Dr. Paul Conti: Tools and Protocols for Mental Health | Huberman Lab Guest Series

1. 0:00 – 2:37

   Self Care

   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 marks the fourth episode in our four-episode series with Dr. Paul Conti about mental health. Today's episode deals with the topic of self-care. We hear the phrase self-care a lot nowadays, but rarely if ever is self-care precisely defined. For instance, is self-care about pampering oneself? Is it about self-acceptance? Is self-care about just making sure we get enough sleep and enough exercise and have healthy relationships? Well, it turns out that, yes indeed, adequate self-care is about all of those things, but true self-care, the topic of today's episode, is about far more as it relates to our mental health. True self-care is also about constructing a life narrative in which we frame our past, our present, and future in a way that allows us to see what's gone wrong, what's gone right, and the best path to navigate forward. So in many ways, true self-care is really about fostering a sense of self-awareness, and doing so within the context of a framework that is known to work. And today, Dr. Paul Conti shares with us exactly how to do that. He also touches on some of the things that if not properly understood and processed can inhibit our ability to take excellent care of ourselves, including how to properly process traumatic experiences, something that he is expert in, among many other topics as well. He also touches on some of the things that can potentially serve as barriers to excellent self-care, including traumatic experiences, and explains how to frame those traumatic experiences so that we can best move forward. He also shares with us various practices that include therapy, but also practices that we can carry out on our own, such as specific forms of meditation, journaling, and other ways of examining the self and fostering better self-care toward our mental health. As I mentioned before, this is the fourth episode in our four-episode series all about mental health. I realize that perhaps not everyone has had the opportunity yet to listen to the previous three episodes in this series. If you haven't, it certainly won't prevent you from gleaning important information and protocols from today's episode, but I do encourage you at some point to try and listen to all four episodes in this series, because at some level, they are interwoven at the level of concepts and of practices. I'd also like to highlight that Dr. Paul Conti has generously provided some simple diagrams that can help you navigate today's material and the material in the other episodes. They are available as zero-cost PDFs by simply going to the show note captions, where you can view them or download them.

2. 2:37 – 5:34

   Sponsors: BetterHelp & Waking Up

   1. AHAndrew Huberman2:37

      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 all online. Now, I've been doing therapy for more than 30 years, and while I confess that initially I was forced to do that therapy as a condition for being let back into high school, over time, I learned that therapy is a tremendously valuable practice. In fact, I consider doing regular weekly therapy as just as important as doing regular physical exercise in order to improve one's health. The beauty of BetterHelp is that it makes it extremely easy to find a therapist that's excellent for you, and we can define an excellent therapist as somebody who's going to give you a lot of support, but in an objective way, as well as somebody with whom you can have excellent rapport and that can help you arrive at positively transformative insights that you wouldn't have otherwise had. And with BetterHelp, they make it convenient so that it's matched to your schedule and the other aspects of your life. If you'd like to try BetterHelp, go to betterhelp.com/huberman to get 10% off your first month. Again, that's betterhelp, 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 Conti.

3. 5:34 – 13:18

   What is Self-Care?, Foundation, Self-Understanding

   1. AHAndrew Huberman5:34

      Dr. Conti, welcome back.

   2. PCDr. Paul Conti5:36

      Thank you. Pleasure to be here.

   3. AHAndrew Huberman5:38

      For this series, we've been focusing on mental health and really defining what mental health is.

   4. PCDr. Paul Conti5:43

      Mm-hmm.

   5. AHAndrew Huberman5:43

      And a roadmap to achieve mental health. And in episode one, you laid out for us a map, essentially of the things that any and all of us can look at, pretty much at any time, with essentially any degree of resources to try and get a better understanding of ourselves.... and how well or not well we happen to be moving toward, or creating true mental health for ourselves. In addition to that, you spelled out for us what true mental health really is. And just to recap a little bit of that, it really boils down to these verb states, action states of agency and gratitude.

   6. PCDr. Paul Conti6:23

      Yes.

   7. AHAndrew Huberman6:24

      And then in episode two, you covered some of the common challenges that you've observed in life and in your clinical practice. And we addressed some of the ways that people can overcome those challenges by going to the map, opening the so-called cupboards, as we're referring to them, and asking specific sorts of questions. And then in episode three, we talked about how looking at the map and exploring the map, and those cupboards in particular, can help people in relational aspects of life, romantic relationship, work relationships, family relationships, and the relationship to self.

   8. PCDr. Paul Conti6:59

      Yes, very important.

   9. AHAndrew Huberman7:00

      Very important.

   10. PCDr. Paul Conti7:01

       The foundation of all relationships outside of ourselves.

   11. AHAndrew Huberman7:04

       And I'm so glad that you highlighted the relationship to self, because today's episode, we will of course return to the map, and I should mention that if people have not seen episodes one, two, or three, that's okay. Today's discussion will be entirely accessible to them. But I do recommend that at some point, they especially listen to episode one, and hopefully episodes two and three as well. But today's discussion is really about the aspects of ourselves that exist in all people, and the action steps, the paths of inquiry that are available to all people that can allow anyone and everyone to improve their mental health, to move toward these ideals of agency and gratitude on a regular basis.

   12. PCDr. Paul Conti7:45

       Yes.

   13. AHAndrew Huberman7:46

       And as you pointed out, it is a process. It's not that we arrive at agency and gratitude, and just to reiterate, agency and gratitude are verb states. They involve ways of being in the world.

   14. PCDr. Paul Conti7:58

       Right. They're active processes like life is an active process, right? There's not an end point we're trying to reach, right? We're trying to live.

   15. AHAndrew Huberman8:07

       And in thinking about today's discussion, you know, it occurred to both of us, really, that today's discussion is really about self-care, you know? Self-care as a concept, I think for many people, evokes notions of like, okay, you're gonna take a vacation, or you're gonna kick your feet up, or, uh, get a massage, you know, things of that sort. And certainly it can involve those sorts of things, but just as if we were having a discussion about physical health, and we were going to talk about ways to take care of the physical body to enhance health span and life span, today's discussion is really about how to take care of the internal landscape, the mind.

   16. PCDr. Paul Conti8:42

       Right.

   17. AHAndrew Huberman8:43

       Which also qualifies very strongly as self-care.

   18. PCDr. Paul Conti8:46

       Yes.

   19. AHAndrew Huberman8:47

       So if you would, could you tell us how you think about self-care, you know? Regardless of whether or not you have a patient who's dealing with severe mental illness, or somebody who's just, you know, um, hitting the same speed bumps of life over and over again, or anything in between, you know, what sorts of self-care practices and mindsets do you suggest people-

   20. PCDr. Paul Conti9:08

       Mm-hmm.

   21. AHAndrew Huberman9:09

       ... take on for themselves, and for that matter, how do you think about self-care?

   22. PCDr. Paul Conti9:13

       Mm-hmm, mm-hmm. Well, I think we start with, with factors that are really just baseline factors, uh, that have to be in place in order to achieve good things upon them. So the basics of, you know, we have to be eating well enough to feel okay, and hopefully eating really well. We have to stay hydrated. We have to get sleep. We have to move the body. I mean, the- these are basics, but basics a lot of people are not attending to. Similarly, we have to be in a situation that isn't making fear and misery all the time. So an example of an abusive relationship, right? A person has to be- has to navigate out of that before they can really start taking care of themselves in the way that builds goodness, right? So, so we look for the basic factors that we need to take care of in order to then look at the factors that become particular to each of us. And what we're really looking for is self-understanding, right? How, how much can we understand about ourselves, be knowledgeable about what's going on inside of us, why it's going on? Also, and very importantly, being aware that we don't know everything that goes on inside of us, and being curious about that, and looking at how we're engaging with the world around us. Are ... Do we feel happy? Do we not feel happy? How do we define what happy means? How are we engaging with the world? Because a- as you were saying, the agency and gratitude are verb states, so how are we living life? How are we engaging with the world? Do we feel like life is a sequence of things I have to do, you know, for example, right? Or are we doing things we really, really don't want to do, right? Do we have to do those things? How could life be different, right? We start looking at ourselves to, to assess how we're engaging with ourselves, the people, the world around us in a way that is either generative or not generative. If we're in that state of agency and gratitude, then we are gonna have periods of time where we feel peaceful, right? We feel a sense of contentment, or we feel delighted. So is any of that in my life, right? If not, why? Can, can I start thinking about that? Sometimes the answer's quite clear, like, oh, there's this thing I love, and I'm not doing that, right? And I, and I can't do it. And then you revisit, like, is it true that you can't do it? I mean, a lot of times, it is not true. And if it is true, how does the person come to terms with that, process that, perhaps grieve, right? So say if it's the loss of a person, right? That can keep people, you know, in terrible misery over years and years. So there may be things we have to understand, we have to process so that we can get ourselves to that place of knowing ourselves pretty well, and engaging in the world in ways that we have a pretty good understanding of, and that, that are adaptive. And then we look to say, okay, now how do I make that better? Because now we're thinking about preventive medicine, right? We want our bodies to be healthy because of course we want to be healthy today, right? But we also don't know what will happen in the future, right? Will there be an injury or an illness? I mean, eventually, like, you know, we all have an injury or an illness in some way or another, so we're preparing for the predictable challenges that will come our way in the future, and-... we're well-served by doing this about our mental health too, right? There will be challenges that come our way. There'll be losses and stressors and things that make us feel bad or feel scared. I mean, the- these things will happen to us, so the healthier we are, the better today is, and the better we set ourselves up to either make tomorrow even better today, or if tomorrow gives me a challenge I don't have today, I can meet that challenge and get back to a better place.

