The Brutal Reality For Most Men Today (& how to fix it) - Dr K HealthyGamer

1. 0:00 – 4:55

   Why Young Men Are So Vulnerable to Addiction

   1. CWChris Williamson0:00

      People of the UK and Ireland, if you're coming to my live shows this October, there is a chance that your story could end up on stage. Worst first dates, problems that you need solved by me, you will not believe that this happened stories, and much more. I'm going to be reacting to my favorites live, plus doing a Q&A where you can ask me about relationships, careers, existential crises, or whatever questionable life decision you're currently considering. I've spent over a year building brand-new stories and ideas, and it is hands down the best thing I've ever put on stage, and you can get your tickets now at chriswilliamson.live. That's chriswilliamson.live. Can you look at this chart for me?

   2. KDr. K0:34

      Yeah, sure.

   3. CWChris Williamson0:34

      One in eight young men watch porn, gamble, and play video games every day or more. Almost one in four gamble daily. More than one in four use porn daily, and only 26% do none of them. What do you make of that?

   4. KDr. K0:50

      Oh, what do you make of that? [laughs]

   5. CWChris Williamson0:53

      Well, [laughs] it... The issue here is about once a day or more often.

   6. KDr. K0:59

      Okay.

   7. CWChris Williamson0:59

      Um, I wonder, we don't know what the life of people that are doing this are like. We don't know what the lives of them are like. Is this compulsion? Do they wish that they could do it less? Is this something that borders on an addiction or something that's kind of, uh, guiding their life, taking over their life? Or is this just a natural response to a world that's maybe been tapped of meaning, and this is a good coping strategy for 74% of men to get through? I don't know. Um, but you-

   8. KDr. K1:32

      Yeah. So I, I, I-

   9. CWChris Williamson1:33

      ... work on this much more than me, so you can probably see through the headline a little bit more deeply.

   10. KDr. K1:38

       Yeah. So I, I think the answer is yes.

   11. CWChris Williamson1:40

       Brilliant.

   12. KDr. K1:40

       [laughs] So I, I think-

   13. CWChris Williamson1:41

       Thanks for coming, everybody.

   14. KDr. K1:42

       Yeah. So, so, so, you know, are... Is it a compulsion? Yes. Is it a coping strategy? Yes. Are people's lives devoid of meaning? Yes. Is technology getting addictive? Yes. So the first thing that I, I wanna kinda point out here is that there are three things, right? Gambling, pornography, video games. So generally speaking, when you see multiple overlapping things, they tend to have a shared etiology, right?

   15. CWChris Williamson2:07

       Mm-hmm.

   16. KDr. K2:07

       So these are symptoms.

   17. CWChris Williamson2:09

       Mm.

   18. KDr. K2:09

       Sure, they have their own, like, diagnostic criteria and things like that, but I think what this is... What, what I... Men are jerking off, gambling, and playing video games. Yes, this is correct.

   19. CWChris Williamson2:20

       Yes.

   20. KDr. K2:21

       Um, and, and to me, if you look at sort of, uh, uh, things from an addictive perspective, so all three of these activities are addictive. Um, what are the... What's the core feature of addiction? Something that gives you pleasure and takes away pain. So all of these three things do that. So anytime you're looking at compulsive behavior, this is at the root of it.

   21. CWChris Williamson2:43

       Mm.

   22. KDr. K2:44

       So then the question becomes: What is pleasurable, pleasurable about these things? And more importantly, what is the pain that's being taken away?

   23. CWChris Williamson2:52

       Mm.

   24. KDr. K2:52

       So oftentimes, I think there's a, a, a big kind of misemphasis on addiction. When people talk about addiction, they talk about dopamine predominantly. But if you look at an addiction, addiction has three stages. In the first stage of your addiction, it gives you pleasure, and it takes away pain. But then what happens is we develop tolerance to the pleasure. So if you ask most people who gamble, play video games, or watch pornography, they won't say that, like, this is a huge source of pleasure.

   25. CWChris Williamson3:23

       Mm.

   26. KDr. K3:24

       So prior to being addicted, you can say, "Oh man, this weekend is coming around. I'm gonna play lots of video games. It's gonna be great."

   27. CWChris Williamson3:30

       Mm. Mm.

   28. KDr. K3:30

       But as you progress into this, people aren't, like, looking forward to it. They're like, "Man, I can't wait till I have vacation this... at the end of the month, and I'm gonna just, like, jerk off a whole lot and just-

   29. CWChris Williamson3:39

       [laughs]

   30. KDr. K3:40

       ... I'm gonna, I'm gonna go to Mexico, and I'm gonna take a, a, a laptop and, and-"
2. 4:55 – 13:59

   Are Video Games Actually Bad For You?

   1. CWChris Williamson4:55

      else daily.

   2. KDr. K4:55

      Are you okay if I ask you questions?

   3. CWChris Williamson4:57

      Sure.

   4. KDr. K4:58

      Okay. So what do you... Do, do you play video games?

   5. CWChris Williamson5:01

      No.

   6. KDr. K5:02

      Okay. What do you know about video games?

   7. CWChris Williamson5:04

      I played a lot in uni and stuff-

   8. KDr. K5:05

      Okay

   9. CWChris Williamson5:06

      ... and then business became my video game.

   10. KDr. K5:08

       Okay. So, so what w- why did you used to play video games? What did video games do for you?

   11. CWChris Williamson5:12

       Uh, they were a way to pass time when I was bored. They were a way to connect with my housemates because a lot of them did-

   12. KDr. K5:18

       Yep

   13. CWChris Williamson5:18

       ... too. I was living in, you know, like, a five-person house in university. I used to play Borderlands, and you could play-

   14. KDr. K5:24

       Mm-hmm

   15. CWChris Williamson5:24

       ... Borderlands co-op locally-

   16. KDr. K5:26

       Yep

   17. CWChris Williamson5:26

       ... which was sick-

   18. KDr. K5:27

       Casual co-op

   19. CWChris Williamson5:27

       ... because it's you and another person doing the same thing, talking shit to each other, but, like, working on a team but complaining about stuff. Borderlands 1, 2... Pr- pretty sure I completed 1, 2, and maybe even 3 with my housemates.

   20. KDr. K5:41

       Yeah.

   21. CWChris Williamson5:41

       So sick. I loved that.

   22. KDr. K5:42

       Yeah.

   23. CWChris Williamson5:43

       That was great.

   24. KDr. K5:43

       So-

   25. CWChris Williamson5:44

       Also a massive fan of watching people in the house playing a video game that I'm not a part of. So if I watch someone play Fortnite, if I watch someone play FIFA, one of my favorite things to do because I get to shit talk them-

   26. KDr. K5:55

       Yeah

   27. CWChris Williamson5:55

       ... while they're playing.

   28. KDr. K5:56

       Yeah.

   29. CWChris Williamson5:56

       And I get to comment on their, like... So I, I enjoy video games. I watch a lot of, uh, like, uh, reviews of video games. Obviously GTA has just come out, and I'm, like, enjoying seeing the fallout of that, but I don't have really any desire to play Video games. Not now, not anymore

   30. KDr. K6:12

       Why do you think that is?
3. 13:59 – 22:45

   Why Gambling Is a Terrible Success Strategy

   1. KDr. K13:59

      Then we end up with gambling, which is really interesting because there's a lot of research coming out about this. Gambling is like a whole different ballgame, so with just different neuroscientific mechanisms, and especially if we're talking about young men. One of the, um... What's the right way to put this? One of the more unique things about gambling is sometimes the reason people get addicted to gambling is because we live in a society where it's hard to be a successful man.

   2. CWChris Williamson14:31

      Mm.

   3. KDr. K14:32

      So the standards for men have not changed, but the, uh, the expectations of me- for men have not changed. If ar- if any- anything, they've gotten arguably more difficult, and the capabilities of men have decreased.

   4. CWChris Williamson14:45

      Mm-hmm.

   5. KDr. K14:46

      So, uh, uh, many women will still want a male partner who makes more money than they, they do, but if you look at, like, college matriculation rates and things like that, fewer and fewer men are going to college, more and more women are going to college. So there, there's kind of this really rough gap between what society expects of a man and what a man is capable of, and that gap is widening. So one of the simplest ways to solve that gap is to make it big in gambling. So this is the kind of stuff that I don't think you'll see much research about. I've, I've seen a couple of papers. This is really more clinical experience. When I, when I talk to people who gamble-

   6. CWChris Williamson15:23

      Mm

   7. KDr. K15:23

      ... and I get into it, like, you know, "How do you feel about yourself? What's going on in your life?" They all wanna make it big, and they don't know how. And then gambling enters the picture, and now you, you have a big problem because the root of gambling is, "I wanna be someone one day. I, I wanna have what everyone says I should have. I wanna have what everyone... You know, what I see other people having. I, I wanna have..." And, and it's not like they all, they want a bunch of cocaine and bitches and, and yachts and stuff like that, right? But they, they wanna be able to h- buy a house. They wanna be able to take their partner out. They wanna have freedom and security in life. But college is all messed up because of AI and lower matriculation rates and things like that. So there is a future that many men are grasping for that they don't know how to get, and one really, really, really simple way is to win it in gambling.

   8. CWChris Williamson16:18

      You know what's interesting? I was talking to Paddy Galloway. Do you know Paddy?

   9. KDr. K16:20

      Mm-hmm.

   10. CWChris Williamson16:20

       YouTube, uh, uh, wizard of YouTube. He's employed by Google to help them do their own YouTube channel.

   11. KDr. K16:26

       Okay.

   12. CWChris Williamson16:26

       He's pretty fucking hilarious.

   13. KDr. K16:28

       Yeah.

   14. CWChris Williamson16:28

       He's, like, kind of the guy at the top of the tree. And, um, he was telling me, 'cause he's got access to all of these channels behind the scenes and all of this proprietary data and stuff like that. We were at dinner, and he was saying, uh, in 2019, 2018, 2019, all of the biggest finance niches were, uh, slow investing, dollar cost average, S&P, 401 (k) , uh, tax efficiency. It was long-termism, long-termist thinking. And the biggest financial niches in 2026 are all make cash fast, uh, prediction markets, Kalshi, Polymarket, um, crypto. And I know we went through a crypto NFT wave as well.

   15. KDr. K17:09

       Yeah.

   16. CWChris Williamson17:10

       Kind of in the middle of that, we had a wobble. But what is being talked about online, and he, he thinks that this is a, um, wind changing of people wanting to try and make it big quick. Uh, I think maybe concerns about AI, uncertainty about the future, geopolitical ins- instability, stuff like that. Like, "Ah, I just don't know what's going on. I don't know the future. Like, I'll just YOLO."

   17. KDr. K17:30

       Yeah.

   18. CWChris Williamson17:31

       You know? Like, uh, what's it called? Fast life strategy. Uh, it's kind of an equivalent of that, but it's fast money strategy in the same way. But if you were to think, um, globally, that's caused everybody to be like, "I don't know what's going on. I don't know how to make it. I'll just go harder." That's... Some of those things are, like, gambling adjacent and, um, uh, or ga- di- direct gambling advice, and that kind of plays into what you're talking about here too.

   19. KDr. K17:53

       Yeah. So I, I, I think it's... I mean, it... We can go as wide or as narrow as you want, but I, I think this speaks to, like, a broader problem, which is that... So things are, like... This wasn't, this wasn't what I was planning on talking about today, but this is something that I've been really mulling over. Things are, like, really reaching a critical point, and something fundamental is, like, breaking in our society. I, I think we're, we're seeing, like, a midlife crisis of sorts in humanity.

   20. CWChris Williamson18:22

       Hmm.

   21. KDr. K18:22

       Like, so I, I think a lot of what's happening, a- and I think men are sort of feeling the crunch of this in a different way, and we can talk about how women are feeling it. But I, I, I think when we-- w- well, what's going on is, like, there used to be a path to success, right? The, the, there used to be this thing, and especially if you look at men, uh, uh, the core psychological problem that men need to solve is conquering themselves. So if you look at, like, most of the advice out there, most of, of what men need to do, they struggle with themself, and it's about getting the most output out of yourself.

