172 - Esther Perel: Trauma, how narratives shape our worldview, and accepting uncomfortable emotions

1. 0:00 – 0:10

   Intro

   1. PAPeter Attia0:00

      [upbeat music] Hey, everyone. Welcome to the Drive podcast. I'm your host, Peter Attia.

2. 0:10 – 7:35

   Esther’s background, adventures in hitchhiking, and how she ended up in the US

   1. PAPeter Attia0:10

      Hey, Esther. Thank you, uh, thank you so much for, uh, for sitting down with me today. It's, uh, it's been a while. I've wanted to sit down and have, uh, the discussion we're about to have.

   2. EPEsther Perel0:20

      It's a pleasure. [laughs]

   3. PAPeter Attia0:22

      Now, I, I, I, uh, I detect a slight accent. Is that New Jersey?

   4. EPEsther Perel0:27

      Oh, yes. [laughs]

   5. PAPeter Attia0:28

      [laughs] Um-

   6. EPEsther Perel0:30

      Right across the river.

   7. PAPeter Attia0:31

      Right, right, right. Uh, how, how many languages do you speak?

   8. EPEsther Perel0:36

      I speak nine languages.

   9. PAPeter Attia0:38

      Yeah. I... As, as someone who speaks 1.25 languages, uh, it just [clears throat] it blows my mind, and I'm sure we're gonna get to how one learns nine languages. But, um-

   10. EPEsther Perel0:51

       Hmm.

   11. PAPeter Attia0:52

       W- You grew up in Belgium?

   12. EPEsther Perel0:55

       I grew up in Belgium, yeah.

   13. PAPeter Attia0:57

       Um, tell me a little bit about that.

   14. EPEsther Perel1:01

       Linguistically or-

   15. PAPeter Attia1:03

       Um-

   16. EPEsther Perel1:03

       ... broader? [laughs]

   17. PAPeter Attia1:04

       Yeah, broader. I think, um, you know, you've, you've spoken in the past about the impact that your parents', uh, survival had on your upbringing. Um, maybe you could tell folks a little bit about that, 'cause I, I, I'm gonna assume not everybody is familiar with your story.

   18. EPEsther Perel1:20

       Mm-hmm. So I grew up in Belgium. I was born in Leuven, which is a, one of the oldest university towns in Europe, and then I grew up in Antwerp, um, to two Polish parents who were both the sole survivors of their entire family of the Nazi concentration camps. And they, by fluke, arrived to Belgium. There was no... They had a permit there for about three months, and then they decided to stay, and so they ended up being another five years illegal refugees in Belgium. And, um, I was educated in Antwerp, which was a Flemish city. So I did 12 years of schooling in Flemish, but we spoke also French and Yiddish and German and Polish in the house. And that just was the way it was. It's the air that you breathe. Nobody made a big deal out of speaking all these languages and learning them. Um, so that's the, the basics.

   19. PAPeter Attia2:27

       Um, when you finished your, uh, education, your high school education, what was the next step for you? Where did you go after that?

   20. EPEsther Perel2:35

       The first thing I did after I finished high school was come to the United States to travel for almost two months, and I ended up hitchhiking across the US and seeing the country in a way that I probably will never see it again. And then I went to study in Jerusalem. So I went to the Hebrew University, that's where I did my undergraduate, and then I started my graduate school there. And I came to Boston, to Lesley College, to finish the second year of my master's program and to start my training in family therapy at the Cambridge Family Institute, and to work at MassMental Health, which was one of the Harvard Medical School hospitals. And, um, and then basically, I never used my return ticket.

   21. PAPeter Attia3:23

       W-

   22. EPEsther Perel3:23

       And here I am.

   23. PAPeter Attia3:24

       Well, let's go back to the, the, the, the hitchhiking trip. What, what made you decide to venture from Europe to the United States in the first place? And when you did so, did you have this plan of actually hitchhiking, or was that something that developed once you arrived?

   24. EPEsther Perel3:40

       I had hitchhiked before, in Europe and in Israel. Um, I had... Since I was traveling at age 14, a major way that you traveled when you were curious and broke was to hitchhike. So it was perfectly, uh, in fashion at that time to do so. And why the United States? 'Cause it was the bicentennial, and, uh, there were cheap cargo flights that took you from Belgium to the US. Uh, Capital Airlines [laughs] was, like, this first invention of old planes refurbished for, for, uh, people who didn't need much comfort. And, uh, no, I had a Greyhound pass. We, I was with my boyfriend. We had a Greyhound pass, and we thought we would be traveling with Greyhound, but every time my finger went up, it went so well, and I, I got invited into the homes of every kind of person that lives in this country, and the kindness of strangers, really. Uh, like, in ways that I probably would never have access to today. So it was the whole West Coast, it was Louisiana, Mississippi, Alabama, and then the Northeast. So, um, that, that's, that... It, it turned out this way because of a, a whole adventure, basically. I had lost my w- we lost our wallet and our traveler checks, if you remember that concept.

   25. PAPeter Attia4:59

       Mm-hmm.

   26. EPEsther Perel4:59

       And, uh, and everything, and we didn't have phones at the time, of course. So somebody found it, and this man came to pick us up and, and at the downtown station in LA, and he invited us to his house. And from that moment on, this trip took on a whole different, uh, personality for us. And, um, that was that. Seven weeks later, [laughs] I had just, you know, really had an insider's look that, uh, that i- innocence and curiosity allowed me to, um... And, and a good sense of street smartness, which you need when you'd hitchhike, of course.

   27. PAPeter Attia5:39

       Um, did that, in part, i- i- i- sort of give you a little bit of an affection for American culture? Um, and is that maybe part of the reason why you ultimately ended up, uh, setting up roots here?

   28. EPEsther Perel5:55

       Actually, no. [laughs] Um, I, I was fascinated. You know, I came, before I came to study in Boston, I came for another trip. I did another hitchhiking trip in Mexico for quite a few weeks, and then I went all the way from Merida to Miami to Quebec. So, and then I did a third trip where I spent the entire summer in New York City in the late '70s. So you can imagine, um, it, it was a different city. No, I liked it. I was very curious, but I had no intention ever of coming to live in what we called at the time in America. Um, I, and I came to study because, um, I had the opportunity to come to Cambridge, and nobody in my family had gone to university like this, and I was the first. And, you know, I had read Borges, and I thought Cambridge was a fascinating place to come and study, and I should take this opportunity, and I had no idea that I would stay. So I stayed in Cambridge for a couple of years, and then I came to New York thinking, "I have to do the New York adventure for one year." Um, and I came with my husband now, who was boyfriend then, and I really didn't think I would stay, but, um, I fell in love with New York. That I knew. Uh, and it's always been very clear to me that it would be Manhattan or abroad, that my real affection was for New York City. You could be anything and every part of you in one place, and I had always looked for a place to integrate the multiple parts of me, and this seemed to be the place where I could do so.

3. 7:35 – 17:21

   The lasting effects of the Holocaust on Esther’s parents

   1. PAPeter Attia7:35

      Now, I wanna kinda go back to something you said at the, at the outset, which is both your mother and your father were the sole survivors from their families, meaning their parents, their siblings, their aunts, uncles, everybody perished. Is that... Did I understand that correctly?

   2. EPEsther Perel7:49

      That's correct. Yes. My father came from a family of, uh, nine, and he was the youngest.

   3. PAPeter Attia7:57

      Mm-hmm.

   4. EPEsther Perel7:57

      My mother came from a family of seven. Every single one of their siblings were married with 7 to 10 children, and so each of them lost 200 people about. Um, and, um, they basically met on the day of liberation, uh, on the roads where people were looking for other people from the same area that could tell them if anybody else had survived. You know, it was, uh, um... And that's kind of how they met up, and, um, um, yeah, that was it. They were the only ones.

   5. PAPeter Attia8:32

      Do, do you have a sense of what permitted them to be the survivors? Do, do, do you attribute it to sheer luck, or-

   6. EPEsther Perel8:41

      Hmm

   7. PAPeter Attia8:41

      ... uh, I mean, it- it, the odds seem almost unimaginable given the circumstances of their periphery.

   8. EPEsther Perel8:49

      So the war for them starts in '39 because they live on the German side of Poland, so this is a very long war.

   9. PAPeter Attia8:55

      Mm-hmm.

   10. EPEsther Perel8:55

       It's six years about. Uh, my mother spends the first year in the woods. She's 18. She hides in the woods, which is really where she suffered the most. And she actually went by herself to a labor camp, a men's labor camp, because she had in her mind that if she can work in the kitchen or laundry, that somehow at least she will wake up every morning in the same place. Whereas in the woods, she had no idea, and she, she couldn't take the dread anymore. Um, she proceeds to go to nine different camps over the five years, and my father went to 14 of them, including a stint in L- in Siberia. When I would ask them, uh, there were generally a, a series of three points. The first one was luck, simply sheer luck. "I wasn't selected every morning when they chose 1,000 people. Somehow it didn't pick me." The second one was, "We wanted to live. We wanted to live. We thought maybe somebody's waiting for us somewhere, and we were going to live with dignity." So my mother describes mending her socks, folding her clothes, doing basic things that kind of maintain their sense of humanity. And for my father, uh, my father basically in the last year and a half created a kind of a black market in the kitchen where he had more access to potatoes. It wasn't very... [laughs] Potatoes and potato peels, and he managed to feed about 60 young people that all survived thanks to that, because it meant that they could go work, and as long as you could work, you had a chance of at least surviving, including him. He fed the Germans, the Nazi, the, the SS guards. And, uh, and I think feeling that he could help others gave him a sense that, um, of, of, uh, of agency, of mastery, of purpose, of, "I'm, I, I, I can do something here." So luck was a piece of it. It wasn't the only thing, but it always was mentioned.