   23. AHAndrew Huberman12:48

       So if I understand correctly, it sounds like one of the cornerstones of self-care for sake of mental health involves asking really good questions about oneself.

   24. PCDr. Paul Conti12:58

       Yes, yes.

   25. AHAndrew Huberman12:59

       I don't think I've ever heard it defined that way before.

   26. PCDr. Paul Conti13:02

       Yes.

   27. AHAndrew Huberman13:03

       You know, um, it's in such stark contrast to the other forms of self-care, which I certainly subscribe to as well, like making sure one gets enough rest and, um, you know, avoids toxic people to the extent one can, et cetera, or toxic environments, uh, and so on.

4. 13:18 – 15:24

   Life Narratives

   1. AHAndrew Huberman13:18

   2. PCDr. Paul Conti13:18

      Right. Y- you mentioned, okay, ask questions of the self, but, but the, the logical next question to that is, well, what questions do I ask myself? Sometimes we know when we have an idea, right? Sometimes we don't. And this is where the construction of a life narrative, like, let me think about my life, let me potentially talk about my life with a trusted other person, let me potentially write down a narrative about my life, and we can learn so much from doing that. So the person who thinks back and starts to tell a story of themselves and, and let's say just as an example, you know, that story is- is going pretty well and the person is feeling pretty good about themselves and then say something happens and- and it starts to change. Well, then this thing happened and then, you know, I started kind of spending time with different people or I started dating different people or I took a different kind of job and, and it can engender the reflection of like, oh, like, things really kind of changed then. Because- because the emotion systems within us don't care about the clock or the calendar, the emotions often of negative experiences can back map into our lives. And someone who can tell you, "I was miserable ever since I was a child," can then write out a life narrative that describes a very happy childhood until something happened or something changed at a certain point, which could be something dramatic or it might be increasing pressures of school or increasing social pressures or how things changed at puberty, right? A- and if we have an understanding of that, we may know the right questions. Like, for example, let's say afterwards the person finds that they're drinking more. It's like an example, but a common example. I- instead of taking that for granted, "Oh, that's what I do," right? Or, "Yeah, I can't cope any better," right? The negative things people will say to themselves, the narrative can often point out, "I can cope better, I did cope better, I did feel differently about myself." So the- the life narrative can really help us establish the roadmap, right? And part of what the life narrative does is it guides us to the places to ask the questions.

5. 15:24 – 24:41

   Journaling, Self-Inquiry & Therapy

   1. PCDr. Paul Conti15:24

   2. AHAndrew Huberman15:24

      If you would be so kind as to tell us a little bit more about how one would do this on their own.

   3. PCDr. Paul Conti15:29

      Mm-hmm.

   4. AHAndrew Huberman15:29

      So does this involve journaling things out? I confess I have a file on my computer, uh, that has a bunch of other files that starts with, you know, age zero to five, and then I have some notes in there. It's not an autobiography, uh, far from it. It's just kind of highlights of events that I remember, you know, six to ten and so on, and places I lived, and, um, I use it just to kind of orient myself in time.

   5. PCDr. Paul Conti15:55

      Yes.

   6. AHAndrew Huberman15:56

      Um, I actually don't know what the- the purpose and utility of it is, uh, why I initially started doing this, but it's- it's an important file to me. Um, and when I return to it, I often remember additional key events, so it's constantly growing. I mean, the- the, (laughs) these files are getting quite large. Um, again, with no specific, uh, purpose of writing this out at any point, but just to orient.

   7. PCDr. Paul Conti16:19

      Right. Right, you- you- you can't not learn about yourself from doing that, right? It exposes truths of self, it makes you ponder about things, it draws your attention to ways in which you've changed, whether you think those ways are good or bad, right? You- it draws your attention to change, it draws your attention to the impact of external events. And as you said, it sort of, it grounds you. It provides a way of localizing oneself in time, like, "I am here now. Wait, how did I get here," right? And- and the thoughts and ideas of how we got here very much help us, because often we don't do that. You know, we're sort of rushing headlong forward, because in many ways our- our society is prompting us. We live in a very fast moving society and we want information and gratification and often we don't even want it very fast, but it's coming at us very fast anyway. And to stop and reflect makes a very, very big difference, even to think at times beyond our generations, right? I mean, to the best of my knowledge, the vast majority of people on one side of my family, everyone was a shepherd for like every generation until like two ago, right? And thinking about that of like, huh, that's interesting, right? It makes me in many ways grateful, so grateful for the opportunity I've had. But I also think like, well, they lived in close-knit communities then, and what was that like? And you know, we begin to see ourselves in a broader way, both in our own history and then projecting forward, which- which sometimes is about children and nurturing children, but it can certainly be about other things. It can be about friendship, it can be about work. So we start to see ourselves in ways that are interesting, that are through the lens of truth and that speak to our place in the world around us, and I think this engenders both agency and gratitude, right? If I'm aware of like, hmm, what have I done? What have I accomplished? When haven't I accomplished things? How might that be different? And- and a sense of gratitude for being here and having opportunity and even being able to think about this. You know, my guess is when you read through those files that at some points you have sort of a sense of marvel, like, "Whoa, that's me," right? Whether it's a good memory or it's a difficult memory, you know, it's all part of you that leads you through to today, and you do have a better sense of self through that.

   8. AHAndrew Huberman18:35

      One of the feelings I most often come away from those excursions into those files with is one of gratitude. Because so much of what's in those files, um, are recollections of others that I really appreciate, some are still alive, some aren't, and, um, what that's meant to me and how that carries me forward. So, you know, I, so that's what I do. Um, I- I'm sure there are a near infinite number of ways that people could do this. But what- what are a few that you've seen work really well, um, that people can do on their own or perhaps with a clinician as well? In fact, that raises the question, should people share this sort of practice and the contents of that practice with- with a trusted clinician?