   22. CWChris Williamson18:57

       Hmm.

   23. KDr. K18:57

       If you know how to bring out the best part of you, you can do fine in life, right? That, that's what-- uh, y- this is just my experience of sitting with men and things like that. There's some psychoanalytic literature that kind of supports this. But it- it's kind of like arguably I'm competing against other men, but if you sort of think about what is the lever that I pull, it's my own effort, right? How do I beat somebody else at football? I practice harder, I train harder, I get better. So the, the core issue is effort. And then what's really interesting, this is a little bit of a shift, but then if we look at what triggers a midlife crisis, um, which I went through recently myself-

   24. CWChris Williamson19:37

       Mm-hmm

   25. KDr. K19:37

       ... it was a fantastic experience. It, it's that the realization that when you're young, the main thing you need to do is, generally speaking, work harder, right? So there's, like, a lot of options, and if you put forth the effort, you've got, "I'm 20 years old, I have 60 years on the planet," right? "And if I work hard every day, if I can bring a lot of effort every day, I can become married, I can get-- I can have kids if I want, I can develop a career. I need to extract the potential from myself." Midlife crisis psychologically happens when that strategy no longer works.

   26. CWChris Williamson20:12

       Hmm.

   27. KDr. K20:13

       So at some point, you wake up and, and in my case, I'm 43, and then you realize that, "Oh, crap, working harder is fundamentally not going to solve my problems anymore. It solved my problems when I was 21 and addicted to video games and all this, all this good stuff. It doesn't solve my problems anymore because there's just not enough time left. I can work as hard as I want to for the next 40 years of my life, and it, it's not gonna get done." We're-- midlife is actually 36, which is, like, really scary, okay? So we understand this from the, the psychological literature, and if you look at what's happening in society, hard work doesn't work anymore, especially in places like America. So we have this-- in America, we have this idea, right, of, like, the American dream, which is, like, independence and working hard and, and pulling yourself up by your bootstraps.

   28. CWChris Williamson21:00

       Meritocracy.

   29. KDr. K21:00

       Meritocracy. A- and this is, this is the right way. Well, this is really scary, but we've sort of assumed that meritocracy is, like, kind of the best way to navigate life. But this is not working anymore, right? So, so co- you know, college used to be a secure path to, uh, it used to be a path to financial security.

   30. CWChris Williamson21:22

       Hmm.
4. 22:45 – 28:21

   Are AI and GLP-1s Doing More Harm Than Good?

   1. KDr. K22:45

      Really scary. A lot of people don't realize... And I'm going off, off-

   2. CWChris Williamson22:49

      Oh, dude, I-

   3. KDr. K22:49

      ... off the leash but-

   4. CWChris Williamson22:49

      I'm fucking loving this. You're cooking.

   5. KDr. K22:51

      So, so j- j-

   6. CWChris Williamson22:51

      Keep going

   7. KDr. K22:51

      ... just a simple example.

   8. CWChris Williamson22:53

      You are cooking a chicken korma, though.

   9. KDr. K22:54

      So we used-- like, everyone has body image issues, right? And so everyone wants to be thin, and everyone wants to be beautiful, and, like, social media is a big part of that.

   10. CWChris Williamson23:03

       Yep.

   11. KDr. K23:04

       So then along comes a medication which is amazing, because this medication makes it so that you don't want to eat. So this is what's really scary about society. Up until now, human beings have had to obey the laws of physics, that if you want something in life, you have to put something in. And what scares me about semaglutide is up until now, if you wanted to be healthy, if you wanted to have-- if you wanted to lose weight, if you wanted to get fit, it required you to put in a certain amount of effort.

   12. CWChris Williamson23:42

       An honest signal. The body that you had was an honest signal of the effort that you'd put in.

   13. KDr. K23:46

       Uh, uh, there's-- but yes. But, uh, there are variables that go into that, like upbringing and, and stuff like that, and whether you're in a food desert. But basically, yes, like you, you had to work for stuff in life. And I think that that's good, and the reason that it's good is because the body doesn't wear out. It rusts. So the more you use your muscles, the stronger they become. The more that you write essays yourself, the more intelligent you become. Human beings have, have gotten stupider for the first time in the history of recorded IQ.

   14. CWChris Williamson24:16

       Is that the Flynn effect?

   15. KDr. K24:18

       I don't know what the Flynn effect-

   16. CWChris Williamson24:19

       To re- re- can you... ChatGPT, is the Flynn effect about IQ? I'm pretty sure that the Flynn effect is people got smarter basically throughout all of human history-

   17. KDr. K24:26

       Yes

   18. CWChris Williamson24:26

       ... if you were to grade them by IQ. Slowly, slowly, slowly get smarter, uh, and we Gotten dumber for like the last decade?

   19. KDr. K24:34

       Uh, probably

   20. CWChris Williamson24:35

       Two decades?

   21. KDr. K24:35

       Yeah.

   22. CWChris Williamson24:35

       Yeah.

   23. KDr. K24:36

       So, so for the first time in the history of like g- recorded IQ measurements-

   24. CWChris Williamson24:39

       Yes. Here it is. Scroll up for me. Uh, the Flynn effect is specifically about IQ scores. It refers to the observation first documented by a political scientist, James Flynn. The average IQ test score has increased substantially throughout the 20th century in many countries, many developed nations.

   25. KDr. K24:53

       Yeah.

   26. CWChris Williamson24:53

       The increase was roughly three IQ points per decade. Uh, and has the Flynn effect stopped? In many developed countries, yes, since the 1990s or early 2000s, researchers have found that IQ gains have plateaued in some countries and reversed slightly in others, sometimes called the negative Flynn effect.

   27. KDr. K25:10

       Yeah. So, so, and this is happening. So the, and, and what's happening is, is, especially if you look at IQ reductions, I see this a lot, so I have friends in academia and stuff, and like, the more that people use AI for stuff, the stupider they get. And there, there's lots of good studies that show this. So the MIT released a study a couple of years ago that showed a decay in critical thinking skills with AI use.

   28. CWChris Williamson25:34

       Yep.

   29. KDr. K25:34

       And, and w- you know, AI is basically like taking the elevator instead of taking the stairs for your brain. So what, what's happening is something weird is going on where like society is progressing, but human beings are getting worse. And as we get worse, like things are really starting to come apart at the seams. I think we sort of feel it. We see evidence of it in, in, in mental health. Um, but we were talking about Ozempic. So basically what happened is, uh, up until now, you've had to work to get something, right? And along comes semaglutide and these GLP-1 agonists, and suddenly you don't have to work to get something. You take an, an, an injection, and then your cravings get reduced, and then we're starting to see some really scary things around GLP-1s. So they're amazing medicines because if you have, if you have like, if you're overweight and you have like cardiac risk factors, um, endocrinology risk, risk factors like di- type 2 diabetes and stuff like that, the- these medications are amazing at all this kind of stuff. We're also seeing some really cool mental health effects, so we're seeing reductions in cravings on alcohol. Um, we're seeing, uh, improvements in even things like nicotine cessation and stuff like that.

   30. CWChris Williamson26:52

       Weeds? I think it's-
5. 28:21 – 38:01

   The Binge Eating to Eating Disorder Pipeline

   1. KDr. K28:22

      It's a simple example of GLP-1. Fascinating study. If you take someone who has a binge eating disorder and you do cognitive behavioral therapy on them, the more weight that they lose, the more effective the car- uh, cognitive behavioral therapy is, the higher their risk is of developing anorexia. That's correct. It's confusing. If I have a binge eating disorder and I lose 50... If I lose 20 pounds from seeing a therapist around my binge eating disorder, rate of anorexia is low. If I lose 50 pounds from cognitive behavioral therapy, my a- rate of anorexia increases. So rapid weight loss is an independent risk factor for developing anorexia, and we see this, right? We see this. We see that if you look at celebrities, if you just take pictures, like you could just take a collage of celebrities from now versus 20 years ago, if you take a collage of like Instagram influencers or whatever, you will see that like eating disorders are shockingly on the rise. We're also seeing equality with like looksmaxing, where there's a, a, a drastic level of body dysmorphia-

   2. CWChris Williamson29:33

      Hmm

   3. KDr. K29:33

      ... in, in men now.

   4. CWChris Williamson29:34

      Hmm.

   5. KDr. K29:34

      And so there, something weird is going on where like as we move away from the laws of physics, like as we move away from this fundamental idea that if you want something in life, you have to pay something.

   6. CWChris Williamson29:46

      What do you think is the mechanism for that binge eating to anorexia pipeline?

   7. KDr. K29:51

      Um, it's a fascinating question. So I think there are two or three different factors. One is... So one is... This gets a bit complicated, but let me... So if you look at what is the, what is the psychological makeup of someone who loses 20 pounds versus someone who lose, loses 50 pounds?

   8. CWChris Williamson30:14

      Hmm.

   9. KDr. K30:14

      First thing that you can argue is that someone who's likely to lose 50 pounds is more motivated to begin with-

   10. CWChris Williamson30:19

       Hmm

   11. KDr. K30:20

       ... is more concerned about their appearance to begin with. So I don't think it's a direct effect necessarily of just CBT.

   12. CWChris Williamson30:25

       There's a, there's a selection effect going on here to some degree.

   13. KDr. K30:27

       Absolutely. Right? So the, the harder that you, the more-

   14. CWChris Williamson30:30

       Hate yourself or are motivated to look good or whatever.

   15. KDr. K30:33

       Absolutely. So that probably is part of the reason for it. It's not that the weight loss itself is all causal. It's that the people who lose more weight are more, more motivated to begin with, maybe have more body-

   16. CWChris Williamson30:42

       I h- I have to assume as well, like, yeah, body dysmorphia or, or, um, mirror hatred, uh, but also- People that are anorexic, they must have a good amount of willpower. Like I-

   17. KDr. K30:54

       They have a ton of willpower

   18. CWChris Williamson30:55

       ... I have to imagine that you basically, your willpower muscle is like so hypertrophied that you're able to voluntarily starve yourself.

   19. KDr. K31:03

       Yeah, absolutely. So, so that, that's exactly what we see. So what we see with people with anorexia is they have so many physiologic signals telling them to eat. And so the, the, one of the things I love about being a psychiatrist is like there's a lot of cool neuroscience, but there's a lot of old stuff too that I think is just as relevant.

   20. CWChris Williamson31:21

       Mm.

   21. KDr. K31:21

       I think psychiatry is the only field of medicine where stuff that was true 100 years ago is just as true today.

   22. CWChris Williamson31:27

       Mm.

   23. KDr. K31:28

       Um, and I think some of the stuff about like Jungian archetypes and things and, and modern like dating and the manosphere is like it's, it's like textbook. Like literally there's a textbook written from 1920 by someone named Emma Jung who like describes the manosphere and our dating and mating crisis to a T.

   24. CWChris Williamson31:43

       Mm.

   25. KDr. K31:43

       It's, it's insane. Um, but going back to this question of, of why do people develop anorexia, so at the root of anorexia is control. So like if you look at like people who develop anorexia, they're people who are deprived of control in their life. And so what, what tends to happen with human beings is we tend to displace things. So if, if, if I'm out of control over here, I'm going to balance that out by being extra in control over here.

   26. CWChris Williamson32:10

       Mm.

   27. KDr. K32:10

       And we see this in places like, you know, if I have, if there's a parent who has a toxic work environment and they can't get angry at their boss, they're gonna displace that anger onto their loved ones at home, right? So this is just how we manage like psychiatric stuff. So in anorexia, it's all about control, and, and what happens is once you start to get the reward, right? Oh my God, from the cognitive behavioral therapy, I have lost this weight. Look at how much better I look. I can do this. I am now in control.

   28. CWChris Williamson32:40

       Mm-hmm.

   29. KDr. K32:40

       I'm so much more in control at a 50-pound loss than I am at a 20-pound loss. And so there's something there that, that is very almost like addictive or compulsive or gratifying about taking control of yourself, and then you just keep going.