   11. PAPeter Attia11:07

       So when you were growing up, I assume that you had friends who were not from that, uh, background, and therefore they would have, uh, quote-unquote, "normal things" like grandparents and cousins and aunts and uncles, things that you did not have. Was that contrast stark for you as a young child?

   12. EPEsther Perel11:28

       So I grew up in a, a kind of a, a, a dual situation. Um, I grew... W- we had a clothing store in a working class neighborhood. I lived above the store. I worked in the store. We were like the immigrant family on the block. The, my parents had accents. They didn't speak very well Flemish. Um, it, it, like in any neighborhood where you have that, that store that is owned, but instead of a food store, it was a clothing store, you know? That's when I am born, but I come 12 years after my brother, so this is, by then there is a store that, that, it didn't start like this, right? And, um- My father on occasion would kind of say, you know, he would put their hand on the shoulder of p- of a client, of a customer, and just say, "We went through some very bad things during the war." Like, and I would think, like, how would they relate to any of this? Then there was the Jewish community that we were a part of, where most of the people had numbers on their arms. So, uh, the first question you ask at two years old is, "Why don't I have a grandma or a grandpa?" And then the second time is, "What is this number?" And then the third time is, "Why don't I have uncles and aunts?" And so you, you ask these very... And you don't-- It's not just because you see other children, it's because you read children's books, and in the children book is a story of a family, and it has a few generations. And we had none of that, and we had about five pictures that showed that they were, you know, they had managed to save a few pictures. So that said there were these other people. Um, and so the Jewish community that I grew up in was all Holocaust survivors. That's-- This was normative for me. This was a very normal, you know, it's like a refugee community, then you only know refugees. But then in the store were these other people.

   13. PAPeter Attia13:23

       You've spoken a little bit about it, but I, I, I, I find it to be kind of amazing how your parents' survival changed their outlook on life and how that impacted your out- out- uh, outlook on life. Um, say a little bit about that. Uh, uh, their, their sort of, uh, their zest for life, if you will.

   14. EPEsther Perel13:46

       You know, one of the things my dad always used to say is, "We came from harsh circumstances. We were used to the bitter cold. I used to ca- carry bags of cement on my back. I was, I-- We were much better prepared than those who came from Greece or the Mediterranean or, you know, urban environments." There was something about being from kind of peasant stock, basically, that prepared them for hardship. Um, and I don't know. You know, the, the interesting thing is why does this story stay with me out of 1,000 others that he has told me? They, they talked a lot, so it's like, [sighs] what, what, you know... Today, this is not really what you ask, but it's often, you know, when I get asked a question like this and I start to answer it, I realize 1,000 questions that I didn't get to ask, that I just took the story as it was told like a Swiss cheese, with all the holes in it, and never kind of said, "But how did you go from here to there?" [chuckles] It's just like, we went and, you know, uh, like she mended her socks. How did you do that? Where did you find the needle? Where did you find w- you know, all these very granular details that I have, uh, no real answer to. But I think, uh, what, what I got was a few different things. The first thing I got, which actually really came back very strongly during the pandemic this year, you know, was the notion that everything can disappear in a split second. Don't ever think that what you have is there to stay and is yours. And on the one hand, it prepares you for dis- for, for catastrophes, for disasters, for change, and on the other end, you can never fully, fully settle, and you never, uh, you're never fully calm because you don't know that the ground you sit on could not at any moment, you know, open up. That's, I think, probably the most important thing is that sense of impermanence, the sense of loss, the massa of loss, the collective loss of not just people, but life, community, legacies, generations of stuff. Um, that's another thing. I, I think I have a real, um, a, a sense of what that is, you know? And, and yeah, I, I, when I s- c- I, I plumb into mine when I need to reach in other people's experience of loss like that. Um, but also, and dread. I mean, that goes with that. And then on the other side, yes, this enormous zest for life. I mean, they were not just there to work and rebuild. My parents were real bon vivant. I mean, they loved life. They really enjoyed to party, to sing, to dance, to, um... And that, in my work and in my personal life, but in my work when I s- around trauma and around pain and suffering, I, you know, I c- I, I have a reference for how one comes back from there, how one loves again, celebrates again, parties again, um, in a way that is not just them, but they happen to be the ones that I knew the best. And, um, and these things have very much influenced me in, in my thinking and in my outlook on the world. I mean, yeah, there's

4. 17:21 – 24:28

   Grappling with a dark past and feeling alive again after trauma

   1. EPEsther Perel17:21

      lots of other things, but...

   2. PAPeter Attia17:22

      So if on the one hand it's entirely remarkable that your parents survived the ordeal that they were placed in, it seems equally remarkable that they weren't permanently scarred by it. And if we've talked about some of the factors that may have contributed to their ability to survive what they did for six years, what do you contribute to their ability to come out the backside and experience everything you just said? Which is, um, I g- because I have to imagine that there are many people who survived concentration camps, but they were never the same again. Uh, they were-

   3. EPEsther Perel17:58

      No

   4. PAPeter Attia17:58

      ... never able to form meaningful relationships. The PTSD of the experience effectively left them dead even though they were still breathing. So why-- I mean, I, I'm guessing your parents didn't have access to MDMA-assisted psychotherapy for PTSD and world-class psychotherapists. I'm, I'm guessing they did this somehow on their own.

   5. EPEsther Perel18:17

      No, but they had access to something else. See, my mother in the '50s went to the big professor at a university in Leuven, and basically he kind of said to her, "What you experienced, one can't just come back from, and there is nothing, there is no medication or treatment for this kind of stuff." And she had nightmares, and she had, uh, uh, m- massive eruptions sometimes. Um, and she, you know, she'd go and check the door a few times in the night at that time and stuff. So we didn't call it PTSD, we just called it survivor syndrome, actually was the name at the time. But she had access to what today are called a spa. My mother did thalassotherapy, mud therapy, uh, walking on wet grass, all the things that today are part of the wellness treatments that were, that are all traditional ch- things that were done in the bath of Eastern Europe, in Czechoslovakia, in Hungary, in Poland. And she went every year for a month to the spa where she was doing wa- bath and water and mud and big jets of frozen water. Uh, the stuff that you do when you go from hot to cold. This was like traditional medicine. So that's the stuff she did to calm her nerves, which was called at the time, calling you, you know, you had nerve, nerve issues, [laughs] nervousness. The other thing, because I have said, I mean, it, it, it is a thing I wrote in Mating in Captivity that kind of followed me around afterwards where I said that I was interested in w- that very question, what made some people wanna live? What feeds aliveness? What is this antidote to death or deadness? And I remember describing my observation between those who did not die and those who came back to life, you know, those who could never trust and those who reconnected again, et cetera. But I think what really, and this is very relevant for today, what my parents had was a strong sense of community. So, you know, all these people come out of the camps, and first they go to DP camps, to temporary camps, and the amount of babies that were conceived there, because all these people wanted to have children, to know as a way of proving that they are alive, that they are human, that they can still procreate. And that in itself is such an act of healing. You know, you, you rebuild. You didn't destroy it all. You didn't dis- you didn't sever all connection. You know, there will be a future, there will be more of us. That's the first thing. Then this community comes together, and they have gatherings for the survivors of town such and such, for the survivors of camp such and such. They plant trees, they celebrate, they tell stories. They fundamentally understood something that today we're trying to bring in, that is that such a, what is called today collective trauma, that was called psychosocial trauma, demands collective resilience. They didn't try to do anything on their own, you know. Now, the first years, they don't talk much. They arrive to these foreign countries, and most of the time people don't really wanna hear much of what they've gone through. You know, it's like you tell two sentences and people can't hear anymore.

   6. PAPeter Attia21:50

      Meaning even amongst each other, not-

   7. EPEsther Perel21:52

      No, no, no. With each other they tell, but they don't always have to tell... You see, it could be this kind of short, you know, "That camp was a bad camp. That SS guard, you did not wanna be under him," you know. "I managed in that winter." [laughs] They had all these sentences like that, that just shorthand, and everybody knew what was the reference. Everybody knew what w- where, you know, what it came back to. So to, to each other, they talked a lot. And you know, I've always had this image that, that I, I once told because it's such a powerful thing. Every Sunday my parents played cards, friends came over and they played cards. So they're playing gin rummy and stuff, and as they were playing with these cards, somebody would just suddenly say, "Whatever happened to John," you know, "Morris, [laughs] John Mitchell, John Z-" whatever. "Oh, this one was gassed, this one was murdered, he didn't make it, he went to Australia." And I couldn't believe what I was hearing. It was like there was no child development approach in my house, you know, nobody looked to see if there's a child there to hear all of this. It was done in this affectless way. There was no affect. Horrors were told in that disso- what today we would call dissociation, but for the purpose of survival and regeneration. It was a very good natural defense. And I think that what is interesting about that group, which is really the first time that people understood the concept of adult trauma, 'cause until then it was all about first five years of your life, is that they came up with some of the most adaptive, resilient ways of going about things without ever seeing a shrink, without any access to mental health, just something inside their own tradition that they had, you know, that history, this was not the first time Jews were having a rough time in history, right? They, th- these resources really were gleaned from a, a culture that is collective in nature, and it's not the only one for sure. So that's I think really what helped them more than anything else. Walks in the woods was a ritual. You needed to go into nature. This is like, you know, everybody's writing about that this pandemic year. Something that, about them knew that being in the forest in- Is healing.