   9. PCDr. Paul Conti19:18

      Right. Right. Yeah, I think sharing with an- with another person always should be a- a trusted other. Right? And we can kind of take stock of that. You know, of people have a- an idea of who may be safe, right? Often people say, "Oh, there's no one I could share something with." But really, that often comes through a lens of fear, you know, of exposure of self, of rejection, of vulnerability, which often is warranted, but sometimes is not. Sometimes there really are, in fact often, there are safe people. All right? So the- the act of doing something other than just thinking about something brings, as y- you well know, it brings parts of our brain online that then are thinking in a different way. So for example, they may bring error correction mechanisms online. So if I'm thinking over and over again that I've never been good enough to do anything, you know, that can be just automatic inside of me, but if I start to write or to talk or even to formulate words, to talk to myself or to put words in my mind as if I were talking, now (pauses) we come at it in a different way. And we- we can s- ferret out the truth within us which might be, you know, it's not true that I've never been able to do things or achieve things and- and people often bring that online by doing something other than the same thought process that's gone often over and over, and it's non-productive and it brings down mood and it raises anxiety, and it also builds a sense of futility. I mean, I can not tell you how often I've heard a- a person say, like, "No good will come of this." Or like, "Okay, try. We'll try it, but I know I can't be of-" "I've been thinking about this for 10 years or 20 years." But what they've been doing is the same thing, they've been ruminating on it for 10 years. They start talking about it and- and people will say, "Oh my goodness, like, I- I've achieved more in two hours, you know, than- than I- than I did in years." Right? But- but that's because you're doing something different in the two hours. So I think that's very important, especially because we can't say, "Okay, go look in your unconscious mind and see what you find there." Right? So then we need ways of accessing the unconscious mind and the communication either with self, in writing, with others, can be very, very helpful in doing that. I also, I am a firm believer that knowledge is power. Many times, I- I will feel like I've- I'll- I'll have a sense of really having helped someone, and the other person may have that sense and we can see the change, and all that I've done is impart knowledge, right? W- we all know different things, so often it's the case that, hey, I happen to have learned things that are different from what that other person learns. T- then I am communicating to them things that I have learned so they know them too, and then they feel tremendously better. All right? Because if we put inside of ourselves the tools of understanding, our unconscious minds, and sometimes our conscious minds too, will work on them, will make use of them. So- so if you talk to a person, for example, about how trauma can impact us and how we can shove it underneath the surface and how it can spin off shame, then that person may take that knowledge away and come back with real understanding, a- and the fact that we can do this on our own, right? We can do this through good resources, we can do this by taking information into ourselves, that can be very, very helpful, and it doesn't require... Because the f- first place to start are with things we can do that don't require professional help, right? And- and- and sometimes we may come at problems that- that do tell us that we should get professional help, right? So if we're having thoughts of self-harm, thoughts of not wanting to be alive, thoughts of real despair, thoughts of real- of hopelessness, that's telling us, okay, l- let's get some help. There's a role and a place for professional help, but people come to professional help in other ways too, such as, for example, reflecting on the self, and- and so real example, a person thinking, "You know, I really became kind of different when, you know, when things started changing, like after college, and then I thought like, 'Oh, I've kind of gotten to this place and I've got a good job and like things really should get better,' but like they kind of haven't," right? And that was really a branch point. That person may have never really thought about that or they may have thought about it 10,000 times and then shoved it underneath from- from consciousness to unconsciousness because it's a scary vulnerability inducing thing. It seems scary, like how could it be that I achieved things and didn't get healthier? Now we're afraid of that, right? And- and letting that come to the surface, being able to say, "Oh, like that's true." Like I- I don't have to be afraid to shine light on that. Then a lot of times that alone sometimes a person will solve their own problems. They think about it, they come in, they have all the answers, they thank me, I did nothing but listen, but the listening part is important, it allowed them to come in and say what they needed to say, and other times then i- i- it's not... It can be that, but it's not always that. Other times it informs us about what to work on clinically and it might not be something that's dire, right? It might just be like, "I want to understand this. I want to be happier, I want to be healthier, I want to work towards these good things." When people talk about that, they're always, if you really distill down, what are they talking about? A sense of peace, a sense of contentment, coming at the world through agency and gratitude, and- and we can do that through self-inquiry, including through therapy. I- it doesn't have to just be for situations where, oh, there's a significant clinical problem.

6. 24:41 – 28:20

   Unconscious Mind, Salience & Journaling; Panic Attacks

   1. AHAndrew Huberman24:41

      Is it the case that when somebody journals a bit of their life narrative or thinks about some great or sadly traumatic events that perhaps happen to them at whatever stage of life, that there's something accomplished in that action, uh, or in that therapy session if they're doing it with a clinician, but that when they go to sleep that night and perhaps in their waking states as well, that the unconscious is working some of that through such that, you know, revelations come to mind later, uh, insights come to mind? You know, I'm certainly familiar with the fact that there are certain times of day and evening where my brain is in a bit of a liminal state, feels like somewhere between sleep and awake. And I just have learned that provided I block against, um, outside sensory input (laughs) as much as I can, uh, in particular social media and the news, that I'll just be, you know, doing the dishes or preparing coffee or something and something will come to mind seemingly out of nowhere, right? It's not always a great insight. In fact, it's rarely a great insight, but it, it always takes me a bit by surprise, sometimes a little bit of delight, sometimes a little bit of shock, like, wow, like, where did that come from?

   2. PCDr. Paul Conti25:55

      Right. 'Cause it came from your unconscious mind, right?

   3. AHAndrew Huberman25:57

      Mm-hmm.

   4. PCDr. Paul Conti25:57

      It was invisible to you, then it got thrown up-

   5. AHAndrew Huberman26:00

      Mm-hmm.

   6. PCDr. Paul Conti26:00

      ... and you're, whoa, and you realize it while in the midst of doing something relatively mundane, right? Because during the day you're engaging, your brain is highly engaged, which is great, but it doesn't leave a lot of room, right, for, for the unconscious mind to do its millions and millions of things a second that can help you figure things out, which is the same reason, I mean, it's uncanny, any, any psychiatrist will tell you this, that, that people... a person will come in and say, "It's strange, you know, all of a sudden when, when I can finally relax, like, that's when I have a panic attack," right? Or they don't know, like, then I can finally relax and I go, "Ah." And then my heart's beating fast and I'm sweating, right? Because that's when the panic attacks come. If the person is laboring under something that is, that is causing them this sort of constant distress, when, when you stop focusing outward and you sort of settle into an inward state, then the things that are underneath the surface are gonna come to the surface. And if there's something really bothering you that your brain is very upset about or very afraid of, what does it throw up to the surface? A panic attack, right? But if you're in a good place, you're taking care of yourself, you're in a generative stage, you're in a safe environment, then when you, you stop putting all the attention outward. So we imagine then salience changes, and instead of a lot of the salience being outward, it starts to be inward and you're just sort of meditative. You're washing the dishes, right? And there's room then for your unconscious mind to throw something important to the surface. It's the exact opposite of how people can't remember something if they're trying to think of it. I mean, we all go through this like, "Oh, I can't remember that person's name or that restaurant," or whatever it is. Try to keep thinking about it and see if you figure it out, right? The answer is not in your conscious mind. So if you keep bringing your conscious mind to bear, you just generate frustration, right? But then when you stop thinking about it, the answer is there inside of you. "Oh, I remember now." Right? So, so that's how if we, if we have the conscious mind engaged in something it's not going to figure out, right, then it doesn't figure the thing out, right? And, and that works for our problems too. That's why a person can say, "But I thought about that for 10 years." No, you ruminated about it for 10 years. It just ran over and over and over in the conscious mind. And how ironic, right? It prevents understanding.

7. 28:20 – 33:23

   Self-Inquiry; Grief & Death

   1. AHAndrew Huberman28:20

      So it's very clear to me that asking certain kinds of questions about oneself and one's self narrative, you know, life history essentially can be very beneficial in the moment or moments of doing that practice as well as the subconscious or I, I guess, the, the appropriate way to refer to it is the unconscious.

   2. PCDr. Paul Conti28:39

      Unconscious.

   3. AHAndrew Huberman28:39

      Right? Okay. So for those out there who like me sometimes say subconscious, it's unconscious. Uh, the unconscious can throw things up to the surface that can be real insights, can, can give us not just panic attacks, which I think most people would like to shy away from, but as you point out, there's information in the fact that the panic attack is occurring under-

   4. PCDr. Paul Conti28:59

      Right.

   5. AHAndrew Huberman28:59

      ... conditions of rest.

