going to return to that state that I fear so much once again"? This kind of, like, n- you know, lack of agency, right? Just lack of agency (laughs) , lack of agency, lack of empowerment.

    6. PCDr. Paul Conti1:08:04

       Mm-hmm.

    7. AHAndrew Huberman1:08:05

       What, what sorts of practical tools can, can one give, uh, themselves or, or that you would provide to somebody?

    8. PCDr. Paul Conti1:08:11

       No matter what is behind what's going on in that person's mind, it's addressable. But you don't know what it is and how to address it until we ask the question of what's going on inside, right? So if he's afraid that he's gonna gain all that weight back, right, and he has a history that if significant negative things happen, he throws self-care to the wind, right, that then, uh, we'd come at it through that pattern, right? Because he would have a very, you know, he would have a good reason to be worried, right? Because this pattern of something bad happens and I can't, I don't take care of myself for six months, you know, maybe someone... I'm just making this up, but maybe someone in his life is ill or he's fearing a death, you know, in the future. So something that would say that's a very legitimate fear to have. Like, let's, let's talk about that. Like, let's look at where that comes from, right? What, what got that person into the, that pattern in the first place, right? By understanding the pattern and by working together, right, can we, can we stave that off, right? But it could be different. The person might say, "Well, I'm really, I'm having a lot of food cravings," right? And we're like, "Okay, well, what does that mean? Where's that coming from?" Or maybe he's depressed and when ... and he's getting depressed. And when he's depressed, he can't stop eating more, right? So, you know, you would look... Or it might just be plain old fear, like, "This is so good, right, that, that I'm worried it will go away," right? Then we might want to reinforce, like, okay, like, you, you know, you're a person who's able to use circumspection and perseverance and preserve goodness, right? So, like, you do that and you do that really well, so l- let's, l- let's make sure we're doing that here, right? So, you know, a lot of times a person is worried, but that worry is coming through the lens of health. Like, they're healthy, right? So then we look at, okay, can we soothe that worry? Where, where can, where's that coming from, right? We can come at it and reinforce the positive. But if there is something negative, there's a trauma-driven cycle, there's depression, there are cravings, w- we can understand that too. So, so I come back to this idea that there's answers to just about everything. And in a very regimented, scientific way, i- i- it's not that hard to come to them, right? Just like in physical medicine. Like, we have the para- we have the tools that we need to bring to bear, but you have to understand the person. Again, if you come in and say, "I'm not feeling good," and someone else comes in and says, "I'm not feeling good," the doctor better not do the same things, right? (laughs) i- this, "How are you not feeling good? Okay, let me understand that, and then let... or let me map that also to you, whatever underlying state of health you may have or diagnoses you may have." The same is true in mental health. If we just apply that, then it's remarkable the good that we do, which I've seen very consistently across 20 years of doing this, not only in my own practice. But like, who are the people who do really, really well trying to understand and take care of people, including sometimes not doing too much and realizing like, "Hey, this person is okay. Like, there's a state of health here, but this person is worried. How do we reassure them?" Right? How do we help someone living a good life live a better life, right? If we're gonna do all of this, we have to approach people as individuals. It's just, uh, I mean, the science tells us that and common sense tells us that too. But if we do that, a person can get to the place they want to be.

    9. AHAndrew Huberman1:11:20

       I'd like to

15. 1:11:21 – 1:17:32

    Mental Health Goals & Growth

    1. AHAndrew Huberman1:11:21

       address a different person-

    2. PCDr. Paul Conti1:11:22

       Okay.

    3. AHAndrew Huberman1:11:22

       ... as an example. A hypothetical person.

    4. PCDr. Paul Conti1:11:24

       Okay.

    5. AHAndrew Huberman1:11:25

       And I'm certain there are many, many of these people out there. Uh, these are the sorts of people that think, "Okay, there's a self and a mind and a unconscious mind," et cetera. But, you know, at some level, w- why not just do what needs to be done in life? Like, the, the people that don't want to explore the self, you know, because to me, it seems so absolutely clear that just as it's important to have a certain level of endurance, strength, flexibility so that one can extract the most joy and agency and gratitude and empowerment and humility from life, that it makes sense to explore the self. To ask, you know, w- w- where am I internally strong? Where am I internally weak? You know, where might I perceive myself as strong whereas I'm actually weak, right? These seems like, these seem like very important, if not crucial, questions to ask. But I know that there are a certain number of people in the world who think all of that is just kind of a waste of time, right? It's all about doing stuff. It's, it's all, you know, why explore the self, you know? And, um, I think the rest of us are looking at that person often and thinking, "Well, you're exactly the kind of person that needs to do this because of the ways that you grate on other people." But, but not always, right? Sometimes these people just appear to be just very effective. They're all about the outward expression of what they're doing. And I certainly don't know how other people feel waking up in the morning and going to sleep at night and throughout the day. But to the person that-... feels like introspection and exploring, maybe even excavating for trauma that they haven't been in touch with or haven't dealt with yet, but the person that feels that all of that is, is kind of not really worth the effort, and that it's all about action, you know, w- what can we say to that person, uh, or those people? Put differently, does one need to change and need to believe in the power of these sorts of approaches in order for them to work? Uh, we often hear that people don't change until they want to change. And, um, and could we also say perhaps that even for the people that feel like they're functioning extremely well in all domains of life, I know no such people-