   30. CWChris Williamson32:54

       How do you think that continues if somebody isn't using control themselves but is artificially, uh, supplementing their control by using GLPs? So your suggestion here is that people use CBT. There's an intervention that gives somebody an additional amount of control over their weight and, and how much they eat, and some people overshoot that and kind of get a kind of addiction to the control that they have. Are you suggesting that GLPs allow people to shortcut, or people who wouldn't have typically that access to willpower that these people would, uh, and they, they're able to, um, the, the mechanism still holds even though the way that they've arrived at the mechanism isn't, isn't the same?
6. 38:01 – 43:54

   What Gambling Does to Your Brain

   1. CWChris Williamson38:02

      Let's get back into gambling. You said that neurologically that's very interesting. We'd explained, um, uh, sociologically-

   2. KDr. K38:11

      Yeah

   3. CWChris Williamson38:11

      ... what's going on there. What's happening inside of the brain?

   4. KDr. K38:13

      So what's happening, [laughs] so the most danger-

   5. CWChris Williamson38:17

      Why are you laughing about it? Is it because you did the Indian accent? Is that why?

   6. KDr. K38:19

      No, no, no. So, so I'm just laughing because of what's going on in the brain.

   7. CWChris Williamson38:22

      [laughs]

   8. KDr. K38:23

      So the most dangerous thing about gambling now is that it's available 24/7.

   9. CWChris Williamson38:28

      Mm-hmm.

   10. KDr. K38:29

       There used to be, and we know this, right? Casinos are open 24/7. So they figured out a long time ago that if you're a predator and your prey is somebody's bank account, making things available 24/7 is a really good idea. And there's a really simple neurological reason, reason for this. So as we, as the day goes on, we get more fatigued. As we get more fatigued, we make worse decisions. So as the frontal lobes are, as our frontal lobes get fatigued-

   11. CWChris Williamson38:56

       Mm

   12. KDr. K38:56

       ... as we get tired, our ability to play the tape through to the end decreases.

   13. CWChris Williamson39:00

       Mm-hmm.

   14. KDr. K39:00

       Our ability to anticipate consequences decreases. Our ability to control our impulse decreases. So many years ago, I spoke with someone who, uh, maybe this is supposed to be secret information, but I, I'm not under an NDA, who's telling me that there's a, there's a day trading app that not only facilitated trades, they built this algorithm where any trade that is made at like 2:00 in the morning, they're gonna be on the opposite side of.

   15. CWChris Williamson39:30

       Mm-hmm. Mm-hmm. Mm.

   16. KDr. K39:31

       So it's, it's not like you're, you know, if I'm buying this share at 2:00 in the morning, somebody else is selling it. Anyone who wants to buy or sell anything at 2:00 in the morning, the app itself is taking the other side of the trade because they realized through their big data set, right, because they're seeing all this trading volume and stuff like that, that people just make really, really, really stupid decisions at 2:00 in the morning. So a big part of gambling is that the, the, the gap between the impulse to engage in gambling, which we know there's a lot of stuff around r- random reinforcement schedule and things like that.

   17. CWChris Williamson40:03

       Mm.

   18. KDr. K40:03

       There's all these biases like, you know, h- human, there's a superiority bias, so everybody thinks they're better n- than average. Everyone thinks that they're gonna get lucky. Everyone's luckier than average, right? So there are all these biases have existed, but there used to be a very like physical barrier of going to the racetrack, going to the gas station to buy a scratch ticket.

   19. CWChris Williamson40:21

       Friction.

   20. KDr. K40:21

       Huh?

   21. CWChris Williamson40:21

       Friction.

   22. KDr. K40:21

       Friction. Absolutely, right? So you had to, you had to like do something to gamble.

   23. CWChris Williamson40:24

       Waiting until it opens up again.

   24. KDr. K40:26

       Waiting until it opens up and then, then the impulse will pass.

   25. CWChris Williamson40:30

       Mm.

   26. KDr. K40:30

       So now what's really happening with these gamblings, uh, gambling apps is that impulsiveness, we've made it really, really, really easy, right? And everybody's doing this. It's like one click to purchase. You don't even have to go to checkout anymore, bro. Just tap a button and, and it's gonna be so easy. And so what, what's really happening, and this is also kinda scary, is like the other thing I sorta realized recently, this is kinda like a... I don't know if this is really stupid or really smart. I can't tell yet. I realized something y- recently. We have no psychological immune system that is prepared for the world that we live in. So we have like an immune system that protects us against attacks, right?

   27. CWChris Williamson41:12

       Mm-hmm.

   28. KDr. K41:12

       And we even have a psychological immune system that protects us against attacks. These are things like Freudian defense mechanisms like displacement and, and re- yeah, projection.

   29. CWChris Williamson41:22

       Distancing, distraction.

   30. KDr. K41:23

       Yeah. So like we have all of these like psychological defense mechanisms that we use to protect our mind.
7. 43:54 – 50:16

   Why We Get Hooked on Dopamine Hits

   1. CWChris Williamson43:54

      What do you think happens to someone's brain when they engage in all three of those things daily?

   2. KDr. K44:00

      Um, I, I think the, the most synergistic effect is gonna be the most fundamental. So your dopaminergic cir- I would, I would predict two things. One is anhedonia, so the inability to experience pleasure. So that's gonna cause huge problems for trying to put your life together because the part of your brain that rewards you for doing a good job won't be able to do that anymore. So the feeling of like, "Oh, I got an A on a test," like literally you'll be like blunted-

   3. CWChris Williamson44:28

      Hmm

   4. KDr. K44:28

      ... and, and not be able to experience that. Um, one thing I started telling my patients that have helped them immensely in, in dating, or actually in falling in love, is to not use their cellphone for an hour before they go on a date. No t- no screens.

   5. CWChris Williamson44:44

      Hmm.

   6. KDr. K44:44

      So go for a walk, because what, what people don't realize is that your, your dopamine is like you have a storage of dopamine, and if you deplete it with a screen, there's none left over until you go to sleep.

   7. CWChris Williamson44:54

      People are comparing the level of stimulus that they had from their screen to the person that they're going on a first date with.

   8. KDr. K44:59

      It's not even that they're comparing, it's that there is no dopamine left-

   9. CWChris Williamson45:03

      Right

   10. KDr. K45:04

       ... for them to experience pleasure. And if we look at what love is, love is literally a trickle of dopamine because, like, the presence of this person is like, "Oh my God, it feels amazing." Like, "I can't wait to be right next to you. Oh my God." It's ju- just like being across from this person and your brain is flooded with dopamine. If your dopamine stores are empty, you're not gonna feel any of that.

   11. CWChris Williamson45:23

       Hmm.

   12. KDr. K45:23

       And so people aren't falling in love anymore because technology is draining our dopamine.

   13. CWChris Williamson45:29

       Are you worried about GLPs impacting dopamine for people falling in love?

   14. KDr. K45:32

       Um-

   15. CWChris Williamson45:32

       Or cravings, I guess?

   16. KDr. K45:34

       Yeah, so they, they do blunt cravings. This is where things get, like, really neuroscientifically, like, specific.

   17. CWChris Williamson45:39

       Hmm.

   18. KDr. K45:40

       Um, so, so they do blunt cravings, but they don't work directly on the dopaminergic circuitry. So they, they, they work... I mean, everything's kinda tied together, so they're not... But what we do know that GLPs do, so, is they cap the amount of dopaminergic response that you can get.

   19. CWChris Williamson46:01

       Hmm.

   20. KDr. K46:01

       That's part of the reason that they're kinda like good. So people with, um... So if you look at studies of people who use alcohol on GLPs, their desire for the first drink is the same. The number of days that they drink doesn't go down. What decreases or what improves with alcohol is the number of drinks they have when they drink. So, like, after a hard day's work, if we're gonna go to happy hour, like let's grab a beer, that desire is absolutely the same. What's blunted is the joy that I get from my first beer is blunted.

   21. CWChris Williamson46:31

       Hmm.

   22. KDr. K46:31

       And so that's really where G- where GLPs work.

   23. CWChris Williamson46:34

       Okay, so going back to someone doing all three of those things-

   24. KDr. K46:37

       Yeah

   25. CWChris Williamson46:37

       ... uh, uh, every day.

   26. KDr. K46:39

       So anhedonia is number one.

   27. CWChris Williamson46:40

       Mm-hmm.

   28. KDr. K46:40

       So the inability to experience pleasure. If you talk to these people, life will feel boring, which is why they wanna pass the time, right? 'Cause they don't feel like doing anything.

   29. CWChris Williamson46:49

       Becomes a vicious cycle of life is boring, therefore, I need to do more exciting stuff in order to make it less boring, which means more porn, more video games, more gambling.

   30. KDr. K46:57

       Yeah. So a lot of people don't realize this. So, you know, you know, when our body and brain wants stuff, and then there's the physiologic signaling, and then there's the subjective experience. So when you are... When your liver is out of glycogen, I know you're pretty knowledgeable in this stuff, and if you need some background, let me know. But when your liver's out of glycogen, do you know what the subjective experience of that is? Hunger. Okay, so if you're calorically low, I... You know, if your calories are low, you're gonna feel hungry, okay? So if your, if your cells have insufficient water, what do you think is the sufficient feeling of that?
8. 50:16 – 57:44

   How to Rebuild Your Tolerance for Boredom

   1. CWChris Williamson50:16

      What do they need? These people, let's say that someone resonates with, "That's me, I have the novelty seeking but kind of mundane. I'm doing it through the screen. I have the bit of anhedonia. I have the intolerance for boredom." If they don't need more discipline, which is kind of the go-to, especially for men, right? Like David Goggins montages and 4:30 AM ice plunges and stuff like that. W- what does recovery from an intolerance to boredom look like?

   2. KDr. K50:46

      Great question. So I think it starts with one question: What is the cost you're willing to pay? Right? So w- like if you look at David Goggins, he'll pay any price. That's what makes him David Goggins. I mean, I've never met the guy and I, I try not to comment on people that I haven't met, but I've listened to enough of his stuff, and it's, it's really interesting 'cause if you l- listen to what he talks about, his mind is always thinking about cost and how to pay the cost.

   3. CWChris Williamson51:09

      Mm.

   4. KDr. K51:10

      And going back to what I was saying earlier about everything being free, you know, we live in a world where no one wants to pay anything, and this is what's so interesting is, is when I work with people like this, it's like they're always running away from something bad. So I'm isolated, and then when I... I'm isolated and lonely. I'm tired of feeling that way. I'm gonna go, go to a party and then I'm socially anxious, so then I go home. So people are like, people are, are... The, the... People aren't stuck in life, they're, they're swinging on this back-and-forth pendulum of being, like, bodied on one side and bodied on the other side. And what's really interesting about this, this is a, a condition called ambivalence, which is internal conflict. And the really interesting thing about internal conflict is that any time you start moving, the cost is far away, and the further you move, the more real the cost becomes. So as long as you are... Like, so for... Let's say for example I wanna get in shape. I want to get into shape. Easy to say that when I'm sitting at home. Once I go to the gym and once I start huffing and puffing, now I'm paying the cost. So what motivates us, right, is the, the goal, like, like the, the w- the reward that we want at, at the end. That's what gets us moving. And then at the very beginning, we're thinking all about the reward and not about the cost. And once we actually do something, we think we're experiencing the cost and we see zero of the reward.

   5. CWChris Williamson52:37

      Mm.

   6. KDr. K52:37

      Right? So the first 10 times you go to the gym, you're gonna have zero improvements in your health that you're... that is gonna be visible. It's just gonna be all suffering. And so this is what's really scary is we've, we've become such a reward-oriented society, right? And if you, like, look on the internet, right, everyone's offering you value. Like, "Do this and you'll get this. You'll get this. You'll get this. You'll get this." And so this is how we pull people by offering them rewards. And so what someone really needs to do is, is grapple with the cost and kind of accept, like... And there are ways to do this. There's all kinds of stuff that can be done. So one is first of all to, to ask yourself, what are you willing to pay? Right? What's the price you're p- willing to pay?

   7. CWChris Williamson53:20

      What could an answer to that question look like?