   6. PCDr. Paul Conti28:59

      And if you stir up the pot of the unconscious and you put some new information in, it, it can do new things. It can figure new things out, which is why the process of self-reflection, for example, and often the process of therapy, is not always, and in fact often is not a pleasant process, right? But then we take away from that hard work renewed insights. So someone, this happens all the time, who, who knows, they know that a certain trauma is inside of them and has been affecting them, whether it's for days or weeks or years. They know it. They don't know what to do about it. They have a conflict about it, so they keep trying to shove it under the surface and they, they finally accept for whatever reason to, to talk about it. And, and what often happens then is, let's say during three or four successive weeks of hourly therapy, I mean, that person is crying and that person is upset or that person is angry. I mean, it doesn't always happen this way, but it does a fair amount of the time as they get better and better, right? Because they're discharging some of the energy, right? Maybe they're crying and, and they're sad because they're grieving something they haven't grieved before, right? Because they've just been angry, right? Or they've just been ashamed. A classic example is a death. I mean, how many times do people think, "Well, that can't be still affecting me. It was X number of years ago," but they've never actually grieved because they carry in them, "Oh, it was my fault." Right? And, and how many times do we hear that, "I should have said something different before. I should have gone..." You know, we, we then back map something that makes us feel bad. And then from the guilt and shame comes the inability to process grief. So if the person then deals with, right, "I feel so bad about this. In fact, I feel so ashamed of it, and I feel like it's my fault." And say, "Okay, well, let's talk about that."Right? After my, after my brother's death by suicide, I felt responsible. I, I was not involved in any way in mental health. I had a business career at the time, and I finally went and saw someone. I wasn't acculturated that getting therapy was something one did, but I realized, hey, I'm not okay. Right? So I didn't know, I didn't know how, right? I just knew the manifestation of it, which was misery and risk and, you know, I could just tell. Like, I know what it feels like to not feel like this, and this is not okay. So, so then I, you know, I call the insurance number. Eventually I go in and see a therapist and, you know, she did... I'm sure she was a very good therapist, but she didn't, in a sense, need to be in the sense that sometimes we don't need to use all the things we know. We can do just something basic with someone, and that's all she did with me. I mean, she got me talking about it, and then I talked about how ashamed I was because it was my fault, and then really? And then she challenged me about that. And then, you know, in a nice way, but then it was... became clear that I was so utterly shocked by it, right? Far from it being foreseeable to me, right? That, that the problem that I was having now was the shock of it and the sense of shame and guilt that it raised in me, and then me shoving it under the surface, not knowing what to do with it, then it's making all sorts of misery in me and I can't actually grieve, right? So at some point during those sessions, now I'm sad and I'm crying, right? And, and I know what she was thinking, right? She's, good, okay. This is like, this... Thank goodness, this, this person's getting better. She probably felt a sense of relief because she could see, hey, maybe he's, he's coming out of risk. He's able to feel sadness, he's able to grieve. He hasn't been doing this before, you know? So it's, it's that, it's that work, what if we put into it that makes a difference, just as when physical health. I mean, if I want to be stronger, I want to be more robust, like, I have to go to the gym and work or I have to do something that's, that's hard work and then I get the benefit of it. And the same is true whether we're reflecting on our life narrative and it brings, you know, some difficult emotions to us or whether we're talking with someone or whether we're doing it in therapy, but that's how that, that process of inquiry leads us, you know, to take some of the Gordian knots in us, so to speak, and to cut them instead of trying to figure out, like, how am I going to feel okay about myself even though I'm responsible for my brother's death because I should have foreseen it? I mean, like, that doesn't work, right? You have to say, like, I see what that thing is and that, that has to go away, right? And then therapy can lead us to the point where, oh, it wasn't my fault then. Oh my goodness, I'm sad.

8. 33:23 – 34:39

   Sponsor: AG1

   1. PCDr. Paul Conti33:23

   2. AHAndrew Huberman33:23

      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

9. 34:39 – 37:27

   Self-Harm, Hopelessness & Therapy

   1. AHAndrew Huberman34:39

      special offer. They'll give you five free travel packs and they'll give you a year's supply of vitamin D3 K2. Again, that's drinkag1.com/huberman to claim this special offer. I can see how self-inquiry is really powerful. I've certainly experienced that in my own life and, um, it's an ongoing process, right? This is not something that one does and then stops. Ideally you do it forever, just like physical fitness. Um, and at the same time I know that a number of people perhaps are wary of self-inquiry especially because of the pain points it can bring about and make conscious and that we have to really sit with. Um, and most people would like to avoid discomfort. Um, I'm sure there are also people who are doing quite well in life and therefore think, oh, you know, a pattern of self-inquiry, all it could do it sounds like is more harm, like why would I want to do that? But I think we both agree that there's nothing but good and progress and more agency and gratitude to be had by going through patterns of self-inquiry.

   2. PCDr. Paul Conti35:40

      I think that really highlights something very important which is that self-inquiry isn't always the right answer. Now I think just because things are going well, that doesn't mean self-inquiry isn't the right thing to do. Self-inquiry is always the right thing to do if we want to understand ourselves better unless we're in a place where it can bring real risk to us. So when I was trying to think about myself, inquire why was I so miserable, what's going on in me, you know, I reached a point where I realized, like, I'm not, I'm not getting myself anywhere and I'm getting worse and like this is now... This is not good for me because where did this self-inquiry lead me? To more guilt and shame. So then at some point I sort of pulled the rip cord right on. It's like I can do this on my own anymore, right? And, and that's very, very important to anyone who's listening. If you feel like, look, I don't think I'm in a safe or a stable place, again thoughts of self-harm, thoughts of hopelessness, then, then i- it probably is not... Or let's err on the side of being cautious, right? It is not a good idea then to engage in self-inquiry, right? First go see someone clinically, right? And I know that can be hard to do in this day and age but if we really advocate for ourselves, we really push, you know, we really, you know, we do whatever we can do to try and get in front of someone who can kind of help us understand what we may need and maybe that person helps us with the process of self-inquiry. Maybe that person reassures us. Maybe that person then tells us that we, we really do need, you know, more care or more help and then it leads to us getting that so that we can come back to the good place of being well enough for the self-inquiry.

   3. AHAndrew Huberman37:13

      I'm grateful you shared your path to working with a clinician, and the fact that just focusing on something on your own wasn't really working, and there was a, it sounds like, a requirement for a clinician to help guide you through that. Um,

10. 37:27 – 42:34

    Apprehension of Unconscious Mind Exploration

    1. AHAndrew Huberman37:27

       it relates directly to, um, what I'm most curious about at this moment, which is, you know, it, in the map that you established for us in episode one, and that has carried through all these episodes, and, and by the way, if people are not familiar with the map, we will cover it, um, in top contour in a little bit more depth, uh, in a moment here. But one of the key things as, or cupboards as we're referring to them, uh, to look in, in order to exert self-care and improve one's mental health is this, um, notion of self-awareness, of really understanding that there's an, an I, a me, and exploring what that's really about, in the moment, but also historically through narrative, et cetera. Uh, also in this, uh, map is a cupboard that, um, relates to salience. What's most obvious, or what do we default to, both internally in terms of what sorts of thoughts we default to, and externally, what are we focusing on in the outside world? And I think I, and perhaps many other people out there, are wondering how to resolve any conflict between a practice that is aimed at increasing self-awareness and perhaps even drawing to mind early traumas or challenges, or recent traumas or challenges, and salience. In other words, if I were to, you know, take some moments or even an hour once a week and sit there and really, like, think about the sorts of things that I don't want to think about.

    2. PCDr. Paul Conti38:50

       Mm-hmm.

    3. AHAndrew Huberman38:50

       Like, that, that have been, ah, gnawing at me below the surface for a very long time. The, the stuff that I, you know, gained some proficiency at pushing down beneath the surface. I think one fear that I have, and so I have to assume other people have it as well, is that if I were to bring that to mind, that it would overtake a lot of my waking hours. Like, it's like I don't want to think about this thing or those things. And so now what's salient is something negative. And when I'm focused on something negative, then I'm not able to be as generative as I would like. You know, move my life, move forward toward my life goals. Now, I, I could even have the realization, the, the cognitive understanding that, okay, that's, but that's necessary, right? Like, this is like getting a, a wound fixed or, or dealing with a, with a chronic injury. Like, sooner or later you got to deal with it, otherwise you're not going to be at your best. But that, um, conflict between gaining more self-awareness and also the understanding that what is most salient to us is, kind of defines the quality of our daily life.

    4. PCDr. Paul Conti39:50

       Mm-hmm.

    5. AHAndrew Huberman39:50

       Um, that, that conflict or friction, um, seems like an important thing for us to drill into a little bit.