5. 24:28 – 32:19

   How Esther came to understand her parents in a new light

   1. PAPeter Attia24:29

      Now, recently you wrote something, um, on Mother's Day actually, about your, um, relationship with your mother, and you wrote about, um, all the positive things and many of the positive things that your mother did for you, but at the same time, there were things she didn't do for you, and it's left you with a feeling of ambivalence, uh, at least with respect to, to, to some of the mother-daughter things that, um, maybe weren't there. Uh, w- h- how, how did that unfold for you as you went from being a child to an adolescent? And, and I assume at the time you didn't think this was abnormal 'cause you had nothing to compare it to. I assume this was a, a retrospective reflection?

   2. EPEsther Perel25:15

      I would say from the time I was an adolescent to the time I was an adult is really more the, the, the sequence, you know. So it's very interesting. I have, I have not talked often about this, but I just was s- tired of hearing about Mother's Day and Hallmark card Mother's Day, and I thought, I, there's so many people who have complicated relationships with their mother. Maybe we should put that on the table for a change. So I whipped this thing out on, on Sunday because it's very easy for me, with a, a good dose of humor to, to, to describe [laughs] my mother. And what's phenomenal is thousands of people are writing to me basically saying, "This is my mother. This is my mother."

   3. PAPeter Attia25:58

      [laughs]

   4. EPEsther Perel25:58

      So I know she's not unique, you know, and she comes in every culture [laughs] and she comes in every color. Um, you know, but basically, uh, she had this thing with the evil eye, right? She was a very superstitious woman. So this whole idea that you shouldn't say good things to your kid because it will blow their head, [laughs] that she took that to the very concrete level, you know. And so, you know, she had this notion that she's there to tell you what other people will not tell you, and that's usually not the good stuff. And so she was true to, to herself till the end. She didn't say one good word to me ever. Ever.

   5. PAPeter Attia26:39

      How old were you when she died?

   6. EPEsther Perel26:41

      I was, uh, she was 80, uh, and I was 42.

   7. PAPeter Attia26:47

      So by the time she died, you had already achieved a lot of professional success.

   8. EPEsther Perel26:52

      N- in, I was, no, not completely. Yes, in my field, but I hadn't written Mating in Captivity. I actually started to write Mating after she passed away, and I remember saying, "This is the first time I'm actually doing something that I'm not sure I can do, and I don't think I could ever have done this when she was alive."

   9. PAPeter Attia27:15

      For fear that she would be critical of you saying, "Why are you doing this? You don't have the, uh, you don't have the experience to do this," or something like that?

   10. EPEsther Perel27:23

       Yeah. I mean, because every time I made a decision, I had to have confidence one time for me and one time for her anxiety. I had to prove to her, whatever it was, this was true for the hitchhiking trip, too. This was true for going to study in Jerusalem. This was true for coming to live in New York. This wa- everything. Everything I decided, you know, she would challenge me, challenge me, challenge me. And so I had to, I had to have inside of me a sense that I knew that I can do it. I have to succeed at this, you know. Not to prove her wrong, but just to be able to do what I want. I wasn't, you know, it wasn't to defy her. But, um, this time I began to write and I thought to myself, "I have no idea." I, I had, I remember saying, "I've always done things that somewhere inside of me I think I'm capable of doing." Uh, you know, these are sentences that I remember saying back then, and this is the first time that I'm taking something on I have no idea. But her voice isn't there to make me feel like I have to be sure. I'm allowed to do something without knowing, and I'll do the best I can, and I'll pour my soul into this, but that's all I have. Rather than, "I know I can," which was the stance I had to have before then. So I think the ambivalence that you're asking about is really, you know, it's not uncommon that you have a family and the mom becomes the strict one. She's the stern one. She's the more critical one, and my dad is sugar candy. He's the sweetest, you know, the sweetest, kindest, uh, loving, adoring dad. And what you begin to understand once you start to study family therapy is that of course he's always kind and loving and adoring because he leaves some of the dirty job to her. She has to put the limits. She has to, you know, uh, um, basically put the limits, do the discipline, do all the stuff that he doesn't like to do. And I began to understand that the good parent and the bad parent or the, the, the soft parent and the harder parent, that's a construct. That is not just a matter of personality because my mother was also very... She had tremendous charisma and she was funny and brilliant and all of that, too. That in fact, it's because of how he acts that that puts her in this role, and this role then is already the quota is filled, so he doesn't really have to do it. And once I saw that, I began to see my dad is not the all good, that he actually leaves her alone, comes home three hours later, doesn't call to tell her, leaves her standing with all the cooked food in the kitchen, and of course when he comes home, she's all pissed and yelling that he doesn't respect her or that she's there, you know, standing there like an idiot in her... You know, and me, instead of thinking, "Stop screaming," I began to say, "Why did you just do this to her?" You know, in your beautiful loving way, but you just stood her up. And once you begin to reorganize the movie and the interpretation of the movie, then you suddenly realize she's actually not only the negative, you know, I, my anger goes to her and my love goes to him kind of thing. And that's when you begin to experience the ability to hold contradictory emotions at the same time, and that's ambivalence. Ambivalence is the ability to hold both end. I love you, and I also have a lot of anger toward you, and those two are coexisting inside of me, rather than I split off one part and then I attribute it somewhere else. Um, and once I began to do that, then I was able to diffuse her things. You know, if she was critical of something, you know, I had a way of joking with her, um, that, that basically didn't allow her to enter under my skin. And I just could re- really say, you know... I... All kinds of diffusing tricks that I had learned, basically. My favorite one, which... Because I, I've used it with so many people in my own therapy work afterwards, was to just give her a kiss on the cheek and just say, "I so appreciate how you're trying to make me a better person, but I want you to know, I think I... You've done a good job. I, I think I've got... I'm, I'm where you'd... I w- I'm where you... I think you would want me to be. So if you want, you can go try to improve others." [laughs]

   11. PAPeter Attia32:10

       [laughs]

   12. EPEsther Perel32:10

       It worked very well for me. I would laugh as I said it instead of feeling the wrath mounting inside of me.

   13. PAPeter Attia32:17

       [laughs]

6. 32:19 – 43:57

   Why Esther chose therapy as her career

   1. PAPeter Attia32:19

      So what drew you to therapy as a career?

   2. EPEsther Perel32:25

      I would s- ask myself what drew me to psychology first. So I'm a teenager. I, I'm a teenager at that time. I have a very contentious relationship with my mom. We do a lot of good screaming on occasion. Um, I am in a school system that is extremely, uh, uh, traditional. The student doesn't matter, only the content matters, the material matters, you know. Um, and I'm thinking, you know... I start to read these alternative education books, and I start to read, um, Victor Frankl, and I start to read R- Bruno Bettelheim, and I start to read Free Children of Summerhill, and R.D. Laing in Anti-Psychiatry. And I just... I, I become very, very interested in why do we feel what we feel? How come I'm having dreams about Hitler and Nazis and c- you know? It's not my life. I didn't go through that. Why do I have those dreams? What does that do to me? Um, and how do people get along better with their parents? Uh, you know, at that time, sometimes, you know, when things were really, really tough with her, I had this idea that if I could disappear, then I would see if she ever misses me, you know? And if she... Then... But of- I have these fantasies of, how can I disappear for a while and put the, the fear in her that she may have lost me, and then see if she actually cares about me? And then I thought, where does that come from? Why would I wanna do such a thing? And this is the beginning of my interest in psychology and in hu- in, in reading about human relationships, which I then did profusely. And, and then I also realized I actually am quite good at this. People come to confide in me all the time, all my friends. I, I see this... I s- I, I see, I see what's not visible in relationships. And, you know, everybody thought because of my languages that I should be an interpreter or maybe a journalist or a lawyer, 'cause I could argue my case, a litigator. And I decided I think psychotherapy could be a very interesting profession.

   3. PAPeter Attia34:42

      Or a spy, by the way. You'd be... You would've been a great spy.

   4. EPEsther Perel34:44

      [laughs] That's right. I never thought of that way. [laughs]

   5. PAPeter Attia34:49

      So when you found yourself in Boston, you're, you're now going through your graduate program. What is your first job, career? You know, your first, your first step into your professional career. Is it family therapy?

   6. EPEsther Perel35:03

      No. My first, first job was at the hospital, uh, as an expressive arts therapist working on the psychiatric unit. And because I had also had the whole adolescence and young adulthood in the theater, and I had done a lot of puppetry, and I thought to study expressive arts therapies would be a very interesting way of bringing together the arts as a modality, as a psychotherapeutic modality. And I just worked two years first in the hospital, um, as an expressive arts therapist, primarily with groups actually. Sometimes with families, but mostly with groups. And there was something missing. I felt like there must be more. Plus, it... You're at the bottom of the totem pole when you're an expressive arts therapist. It's like you're the recreation therapist. After the doctors have gone by, the therapist, the psychologist, then, you know, keep them busy. And I just thought that that isn't gonna go f- very well for me, you know. Uh, to be in a profession that is not valued when I think it is so incredible, s- something is off. So I, I was with Jack. I was talking to Jack at the time, and w- who was just a colleague at that moment, and my... And kind of mentoring me slightly through, um, through my thesis. And he said, "I think you would... You sh- you would be interested in family therapy. It's more contextual. It's more anthropological. It's more intercultural. It takes all the other pieces into account the way that you have done." I was writing about cultural, religious, and racial identity. I was, uh- A- and this was too small for me. I needed a, a field that I could, you know, that was more expansive. And, uh, the revolution was to begin to think s- in systemic terms, away from the individual intrapsychic model into the interpersonal and, uh, societal or contextual model. That just opened up a gate for me. And then I went to work at Mass Mental and, uh, and slowly I thought, "I'm not sure that the hospital setting is the best setting for me."