   8. KDr. K53:23

      Five minutes a day. Right? For five minutes a day I am willing to stare at a blank page and struggle to put words on a p- piece of paper. Right? That cost could be I'm willing to travel to India and stay there for three months and see what happens. So a big part of it is, is focusing on the cost. Another huge part of it is focusing on uncertainty. What is your tolerance of uncertainty? Because we live in a world now where we want guarantees. We wanna know, okay, we're gonna ask ChatGPT which major will give me the best, uh, earning potential, right? And so what we really... what people really need to do is, this is crazy, but you... no one can predict the future, and so you gotta roll the dice. Like, that's the only way to live life.

   9. CWChris Williamson54:10

      Mm.

   10. KDr. K54:10

       Right? You, you have to take chances. Um, and, and chances come with pain and suffering which is why it's, it's kinda cost. So I, I think really embracing the, the bleakness to it. And the, the good news is that this is very doable. Like, uh, people who struggle with things like uncertainty, they struggle with things like paying the cost, there are, like, methodologies that really, really help people do that because this is something that is actually natural for us. Human beings have always dealt with uncertainty, but, uh, we've all been tricked into believing that there's no risk in life, you know? Risk-free.

   11. CWChris Williamson54:44

       Mm.

   12. KDr. K54:44

       Like, uh, get free stuff. Um, and then I think the third thing that's probably pretty helpful... Uh, uh, two or three other things. One is e- emotional regulation. So you need some way to manage your emotions when they come up. You can't keep running away from your emotions, and you can't keep preventing emotions or avoiding emotions. So the problem is that most people will live a life where they try to avoid emotions. Like, how do I go to a party and not be socially anxious? And if you pay attention to people who ask for help on the internet, you'll notice that everything is conditional. How do I do this without this?

   13. CWChris Williamson55:20

       Mm.

   14. KDr. K55:20

       How do I, how do I ask this person out without messing things up at work? How... That's what I... You have to remove the conditional. You have to pay the cost. And then the last thing that I think is really, really, really important, amazing study, I think, um, it was something like 78... I'm rusty on the numbers. I think something like 70% of soldiers in Vietnam were using opioids or other drugs, and only 9 to 12% continued to use them when they came back to the US with zero treatment. So a lot of people don't realize is their, their existence and, and what they're capable of is largely created by their environment. So in my case, I had to travel to India, and I stayed at an ashram for like 90 days. And, and I can teach these yogic techniques, and there's, there's good stuff that can be taught and people... You know, you can DIY this stuff from, from home. But what a lot of people don't really appreciate, I think, is that the... This gets a bit philosophical, but your mind is actually not you, it's part of your environment. So I don't know if this makes sense, but, like, you struggle against your mind, right? Like most people do that, which means that you are over here and your mind is over here. The way to make your mind calm is... First of all, your mind is part of your environment, and then the way to make your mind calm is through your, through its environment. So the food that you give it, the, the circumstances that you're in, even these little things like when you were saying you used to play Borderlands and you'd hang out with your friends.

   15. CWChris Williamson56:54

       Mm-hmm.

   16. KDr. K56:54

       Like all that kind of stuff is shaping your mind, right? So how lonely do you feel? And if your mind feels less lonely, getting it to do things is like way easier.

   17. CWChris Williamson57:04

       Is that one of the big levers, loneliness? Just wonder why you went to that as opposed to how spacious the fucking vista is that you walk out of on a bedroom morning.

   18. KDr. K57:15

       I, I think, I think loneliness is one of the things that the human mind does not do well with. So human mind does really well with solitude. Solitude is amazing. Loneliness is terrible. So human beings, the human mind is not designed to be lonely. This is why ostracization is... It used to be a death sentence, right? So to be, to be kicked out of the group was like exile was like, is just as bad as death.

9. 57:44 – 59:40

   Can Addictive Behaviours Ever Be Safe?

   1. CWChris Williamson57:45

      At the risk of sounding like a prude, is there a safe way to gamble, watch porn, and play video games every day?

   2. KDr. K57:52

      Abs- absolutely, 100%. Uh, it, it's just that you... The thing should do what it is designed to do.

   3. CWChris Williamson57:59

      Mm.

   4. KDr. K57:59

      So the moment that gambling, pornography, or video games become a substitute for other things in your life, it's game over.

   5. CWChris Williamson58:07

      Mm.

   6. KDr. K58:08

      So I play video games, um, and I teach my kids to play video games. Like I love playing video games. It's great. I used to be addicted, now I'm not. So the good news is with behavioral addictions, it's not quite like alcoholism where it's like one drink and it's like game over. Even that is somewhat mythological. It's only some people who are like that. Um, the majority of people who qualify for an alcohol addiction in college will still be drinking, but not qualify for an addiction in adulthood. So yeah, I, I think as long as you are, have a happy and fulfilling life, you can gamble, watch porn, and play video games every day.

   7. CWChris Williamson58:42

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10. 59:40 – 1:04:07

    Is Addiction a Choice or a Compulsion?

    1. CWChris Williamson59:40

       Of the roughly 75% of men who are doing one of those three things every day, or one in eight that are doing all three of them every day, how many of them do you think are doing that from a place of volition and are sort of choosing, and how much of them do you think are compulsive or addicted?

    2. KDr. K59:59

       I'd say compulsive and addictive is 95%.

    3. CWChris Williamson1:00:03

       Wow. Yeah, 'cause-

    4. KDr. K1:00:05

       I, I, I mean, I, I'm tempted to say 99, but that's probably statistically wrong.

    5. CWChris Williamson1:00:09

       Just what, what I think about is you saying, and I agree, the modern world makes people feel really displaced in many ways, and there aren't a whole number of previously more accessible solutions to that. The displacement, uh, is salved unfortunately by things that people judge or that might, might have some side effects that wouldn't have done previously. Um, so, you know, on one side you have this kind of increased burden that people are trying to fix with novel solutions, but all of the novel solutions come with these side effects that are both social and internally shameful and externally judged and then potentially neurologically catastrophic, financially ruinous, you know, sexually dysfunctional. Like there's all of these fucking things going on, but you have this increased burden with these increased novel solutions, solutions. Squaring that circle just seems hard, and I think a lot of people will feel like, "Well, fuck, like, I've got so few opportunities in front of me. Can I not get some pleasure? God, is there nothing that I can do? I can't have any fun at the moment. I can't get any..." Uh, lots of people are using it to solve them... It's an artificial solution to an artificial problem, which is painful if it's not fixed.

    6. KDr. K1:01:23

       Yes. So, so my answer to that is there are new problems, and as we're saying, new solutions don't really fix new problems.

    7. CWChris Williamson1:01:33

       Mm.

    8. KDr. K1:01:33

       So this is where I go back to if you wanna fix new problems, you need old solutions, the old solutions that have worked for thousands of years, the old solutions that go to the fundamental of what people are.

    9. CWChris Williamson1:01:48

       Mm.

    10. KDr. K1:01:49

        Right? So if you look at some of these contemplative traditions, and there's a reason why, like, mindfulness and stuff is exploding. It's because it's what works, and it, it's always worked. And so, I mean, so many of the problems that we talk about, finding purpose, like all, all this... I mean, I deal with these people day in and day out. I deal with men and women who are living in a society where they don't just feel displaced, they are displaced.

    11. CWChris Williamson1:02:12

        Mm.

    12. KDr. K1:02:12

        There's no, there's no pla- It's not displaced. There's no space for them anymore. And so how do you grapple with a world that AI is taking your job, inflation is an all-time high, gender dynamics are at an all-time toxicity? The, the problem is that no- actually no one is living in the real world anymore. Everyone is l- living in a construction of social media algorithms. And so how do you fix this? You go back to, like, the fundamental of who you are, and this gets kind of weird, but, like, all of that crap enters you at some point. So inflation, fine. At some point, when you go to the store and you try to buy something, you have a $10 bill and you can only get one thing instead of two things, that has an internal psychological impact into you.

    13. CWChris Williamson1:03:01

        Mm.

    14. KDr. K1:03:02

        And I think the problem with all of the artificial solutions is because they don't focus on the one thing that you can really control, which is yourself. That's the only thing you can control. And here we are having a lot of people offering us solutions that, semaglutide is a great example, remove the need to work on yourself. All of our solutions have people not working on themselves, which is exactly why we're seeing a whole scale deconditioning of our body, our mind, our critical thinking.

    15. CWChris Williamson1:03:32

        It's all of the outcomes without any of the inputs.

    16. KDr. K1:03:36

        Um, yeah-

    17. CWChris Williamson1:03:36

        You're able to lose weight without the traditional input that would have gotten you there.

    18. KDr. K1:03:40

        Yeah, so that's a good way to put it, and I would say it's like, it's all of the outcomes without the inputs, and really all of the outcomes, and some of those outcomes aren't good.

    19. CWChris Williamson1:03:51

        You don't... Yeah, yeah.

    20. KDr. K1:03:52

        Right? So it's, it's writing a paper, this is what's really fascinating. AI usage improves grades and decreases knowledge, right? So you're right. It's, it's all of the outcomes. It is, it is a deconditioning of people wholesale.

11. 1:04:07 – 1:13:36

    Have We Been Lied to About GLP-1s?

    1. CWChris Williamson1:04:07

       But GLPs, I would guess for people starting under a BMI of 30 would probably decrease body fat and decrease health.

    2. KDr. K1:04:20

       N- uh, I don't... BMI under 30, you'll probably still have a positive effect. So, so they largely have positive effects for most people that take them.

    3. CWChris Williamson1:04:27

       Mm.

    4. KDr. K1:04:28

       But the-

    5. CWChris Williamson1:04:28

       How many of those people are going to overshoot? How many of those people that are using them already aren't eating a well-balanced, uh, micronutrient-rich diet that is now being chopped in by two-thirds or half? So a spar- nutrient sparse diet has now turned into a, uh, calo- caloric deficit nutrient sparse diet, which means that the fucking tiny little bottom filtering of nutrients you were getting has been cut down too. Uh, I... How many people were using foods to cope with their emotional issues and now they don't even have that to do?

    6. KDr. K1:05:05

       Yeah, so, so this is... It, it's all great questions, so here's a couple of answers. The first is one of the most important pieces of advice that I give to people, this is family, friends, patients, whatever, when they start a GLP, I mean, usually I don't prescribe GLPs, so somebody else should be doing this, but if I have a patient who's on it, I try to tell them, "Remember to eat." So, so, uh, they just don't feel like eating. And so, so you're right that I think we're starting to see like nutritional problems with, with some of these people. Um, and then I, I, I think on balance though, given how bad people's diets are, I think there's, there's a lot of data that GLPs are like really good.

    7. CWChris Williamson1:05:42

       Mm-hmm.

    8. KDr. K1:05:42

       You know? And, and I'm not saying that they're not good when you look at those indicators, but there are these hidden costs. Like maybe we'll see micronutrient deficiency, and here's the real answer to all of your questions. We don't know.

    9. CWChris Williamson1:05:55

       Yeah.

    10. KDr. K1:05:55

        Right? They've hit the market and, and we don't have any long-term surveillance data on what this is gonna do to people.

    11. CWChris Williamson1:06:00

        They're also designed for people, originally designed for people, and most of the longer term studies, which are still relatively novel, were done on people that were morbidly obese because it was built for diabetes, right? Built around diabetes originally.

    12. KDr. K1:06:13

        I mean, that depends on whether you want me to put my tinfoil hat on or not.

    13. CWChris Williamson1:06:16

        Oh, yeah.

    14. KDr. K1:06:18

        So here's, here's my tinfoil hat.

    15. CWChris Williamson1:06:20

        The captain's hat.

    16. KDr. K1:06:21

        Okay. So here's, here's my tinfoil hat.

    17. CWChris Williamson1:06:24

        Yeah. I do have a disguise actually-

    18. KDr. K1:06:26

        So-

    19. CWChris Williamson1:06:26

        ... if you wanted to put something on

    20. KDr. K1:06:27

        ... I, I would not be surprised one bit if we discovered many years from now that the same thing that happened with opioids is what's happening with GLPs. So were they designed for morbid obesity or did the companies that developed them understand very clearly that this is a medicine that will make someone not want to eat? And so they, they move forward and, and they weren't designed for obesity. They were designed to help people not eat, and there's a subtle difference there. Then what hap- And I, I don't know if that makes sense, but like, like they, they know there's a very good chance that they... Actually, there's not a very good chance. We have no idea. But if I put my tinfoil hat on, they damn well know that this is a medicine that everyone is gonna wanna take because everyone is wanna, gonna wanna lose weight. Everyone wants to be pretty. This is the age of social media. We are going to give people a medicine that takes away their cravings. That's what they're designed to do, is to take away cravings. Now, here's the subtle important part here. They were tested in people with obesity.