    6. PCDr. Paul Conti39:56

       Absolutely. A- and I would say this. If you think there's something that you can't bring up into consciousness because it's going to take over your mind, or as people often say, "I'm going to curl up in a fetal position. I'm going to cry and never stop," that is exactly the thing you must look at. Because salience presents itself in a whole array of ways. So if there's something inside of you that's, that's strong enough, right, that it's throwing itself up to the surface like, "Hey, maybe you want to think about me," right? So your unconscious mind throwing it up to the surface, that is active in you. And often, although a lot of it happens in the unconscious mind, it happens also in the conscious mind. And if the person then stops and thinks, how much might that thing that you are not thinking about be impacting you? How might it be salient in other ways? And sometimes a person will realize like, "Yeah, that's on my mind." People say, "Oh, that's on my mind, yeah, all the time. It's like kind of on the back burner, but always there." And he says, "What do you mean, on the back burner?" You know, that's like having a voice in the background telling you something, you know, very negative or very distressing, and it's just one example where, where oftentimes there's a realization that that thing is actually quite salient. Sometimes there isn't a realization until later. "Oh, the salience of that is that I, that's how or that's why I don't let myself get ahead," right? Mm-hmm.

    7. AHAndrew Huberman41:27

       It can come out later because, you know, we don't know how much of it is unconscious, how much of it is conscious. But, but under the right circumstances, if things are safe, uh, as we said, if there's not something going on that presents risk and warrants clinical care, if there's something inside of you and you think, "I can't let that to the surface," then what that is telling you is, "I must let that to the surface." Now again, we want to do it in judicious ways, uh, and do it in ways that are safe, but that's, that's the message. I think it's especially important that you mentioned that if something is gnawing at our conscious mind every once in a while, then it absolutely has to be operating below the level of our conscious awareness.

    8. PCDr. Paul Conti42:09

       Maybe running amok.

    9. AHAndrew Huberman42:10

       All the time.

    10. PCDr. Paul Conti42:11

        Below the level of consciousness, yes.

    11. AHAndrew Huberman42:12

        Right. So if ever there was a, um, a cause for exploring something like that-

    12. PCDr. Paul Conti42:17

        Mm-hmm.

    13. AHAndrew Huberman42:18

        ... um, that's it, right?

    14. PCDr. Paul Conti42:19

        Mm-hmm.

    15. AHAndrew Huberman42:19

        Because we can't be aware of the ways that's damaging to us or limiting us. Again, you know, somebody listening to this could be doing quite well and thinking, "I'm doing great. Like, why would I want to do any of this?" Well, uh, perhaps they could be doing that much better.

    16. PCDr. Paul Conti42:31

        Right.

    17. AHAndrew Huberman42:32

        Which is-

    18. PCDr. Paul Conti42:32

        Absolutely.

    19. AHAndrew Huberman42:33

        Self-awareness

11. 42:34 – 54:18

    Mental Health Map: Cupboards, Agency & Gratitude, Generative Drive

    1. AHAndrew Huberman42:34

       and addressing one's personal narrative and a sense of I is, uh, what we called cupboard one, uh, under, uh, the function of self. Now, for those that listened to episodes one, two, or three, uh, they'll be familiar with what I'm talking about when I say a cupboard, cupboard one, function of self. But, um, just for sake of getting everybody on the same page as we move forward here, maybe we could just return to the map of mental health, uh, for a moment. You know, we talked about agency and gratitude as verb states. And you also described in previous episodes this key really essential concept of this generative drive.

    2. PCDr. Paul Conti43:12

       Yes.

    3. AHAndrew Huberman43:12

       So if you could just take a few minutes for us and really explain what agency and gratitude are, how one goes about building those up and expressing those, and what the generative drive is. And then we'll return to the 10 cupboards of inquiry under the structure of self and function of self, which-... really represent the pillars and, and all the stuff that geysers up into, uh, these simple but extremely powerful concepts and ways of being, which are agency and gratitude.

    4. PCDr. Paul Conti43:40

       Yes, yes. So, I, I really liked when y- y- you brought the image of a geyser, right, to, to mind. Because if we think about the structure of self, which is one pillar, and the function of self, which is another pillar, underneath those pillars, they're the 10 cupboards we've been talking about and they represent the areas of inquiry for us, because they're the aspects of the structure and function of self. So, that's where the answers are, right? The answers are in those pillars, the answers are in those 10 cupboards. So, if we're doing that, we're looking there, we're honoring what we find there, we're becoming healthier, then that geyser, right, I imagine it coming out, you know, like, th- the space in between the pillars, right? And, and what it is lifting up is first empowerment and humility. But empowerment and humility are qualities. It's certainly the w- the way... and the way we're u- using them, they're, they're qualities, they're potential. So, I have empowerment as opposed to being disempowered, right? So, I have humility instead of, for example, a reactive grandiosity or even a reactive self-oppression, right? So, I have these qualities of empowerment and humility, and then they become enacted, right? They become expressed by us. And I imagine riding on the top is the agency and the gratitude. It's at the top of the geyser and it's moving, right? They're verbs. We navigate life as life moves forward, right? I will often think, like, being on, like, the, the luge, right, in... you see in the Olympics where everybody's going down the twisting path and it's like, that's us moving through life, right? And we all have different pathways, but they can interconnect and they can cross. But that's what's happening. Living is an active thing, right? So, agency and gratitude are active things. Why? Because they're the ultimate expression of all underneath of i- o- of them. That's where it goes. If the pillars are in the right place, the geyser can function. The empowerment and humility are with us, so we're engaging with ourselves, with others, with the world through a lens of clarity and through a lens of knowing we can make the world a better place and knowing our role in it. That's very, very active and then it brings to us the peace, the contentment, the delight that weaves in and out as, as you described, that you will feel the peace, the contentment, the delight when you're doing the solo podcasts, right? But y- you're doing something very, very active, right? Th- th- that's not... um, it's not a passive endeavor, right, during which you feel all those things, but that makes sense, right? Peace doesn't mean nothingness, right? Now, it can. Someone who's looking out the window at the garden they planted can feel that too, but, but there's life going on in them also, right? They're, they're contemplating the garden. They know that they made the garden. So, these are all active processes because life is an active process. And then we end up in this place of looking inside of us. These drives within us are both deterministic and determined, right? So, think about how active a process that is, where we have a natural bias one way or another because of our genetics. Just like someone has a natural aptitude to be taller and someone shorter or to be more or less athletic, right? We have potential within us when the genetics come together, right? And, and that may determine some sort of set of parameters. So, so maybe someone who doesn't have the, the blessings of being so athletic, perhaps myself, right? R- I, I'm not gonna be the world's greatest athlete, right? But if I work hard, like, I could be a lot more athletic and have been at times, right? And if I don't, I could be a lot less athletic, right? So, so there are potentials within us that get sort of genetically determined but have a wide array of, uh, of variance around them and then our choices determine where we are in that variance. If I don't take care of myself, I will be on the very low end of the athletic spectrum, right? If I do and I cultivate myself, you know, I can be on a higher end for me, right? But still, that's a lot better than the lower end. There's a very big difference. The same is true in our drives. So, so the more we're taking care of ourselves, we're reinforcing the primacy of the generative drive. Then the aggression, assertion, proactive, right? That drive in us is realized as best we're gonna realize it. And not everyone's is gonna be off the chart, right? And that's okay, right? But the, but that drive is in a place that lets that person take care of themselves, you know, have a, a job they enjoy a- a- and can do well at and make their home life better. Whatever it is that we can do, like, w- we're more assertive, we're more engaged and then that's bringing us more pleasure. So, the pleasure drive, it... again, it's not a hedonistic drive. It's a drive for things we enjoy. Like, we enjoy safety, we enjoy absence of pain, but we also enjoy friends and romance and sex and food. Like, these are things that bring us gratification and we can have that in a healthy place too. So, there's not too much and not too little of the aggression, assertion, proactive drive. Not too much, not too little of the pleasure drive. And then we're in a place where we can meet where those drives are at. So, if the pleasure drive is in a certain place in us, we can meet that, right? And maybe we foster it moving a little higher up because we're doing good things and we're taking care of ourselves. So, if our romance is in a better place, you know, then we can take more pleasure in our romance, right? If our physical fitness is in a better place, we can enjoy that more, right? We can do more things. So, we are...... helping those drives to be in the optimal place to subserve the generative drive, which we are trying to optimize and maximize, and that puts us in the best place to have the things under those pillars, in those cupboards, in a good place. And then on top of that geyser is the empowerment and the humility, and then that gets enacted as agency and gratitude, and we have more of the goodness of, of peace, and contentment, and delight, and that reinforces the generative drive. So that's what's going on, and look, it has never failed me yet to read or listen to someone communicating happiness, either what they think it is, how they found it, what they're striving for, what they think it philosophically is, right? It's all that, right? And it's not as sk- as simple as a word, right? But because it's complex. We're complex. But the beauty of it all is the complexity is within us, but it's not out of our reach to understand ourselves better and help ourselves. And if we do that, as we move further up the hierarchy, it gets simpler. Approaching the world through agency and gratitude as verbs, you know, it's pretty straightforward. That's why that's the best metric for romantic compatibility, right? It's not this person plays a musical instrument and that person's a mathematician, so they're not compatible, no more than one plays the trumpet, one plays the, the clarinet, and we assume they are compatible. Where are those drives at? Are people healthy, in a healthy place? We can then take the best care of ourselves, engage with others in a healthy way, understand who's a healthy other to engage, uh, with, right? Get ourselves out of unhealthy situations, and then we're building health within ourselves and around ourselves. And that's how, at the different levels of emergence things get better. So if I make myself healthier and you make yourself healthier, we will be healthier as a group of two. That's always how that is. And if we're healthier as a group of two, we can be healthier as parts of larger groups, right? Uh, or where if the groups aren't healthy, we're pushing towards greater health, right? We're engendering health, and that's how we see health grow until it can be manifest even on a cultural level, where we're taking better care of ourselves, we're less punitive, we're less rushing forward as a society and trampling the vulnerable, right? And we realize, oh, I could be the vulnerable, right? I care about other people even if I don't know them because I can understand and empathize with what it feels like to be vulnerable. And furthermore, I could be among the vulnerable. So we behave differently as a culture, and that's what we're searching for f- on an individual level all the way up to a cultural level.