   7. PAPeter Attia37:15

      H- how do, how does that family therapy work in a hospital setting? When you say hospital setting, do you mean inpatient setting?

   8. EPEsther Perel37:22

      Yes. Yes, inpatient.

   9. PAPeter Attia37:24

      So does that mean that, that, that you're taking care of psychiatric inpatients as individuals, or you're helping families of-

   10. EPEsther Perel37:33

       Families

   11. PAPeter Attia37:34

       ... of inpatients?

   12. EPEsther Perel37:35

       Yes, with the, with, with the identified patients. So I did it both inpatient and outpatient, and basically, yes, you do sessions with the whole family. But it's not just who is in the room, it's how you think about what is, what is a patient? In a s- in, in family therapy language, the patient is not just a patient because they have... they feel certain things or they are struggling with things inside of them. The patient has a function in the family, is often as- assigned by the family. That is the person who's allowed to struggle and suffer out loud amongst a group of ascetic people, you know, who are just, like, holding it all in type thing. That's just a one tiny example. So you work with the system and you try to understand, you know, what led this person to wanna commit suicide? What led this person to not eat? What led this person to, you know, destroy themselves, or whatever the issues are. And that notion that things are interconnected was also, you know, what I had experienced. I knew that some of the things I was feeling wasn't just because I was born this way. It was in my dynamic with my parents, with my mother in particular. And, um, you know, when you study family therapy, you do genograms, you look at intergenerational transmission, and so you constantly are studying yourself as you are learning the paradigm. And I, for, and at no time did I think, "Oh, this just applies to me." This is a fascinating other way to look at things.

   13. PAPeter Attia39:18

       Now, when you studied, when you did your master's, it was focused on family therapy?

   14. EPEsther Perel39:25

       My master's is in expressive arts therapy.

   15. PAPeter Attia39:27

       Okay. So that's, that's what took you to your first role. So, one thing that is interesting to me about psychology versus, uh, medicine, in medicine, your postgraduate training, your residency really prepares you for what you're going to do in your career, and frankly, many people don't do much training beyond that, even though, you know, obviously one should. But it seems that in psychology you have to reinvent yourself. I mean, if you want to make the leap from expressive art therapy to family therapy, you're not gonna go back and do another master's degree or do another, uh, clinical, you know, internship or something like that. So how, beyond your own experience, how are you finding mentors and/or, you know, sharpening the, the, the tool of your trade?

   16. EPEsther Perel40:18

       You can be a practicing clinician who every few years decides to learn one more modality, one more theoretical paradigm. Um, it's endless. It's e- it's absolutely endless. You can have an interest in a topic. I'm interested in the area of trauma. I'm interested in eating disorders. I'm interested in anxiety disorder. This is one way to organize your interest. But you can also say, "I'm interested in working with families." And at that time, this was the heydays of family therapy. There were five schools of family therapy: structural family therapy, strategic family therapy, feminist family therapy, intergenerational. You know, these were... You, you, you had, you, a good 10 years of learning just between those five, right? You can say, "I want to learn..." You know, now there is the neuroscience. The neuroscience have come in and they have so many interesting new things to say about how people regulate and co-regulate each other in relationships. I need to know that, 'cause I wanna be able to use that in my work. So my frame remains the same. I am a couples therapist, a family therapist. I do individual work as well. But I need to understand the new things that we know about the brain. Then there is a phase everybody's talking mindfulness. I need to know everything that mindfulness can tell me about working in relationships. Then, you know, it, it's that way that you... Basically, if you are a curious person in mental health and in psychotherapy per se, which is one practice of mental health, it is an endless, endless school. Um, and I ev- you know, there, I am admire those who sometimes continue. They, they, like... I have colleagues who just, like, throw themselves into a new approach and spend 500 hours [laughs] you know, honing that skill. And then, you know, you have CEUs as well, Peter.

   17. PAPeter Attia42:15

       Yes. Yeah.

   18. EPEsther Perel42:15

       You know, there is a, an incentive that makes you continue to go and learn. Um, but I think, uh, the, the knowledge of human beings, which I think is not different in medicine in that sense, is endless. And there is a new way of thinking, and then there becomes a dominant way of thinking, and then for 10 years everybody thinks like that. And then, you know, the truth of today becomes the joke of tomorrow. And then we move on to a new paradigm, and it's amazing how you are just, you know, depending on when you enter the field, you basically rode the wave of the moment. If I was in the 19th, late 19th century, I would have been a psychoanalyst. [laughs] And you would have thought of medicine very differently than you do today. It's i-i- in a way, it shows you the social construct of those fields. They are sciences and they are humanities, but they are also completely immersed in the, in the time of th- that they are, or, you know, in, in the context of the moment.

   19. PAPeter Attia43:17

       And if your CEUs are as valuable as our CEUs, they don't offer too much. Our, our CEUs are-

   20. EPEsther Perel43:24

       [laughs]

   21. PAPeter Attia43:26

       ... uh, they're, they're something that we do simply to maintain our licensure. But, uh, I, I'm still looking for CEUs that, that teach much valuable content.

   22. EPEsther Perel43:34

       That are worthwhile?

   23. PAPeter Attia43:34

       Yeah, yeah. I... In fact, the ones, at least for me, that I find most valuable are the ones that are so far outside of my area of expertise that I can actually learn something. But, [clears throat] you know, the ones that are generally close to what I do are, are, uh, not that helpful. Which of course then makes me question how helpful the ones are that are so outside of my area, because they may be equally far from what's, what's, what's likely reality. But, um,

7. 43:57 – 53:46

   Using the concept of sexuality to understand society, culture, and people

   1. PAPeter Attia43:57

      [lip smack] so you're going along, you're doing family therapy, you're now transitioning obviously from inpatient to outpatient. Y- I assume you're... Is this when you move from Boston back to New York?

   2. EPEsther Perel44:09

      Yep. Yep.

   3. PAPeter Attia44:11

      And everything's going well. And then how did Bill Clinton change your life?

   4. EPEsther Perel44:16

      [laughs] So, um, there's a little bit of a road to Bill Clinton.

   5. PAPeter Attia44:23

      [laughs]

   6. EPEsther Perel44:25

      [laughs] But, um, you asked me, because I think this training thing, CEU, is a really important thing. So I, I th- and I'm gonna trace this back to my mother. I think that because of how critical she could be, I did often seek mentors. I was very drawn to people who saw something good in me. I was drawn to people who believed in me. I saw... I was drawn to people who thought I can do certain things. It's, it just, it, it w- I would melt when somebody would, uh, would do that. And, and then I began to actually really seek these mentors, not just stumbled upon them as a counselor in a summer camp or things like that.

   7. PAPeter Attia45:11

      Mm.

   8. EPEsther Perel45:11

      And, um, and this is kind of how I learned. I asked people who I wanted to learn from if I could be their shadow. And I just was like a disciple that, you know, an apprentice that watches the craft being done and, and learns from incredible clinicians. I mean, um, then I come to New York and that's when I meet my, one of my next mentors, uh, Salvador Minuchin, who I have spoken about because my two main mentors have actually passed away in the last two years, one by old age and one by suicide. Um, so I've been thinking a lot about these things. And, um, I basically started to, uh, work at the 92nd Street Y and then started to work, um, privately, um, because that's what, you know, I... It had to do with papers and immigration and license and green cards and all of that stuff. And I basically did it the way that I knew my immigrant parents did. You hustle, you find a way, you enter in, you do, you know, that kind of a thing. And, uh, um, and I had, by the time I, this Clinton affair arrives, and by the time I start to write Mating, yes, I had a very nice psychotherapy practice. I would teach, I was at NYU in the medical school as a clinical instructor. I was lecturing. Um, and I had developed a real specialty in the area of working with mixed couples and families, intercultural, interracial, interreligious couples and families. Why? Because the way I could build a private practice in New York City is because I knew languages. I didn't know much about therapy yet, but I knew languages, and these people wanted to speak their language with me, and that's how this began. And I had three supervisors who checked on everything I did, and that's how I began. Um, and by the time the Clinton scandal arrives, I just didn't wanna write a book about mixed couples. That was the main thing. I began to feel like I'm ready for a new subject, but I need a portal topic, and I like topics that open, that open up to me, that can, that, that connect to theology, anthropology, sociology, psychology, you know, big. Like you, the CEUs take place in a different field. You know, I like that too. And, um, and I don't know, I just got inspired by the story because, um, it kind of really was this, what is this American attitude to sexuality and to sexuality as a matter of national political agenda, for that matter, and to, uh, you know, w- how do I make sense of this whole thing? And then I wrote this article in 2003 in an obscure magazine, uh, that was known only in our field, and that changed everything around.