    21. CWChris Williamson1:07:39

        Mm-hmm.

    22. KDr. K1:07:39

        Because in order to get a drug through something, you have to show a certain amount of benefit. But I think the incredibly rapid adoption of using them off-label for people who don't fit the clinical criteria-

    23. CWChris Williamson1:07:54

        Hmm

    24. KDr. K1:07:54

        ... that's like one hell of an interesting thing, right? So like, 'cause we're not-

    25. CWChris Williamson1:08:00

        They were able to predict who the end users of this product be, not the people that were in the original clinical trials.

    26. KDr. K1:08:05

        Exactly. Right? So there's a very real possibility that we will find that, and if we find that, the reason we would find that is because things really get to be a problem. This is exactly what happened with opioids, right? So people damn well knew... Or actually n- not opioids. This is what hap-... Well, opioids as well, but this is also what happened with benzos, okay? So benzodiazepines like Xanax. The Alprazolam or Xanax is one of the first benzos that came out, and there is like very little doubt in my mind that the drug companies who... This is gonna get technical, okay? So if you really wanna understand the conspiracy stuff, you have to understand the science. So everyone got addicted to Xanax. Why? It's because Xanax has a very rapid onset. So the faster something hits your body-

    27. CWChris Williamson1:08:51

        Mm-hmm

    28. KDr. K1:08:51

        ... the more addictive it is. So now-

    29. CWChris Williamson1:08:55

        Crack cocaine.

    30. KDr. K1:08:56

        Uh, yeah, exactly. Right? So, so what happened is we now have benzodiazepines, later benzodiazepines, that are less addictive a- and hit your system slower. A good example of this is clonazepam. So you can still get addicted to clonazepam, but Alprazolam, which is Xanax, hits your system like that. Clonazepam hits it more slowly and also lasts longer. So the, the faster it hits you and the faster it wears off, the more addictive it is. This is crack cocaine, okay? Meth and Alprazolam hits you fast, goes away fast. Diazepam, which is Valium, hits you fast, but stays for a long time. So now we're moving away from those addictive ones. Here's a really fascinating thing. Everyone talks about GLPs like they're the same thing. They're not the same thing. Tirzepatide, semaglutide, they're not the same. They all have different penetrations to the CNS, okay? So where all of these GLPs go is actually different. So if you look at studies on reductions in alcohol cravings and alcohol addiction, they're not the same for all GLPs because they have different CNS penetration. So they enter your brain at different rates.
12. 1:13:36 – 1:33:18

    Should Men Retrain Their Penis?

    1. CWChris Williamson1:13:36

       You talked about numbing earlier on. I've heard you talk about the need for young men to retrain their penis.

    2. KDr. K1:13:41

       Yes.

    3. CWChris Williamson1:13:42

       What's going on there?

    4. KDr. K1:13:43

       [laughs] The, the mother of all non-sequiturs. From, from anal leakage to retraining your penis. Let's go. Okay. So [laughs] this is... Okay, how, how do I... Okay. So first thing, Chris, what is training?

    5. CWChris Williamson1:14:05

       Uh, applying effort to increase capacity.

    6. KDr. K1:14:09

       Okay. Um, how do you train?

    7. CWChris Williamson1:14:13

       My penis?

    8. KDr. K1:14:14

       Uh, anything, just the concept of training. What do we do when you train?

    9. CWChris Williamson1:14:18

       Practice in a manner that is akin to a performance-

    10. KDr. K1:14:24

        Okay

    11. CWChris Williamson1:14:24

        ... that will come in future.

    12. KDr. K1:14:25

        Okay. So repetitive practice, right?

    13. CWChris Williamson1:14:27

        Mm-hmm.

    14. KDr. K1:14:28

        So here's the basic problem. I'm a teenage boy and I discover pornography, and I have an erection, and at some point I start masturbating. And then this is becoming a problem now because my access to pornography is at an all-time high. My access to a healthy sexual relationship is at an all-time low. So whereas, you know... Uh, so, so now what's happening is for maybe 15 years, I am using a certain kind of stimulation for my penis. And just to give you, uh... Uh, okay, so I'm using a certain kind of stimulation for my penis, and then the body gets used to that, right? So in the same way that, like, if I eat spicy food starting when I'm 13, like I can handle spicy food when I'm 15. So the body gets used to caffeine. It gets... The whole point of the body is that it adapts to whatever you give it.

    15. CWChris Williamson1:15:27

        Mm.

    16. KDr. K1:15:27

        So we are literally, we're training our body to tolerate spicy food. We're training our body to run a marathon. We're training our genitals and, and our, our penis to ejaculate in cer- certain circumstances.

    17. CWChris Williamson1:15:40

        Mm.

    18. KDr. K1:15:42

        So we see a, a shockingly high level of erectile dysfunction.

    19. CWChris Williamson1:15:46

        I'd learned from you 40% of men are dealing with erectile dysfunction.

    20. KDr. K1:15:50

        Yeah. So I think it's 30% of people under the age of 30, which erectile dysfunction, uh, maybe I said 40%, I don't remember the exact statistic, but erectile dysfunction used to be an old man's disease. It's not anymore. And what a lot of people don't realize... Do you know what erectile dysfunction is?

    21. CWChris Williamson1:16:03

        No.

    22. KDr. K1:16:04

        Okay. So this is-

    23. CWChris Williamson1:16:05

        Obviously.

    24. KDr. K1:16:05

        [laughs] Okay. So [laughs] okay. So-

    25. CWChris Williamson1:16:13

        Too easy.

    26. KDr. K1:16:14

        Yeah, that was, that was a good one. So erectile dysfunction is dis- defined is the inability to maintain an erection through the completion of the sexual act.

    27. CWChris Williamson1:16:24

        Okay.

    28. KDr. K1:16:24

        Okay? So the interesting thing about the, the young men, 30% of people under the age of 30 who have erectile dysfunction-

    29. CWChris Williamson1:16:30

        Mm

    30. KDr. K1:16:30

        ... it's not that they can't get hard, it's that they can't stay hard enough to finish if they're having intercourse, let's say.
13. 1:33:18 – 1:37:17

    How Social Anxiety Impacts Your Sex Life

    1. CWChris Williamson1:33:18

       What about the social anxiety?

    2. KDr. K1:33:20

       What about it?

    3. CWChris Williamson1:33:20

       I'm in front of someone. Oh my God, what if I'm gonna d- I'm gonna l- lose the thing. Like, w- ah. Too much pressure.

    4. KDr. K1:33:29

       Yeah, so I think one of the key things that we don't really have cognizance of as a society is that a sexual relationship is something that you work on. Like, the first time that you have sex with a-- So I've been married for 15 years, okay? And I mean, not to go into too much detail, but I'm, I'm relatively satisfied, and I'm pretty sure my wife is too. I mean, you'd have to ask her. But, like, we're better at it now than we were 20 years ago, right? And you just don't know someone's body the way, like the first time, right? It, it's not even about the size of your penis. Like this is what pornography teaches all these wrong things, that the manlier you are, the, the better lay, the bigger your dick is. Like, this is where people don't understand. So really big dick, most women don't prefer really big dicks because the cervix, if you're bumping against the back of the vagina where the cervix is, that is incredibly painful. Um, the majority of the nerve endings in the vagina are in the first three inches, okay? So when I'm working with my patients, I tell them, "Have sex the opposite way that you park," which is you want to bump into the walls as much as possible.

    5. CWChris Williamson1:34:41

       Hmm.

    6. KDr. K1:34:42

       So, so you want to go in at, like, angles. And there's a lot of, like, skill, which if what, if you want to talk about it, I mean, there's, there's so much skill at, at sexual satisfaction.

    7. CWChris Williamson1:34:50

       Hmm.

    8. KDr. K1:34:51

       And, and you just-- Like, if you're a novice and you suck at it, like, that's okay. Like the first time you get on a horse, is anyone expecting you to be an expert? And, and with sex, it's a whole new horse, you know, if you're, have a new partner. It's like a whole new person who has their own particular things that turn them on, things that-

    9. CWChris Williamson1:35:09

       Hmm

    10. KDr. K1:35:09

        ... that, uh, uh, attract them. And one of the really fa-- I mean, so I've been doing this deep study for many years. It's like I'll-- 'cause I'll talk to my patients about sex, and I'll take like copious notes about, okay, what actually works, right? In real human relationships. In people who are going through couples counseling or on the verge of divorce because somebody is sexually unsatisfied. In cases of bed, dead bedroom, what actually works? And there's all kinds of stuff that people don't realize. I mean, simplest of which is, I tried to find s- data for this. I really couldn't. But I, uh, tinfoil hat. I'm convinced that-- [laughs] Okay. I'm convinced that semen in the vagina improves the intensity of orgasm for a woman. I'm convinced. The best data that I've got is there's some studies that show that compounds in the semen can be found in the bloodstream of a woman after sex.

    11. CWChris Williamson1:36:05

        Hmm.

    12. KDr. K1:36:06

        And some people have investigated whether some of the compounds of semen have antidepressant prop- properties. And the short answer is there, we don't, it doesn't, there's not a clear answer to that question. But I think the biggest m- mistake men make, like this is such a simple thing. "Oh, I came too fast." That's not a problem, bro. The, the problem-- The question is, do you finish her when you're done? [laughs] Right? And then something really weird can happen, which is if you finish first and then you do a good job afterward, there is a Pavlovian response of finishing and then this is the most arousing thing for your partner because as long as you do a good job afterward. So this is like one of these things where, like, we, like this is dudes getting worried about this. Like if you, premature ejaculation, research shows first of all that the average sexual act lasts three to seven minutes and that 50% of women want it to be over at fif- 15 minutes. So you need to last for 15 minutes, which is really doable with math problems and retraining. And then you just make sure that you, you know, you

14. 1:37:17 – 1:43:33

    Are Sex Toys Making Women Harder to Satisfy?

    1. KDr. K1:37:17

       don't leave her hanging.

    2. CWChris Williamson1:37:18

       Have you looked at any data around whether women have got an equivalent problem with vibrators and sex toys that are industrial strength ... stimulation devices

    3. KDr. K1:37:30

       Yeah, so I, I haven't looked at a whole lot of data, but this is what I-

    4. CWChris Williamson1:37:33

       The, the, the female death grip

    5. KDr. K1:37:34

       Yeah, so, so, so, uh, that is almost certainly true, uh, with a couple of caveats. So some research shows that 70% of women are unable to climax without clitoral stimulation.

    6. CWChris Williamson1:37:48

       Mm-hmm.

    7. KDr. K1:37:49

       Okay? That's kind of the ballpark number, which means that penetrative intercourse isn't gonna do the trick. So enter the vibrator. And, and so the vibrator also has a very particular, uh, motion which absolutely can get trained towards. Uh, if, if you had to ask me, like, my clinical opinion, I think that women are much more... I, I hate to make gender-based comparisons, but there's some truth to this. I think women are much more cerebral with their sexuality.

    8. CWChris Williamson1:38:21

       No, uh, I, I don't think you need to make generalizations to that. Look at the romantacy genre.

    9. KDr. K1:38:26

       Exa- exactly, right? So, so this is where, this is where the, uh, I mean, it does vi- uh, do- does using a vibrator, can someone get dependent on a vibrator? Very possibly.

    10. CWChris Williamson1:38:34

        Vibrator dependency.

    11. KDr. K1:38:35

        Uh, uh, uh, but th- then the other issue is what is the skill of their partner at clitoral stimulation?

    12. CWChris Williamson1:38:40

        Mm.