    5. AHAndrew Huberman52:39

       I have several questions. Um, but first I want to just, uh, highlight what you said about relational structure, relationships, and the fact that, um, as was explored in episode three, and you made so clear, and it just makes so much sense, most of what people explore for, uh, when looking for a romantic partner or determining whether or not their existing romantic relationship could be better or not is focused on the wrong things, right? These, these very kind of superficial notions of what people enjoy and even level of education, some of which can really matter. But that's not the critical issue at hand, and that the maps that the two individuals have and the extent to which they are expressing their generative drive, um, and agency and gratitude is far, far more important. And so for those that haven't heard episode three and are interested in relationships, not just romantic relationships but relationships of all kinds...

    6. PCDr. Paul Conti53:37

       Mm-hmm.

    7. AHAndrew Huberman53:37

       ... work, family...

    8. PCDr. Paul Conti53:38

       Yeah.

    9. AHAndrew Huberman53:38

       ... relationship to self, friendship, I highly, highly recommend listening to that conversation because it's, um, uh, it's truly spectacular in terms of its actionable takeaways, uh, in, by actual, well, I mean, actions of course, behaviors and, and also modes of thinking that can really, uh, serve people. I also just want to, uh, make one clarification that, um, I, I believe that when you said hierarchy when, when you said move up the hierarchy, um, you were referring to the hierarchy within the, within the map that's been laid out here, right, as opposed to... I don't want people to get, um, uh, mistakenly, uh, distracted by the, the possibility that we're talking about some sort of like external social hierarchy. Um, so I just want to clarify that.

12. 54:18 – 1:01:57

    Structure of Self, Unconscious Mind, Abscess Analogy

    1. AHAndrew Huberman54:18

       And that's actually a perfect jumping off place for, um, going into the map with a little bit more, uh, depth and detail, um, and exploring these cupboards that reside, um, at the lower levels of the map and that are quite complex. Okay, so for those of you listening who have not yet gone and accessed the PDF that we put in the show note captions, um, you can do that at any point. But what we're talking about is a bunch of things down at the bottom, uh, under these two pillars, structure of self and function of self. These cover- cupboards, excuse me, that are extremely valuable for any and all of us to look in and explore and ask specific questions because it's what resides within those cupboards that combine in a sort of recipe and then geyser up into whether or not and how much empowerment, humility, agency, gratitude, peace, contentment, delight, and generative drive we are able to, uh, exert and, um, and experience for ourselves in life. So imagine in your, in your minds, if you will, um, and here I'm borrowing directly from, uh, a picture model that, uh, Dr. Conti provided, um, before the, uh, filming of this series, which is an iceberg where below the surface of the water resides a bunch of stuff and then a little bit is above the water, and, and maybe you'll help us revisit that model now for a few m- moments. But if you take nothing away at this moment, um, please understand that there's a lot of complex stuff going on underneath the surface of the brain and mind, but a key feature of this map is that while it is very, very complex underneath-What emerges from that complexity gets simpler and simpler, especially as we move towards places of better health and more effectiveness in life. Um, so if you would, could you, you know, describe the map in a bit more detail, especially what's down there in these pillars, the complex stuff and- and the stuff that we should be looking at. And then we'll touch on some of those cupboards that we all have and the sorts of questions that we should all be asking in the context of some, uh, common challenges, but also some very common and very effective paths to doing and feeling better.

    2. PCDr. Paul Conti56:26

       Mm-hmm. Mm-hmm. Yes. Yes. You know, the- the unconscious mind is the place to start. The- that's the deepest level of the structure of self. So imagine, i- imagine sitting on top of a biological supercomputer the size of a house, right? That's what's going on inside of us, right? The unconscious mind is that biological supercomputer, and if we're interested in ourselves, right, we become very, very curious about what is going on in it. And- and that's where even though it's not directly accessible to us, it can be accessible through other ways, such as w- we talked about reflection or therapy, and of course there are other ways too. But it is accessible to us, and we want to know what is in it, because what it- is in it has such a strong effect on what's going on in our conscious mind, right? That's the- the person on top of the biological supercomputer the size of a house or the- the- the image we've been using is the top of the iceberg that's coming out of the water. So we can look at that either way, but what is in it has, of course, a huge effect on the part that we're aware of, our conscious mind. And- and I think the best analogy here, it's actually, I think, quite a, uh, uh, an analogy that parallels very well, is to an abscess in the field of physical medicine. So an abscess is an area of walled off infection, right? So imagine that there's some infection, for example, it's often in the abdomen, okay? There's- there's some infection, and that infection could be really dangerous, right? If that infection spread, well, it could go to the blood. The- the person could, uh, could die from that, right? So the body does a really good job of walling off that infection, right? And- and that's a good thing, right? Because if the infection weren't walled off, it poses huge risk. But the walled off infection does not represent a condition of health. So someone who has an abscess in them and doesn't know it, this happens frequently in medicine. We see people coming to emergency rooms and, you know, they have a low grade fever and they've had a low grade fever for a while, and they just don't feel good and they have low energy and they're not sleeping well and they find themselves sweating a lot. There are pervasive experiences going on that are really detracting from life, like not feeling great all the time even though the person doesn't feel really sick. That's sometimes why it takes a while for the person to come to medical attention. So what's going on is better than not being walled off, but it is not synonymous with health. So what happens in physical medicine abscess is identified and then someone goes in, a surgeon goes in and drains it, right? And then the person is better, right? Now, think about that process. Like surgery, surgery is not, like, a fun thing, right? There's anesthesia, there's recovery, right? But surgery is great when it cures the problem, right? So it's not that, oh, the- the- the physician in the emergency room or the family practice doc, you know, identifies that there's an abscess, refer to the surgeon, everything is great and happy and they're better. No, they have to go have a surgery, and that's not an easy thing, right? But if they go and do that on the other side, the infection actually is gone, so they do not have the symptoms that was constantly spinning off inside of them, and they also don't have the risk that maybe that infection gets out of the abscess and- and their- their life is then at risk. So the- the parallel is looking into the unconscious mind to what is inside of us that may be acting like that abscess. Even though this is an analogy, it is not theoretical. Like, this happens all the time. And the abscess inside that person emotionally may be the bullying that went on right around the time of puberty, right? It may be that awful boss who was just so mean and, like, took that good job away from me, right? It might be that. It might be, you know, that assault that I don't want to think about that's really still with me. It might be that death I still feel guilty about. I don't know what it is, right? But if there's an abscess in there, we want to understand it and then fix it, cure it, right? And that's what the therapy process can do and that's why at times the therapy is unpleasant, you know, the crying and the anger, you know, that's the parallel of going through the surgery, right? But on the other side, we've dissipated the energy inside of it. Like, we've- we've- we've taken care of it. And- and that's why it is so important to go into the unconscious mind if there are things that are really troubling us or if we don't know what's going on to cast a net of inquiry that may lead us there because trauma is so common and we shove trauma underneath the surface because of the guilt and shame that it generates, and then it stays in us like an abscess and spins off symptoms. They could be symptoms of diffidence, they could be symptoms of overusing a substance, they could be symptoms of avoiding good things in our life, but they're- they're pervasive symptoms that are really harmful to us that we can understand and fix.