   9. PAPeter Attia48:18

      And now I've read this obscure article in this obscure magazine. Um, and you comment on being at a conference and noting the fundamental difference that all the people at the conference who were American had versus all of the non-Americans. W- say a bit more about that.

   10. EPEsther Perel48:37

       [laughs] I think that one way to say it is on a, on a cultural level, uh, there's been a real push to see sex as a risk factor in America. Sex itself is the risk factor Whereas I think the European notion and the public health notions in Europe is that sex is a natural part of human development. Being irresponsible is a risk factor. That changes everything. And so I don't think that clinicians in the field of psychotherapy is free from that. I, you know, was... I studied couples therapy and family therapy without one hour about the subject of sexuality. How can that be in a culture where sexuality is so central? Um, and in a love culture, I'm talking. I'm not talking, you know, just the modern ideology of love is, you know, puts that dimension front and center. How can we do couples therapy and not ever talk about it? Years. Something is missing, you know? And, uh, and the field had organized itself in a very interesting way to never have to talk about it because it said, "If there are sexual problems, it's the consequence of relationship problems. Therefore, focus on the relationship, fix the relationship, and the sex will follow." And that is sometimes the case, but so many times not. There is more to the story, you know. My, my, my thinking has always been this is not inaccurate, but there is more to the story. That's the way probably... That sentence drives my curiosity. Um, and you could be at an entire conference that talked about sexuality and never hear the word pleasure, connection, sexual connection, eroticism. None of these words were being used. And if I looked at the literature, you know, the nice thing about languages is I go and I read other countries' literature, and I realize this is actually not the, the only way to do this. There is another way of looking at these things. That's where I was.

   11. PAPeter Attia50:56

       How is sexuality a lens into society?

   12. EPEsther Perel51:00

       Ah. [sighs]

   13. PAPeter Attia51:03

       Because I get the sense that your real interest is deeper than sexuality. Sexuality is a vehicle, I think, for you to understand more.

   14. EPEsther Perel51:10

       Yes.

   15. PAPeter Attia51:11

       Understand society, understand people.

   16. EPEsther Perel51:13

       That's it. Yes, and cultures and, and... Yes. Yes. Yes. Yes. So the... And the... And I think where I... This thing really originated for me, you know, when you write a book, there's about four or five books you've read that are kind of the foundations for, "Oh, wow, you could see it like that." So at the time, I read Octavio Paz, The Double Flame: Essays on Love and Eroticism, which is a very... First of all, he distinguishes sexuality and eroticism. That distinction, that is so important. And then he looks at religion, and then he analyzes h- religious re- how religion has intersected with sexuality, 'cause every religion has had to do something about sexuality. Here is what I began to look at was this: If you look at a culture or at a civilization and you look at its most archaic, rooted, sometimes intransigent aspects, what it holds onto, many of those things will be organized around sexuality, and particularly the sexuality of women and children. And if you look on the other side at revolutions, radical changes, progressive changes that happen in a society, often also connected to, uh, industrialization and scientific developments and medical developments, et cetera, it also takes place around sexuality. And so in that sense, I think sexuality is a lens. It's, it, it tells a story of the values, the behaviors, and the attitudes towards the body, towards pleasure, towards power, towards connection, towards, uh, uh, the division of, uh, spirit and flesh or mind and body or all of those things. Um, the women in the psychiatric hospitals of Charcot were not just hysterical. They were victims of sexual abuse. [chuckles] That's a very different story. And they were there because some, some crazy way, this was still safer than to go back to the places where they had been used and misused. So that's a, a, a way of, of beginning this answer.

   17. PAPeter Attia53:42

       Mm-hmm.

   18. EPEsther Perel53:43

       Does that make sense?

   19. PAPeter Attia53:45

       Yeah. Give me an

8. 53:46 – 1:03:18

   The significance of sexual revolutions, and the similarities of medical advancements and advancements in psychotherapy

   1. PAPeter Attia53:46

      example in the United States where... I mean, there's an obvious example, which is a sexual liberation in the 1960s, right? Which is a, a, a, a, a step function change in the political climate. Uh, so I can certainly see that lens. I think I've never thought about it through a technological or scientific lens with one exception. The one exception to me that doesn't get enough attention is, uh, the development of the birth control pill. Um-

   2. EPEsther Perel54:18

      Yeah

   3. PAPeter Attia54:18

      ... which I've always thought is one of the most underappreciated, um, highest ROI philanthropic developments ever.

   4. EPEsther Perel54:26

      You're absolutely right. Yes.

   5. PAPeter Attia54:28

      Um, do you know that the cost of developing the birth control pill in today's dollars, I believe it was less than $100 million, and it was mostly footed by one woman. Um, McCormick, I think, was her name. I'm blanking on her name. I used to know the story quite well. But it was an amazing story.

   6. EPEsther Perel54:45

      Mm.

   7. PAPeter Attia54:45

      And, um, she basically partnered with a, with a, with a scientist at Harvard who- whom she'd met at a dinner, and he had this idea that if you gave women enough estrogen and progesterone, you could actually, uh, f- you know, basically suppress ovulation and, and flatten the, the luteal and follicular, uh, cycles. And it, it was one of these things where everything came together at the right time. So it was the combination of doing it In a, in a, in a political environment, I think prior to, uh, I think they started their work prior to the Kennedy ad- Kennedy administration. There was a lot of fear that a Catholic president, uh, would not, you know, uh, allow-

   8. EPEsther Perel55:30

      Mm

   9. PAPeter Attia55:30

      ... allow the FDA to endorse such a thing.

   10. EPEsther Perel55:32

       Mm-hmm. Mm-hmm.

   11. PAPeter Attia55:33

       But, but nevertheless, she very quietly plodded along in funding this, this scientist, and I can't believe I'm blanking on his name. Um, but the two of them really did this amazing work, and it's one of the few things where there's no ambiguity about the impact it had. So if you look at pre-birth control versus perth- post-birth control, you look at the number of women that have advanced degrees, the average income of women. I mean, these, these things changed not subtly, but logarithmically. Um, I'm trying to think of other examples, uh, where sexuality is so clearly tied. Uh, you know, for example, like the space program or something like that. Are there other examples I'm just missing?

   12. EPEsther Perel56:18

       I mean, I typically look at three of these revolutions, you know. Um, one is the democratization of birth control, first and foremost. It, I mean, it changed so much other things, you know. Yes, of course, the entrance of women in the workplace and the advanced degrees, but also it fundamentally changed the meaning of sexuality in romantic and l- in long-term committed relationships. Uh, it also allowed for the first time to separate sex from reproduction, and then we began to separate reproduction from sex, and now we are separating anatomy from gender. I mean, these are conceptually revolutions. They're not just, you know, uh, uh, uh, the, the mind has to adapt to this thing. You know? What that actually would mean for an entire history of humanity does not understand that sexuality could ever not carry the consequence of l- that intercourse, you know, penetration could never, you know, be separated from the potential of childbirth, and unwanted child, et cetera, et cetera, et cetera. So the second revolution for me is the gay movement. They're not in order here, you know, but I do think that our, our, uh, in those countries where the attitude to homosexuality has shifted, so many things shifted because by definition, once we had contraception and once we were able to have sex before marriage, we basically began to queer our relationships. You know? Uh, uh, uh, homosexuals have often, gay people have become more straight in their pursuit of marriage sometimes, and for all the legal and every other recognition pieces that are connected to that, I mean, it's, it's really one of the most important shifts around that, including taking it out of the DSM, you know? I mean, de- depathologizing this. I mean, sexuality, the history of sexuality is a fascinating history of society and cultures.

   13. PAPeter Attia58:26

       When was it taken out of the DSM?

   14. EPEsther Perel58:29

       God, I wanna say '73, but I don't remember exactly. I think we should have this double-checked. This is one of these dates that, uh, I look up every, regularly and forget. Um, but it is to me equally important because, because, because gays were so considered as this aberration, this deviance, the anti-normative, and sexuality has been so much something organized around the notion of what is normal, what is acceptable, you know. And the women's movement, I mean, I think that too, the notion that sexuality is not just a woman's marital duty, and that sexuality is not organized around duty, but around desire, and the emergence of the concept of desire, which completely goes hand in hand with the growth of the capitalistic society. So these things are so powerfully interconnected, you know. Um, that's the three main revolutions, and then you look at them across the, the, the, the continents. If you read Foucault, The History of Sexuality, which it, it, it really tells you the history of our attitudes toward children, towards women, towards old age, towards pleasure, towards s- you know, how much agency do we have versus how much does somebody look at us from above there and, you know, sees everything we do. Uh, it, it's a, it's the history of so many things that is being mediated through the history of sexuality. That's what I mean by it's a lens into cultures.

   15. PAPeter Attia1:00:11

       Mm-hmm.

   16. EPEsther Perel1:00:12

       But you probably could say the same thing about the history of medicine.

   17. PAPeter Attia1:00:18

       Yeah. That's, uh, I think in some way you could. Um, I haven't thought about it that way, but I, I, I reckon that, that, that... Because remember, there was a day when medicine wasn't scientific, right? I mean, you know, I, I, in my mind, I divide medicine into sort of, you know, medicine 1.0, medicine 2.0, medicine 3.0.

   18. EPEsther Perel1:00:42

       Right. Right.