    13. KDr. K1:38:41

        Right? And there's all kinds of things that are like ... So a vibrator provides very, very intense, consistent stuff that gets people off. But having worked with, with, you know, a, a lot of people around sexual gratification in their relationship, which includes, like, people in their 60s. Um, I've had patients who have never had an orgasm until their 60s and then, you know, we're talking about something else and they're, they have cancer, and now they're in remission. And, I mean, it, it, it, it, it really is a, it, it's a ... I, I know that people make jokes about sexuality, but, like, this is something that I, I really don't, I'm not judgmental towards, right? And, and I wanna help people have sexual relationships that are very healthy and fulfilling, no matter who you are. A- and so it provides a very specific kind of stimulation. But I'd say that a vibrator is kinda like tugging one out in that there's nothing else involved. So a couple things that I'd say about that is that, you know, the, the kind of stimulation that you can provide is drastically different if you're a human. So the whole labia is very sensitive. Um, and this is where things get really, really technical, but, like, if you look at the anatomy of the clitoris, the anatomy of the clitoris has a fold, and then it has a bead of tissue underneath. That is what in men, um, you know, under the influence of testosterone, is what becomes the glans of our penis. So the cli- the, the, embryologically, the tissue in the clitoris and the tissue of the glans of the penis are the same.

    14. CWChris Williamson1:40:06

        Hmm.

    15. KDr. K1:40:06

        And then if you think about if you're a dude and you're trying to figure out, okay, how do I make ... I'm gonna just ... How do I make a woman come, right, if th- she's used a lot of vibrator? You gotta think about the clitoris the way that you would think about the head of your penis, which is not ... You don't just, like, apply a lot of pressure just right at the head, right? You're gonna use the whole shaft.

    16. CWChris Williamson1:40:25

        I can't remember who it was that I had on the show, but he sent me with the book, every book gifting that he posted out came with a 3D-printed model of what the inside or the, the, the, the entire structure of the clitoris looked like, and I couldn't get over the fact that I was adamant it, it, it looked like a Pokemon. It looked a lot like a Pokemon.

    17. KDr. K1:40:44

        Yeah, I can see that.

    18. CWChris Williamson1:40:45

        And I couldn't look at it any longer. I couldn't look at this thing. I've got the book on the left of the screen as I'm talking to him, and this thing to the, to the, the other side. And every time that I looked at it, I started grinning 'cause I was like, that's a Pokemon. That is, that is a ... That, that was all, that was all I could think about. That was it. Yeah.

    19. KDr. K1:41:02

        And, and so I, I think that, like, a lot of dudes don't realize, like, okay, so, like, don't be intimidated by female genitalia, right? Like, you, you, you, you don't, and you don't have to just do straight clitoral stimulation. There's a lot of stuff around there. There's also lots of, like, different kinds of motions and strokes that a vibrator can't do-

    20. CWChris Williamson1:41:17

        Hmm

    21. KDr. K1:41:17

        ... which can feel really good. And so-

    22. CWChris Williamson1:41:19

        You have a competitive advantage over the robots. That's what you're saying.

    23. KDr. K1:41:21

        Yeah, you're a human, and you, you can learn, whereas it can't.

    24. CWChris Williamson1:41:24

        Mm-hmm.

    25. KDr. K1:41:25

        Right? And, and, uh-

    26. CWChris Williamson1:41:25

        Until the AI sex toys come along.

    27. KDr. K1:41:28

        A- a- and I, and I, I think that, you know, learning about your partner's body in a calm, compassionate, curious, loving way is usually something that your partners are okay with.

    28. CWChris Williamson1:41:39

        Mm-hmm.

    29. KDr. K1:41:39

        And what I literally mean is if you just wanna, like, you know, don't, like, get a speculum and, and make it medical, but, you know, if, if you're just touching your partner, just, uh, touching different things and try to get a sense of like, okay, what does my partner like? Like, if I touch in this way, if you just simply cup the area around the vagina with, like, y- you know, your hand like this, like, that can feel really good for some people. Um, y- there's all kinds of, like, gradients of motion, which is, uh, the biggest mistake that men make, I think, when they, when they have sex with women is they, they focus on the orgasm. The orgasm is the end, right? It, it's like no one wants to watch the last five minutes of a movie, right? Even though it's the best part. Like, the whole point is the whole thing, and the slower that you take it, the, I think the better off it'll be. And, like, by all means, learn. If you premature ejaculate and you have difficulty, you know, getting your partner off because she's dependent on a vibrator, first of all, you can use the vibrator. Frees you up to do other things.

    30. CWChris Williamson1:42:37

        Hmm.
15. 1:43:33 – 1:47:52

    Can AI Companions Actually Cure Loneliness?

    1. CWChris Williamson1:43:33

       Wonderful. Speaking of that-

    2. KDr. K1:43:35

       Yeah

    3. CWChris Williamson1:43:35

       ... you mentioned earlier on, uh Some of the loneliness stats that are going out at the moment, it's hard to imagine whatever it is, like a, a... The number of men with six or more close friends has decreased by basically half.

    4. KDr. K1:43:49

       Yeah.

    5. CWChris Williamson1:43:49

       Like fif- 55% to 27%, uh, men with no friends at all has jumped from 3% to 15%. Seems like a big deal. It's hard to imagine that these things, male loneliness and compulsive behaviors, are unrelated. How do you come to think about how AI might sort of factor into this when we've got people with AI partners and AI friends? I don't know whether you've seen any information on the number of people that have got an AI friend or partner, but I... Are you concerned about what this might cause in future-

    6. KDr. K1:44:21

       Yeah

    7. CWChris Williamson1:44:21

       ... for an increase in localiness and, uh, loneliness and compulsive behavior now fed through AI?

    8. KDr. K1:44:27

       Yeah, so, I, I mean, not even in the future. I think we're already seeing it. So I, I, I don't know the current statistics because they're changing so rapidly. Like, if you have numbers on what percentage of people have an AI girlfriend, I don't, I don't have, I don't have the stats at my fingertips.

    9. CWChris Williamson1:44:40

       See if, uh, ChatGPT can say how many people it's in a relationship with, please, Jared.

    10. KDr. K1:44:44

        So I, I think we see the same thing that we tend to see with AI, which is that it improves things in the short term and makes things worse in the long term. So I, I... There's a ton of studies that I've read that show that if you ask someone, "When you use an AI companion, do you feel less lonely?" And they'll say, "Yes, I feel less lonely." And then if you ask them, "What is your isolation over time?" That, that will go up.

    11. CWChris Williamson1:45:09

        Mm.

    12. KDr. K1:45:09

        Right? So what AI does is it helps you feel better now. So I can use AI to once again write a paper, but I'm not gonna learn the material. So it... You can use it to assuage your feelings in the moment, and then over time it'll isolate you even further. And, and, and one of the scariest examples of this is, like, sort of this AI-induced psychosis, which I don't know if you've run across. But this is happening, like, more and more. There's a really scary paper that found that basically within nine messages, you can... AI will, like, polarize you completely. So i- if I, if I talk to an AI, and I say, "Hey, I'm worried that people at work may not like me," within nine rounds of back and forth, you will be convinced that no one at work likes you. So AI has this fundamental sycophancy-

    13. CWChris Williamson1:46:02

        Mm

    14. KDr. K1:46:02

        ... that it... Because it agrees with you, right? So you can even tell, like... So, so, like, 19% have an AI design. So do this. Now let's ask... Is this ChatGPT?

    15. CWChris Williamson1:46:12

        Yeah.

    16. KDr. K1:46:14

        Say, "I don't think that's correct. I think that you're missing some nuance, and that AI relationships are not as important as you think." So let's just disagree with it and see what happens. I don't think you're factoring in nuance from internet discussions or peer-reviewed research. Let's see what happens.

    17. CWChris Williamson1:46:37

        I'm sorry. I, I, I realize that-

    18. KDr. K1:46:40

        Let's see

    19. CWChris Williamson1:46:40

        ... I actually da, da, da, da, da, da, da.

    20. KDr. K1:46:42

        Right? So, so there are studies, and, and I'll... I... If you guys have media that y'all can play, remind me and I'll send you. Right? So, so this is... The p- best peer-reviewed evidence is much more cautious, right? One in five. N- it's already walking it back.

    21. CWChris Williamson1:46:57

        Mm.

    22. KDr. K1:46:58

        So, and this is just one message. And, and this came out because there was a case of a person who talked to an AI and became convinced, I think, that their mom and her friends were, like, part of a conspiracy, and then he killed her. So there are, like, a couple of lawsuits about this. And now what's really scary is we, we have one case report of a woman with no history of psychosis, history of mental illness, no history of psychosis, uses, talks to AI a lot, becomes, uh, psychotic, gets hospitalized, gets given antipsychotics, psychosis goes away, leaves the hospital, stops the antipsychotics, still is not psychotic, reuses AI, becomes psychotic again. So we really have the first case report of what really appears to be some hefty, strong evidence that AI can literally induce psychosis.

16. 1:47:52 – 1:50:23

    Can AI Trigger Psychosis?

    1. CWChris Williamson1:47:52

       Are you surprised by that? Are you surprised that, uh, text-based messaging is sufficient to cause a human brain to go into psychosis?

    2. KDr. K1:48:01

       Yes and no. It's a brilliant question, Chris. So it scares me because it's so shocking. But I think that what I've come to realize is how much of our mental health is based on things that we take for granted. So a simple example of this is, like, you are mentally healthy because human beings disagree with you every single day. Right? So if you think about, like, I'm, I'm married. I've been married for 15 years. So I go home, and every day I have a disagreement with my wife. And we talk about that like it's a bad thing. But I want you to think about, you know, when you have a, a political leader who is s- surrounded by sycophants, they no longer live in reality.

    3. CWChris Williamson1:48:50

       Mm. Hitler. Good example.

    4. KDr. K1:48:53

       Presumably. I, I don't know too much about-

    5. CWChris Williamson1:48:54

       A massi- yeah, yeah. The inner circle was hugely sycophantic.

    6. KDr. K1:48:57

       Right? So, so-

    7. CWChris Williamson1:48:57

       Hugely

    8. KDr. K1:48:57

       ... so then they, they-

    9. CWChris Williamson1:48:58

       It's deranging

    10. KDr. K1:48:59

        ... I mean, I remember hearing about some of this stuff with, like, Putin in, in the Ukraine war, and I'm not getting into that. Just a simple example of, you know, I, I remember hearing from people who are more knowledgeable than me that, like, you know, he would ask for military estimates, and there were some generals who were like, "Hey, actually, like, people are siphoning gas off of the gas tanks and selling it. Our military preparedness is not 100%. There are serious problems." And that was not what people wanted to hear, so they got axed. They're, like, anti... They're not supportive enough, right? And so eventually everyone was like, "Yeah, military preparedness at all-time high. Morale's great. Our stockpiles are awesome." They attack Ukraine. Everyone predicted it was gonna be over in three weeks, and here we are years later.

    11. CWChris Williamson1:49:36

        Yep.

    12. KDr. K1:49:36

        Right? And, and so we know that sycophancy is very, very dangerous to people, and everyone who's listening to this, like, knows that. Like, you know that there is someone in your life- Who someone, like, kisses their ass and tells them whatever they wanna hear, and that is not, like, a good thing for anybody.

    13. CWChris Williamson1:49:52

        Mm.

    14. KDr. K1:49:54

        Right? And so what, what AI is doing is really accelerate... I- it's removing contradictoriness from people's minds, and then what we're seeing with AI is really an acceleration of what soc- social media algorithms already do, which is they create this sense of online drift or echo chambers, and then people start believing all kinds of things that are not true. And I saw Lindsay Clancy was on your thing. We can talk about that. That's an amazing example of this happening in real time,

17. 1:50:23 – 1:52:49

    Is AI Therapy the Future of Mental Health?

    1. KDr. K1:50:23

       really scary way.

    2. CWChris Williamson1:50:24

       What are your thoughts on AI therapy?