    6. PCDr. Paul Conti1:13:30

       Mm-hmm.

    7. AHAndrew Huberman1:13:30

       ... and I know some very high achieving-

    8. PCDr. Paul Conti1:13:31

       Mm-hmm, yeah, right.

    9. AHAndrew Huberman1:13:32

       ... people as, as you do too. I know no such people. Uh, the only people who seem to exist in that sphere are the narc- the clear narcissists that to them just seem like they're doing great, but everyone else can't stand them. By the way, narcissists, no one else can stand you. Um, w- what, what do we say to, to those individuals? 'Cause I think it's a big swath of humanity, and I think it, um, it accounts for a lot of suffering in the world, including their own suffering.

    10. PCDr. Paul Conti1:13:57

        Yeah. So I would make an appeal to common sense, right? So imagine y- you take someone who doesn't know anything about health. They, they don't know, they don't know how to exercise, don't know how to eat well. They just don't know, and they're very, really, really unhealthy, right? They're overweight. They, they have low energy. Uh, they have sleep apnea they d- no need to have any. And, and, and you, why not just say to them, "Well, like, just go be different. Like, b- in fact, be different now. Why aren't you different right now?" Right? Like, of course, we would never do that because it, it's a, it's absurd, oh, and by the way, also would be cruel, right? So it's absurd and it's cruel, so we would never do that, right? Let's say now, you, you, you, let's say we fast-forward some period of months, say, make it up, right, and we see that person and wow, they are much healthier. They have much more energy. They've lost weight. They're, they're physically fit. A lot will have gone on in between those two snapshots of that person. That person has to learn a lot, right? H- how does one take care of oneself, right? Then more specifically, how do I take care of myself, right? What healthy foods, you know, w- will I like? What healthy foods will I, will I eat? How will I put that on the table? What kind of exercises can work for me? How will they work for me? How do I strengthen muscle? How do I strengthen the heart? How do I increase lung capacity, right? There's learning. There's diligence. Um, you know, there's sticktuitiveness, right? There's resilience. That's how the person gets there, right? It, it, it is no different when it's mental health, right? If we say, "Wow, you, you feel, you feel diffident across the board or you feel superior across the board," or whatever it is, like life isn't going well and you don't have things you want and, you know, the self-talk is negative, and we say, "Well, look, well, just be different right now," right? I mean, it's remarkable that people will say that at times, t- uh, n- not just in a way that's denigrating and awful for others, but to themselves too, right? I mean, th- I hear people say this most often to themselves, like, "I, why am I not just different," right? "I, I want to be different," or, "What's wrong with me that I'm not..." And, and like, yeah, i- it's like everything else. Like, you have to apply understanding and work and effort. Like, the good news is you can get to whatever change you want. I mean, a person can get to whatever reasonable change that person wants. Like, you know, I, I'm 54 years old. I'm not going to climb Mount Everest. I'm not a mountain climber, right? But if I want to, like, I wanna learn to climb some mountains, I wanna get out there and do some things, I can go do that, right? The same thing is true with our mental health goals, but not at the snap of a finger, not by magic, right? It's through applying the same science and common sense, combination of science and common sense that we apply to other things. That's why we go through this procedure of unconscious mind, conscious mind, the structure and function of the self, because that's how, that's how it's done. That's how the after snapshot looks different than the before from the mental health perspective as well.

    11. AHAndrew Huberman1:16:52

        That's very helpful, and I think it's going to be very helpful to a lot of people in thinking about what to think about-

    12. PCDr. Paul Conti1:16:59

        Uh-huh.

    13. AHAndrew Huberman1:16:59

        ... what sorts of questions to, to address, maybe even whether or not to get therapy, and hopefully we'll remap their notions of therapy. I mean, of course, this critically relies on the therapist being good to excellent, um, and I think in the previous, um, sit-down we had around the, uh, in the episode on trauma specifically, you mapped out a number of the features of quality therapy-

Episode duration: 3:42:49