   19. PAPeter Attia1:00:42

       We have these different... And, and, and obviously the, the f- the first iterations of, of medicine were entirely unscientific, and so as science developed, so too did better understandings of, of, you know, not just germ theory, which is perhaps the first and most salient advent within medicine. Um, but it allowed you to dismiss the idea that bad humors were the cause of so many ails. Um, but it, but it's interesting. Um, but you're, you're right. I mean, uh, I just haven't thought about it through the lens of that, but, but certainly the genetic revolution was a Even though it hasn't panned out as very interesting from a treatment perspective, I think being able to-

   20. EPEsther Perel1:01:25

       Right

   21. PAPeter Attia1:01:25

       ... you know, clone the human genome some 21 years ago, uh, was a big step forward from a cultural standpoint in that we now realize how similar we all are. Uh, we're, we're less dissimilar than we probably previously-

   22. EPEsther Perel1:01:42

       Mm-hmm

   23. PAPeter Attia1:01:42

       ... thought genetically. So, um... And I think it also gave us a sense of realizing how non-deterministic genes are. Uh, in other words, it feeds into the importance of the environment more. Uh-

   24. EPEsther Perel1:01:55

       Yeah

   25. PAPeter Attia1:01:55

       ... so much more about what probably creates differences between us is, is either epigenetic or simply not modulated genetically at all. Um-

   26. EPEsther Perel1:02:07

       So this is exactly the same way that I think in terms of psychotherapy.

   27. PAPeter Attia1:02:13

       Say more.

   28. EPEsther Perel1:02:14

       Well, you're looking at just the, the contextual factors, the environment, the ecology, the social class, the, you know, the, the non-deterministic-

   29. PAPeter Attia1:02:26

       Mm-hmm

   30. EPEsther Perel1:02:26

       ... gene is the same as I am looking at the non-essentialist view of a person.
9. 1:03:18 – 1:17:13

   The impact of the rise of individualism and the focus on happiness and self-esteem

   1. EPEsther Perel1:03:18

      my work.

   2. PAPeter Attia1:03:19

      Now, your work today is quite vast, and while I think many people publicly who know you are familiar with your writing, your talks, uh, y- y- y- a lot of it focuses on sexuality, but yet so much of your clinical work is still rooted in, you know, couples therapy that doesn't necessarily involve sexuality or doesn't involve sexuality as the core issue. Uh-

   3. EPEsther Perel1:03:40

      Absolutely

   4. PAPeter Attia1:03:40

      ... individuals whose issues go far beyond sexuality or maybe don't include sexuality at all. You do a lot of trauma-based therapy, and, uh, that's not surprising based on the background in which you, you came from.

   5. EPEsther Perel1:03:53

      Mm.

   6. PAPeter Attia1:03:53

      Uh, you, you experienced firsthand what it's like to grow up with trauma survivors. And, um, you, you, you alluded to earlier kind of spending time reading a lot, I- I'm sure... Did you, did you ever come across Felix Adler's quote, I think he said something to the effect of, "The purpose of a man's life is not happiness, but worthiness." Um, I'm, I'm curious if you agree with that.

   7. EPEsther Perel1:04:18

      I agree. [laughs] Yes. Yes, but I, I... E- even if you didn't have the but, I, I don't understand the sentence that a person, the purpose of a person's life is happiness. Happiness cannot be a purpose. Happiness is an outcome of multiple purposes for that matter. Happiness emerges out of something. It's not the goal, at least not in the way that I look at things.

   8. PAPeter Attia1:04:46

      But wouldn't you say that for many people, they... Wouldn't, wouldn't people come to you and say, "I'm not happy," and that's a chief complaint?

   9. EPEsther Perel1:04:54

      Oh, yes. Yes. So, you know, I'm a, I am a clinician for almost 40 years, right? I write a book about sexuality, and suddenly it looks like that's all I do. Of course, it's by far not. Um, it's a subject I find very interesting, but it's one of many. Um, now, when people come and they say, "I'm not happy," you know, my first thought, this is not what I say to them, but, uh, in my mind, what I'm, uh, uh, in, in, in line of this historical perspective we take, I'm thinking, "This is such an interesting thing," right? For so long, happiness belonged to the heavens, to the afterlife.

   10. PAPeter Attia1:05:35

       Mm.

   11. EPEsther Perel1:05:35

       Basically, you suffer well on Earth, and if you've done a good job at that, you may get rewarded later. When did we bring happiness to Earth? When did... And this is a, a, a book actually called Happiness. Uh, that I, I met the author, whose name now escapes me, at a conference, and he was telling me that one of the very interesting developments was how did the Western parent... When you ask, "What do you want the most for your child?" The main thing they will say is, "I want my kids to be happy."

   12. PAPeter Attia1:06:09

       Of course. Uh, but yes.

   13. EPEsther Perel1:06:10

       This is very recent.

   14. PAPeter Attia1:06:10

       That seems like, that sounds like a knee-jerk reaction. I, I, I, I would catch myself saying that.

   15. EPEsther Perel1:06:16

       Right. They don't want them to be healthy.

   16. PAPeter Attia1:06:18

       [laughs]

   17. EPEsther Perel1:06:19

       Right? Because, you know, the state that you said, by the way-

   18. PAPeter Attia1:06:20

       Well, you could argue we almost take it for granted, right? Maybe that's such a part-

   19. EPEsther Perel1:06:24

       That's right

   20. PAPeter Attia1:06:24

       ... of US culture now.

   21. EPEsther Perel1:06:25

       Exactly. Exactly. Because, you know, your thing about the, the, the, about the contraception is how much contraception not only changed female sexuality and couples' sexuality, but it also changed the meaning of the child. When you have 10 versus one-

   22. PAPeter Attia1:06:41

       Mm-hmm

   23. EPEsther Perel1:06:41

       ... I tell you, the child has a very different role in the family. Um, plus you needed to make sure that kids could live past age five, and that you were not living with child mortality in, as, as a massive phenomenon, and then you can begin to talk about early attachment and all those things. You know, it needed kids who survive for us to develop attachment theories like this with early childhood, and look at the child development so completely different. So when I s- when people say, "I want my kids to be happy," it needs you to know that it's a given they are healthy. That's obvi- uh, after, after them being healthy, what's the next thing you want? Oh, you don't want them to be good people. You know, decent human beings, people who... That is a framework that, you know, that, that also is obvious, you know? Because the notion is if they feel good about themselves, [laughs] they will be good to others. That, that's the new framework, that self-esteem becomes the root of this thing and not values. You know, that's a, that's a new paradigm, right? Um, so when people say they're not happy, we start a long conversation.

   24. PAPeter Attia1:07:50

       Before we go there, I, which I want to come back to, I wanna go back to this point of when did that transition take place towards the, the self-esteem view of the world? Because I, a- again, I, I think back to my parents, who are also immigrants, and I... It's just a different world, right? I mean, the world they came from, you never puffed your chest out. Your parents never puffed your chest out and told you how wonderful you were and how special you were. And, uh, y- y- you know, Bill Maher, who is absolutely hands down one of my favorite commentators on this subject says, "You know, we live in a world today where if a teacher complains that the child is doing something bad in class, the parent attacks the teacher." And, you know, when I was growing up, if the teacher complained to my parents, I was always assumed to be wrong.

   25. EPEsther Perel1:08:42

       Right.

   26. PAPeter Attia1:08:43

       Even when I wasn't, by the way. There were some times when the teacher was wrong. But, but, but there was this, there has been this transition towards the child is always right, self-esteem is the most important thing. What, what, what drove that?

   27. EPEsther Perel1:08:56

       I think that what we have is an, uh, the rise of individualism that goes hand in hand with modern economies, uh, and modern psychology. You know, for most of traditional life, basically you lived as part of a community. You were, uh, your sense of identity, your sense of belonging, your sense of continuity, it was all assigned to you. All the big decisions basically were made for you, what you were gonna do, if you were going to be in the priesthood, in the military, or on the land. I mean, um, and we had very little freedom, but we had a lot more certainty of some sort. And, um, you got your happiness or your sense of wellbeing from doing the things that were expected from you. That's probably where the values actually of your parents too. If you provided well for your family, if you were able to take care of your loved ones, if you were an upstanding person in the community, if people respected you and invited you at their table, you ha- were happy. And we move to a system in which the individual becomes the center, not the community, and you have a lot more freedom for the first time, but also a lot more uncertainty and a lot more self-doubt. On the other side of self-esteem is self-doubt, and you have to make all the big decisions yourself now. And therefore, you need a lot of certainty to know that it is the right decision. You're not just part of a legacy that says, "This is how we do it. This is the transmission of what this is supposed to mean, how this looks like, what are the protocols." It's all up for you now in this world of innovation. Now, when does it start? I think it, there's different stages, you know? Romanticism is already a beginning of that too, but ni- end of the 19th century. But the '60s, the grow- in the, in, in our, in our psychology, in modern psychology, it really is the beginning of the growth movement, this notion that we can change ourselves. The goal is no more to stay connected to the past and to the tradition and to the... but, and the transmission, the goal becomes to be able to innovate, to change oneself, to uproot oneself, to leave to the, you know, to go and be in a whole different part of the country in order to do more. And, um, and that's m- begins to really change the notion of when you are a two-year-old, I'm not just expecting you to do by learning what, and seeing what everybody else is doing. That's a piece of it, but I'm also saying, when you are waah, I say, "Use your words. Tell me what you want. What do you want to eat? What do you want to wear?" Because I have a sense that if I give you that notion of knowing thyself and being able to make clear affirmative statements about it, that this is going to build your sense of self and your sense of confidence. Now, this is a Western model, let's be very clear, but that starts from the beginning. I am going to build that individual that becomes my child.