    3. KDr. K1:50:28

       Um, I think that AI therapy can be useful, and also likely misses some of the most fundamental mechanisms of therapy. So people who use AI for mental health support, I'm not perfect on this data, but I, I think I've seen studies... So I've seen studies that show short-term trials that show that AI for mental s- health support can help people feel better. But I- I'm pretty sure that people who use AI for mental health support are... People who use AI regularly have worse mental health outcomes as well, right? So I think both of these things can simultaneously be true, and I think we're seeing a really simple kind of, like, thing that floats to the surface, which is AI is good short term and is bad to use long term.

    4. CWChris Williamson1:51:22

       Hmm. That's interesting. I ca-

    5. KDr. K1:51:25

       Well, well, there's a caveat, but keep going.

    6. CWChris Williamson1:51:26

       No, no, you... No.

    7. KDr. K1:51:27

       So, so, so the caveat is AI is, is fine to use once you're already good at something. So anything that you want to learn or any capability that you want to have, and this is what's really scary about AI for mental health, if you, you are using AI to manage your mental health, your own ability to manage your mental health will decrease over time.

    8. CWChris Williamson1:51:48

       How would someone use AI to manage their mental health?

    9. KDr. K1:51:51

       The healthiest versions are AI is pretty good at giving people insight. So I work with a lot of clients and patients who do use AI for their mental health, and I don't think it's a bad thing. Like, AI really remembers a lot of things, and this is where the AIs are not all the same. There's some really interesting studies that rate their safety and, and, uh, efficacy, how sycophantic they are. Um, uh, like I think the TLDR of some of those studies and, uh, people, everyone's gonna get upset with me, but DeepSeek tends to be the worst, and Claude tends to be the best. Um, and, and I'll show you guys the actual paper, and you can look at the analysis that they, that they did and things like that.

    10. CWChris Williamson1:52:27

        And every new model that comes out completely upends probably a good bit of this, that in the space of two years' time, th- this would be-

    11. KDr. K1:52:35

        Yeah. Yeah. So, so the cool thing about this paper is it did look at different versions-

    12. CWChris Williamson1:52:39

        Right

    13. KDr. K1:52:39

        ... of, of AIs. So, so I think they compared something like close to a dozen, including multiple versions of some, like, ChatGPT and stuff like that.

    14. CWChris Williamson1:52:47

        So they've got some fundamental physics in there. That's interesting.

18. 1:52:49 – 2:11:26

    Are Therapists Turning Parents into the Villain?

    1. CWChris Williamson1:52:49

       I saw this Wall Street Journal article that said, "Are therapists to blame for the rise of adults cutting off their parents? Many moms and dads believe that their adult children are getting bad advice, and a growing number of researchers agree everything becomes trauma." What do you make of that?

    2. KDr. K1:53:06

       Yeah. What was the quote again?

    3. CWChris Williamson1:53:07

       "Are therapists to blame for the rise of adults cutting off their parents?"

    4. KDr. K1:53:12

       Yeah. Sure. [chuckles] So, so I, I think this is, uh, you know, I, I think we're setting a lot of boundaries nowadays. So a lot of, uh, a lot of, a lot of people are big on setting boundaries. So this gets, like, complicated. Um, but I think that we're sort of, like, I don't know if you've heard the t- term late-stage capitalism.

    5. CWChris Williamson1:53:35

       Yeah, and I have no idea what it means.

    6. KDr. K1:53:37

       So that's like if a capitalist society, like, keeps going in a particular direction, it reaches this, like, terminal stage where things get really damaging. I can't comment on that. I think what we're seeing, though, in our society is, like, late-stage independence. So human beings, for the majority of humanity, have usually valued or needed a community, and the, the community is more important than the individual. So we see this in themes like why do people fight in wars? Because I wanna serve my country. Why do people donate organs? Because I care about people around me. And I, I think what we're starting to see now is people are valuing their independence more than their community, and I don't think that this is necessarily bad. So I, I think if you have, you know, a narcissistic parent, because this is another problem, is that the generation above us is not very mental health aware-

    7. CWChris Williamson1:54:34

       Mm-hmm. Mm-hmm. Mm-hmm

    8. KDr. K1:54:35

       ... not very mental health capable. Um, I have a family member who's a little bit older. Literally every one of their three siblings, all four of them h- uh, three out of four have, like, narcissistic personality disorder. And, and in Indian culture, there's this attitude of, like, making it work, and they, they prefer-

    9. CWChris Williamson1:54:52

       Fuck me, that's tough. Mate.

    10. KDr. K1:54:54

        Yeah.

    11. CWChris Williamson1:54:55

        Wow.

    12. KDr. K1:54:55

        Uh, so th- they prefer, they value harmony, which is very common in Eastern cultures.

    13. CWChris Williamson1:55:01

        Mm.

    14. KDr. K1:55:01

        Like, they val- value harmony over individual wellness.

    15. CWChris Williamson1:55:08

        Yep. Understood.

    16. KDr. K1:55:09

        Okay?

    17. CWChris Williamson1:55:09

        Yep.

    18. KDr. K1:55:10

        So-

    19. CWChris Williamson1:55:10

        Yep

    20. KDr. K1:55:11

        ... a- a- and so this is something that, you know, like I saw in, in, in my family in, in a, in a arguably mild, compared to other things, but in, in real time for us, big way. So Indian weddings are big, okay? And the thing about the Indian wedding that I realized pretty quickly is the Indian wedding is not about the two people getting married. It's about everybody else. And so when my mom got married, it wasn't about her. It was, like, the, the senior ladies in her life, and especially her in-laws, made a lot of the decisions. So then my, my mom goes, uh, has this like kind of like it's so baked in she's not even consciously aware of it. Like, okay, my mother-in-law made the decisions in my wedding. My turn will be when I have a mother-in-law. But my wife was not having that.

    21. CWChris Williamson1:56:03

        Mm.

    22. KDr. K1:56:04

        So what's happening right now with this older generation is they're getting squeezed with having-

    23. CWChris Williamson1:56:08

        Mm-hmm

    24. KDr. K1:56:08

        ... toxic parents above them, which they had to support, and now independent children below them that are not putting up with their bullshit anymore.

    25. CWChris Williamson1:56:19

        Mm-hmm. Mm-hmm.

    26. KDr. K1:56:19

        They're actually getting screwed at a, at a, at a colossal scale.

    27. CWChris Williamson1:56:23

        Yeah. That's a really interesting reframe around this, that modern pe- especially Gen Z look at the development that they're doing, m- m- mental health awareness, uh, r- re-patterning of old traumas and visiting what it is that's happened to them, and you're looking at the Jungian shadow and varying levels of success, et cetera. Uh, but and, and they say, um, "My parents didn't have the skills that I do. Woe be on me for this sort of curse of awareness that I didn't have the upbringing that I should have done, and I wasn't treated in the way, and I wasn't held, and my attachment was broken, and now d- the thing, and my kids aren't gonna have to deal with it, but I did." You're like, that's true, but this is the first time that I'd ever thought about what it must be like for a parent, a parent's generation who didn't even have access to the skills and are now in small parts or large parts realizing that there's this thing they could have been aware of but didn't have access to, and their kids are now looking at them and saying, "My parents did the best they could, and I'm still quietly angry about it." Very interesting.

    28. KDr. K1:57:37

        Yeah. So I, I mean, I, I think that, that there is this, this push for independence, and I think you were kind of leaning towards where I think the healthiest place is, which is like, yeah, it sucks. Yeah, they're toxic, and they don't know how to be any other way. And, and even if you say, "Oh, but they..." Like, I'm telling them they need to go to therapy, but they're not going to therapy, but what is their understanding of what therapy is? How, how deeply baked into that is them, right? So you tell them like, "Hey, do this thing," but it's like if I, if I told them, let's say like someone's like, "Oh yeah, my parents won't go to therapy," and then I say, "You do the therapy for them," and then they will rebel against that, right? So like even, even the, the child will rebel automatically against something. There's something they'd never even consider.

    29. CWChris Williamson1:58:26

        Mm-hmm.

    30. KDr. K1:58:26

        So the... So if I tell you, "Do therapy for your parents, take the role of therapy for your parents," your instinctive reaction, the way that you feel about that is potentially the same way that your parents feel about going to therapy. I'm not saying that they should-- that children should take the role of therapist. I think that's actually an overt mistake. You should not do that.
19. 2:11:26 – 2:27:35

    Was Lindsay Clancy Experiencing Psychosis?

    1. CWChris Williamson2:11:26

       All right. Lindsay Clancy, what do you think about the case?

    2. KDr. K2:11:29

       Okay. So let's start with some background for people who don't know who Lindsay Clancy is. So Lindsay Clancy is an obstetric nurse, okay? Um, who has... is married and has three children, has a history of psychiatric illness, um, and after her third child has a psychiatric decline that is characterized by, um, outpatient care, partial hospitalization program, going to the emergency room, being hospitalized inpatient, being discharged, has seven psychiatric providers, uh, psychiatrists and nurse practitioners who prescribe 13 medications over some period of time. So Lindsay Clancy is also like particularly close to home because I trained at MGH, where she went to the emergency room. Um, I know the people who took care of her when she was hospitalized at McLean. So I'm, I'm very familiar with like the, the, this case. Okay?

    3. CWChris Williamson2:12:32

       Wow.

    4. KDr. K2:12:33

       Um, I used to take... She's from Duxbury, where I used to take my wife when she was pregnant. There's a beautiful beach over there and great oysters. So... And then what happened is, is Lindsay Clancy, um, killed her children and then jumped out of a window and, um-

    5. CWChris Williamson2:12:50

       Cut herself first

    6. KDr. K2:12:51

       ... cut herself and then jumped out of a window and is now, I believe, paralyzed from the sternum down. A few months after this happened, I believe her husband divorced her, and I think he's in a new relationship. I'm not 100% sure. And then there are two separate legal proceedings. One is the state of Massachusetts is, is trying to... It, it... Lindsay Clancy is on trial, in a criminal trial by the state of Massachusetts for murder of her three children. There is a separate civil lawsuit, uh, by Lindsay, put forward by Lindsay Clancy and her ex-husband suing various mental health providers for failure to do their duty of care.

    7. CWChris Williamson2:13:32

       I didn't know about the second one. That's fascinating. Okay.

    8. KDr. K2:13:34

       Yeah. So first thing is most people don't know much about... Like, like you said, have you read the legal proceedings? I, I've read some of the legal stuff, but I don't know anything about ethics or legality.

    9. CWChris Williamson2:13:42

       Yeah.

    10. KDr. K2:13:43

        But I know a lot about medicine, and I know a lot about the internet, and I know a lot about how people react to it. So there are a couple things that are like... So this is a thing that- So this is the, these are the facts, okay? Then there's the internet's reaction to it, which is people are blown away that she has, has r- So I heard, this is not something I verified myself, that her husband started a GoFundMe that raised $1.7 million that is not being used for her, her legal defense. I don't know if that's true or not or if that's social media conspiracy hat. She-

    11. CWChris Williamson2:14:24

        There is a GoFundMe for about a million dollars now, I think. I don't know whether he-

    12. KDr. K2:14:26

        She started a GoFundMe-

    13. CWChris Williamson2:14:28

        Okay

    14. KDr. K2:14:28

        ... to which, uh, uh, women have raised a million dollars on her behalf. And then the other really interesting thing is that this is tearing apart couples. So not just gender dynamics-

    15. CWChris Williamson2:14:40

        So someone called off a wedding.