13. 1:01:57 – 1:10:48

    Exploring the Unconscious Mind, Curiosity, “Question the Givens”

    1. AHAndrew Huberman1:01:57

       In addition to quality therapy, what are some other ways to access the unconscious? Earlier we were talking about journaling and spelling out one's life narrative in written or in spoken form, either alone or with a trusted other. Let's assume that somebody either can't afford or is just not at the place where they're willing to do therapy yet, um, but they fully adopt this abscess model that, uh, or this abscess analogy, um, that you described, which I think is, uh, an exceptional one because, um, A, you have the, uh, you know, 20 plus years of clinical experience knowing this exists, but also, um, I think we all at some level can understand that there's stuff happening within us that, uh, we can't explain. And, uh, and I as a neuroscientist can absolutely say that, you know, most of the neural machinery in your head (laughs) uh, and the parts of it that are in your body, like, we don't have access to it, right? We love to think that we do, but, but we don't. It's just clicking away under there. So let's say somebody wants to, um, make some progress, really improve their level of, of mental health, more, obtain more agency and gratitude, improve all aspects of their life and their generative drive, what are some ways that they can start to tap into the unconscious? Um, and my guess is if it's not in therapy, it's going to be by looking at some, in some of these other cupboards as you're describing them.

    2. PCDr. Paul Conti1:03:24

       Right, right. Yes, develop and embrace curiosity about yourself, right? And if you can, go for that curiosity being dispassionate, right? In, in, in the sense that, you know, you talk about these files you have with your, with, uh, memories and events from your past, like, that's so good, right? Because you're exploring your life, right? So, so someone who, who wants to understand themselves better, do that for yourself. Go look at pictures, talk to people you knew at different stages of life, reflect upon how you behaved at different stages of life, what you felt inside. Anchor yourself to memories and then extrapolate from there. Become curious about yourself. And if you can be dispassionate, this idea that sometimes gets called an observing ego, right? There are other words to put to it, but it's, it's not ego in a negative sense, right? Here it means the ability to stand outside of oneself and go, "Huh," right? And to really think about oneself without the negative emotion. We're often able to either see the trauma, for example, or see the change, like, "Huh, why did I go from feeling really good about myself," and, like, "I felt like I could do anything and then just a couple years later, man, I, look at me. I'm mopey in the pictures," and, you know, and then think, yeah, I was drinking more, I stopped taking care of myself. Like, that's a pretty big change, right? And then, so, so now, like, we're calling attention, what's that change? And a lot of times the person knew it, you know? Like, "Oh, I got rejected. I had that terrible breakup," right? And like, they a- they knew it was a terrible breakup, but they keep shoving it under the surface. Maybe they didn't know it was a terrible breakup. Maybe they can't figure out what it is. Like, that's okay, right? Even if they recognize, look, there was a change, then that will put the lie to what in this example is likely going on. So that person likely frames themselves in a way that is very negative and always was true, right? So, so, "I can never achieve anything. I never feel good. No one likes me. I can't find a partner." Whatever it is we say to ourselves, the person ex- it's always been that way, right? Because the negative emotion is so strong and that part of our brain doesn't care about the clock and the calendar, and then the person goes back and thinks, "It was not always that way," right? And it comes to this a lot in therapy. It doesn't have to be, as you said, in therapy, but no, you know, "I was a go-getter," right? Again, I'm thinking of the person who said, "I was a go getter and I went out there and did things," which put the lie to her saying that she was lazy, incapable, all those things that were not true, but she accepted as truth, right? So what she needed from that mathematical perspective, like to go back and question the givens, right? From our perspective, we're saying go look in the unconscious mind, go look in that part of the pillar of the structure of self. Go look there. That's the deepest part, the most complicated part, but it doesn't mean we can't understand it, and if we start to gain understanding, then we can think more about the conscious mind. Like, wha- wait a second, what am I thinking about? What do I think about that, right? Have I really thought about this or is it just running over and over in my head? What would I like to do about it? Maybe I'd like to learn more. Maybe I want to go get a book that I think could help me listen to another podcast, that could help me talk to a friend, like, maybe I want to do those things. So now the flow between the unconscious mind and the conscious mind, right? Becomes much more robust and that lets us look further, right? To look at the next level up, the defense mechanisms that grow up out of the unconscious mind and, and we can have some understanding of them even though they're unconscious, right? So the idea of wait, what, when that, when something shifted in me, how did my way of engaging with the world kind of change, you know? Like, I was perseverant and, um, you know, I would take some of that energy in me that wasn't so good and me- I could put it into, like, exercising, taking care of myself and then, you know, then that sort of shifted and became psych- sarcastic and cynical and, you know, I started avoiding m- you know, those of my friends who were really taking care of themselves and doing well because that made me feel worse about myself. So, so that's a dialogue that is reflective of defense mechanisms. Now, the person isn't gonna n- gonna necessarily say, "Oh, I used a lot of sublimation, which is good, and then I started using reaction formation and avoidance," just as an example, right? But they're gonna understand that in, in words that they can, whatever words they put to it, they understand that there was a change. They can start putting... They put words to that. They can understand that process of change. It's not opaque. They're shining light on it, and now they can gain a better understanding of it and they can change it. Even that realization that I was much more functional, things were different.I mean, that can be a treasure trove of very relevant, very important, and very positive information to bring to the current situation.

    3. AHAndrew Huberman1:08:22

       I think we often romance the idea of the person who can just live life forward, who doesn't look back-

    4. PCDr. Paul Conti1:08:29

       Mm-hmm.

    5. AHAndrew Huberman1:08:29

       ... right, who just doesn't really explore their past, it's just action-oriented, because after all, when we wake up in the morning, all we can control is our actions going forward.

    6. PCDr. Paul Conti1:08:38

       Mm-hmm.

    7. AHAndrew Huberman1:08:38

       We can't re-script the actions of past-

    8. PCDr. Paul Conti1:08:41

       Mm-hmm.

    9. AHAndrew Huberman1:08:41

       ... ours or others.

    10. PCDr. Paul Conti1:08:42

        Right. Tha- that is such a good point of, what happens when we're just looking forward, right? We become like a sprinter who comes out of the blocks too fast, right? So if you think about th- the beginning of 100, 100-meter dash, right? Th- they're the best sprinters in the world, say, right, and there they are in the blocks, and if they come out of those blocks in the right way, they will gain momentum, they will keep their form, and they will run as fast as they can. But if they do not pay attention to what is behind them, the blocks that are supporting their body, right, the whole bigger picture here of the limitations within the body, right? They have to know what those limitations are, they have to understand themselves. That's how they avoid coming out of the blocks so fast and then sprawling headlong onto the track, and we see that happen too. So if we're just looking forward in thought and idea, that's how to live life, we will be tripping forward and ultimately we'll be like that sprinter. No matter how great a sprinter, if you come out of the blocks too fast, you're going to trip forward.

    11. AHAndrew Huberman1:09:44

        Yes, I know I said this in a different form a few minutes ago, but I think a lot of people are afraid of self-inquiry because they just don't want the thing that they discover, which resides in their unconscious, the abscess, if you will, or the, uh, the damaging thought or thing that happened which they are aware of but are pushing down, to take over their daily life in a way that doesn't allow them to be at least as functional as they are in the moment.

    12. PCDr. Paul Conti1:10:13

        If you go visit the person who had the abscess cured by the surgeon on post-op day one, that person will be less functional, right? They'll be in a hospital bed, right? They won't be able to get up out of the bed, they won't be able to exercise, they're gonna feel, they're not gonna feel their best, right? That's okay, right? It is okay that we at times can become intermittently, say, less functional, right, in the sense that we're more upset, that I'm spending more time crying, right? That's okay because that's part of the energy, the effort, the choice that gets us to a better place.