   28. PAPeter Attia1:12:28

       Now, given that for virtually all of our evolutionary history, that was not the case.

   29. EPEsther Perel1:12:36

       Mm-hmm.

   30. PAPeter Attia1:12:36

       So much of our identity was based on our group. We, we weren't looking to leave our tribe. Our relationships with the others around us were at least as important, if not more important, than our relationship with ourself. And what you're describing is, is, is quite a recent phenomenon. And I, I always ask this question through the lens of, you know, I don't think evolutionary biology teaches us everything, but I always like asking the question first through that lens. You know, for example, when you introduce a new food that's never been around, it can have bad consequences, right? If it's, we didn't, if our body never, uh, you know, adapted to, you know, sugars in the quantities we're consuming them now, uh, it doesn't mean it's bad in an absolute sense. Give us another million years, and we might catch up, but, you know, we're not gonna catch up in 30 years. So similarly, does this pose- ... a challenge. Uh, but m- ch- let me make it even put a more negative valence on that. Does it pose a concern for you, um, that we're in unchartered territory with respect to this, this model?
10. 1:17:13 – 1:28:07

    Generational differences in parenting and changing role of fathers

    1. EPEsther Perel1:17:14

       Uh, um, and this is more recent than evolutionary biology. This is just a few decades, you know, where the books before were basically what we thought was is that a child, it was like the Rousseau view, right? A child comes into the world, and your role is to shepherd this child through the pre-established stages of development that are universal, and you're, and, and you just have to help the kid go through those stages. It doesn't really change much if you do this or if you do that. That's how child development was conceptualized, and it moved to a notion where child development is much more flexible and much more responsive to the, to the circumstances and to the kind of input that the parents put in. And so now if you listen to Mozart in, you know, while you're pregnant, you could actually maybe develop some musical taste in utero. And you know, we, this is completely non-biological. This is completely cultural. And what I do with my kid, other people who I leave my child in the care of need to be able to do, so we need mass reproducible child-rearing techniques. This, this is a very important shift, for example, in terms of child development that is a preset number of stages that are just there and the kid goes through them versus child development that is completely in the hands of the person who raises the child.

    2. PAPeter Attia1:18:43

       What, what, what, what is the impact of that then to the patient who arrives in your office, who is a product of that child-rearing?

    3. EPEsther Perel1:18:54

       The impact is how the narratives get created. Who is responsible for my unhappiness? Why am I unhappy? If you wanna take the unhappy, you know, presenting issue.

    4. PAPeter Attia1:19:06

       Yeah.

    5. EPEsther Perel1:19:07

       And have I always been unhappy? And how did people respond to my unhappiness? How alone did I feel with my unhappiness? In a, in an environment where you expect your parents to be attuned to you, if they are not, you will experience your aloneness, your isolation, your emotional disconnection very different than in an environment where that, the attunement of your parents is really not part of your expectation on an emotional level of what Your parents are. You get that attunement maybe from your grandmother or from your auntie, uh, from, you know, from other parental figures who can be kind and sweet because your parent is there to make the rule and to make the discipline and to shape you. That's two different models. So I, I, I keep that model in my head when a person comes in, and I also know where they're coming from and what are the n- you know, what were their expectations? What did you think your parents... What did you want f- that they would do, or your whoever were the people that were in charge of you? Um, and, um, how much do you blame them? How much, um... I mean, look, I was working yesterday with a, a son who feels that his father has been always critical of him, that he can never please him enough, that he could never do good enough for him. And I was thinking, you know, 100 years ago, would there have been such a son? Yes

    6. PAPeter Attia1:20:51

       But he would have probably never thought to have said anything, right?

    7. EPEsther Perel1:20:56

       Well, he wouldn't have had a therapist to go talk about this with, and to think that, you know, the father has to come and apologize to him. I am thinking this is very interesting, you know. Um, and the father, uh, on some level does think he did something, um, challenging. [laughs] Um, but you know, the parent of 100 years ago would have said, "I did the best I could. I, you know, my role is not to pump you up. My role is not to make you feel good about yourself. My role is to, to make you into a responsible person who takes your role seriously and, um, and does for others that what is expected from you. That's my role. My role is not to make you happy." Um, these conversations take place all the time at this moment because there are generational differences and cultural differences. I mean cultural as in the conception of what is a parent? What is the role of a parent? What do we expect should happen between parents and children, little ones and older ones? And it's an, it is... changes nonstop. It moves, it moves, it moves, especially with the father. Because the, the biggest, one of the biggest changes that has taken place in modern family, Western families, is the rise of the role of the father, the father not just as a material provider, but the father as an emotional unit, which coincides with the woman going to work as well, so that, you know, they can both be material providers and emotional caregivers

    8. PAPeter Attia1:22:43

       This, this one to me is very interesting, right? I, I, I, I don't-

    9. EPEsther Perel1:22:48

       I'm saying a lot of things in a, [laughs] in a-

    10. PAPeter Attia1:22:49

        Well, this particular issue around-

    11. EPEsther Perel1:22:51

        ... in a condensed way

    12. PAPeter Attia1:22:51

        ... around, around the-

    13. EPEsther Perel1:22:52

        Yeah

    14. PAPeter Attia1:22:52

        ... the role of the father, because, you know, I mean, I think back to when I grew up, I mean, I, I can hearken to countless discussions between my parents where, y- you know, there would be an argument over why wasn't my dad ever watching me at a sporting event or going to a parent-teacher night or doing anything that involved being a part of my life.

    15. EPEsther Perel1:23:16

        Mm-hmm.

    16. PAPeter Attia1:23:17

        And the reality of it it was he worked 14 hours a day, six days a week, and on the seventh day he worked maybe eight hours. So there was simply no time for him to do those things, and he, he was, I mean, frankly incredulous that he would even be asked to do such a thing.

    17. EPEsther Perel1:23:38

        But he was at your wedding.

    18. PAPeter Attia1:23:40

        Yes, [laughs] he was at my wedding.

    19. EPEsther Perel1:23:42

        Right. And he was at... Was he at your graduation?

    20. PAPeter Attia1:23:45

        Yes. He, uh, not high school-

    21. EPEsther Perel1:23:46

        Right

    22. PAPeter Attia1:23:46

        ... but, but college and medical school.

    23. EPEsther Perel1:23:48

        No, no, no.

    24. PAPeter Attia1:23:48

        Yeah.

    25. EPEsther Perel1:23:48

        Of course not high school.

    26. PAPeter Attia1:23:49

        Yeah.

    27. EPEsther Perel1:23:49

        High school is a, you know... He, he had a few major dates where he knew the father shows up there.

    28. PAPeter Attia1:23:59

        And his point was, "I am doing the thing that I am supposed-

    29. EPEsther Perel1:24:05

        This for you

    30. PAPeter Attia1:24:05

        ... to be doing."
11. 1:28:07 – 1:43:20

    How our narratives affect our sense of wellbeing and relationships with others, and the challenge of changing them

    1. EPEsther Perel1:28:07

       Not serious. [laughs]

    2. PAPeter Attia1:28:07

       Let, let's talk about, about these narratives because I, I'm very interested in these sort of intra and interrelational narratives that come in and out of your office. Um, a- again, I, there's a form of psychotherapy I'm sure that only deals with the relationship with oneself, and, uh, uh, undoubtedly there must be a lot of good that comes from that. But you don't view it as a vacuum, right? You don't really think that it is possible to simply better one's life by bettering your relationship with yourself. Is that a fair assessment?

    3. EPEsther Perel1:28:43

       Yes, and I would say that the very framework of bettering your relationship with yourself is in itself a cultural narrative. That's a construct. That's exactly what happened in the last 50 years. Suddenly this thing, you know, bettering your relationship with yourself, feeling good about myself, you know, um, becomes a s- an organizing principle rather than feeling good about how I act towards others is my organizing principle or feeling good about how I stand, you know, below God is my organizing principle. So I think that the, this, there's an emphasis, right? No- nobody just looks at the self and doesn't see it, the relationships to others, but there's an emphasis. And one... My emphasis is the, the constant dual track between the intrapersonal and the interpersonal, between what's happening inside and how what is happening inside is affecting my relationship with others. I can't think about one without thinking about the other because I don't fundamentally believe that one can know oneself without knowing oneself in relationships to other. Now, that is a construct, too. It happens to be the one that I work and think by, but I, that is a m- that is not a truth. That just is the way that I organize rel- relational thinking. I think of people as relational beings. Um, and when you talk about your father, and especially when you talk about the way that you looked at these other men, to me, this is a beautiful example of how you th- you say, "This is how I felt," and I know that your feeling sits on a cultural message, that the narratives, the frames with which we interpret and give meaning and give value that the things that are happening to us, they don't just come from us. They come from a combination of the collective manufacturing and the personal responses to it. It's always both/and. Is that clear?