    16. KDr. K2:14:42

        So yeah, so someone called off a wedding. So I am a psychiatrist who has done some postpartum work, and I went to the Massachusetts General Hospital and trained at Harvard Medical School, and I am reading 28-page civil proceedings on this, as well as doing a lot of research on postpartum psychosis. And my wife, who is my boss, comes to me one day and she says, "I'm disappointed in you." And I said, "For what?" She says, "For how you're handling the Lindsay Clancy case." And I mean, like, w- what do you mean how I'm handling... Like I'm, I'm reading things, I'm, like, reading papers, I'm looking at stuff. And, and she was, like, disappointed. I, I was just blown away. Like, this is like, like, I took paternity leave, I changed diapers. Like, I'm pretty sure I'm a pretty good husband. I'm pretty sure I'm a pretty good dad. And I'm pretty sure that I, like, support women through pregnancy, and I've seen postpartum psychosis. We'll get into that in a second. I've helped women through this, and I was just blown away by, like, my, my wife's reaction. She wasn't, like, super mean about it. She was just like-

    17. CWChris Williamson2:15:47

        Hmm

    18. KDr. K2:15:48

        ... you know, "I'm, I'm really disappointed in you." I was like, "What? Like, what did I do?" Like, I'm actually, like, doing, like, what, like, I've spent 10 to 15 hours at, at least, like, getting into the details of what is going on, and like, I, I... So I, I was just struck by that, and I was like, "Wait, what, what is going on?" Right? 'Cause I, I know that she doesn't think I'm a bad person or bad psychiatrist or, or things like that. Like, I've helped some of her people in her life who have gone through somewhat similar things. So, like, I, I know I'm not, like, in the wrong. A- and, and so there's just so much energy around this. And then, so what people are getting upset about, right, so people are breaking up o- over this. People are upset at the women for supporting Lindsay-

    19. CWChris Williamson2:16:40

        Yep

    20. KDr. K2:16:40

        ... and not considering the kids, okay?

    21. CWChris Williamson2:16:42

        Yep.

    22. KDr. K2:16:42

        So-

    23. CWChris Williamson2:16:42

        Uh, and people are upset at, uh, them for supporting the woman full stop-

    24. KDr. K2:16:46

        Yeah

    25. CWChris Williamson2:16:46

        ... which is a separate thing-

    26. KDr. K2:16:47

        Yeah

    27. CWChris Williamson2:16:47

        ... I think, to the kids.

    28. KDr. K2:16:48

        So, so, so let's understand a couple of things. So I think the basic issue here is that i- it's really a lack of understanding for a lot of things. The first is I don't think men, or even society as a whole, understands how hard pregnancy and the postpartum period is.

    29. CWChris Williamson2:17:08

        Mm-hmm.

    30. KDr. K2:17:09

        Like, we all say it's hard, but we don't understand. So the reason that, uh, like my take, this is some hot takes, and I'm not, you know, I'm not really an expert, actually. I think the reason that so many people are rallying to their defense is because-
20. 2:27:35 – 2:33:31

    Can Psychosis Involve Premeditation?

    1. CWChris Williamson2:27:35

       How, how unlikely is it that somebody suffering from that kind of psychosis would be able to plan in advance to get their husband out of the house?

    2. KDr. K2:27:50

       Uh, uh, that, that, that, that, I mean, I, I don't-- The short-- This is not my area of expertise, but I, I think that that holds zero water for me personally. So, so, like, I, I don't think that... So this is why it's important to understand the nuances of the belief system, right? So she's not-- There are some types of schizophrenia. This is a diagnosis. It's not psychosis. Psychosis is a symptom. S- people with schizophrenia sometimes have psychosis, but she, based on the medical records and stuff and, that I've looked at, she probably has bipolar disorder that can manifest with psychotic features, um, which, which, you know, they will make arguments for, so I'm not trying to diagnose her or anything, but that's just what the argument is, which is consistent. So, and, and by the way, the first, uh, so a very common time for women to be diagnosed with bipolar disorder is postpartum. So they will have a history of depression, unipolar depression, and their first psychotic episode or their first manic episode will be postpartum.

    3. CWChris Williamson2:28:49

       Mm.

    4. KDr. K2:28:49

       It's really common. So literally, like, in the hospital when I was training, people were like, "Hey, by the way, if you have a patient who's a woman who has unipolar depression, and postpartum they start doing some weird stuff, you need to think about bipolar disorder." That's, like, a part of my training. And the really scary thing, this gets really detailed. I have a whole YouTube video about this which is, is blown up. But th- there's this thing called the EASE, which is the Examination of Anomalous Self-Experience, which is a 50-page, like, questionnaire about different kinds of psychosis. And if you look at-- I d- I, I go over it in detail. But if you look at, like, her symptoms, like, they map onto the EASE, but very few people even know that the EASE exists. So this is some really weird, like, this is some AB2 I, I'm learning from people who's, have been working on a psychotic disorders unit for 10 years, and this is what they see day in and day out.

    5. CWChris Williamson2:29:38

       Mm.

    6. KDr. K2:29:40

       But anyway, so it, it's, it's, I, personally, I find it fascinating because a lot of psychosis, like, a lot of the warning signs are not what you would think. They're not psychosis, and they're not delusions. They're, they're feelings of, like, disconnection, like vague feelings of something is going wrong. I don't feel like myself. Something is going bad. This is something that, that's pro- what we call prodromal. So, like, you know before you get the flu, you feel sick for a day?

    7. CWChris Williamson2:30:03

       Yep.

    8. KDr. K2:30:03

       So, uh, the, the prodrome for psychosis is, like, this weird sense of, like, something isn't, doesn't feel right. I don't feel like myself. My thoughts aren't my own. Like, I feel like I'm not myself. Like, that's what they, that's what, how it starts. So people don't understand this, and I think, like, people really need to understand this, that, that even if she killed them, you know, 5% of people with postpartum psychosis have homicidal ideation. 6% of people with postpartum psychosis have suicidal ideation. And I think the numbers are there's somewhere between two and 20 people every day who will develop postpartum psychosis in the United States. So what that means is out, out of every, like, five to 10 days, like, someone's gonna get homicidal and someone's gonna get suicidal. This happens. I think the other really scary thing that's causing people to rally around Lindsay Clancy is that-- So, see, i- if someone thinks that this is someone did something wrong here, I, I think the main question to ask is, what was she supposed to do? So she did-- The really scary thing about this for me as a psychiatrist, which I think we don't really understand... See, when you get cancer, everyone understands there's a chance you're gonna die. What we really don't understand as a society is that 5% of mothers with postpartum psychosis become homicidal. Like, that's a part of the disease. Like, we know that. That's an outcome. Trying to kill your kids is a very, very rare but measurable, consistently measurable outcome for this diagnosis. Or not, not necessarily killing your kids, but having homicidal ideation, which then-

    9. CWChris Williamson2:31:46

       Could be someone.

    10. KDr. K2:31:46

        Yeah. The desire to.

    11. CWChris Williamson2:31:48

        But you are around your kids a lot.

    12. KDr. K2:31:49

        Yeah, right. So, so th- th- that's what's really scary, and what's really scary about this is that she kinda did everything right, right? So sh- she was actively in mental health treatment, got into higher levels of care, had multiple providers see her, received care at McLean and MGH, which are respectively the number one and number two top psychiatric hospitals in the country. Right? And maybe, I mean, a couple other. Every year it changes a little bit, but they're definitely top five. Right? So, and so she's got some of the best care on the planet. She has a husband who, according to the civil lawsuit, I don't know how much of this to believe or whatever, but is, like, pretty involved in her care. He's, like, calling her nurse practitioner, calling her psychiatrist like, "Hey, I don't think the medication is working. Can I bring her in?" So supportive husband, doctors from Harvard Medical School, long history of treatment, and this still happens. This is why women are rallying behind her, and this is why women are fucking terrified because she did everything right, but this is medicine and we're humans, and the scary thing about medicine is you can do everything right and you can still get fucked.

    13. CWChris Williamson2:32:58

        Are there any drugs that she was prescribed that would make her more susceptible to listening to the voice to do bad things or-

    14. KDr. K2:33:04

        I, I mean, I, I, like, the sh- I'm not gonna get to that level of resolution because I think there's so much... The short answer is, like, kind of yes and no, but, like, there's so much clinical s- specificity. So if you just take any, any one of the medications she's on and you look at the fold-out sheet of side effects, right? There's gonna be, like, literally hundreds of side effects to each medication.

21. 2:33:31 – 2:34:49

    Did Lindsay Clancy’s Medication Lead Her to Murder?

    1. CWChris Williamson2:33:31

       I'm gonna guess. I mean, I've heard people who aren't clinicians talk about some of the, specifically one of the, um, uh, drugs that she was on is maybe causing hallucinations. I didn't actually hear anything about hallucinations.

    2. KDr. K2:33:43

       She... I mean, the, the short answer, she's on a l- She got prescribed a lot of medications that can-

    3. CWChris Williamson2:33:46

       Is this, like, serious, serious shit? Is this as serious as you can get?

    4. KDr. K2:33:50

       Uh, uh, yeah, uh-

    5. CWChris Williamson2:33:51

       From a, a-

    6. KDr. K2:33:52

       Well, so, so, so y- yeah, but I... The reason I'm hesitant to answer that question is 'cause I think it's very hard to... It's very easy to take out of context. It's very easy to misunderstand. Just to give you a simple example. So she was prescribed an SSRI. So an SSRI is an antidepressant medication. If you have bipolar disorder... It, so, uh, it, it's an antidepressant. So she's depressed. We give her an SSRI. SSRIs can sometimes trigger mania. One of the features of mania can be psychosis. [laughs] Okay? So was she prescribed a medicine that can cause psychosis? Absolutely. But this is also ironclad standard of care for postpartum mothers who are experiencing depressive symptoms. That's what's really hard to wrap our heads around in this case, is that you can do everything right and bad stuff happens in medicine.

22. 2:34:49 – 2:37:37

    Was Lindsay Failed By the Healthcare System?

    1. CWChris Williamson2:34:49

       Are there any other elements of the case that you wish more people were paying attention to before we get into the reaction?

    2. KDr. K2:34:56

       Uh, I mean, not really. Like, I, I think it's, it, it's brought up to the surface and I, I think th- a lot of this armchair quarterbacking, like, I don't know if she got good care or didn't get good care. Um, I, I'm not gonna comment. Like, I, I, we just don't know. Like, you have to be in the room, and what I do feel really strongly about is that, you know, if you look at some of the testimony of, like, cross-examination of the psychiatrists and stuff like that, like, I, I think that the other big thing that this is showing... So for example, she called the suicide hotline twice, but there is no mechanism for the suicide hotline to communicate with her mental health providers.

    3. CWChris Williamson2:35:29

       Hmm.

    4. KDr. K2:35:31

       She went to different mental heal- medical systems that don't have access to each other's EHRs. There's a lot of things that-

    5. CWChris Williamson2:35:38

       EHR?

    6. KDr. K2:35:38

       Uh, electronic health record. There's a lot of stuff that people will ask, like, you know, her, her care providers on the stand, like, "Did you do this? Did you do this? Did you do this?" Like, and that's just completely unreasonable in any sense o- of, of practical care. So simple example is did you as- assess her for all of these things? The appointment lasts 17 minutes-

    7. CWChris Williamson2:35:59

       Mm

    8. KDr. K2:35:59

       ... because that's what insurance will pay for, and so you don't have time to do all the stuff that you're supposed to do. There's just, there's just no way. That is... So the other thing that I think this is really showing is this is a really good example of, like, something, uh, the, the flaws of our healthcare system here in America.

    9. CWChris Williamson2:36:19

       Mm.

    10. KDr. K2:36:20

        So, so what's really interesting is I was talking to some of my colleagues who are also following the case who are psychiatrists, and they're like, "This is not possible in our country because everyone has the same medical record. There's one medical record for everybody. So a- a- everyone sees what everybody else is prescribing 'cause it's all centralized," but that's not how we do it here.

    11. CWChris Williamson2:36:40

        Mm.

    12. KDr. K2:36:41

        So I, I think that this is also really scary because it's, like... And then the thing that I, I wanna also help people understand is that this is not, like, an anomaly. Like, everyone's getting caught up about this, but what's really scary is, like, this happens every day, and I think that's why so many people are, are supportive of her women-

    13. CWChris Williamson2:36:56

        Mm

    14. KDr. K2:36:56

        ... because they know. They're like, "Oh crap, like, I did see a doctor and the doctor wasn't helpful, or the medication didn't work and I was, like, right on the threshold." And I think that there are enough, I think something like 5,000 women donated to, to give her a million dollars. So it totally makes sense to me that there are 5,000 women out there who understand what it's like to be in her shoes and understand that even though they love their children, their mind was so distorted that they were thinking about hurting them, and so I think that's why a lot of people are rallying to support, and I think the men who judge the women don't understand what psych... I mean, she jumped out of a window and is paralyzed for the rest of her life, right? That's not like-

Episode duration: 3:04:07