14. 1:10:48 – 1:19:20

    Conscious Mind Exploration; Self Curiosity, Busyness

    1. PCDr. Paul Conti1:10:48

    2. AHAndrew Huberman1:10:48

       Okay, so it's clear to me why exploring the unconscious mind can be, and really is, immensely valuable.

    3. PCDr. Paul Conti1:10:54

       Mm-hmm.

    4. AHAndrew Huberman1:10:54

       It's just... I'm convinced and, um, I can't imagine anyone out there who would disagree with the idea that getting better mentally, being able to function better in the world as a consequence, i- is not a terrific use of one's time-

    5. PCDr. Paul Conti1:11:11

       Mm-hmm.

    6. AHAndrew Huberman1:11:11

       ... even if it, uh, you know, at the surface seems to take us off course a bit in the, in the moment or, uh, for even a few days. And I think it's also, uh, worth highlighting that it's not the case that if we do an exploration of the unconscious mind or look in any of these cupboards for that matter, that our entire day is going to be overtaken by it or all of our sleep is going to disappear. I mean, we're not talking about, um, uh, a process in which w- everything is d- devoted to exploring these cupboards. I mean, there are instances, of course, where someone hits a crisis and they, they simply can't-

    7. PCDr. Paul Conti1:11:43

       Right.

    8. AHAndrew Huberman1:11:43

       ... function but in that case, the thing they absolutely need to do is to look in these cupboards.

    9. PCDr. Paul Conti1:11:47

       Yes.

    10. AHAndrew Huberman1:11:48

        What are some ways that we can explore this other cupboard under the pillar of structure of self, uh, which is the cupboard of the conscious mind?

    11. PCDr. Paul Conti1:11:57

        Mm-hmm, mm-hmm. So we can also approach this through the, the curiosity of self, right? We do a lot of things automatically, right? That we can stop and think about, like, "Why do I do that thing?" Right? And it's amazing what that can provide, right? So for example, um, I'm working with a person who has been going to work for a long, long, long, long, long, long time, right? Didn't need to go to work a long time ago, right? And there's so many other things this person wants to do with their life. They're curious about things, they want to spend more time with older people in their family, right? But they had to stop and think, "Why am I going to work," right? Now, he's fortunate enough that he doesn't have to. He also earned... You know, he's, he's hardworking, he's diligent, he's fortunate, but he hadn't thought about it. He's been going to work automatically for a long time and it was the thinking about it that, that made him realize, "I, right, I do that automatically." Now, why? Because it's rooted in, in unconscious things but that he's now bringing to the conscious mind, right? Because I value hard work and I value diligence, right? But him stop working doesn't mean that he's not har- you know, he's not innately hardworking or diligent but he's shown that for years and years and years and he can show it in other ways, like by, you know, how... He wants to be attentive to older people who need help. Like, there's a lot he can do but he had to go back and look and then, of course, there's a reason why he didn't realize it, right? And even though it's not even a bad reason but, but clearly there was then an overvalue of hard working, diligent and he didn't realize, "Oh, I... Like, I've done that," right? "Like, I've done enough that I've convinced myself. Like, I know I'm hardworking, I know I'm diligent, it's okay, I don't have to sort of serve that internal master anymore t- and then I can step away." And now his whole life has changed but how'd the change come about? By asking what might, one might think is such a simple question that make no sense like, "Why do I go to work each day? Why have I been going?" He's, he's off on the road to change so, so that's... I- it's one aspect of, of how we can explore the, the conscious mind. It often lead us back to the unconscious mind, right? But it's awareness of our conscious choices, right? We can also then use tactics so for example, cognitive behavioral tactics like thought redirection. Like, if I'm aware that, hey, there's a thought that comes into my mind a lot and I start learning ways I can redirect away from it instead of thinking about it 100 times, right?

    12. AHAndrew Huberman1:14:23

        Mm-hmm.

    13. PCDr. Paul Conti1:14:23

        And if I learn how to do that, there's less of the negative emotion that comes from thinking about it and, and I can start to feel better, right? It's the basic premise of it but these are techniques that can really help us and they involve understanding and guiding the conscious mind.

    14. AHAndrew Huberman1:14:39

        I'm smiling because I'm recalling an experience I had. Uh, I have a female friend who, very impressive person really, uh, has overcome a ton, uh, is a recovered alcoholic for many years, um, and takes, at least by my read, great care of herself and the other people around her, and has a spectacular sense of humor and a bunch of other things. But it's probably five, six years ago that we were in conversation about something, I don't recall what, and out of apparently nowhere, she, she said, "I hate being busy." And it just stopped me in my tracks because I'm somebody who, um, keeps very, very busy. I, my schedule is extremely full with things that I really enjoy. Some things I don't enjoy or enjoy less, but, um, fortunately at this point in my life, mostly things that I enjoy. At the time, I was very, very busy with many things, including many things I didn't enjoy. And her statement just halted me. And I realized, you know, maybe I don't have to be busy. Like, like what this whole notion of doing a bunch of things I don't want to do. Like sure, we have to make our way in the world and make a living and take care of ourselves and others, but, but I realized that there was a lot of extra stuff that I was doing.

    15. PCDr. Paul Conti1:15:50

        Right. 'Cause I think-

    16. AHAndrew Huberman1:15:51

        But-

    17. PCDr. Paul Conti1:15:51

        ... what she meant and what you were reflecting on was, I hate being automatically busy.

    18. AHAndrew Huberman1:15:57

        Right.

    19. PCDr. Paul Conti1:15:57

        Right? It's not good to be automatically busy and then it makes you think about, wait, wh- how am I busy in ways that are good for me and how am I busy in ways that are not? Am I just taking up time, you know, to avoid something? You start really thinking about it.

    20. AHAndrew Huberman1:16:09

        Yes. And the conversation stays with me to this day, because up until then I never really thought about the possibility that some or a lot of the things I was doing were truly a waste of my time. Like, it, mostly because I could be putting that energy into generative j- things, right? Generative drives. Things that would bring me agency, gratitude, peace, contentment, delight.

    21. PCDr. Paul Conti1:16:34

        Yes.

    22. AHAndrew Huberman1:16:34

        These sorts of things. What I'm giving as an example, I realize is quite different than sitting down in a chair and asking oneself questions about, uh, one's self and, and one's schedule and what one's doing.

    23. PCDr. Paul Conti1:16:45

        It's the same endpoint. Same endpoint, right?

    24. AHAndrew Huberman1:16:46

        But, but it, right, same endpoint and, and I bring it up because, um, I think it was the fact that it stopped me in my tracks, but also the fact that I can't seem to forget it.

    25. PCDr. Paul Conti1:16:57

        (laughs)

    26. AHAndrew Huberman1:16:58

        That means that it must have had significance. And I, and I would say that has had significance. Because, you know, I think most people are familiar with, um, seeing these, uh, news articles that come out, you know, you know, woman or man, you know, 104, reflects on what really mattered in life, and it's, it's almost always the same things. It's like close relationships, it, what, you know, no one on their deathbed says, "I wish I spent more time at work." I might be one exception, I actually really enjoy my work, so whenever I see that one, I always think, no, like, my life without my life's work, it would've been a diminished life for me.

    27. PCDr. Paul Conti1:17:28

        Mm-hmm. Mm-hmm.

    28. AHAndrew Huberman1:17:28

        (laughs) Um-

    29. PCDr. Paul Conti1:17:28

        Mm-hmm, mm-hmm.

    30. AHAndrew Huberman1:17:29

        I think there are others out there as well. But I think it's very hard for us to place ourselves into the future of a person on our deathbed looking back and then make really good decisions now. I think there are ways to do that, but it seems that it's far more powerful to just think about what am I doing now? And, and make some, uh, you know, and come to some realizations about what is really of value now and what is of less value or no value now, and then make adjustments now be- as opposed to doing the deathbed exercise.
15. 1:19:20 – 1:24:54

    Exploring Defense Mechanisms, Character Structure

    1. PCDr. Paul Conti1:19:20

       I don't know yet.

Episode duration: 2:41:12