    4. PAPeter Attia1:31:05

       How... It, it, it, it actually is. And, and to me, one of the most, uh, as an outsider, one of the most difficult aspects of what you do must be changing a narrative because when somebody comes in with a narrative, it's, it seems almost hardwired, which is not to say they were born with it, of course, right? This gets back to what's predetermined and what is not. But when a person shows up in your office, it's often in the same way that they show up to the doctor. Very few people come to the doctor when everything is perfect to say, "Hey, I'm just here for some preventative care. I feel so-"

    5. EPEsther Perel1:31:40

       Right. [laughs]

    6. PAPeter Attia1:31:40

       "... good. I just wanna make sure I feel this good in 20 years. What can you do for me?"

    7. EPEsther Perel1:31:45

       Yes. [laughs]

    8. PAPeter Attia1:31:45

       Similarly, I, I guess most people aren't showing up in your office saying, "I've never felt better. My relationships are amazing. I wanna keep this going." So there's a negative selection for people who walk into your life, which is On some level, they must have a narrative that has failed, that has, that has led them astray. Uh, an either a narrative about themself, a narrative about others, and probably more likely a combination of these. Those narratives are probably often quite entrenched.

    9. EPEsther Perel1:32:18

       Yep.

    10. PAPeter Attia1:32:18

        So how do you go about challenging them?

    11. EPEsther Perel1:32:22

        So you're right. Both modern medicine... No, not modern. Medicine today and psychotherapy are problem-ridden contexts. They're problem-ridden narratives. If you don't have a problem, there's no reason to come to me or to you.

    12. PAPeter Attia1:32:42

        That's right. If you don't have a diagnosis code, I can't even charge your insurance company for you to be here.

    13. EPEsther Perel1:32:47

        Same here. Same here. So that is, that is a cultural, you know, construct, right? That is a narrative. You know, so people come to therapy to talk about their problems. They don't go to therapy if things are fine. This is a very important piece of information, by the way, for couples therapy, because couples therapy is in a bind. Relationship therapy is, but especially couples therapy is in a bind because, on the one hand, so many people come way too late. Way too late. Stuff has been so entrenched, and you kind of wanna say, "Why didn't you come five years ago?" On the other end, if they would come when things are still okay or somewhat okay on occasion, then what's the problem that you're already going to therapy now? This is fascinating. It's like you can't go if it's good, but then when you go and it's really bad, you should have come when things were really better. Okay, so this is one thing. I think what you've just, uh, articulated is probably the core of a lot of my work. It is not the core of all psychotherapy work. I think there are different ways to enter the story. What I mean by the story is the life of people. I believe that our relationships are a story. We tell stories about our relationships, and I think that when I... I remember in, in the first episodes of Where Should We Begin?, I said, "When people come to me into my office..." This is, you know, I was, uh, I was trying to explain to the people I was producing the podcast with what is my couples work. And I said, "People come to me with a story. At the end of the first session, the only goal of the first session is for them to leave with another story or with a sense that there can be another story."

    14. PAPeter Attia1:34:48

        I was about to say, uh, your first goal strikes me as far too ambitious for one session. I would think even casting doubt that there could be, you know, uh, casting doubt on that narrative and suggesting there may be an alternative one would be an amazing outcome for two hours.

    15. EPEsther Perel1:35:05

        Yeah. Yeah, yeah, yeah, yeah. That's what I'm talking about.

    16. PAPeter Attia1:35:06

        Yeah.

    17. EPEsther Perel1:35:06

        Doubt and hope.

    18. PAPeter Attia1:35:08

        Yeah.

    19. EPEsther Perel1:35:10

        So an enormous part of my work is to reframe. I think that this is an amazing piece. Why? Because it's not just an intellectual thing in my head. It's because I think that words shape the experience. The way I tell the story is going to create the way I feel about the story, and then it's going to create the way I therefore will act upon the story that I think there is. If I talk with you now, and in my mind I have this notion, "He doesn't really care about me. He doesn't really value me. He's just doing this to be nice. He would have stopped this an hour ago if he could. I have no idea... I think he disagrees with everything he has said. He really doesn't think I have anything interesting to say. He's so sorry he invited me." I mean, yeah? This instantly fills my belly. So this is not just a thought. This is not just a feeling. This is also an embodied experience. So I'm beha- in my, in my belly now, I have this, this knot, you know? And how, how am I going to... You know, what am I gonna do now? And I just feel so bad about myself, and I f- don't know how to talk to him, and, you know. And then it's going to influence how I'm going to talk next. So now I'm gonna start to talk, oh, too long and too much because, because I'm actually feeling unsure, and then my insecurity makes me talk more, and I'm rambling, and I'm all over the place, and he's even more now thinking that I am-

    20. PAPeter Attia1:36:54

        Mm-hmm

    21. EPEsther Perel1:36:55

        ... not interesting and, you know. I mean, this is all, this could all go into my head right now. You know, my narrative, that one phrase, becomes my experience, and my experience becomes the motor for my behavior, and the motor for my behavior is going to land me probably in a place that is often the exact opposite place of where I actually wanna go. That's a narrative. Now, if I sit here and I think, "Peter is really happy we're doing this. He's been waiting for this for so long, and I, I think he's... Uh, you know, he had a doubt for a moment. He was wondering should we, should we not, and, and I, I think he's, he's, he's feeling good that we did it," that is gonna completely change my entire experience.

    22. PAPeter Attia1:37:53

        Now, maybe this example isn't a great one, but does it matter which of those is reality?

    23. EPEsther Perel1:38:00

        But the reality is the story you tell.

    24. PAPeter Attia1:38:03

        Exa-- That's my point, right?

    25. EPEsther Perel1:38:04

        I mean, it's the subjective reality.

    26. PAPeter Attia1:38:06

        Is it for your story... Yeah, your story is independent of how I feel.

    27. EPEsther Perel1:38:10

        That's right. It's a projection. It's what I imagine. It's how I've internalized it. It's how I think my mother did or did not love me, or my dad, or my brother, or whoever, you know. Yes, it, it-- the, the interesting thing is, is it reality? Completely, because it's the one that is dictating my life. That's why it is reality. Not because there's a factual truth to this. So the reframe is not that this is more true. What I teach my students, I say, "When you reframe, the only way that you know it's a good reframe is because the other person bites on it, takes it, likes it, says, 'Oh, I prefer to live by this view.'" You know? Your father wasn't neglecting you because he was away fourteen hours a week. Your father did this because he thought that this, his, his total devotion to his family is to actually never be there, is the ultimate presence and devotion. Now, do we have a different feeling about your dad and about what happened to you? I'm just playing with this here, right?

    28. PAPeter Attia1:39:25

        Yeah, yeah. Yeah, of course, of course. Um, I suspect there are so many patterns that you see in these narratives, and, like, if you think of the, the, the, all of these, all of the negatively valenced emotions, right? Depression, anxiety, sadness, anger, all of the things that can not just hurt a person, but hurt their relationships. I'm, I'm curious as to what, what are some of the common themes that you see around those, and how you begin to chip away at the armor of a person's firmly held beliefs that are no longer serving them.

    29. EPEsther Perel1:40:11

        Let's go back to your word before about wordiness. What I just played out here with you are probably two of the most important narratives. The one-- the first narrative is the narrative of being unwanted. Fundamentally unwanted, not just because born not wanted, but unwanted, unloved, uncared for, undervalued, unappreciated, unseen, un and something after. And I can bring this from my childhood, I can bring this from the way that I grew up, I can bring this from the way that other kids in my classroom never, ever looked at me. There's load, loads of places where this emerged and then grew inside of me, and becomes the lens through which I see myself in the world. The second narrative, where I think, "Mm, I think, I think it's okay. I think, you know, it may not yet be where it wants it to be," da, da, da, you know, "but I'm giving-- I'm not in a, in a state of self-condemnation. I actually am looking for the appreciation. I'm looking for the acceptance. I am ex-- I'm looking and experiencing that acceptance, that I am worthy, that there's a reason I'm here today." There's, you know, all of that. I think those two are probably the most fundamental of our narratives, and they are rooted in trauma and in neglect and in, you know, either having had too much of something or too little of something, right? This is pretty much where, where trauma sits. Um, to me, that's the dominant, and it will influence my anger, my sadness, my loneliness, my sense of, "Shall I tell him what I think or what I feel? Do people even care? Does it matter? Would they miss me if I wasn't around?" You know, my despair. All of these bigger pieces, you can see the way that they are interconnected to this fundamental, "Is there a reason for me to be here on this planet?" You know, for being alive. "Do people think of me when I'm not there? Do I exist inside others? Do they want good for me?" You know? Versus the opposite of all of that. Uh, to me, they're not that complicated. And then the stories, thousands of stories, multitude of different stories can be brought back to these two fundamental pieces. Similar with, "Do I experience a sense of agency and control over my life? Can I make changes?" You know. Or, "Am I completely at the mercy of? I have very little power. I've ex-- I live with a sense of powerlessness. Nothing I will do will make a difference." Those two are directly connected to the first two, by the way.

12. 1:43:20 – 1:54:25

    Generational effects of past trauma, and how relationships to others can be a mirror into your maladaptive behavior

    1. PAPeter Attia1:43:20

       Is there anything adaptive about that narrative? Because w- you know, so much of the, the trauma response is initially adaptive, right? If-- And, and again, if we use the childhood trauma, uh, y- you know, for example, in, in the case of your mother, we could probably look at many of her responses once she survived these concentration camps and say, "Wow," you know, even though the-- through the lens we would look back, we would say those were really maladaptive behaviors, they actually had a very adaptive, uh, root or origin. They protected her in a way. T- they, they shielded her from subsequent pain. When you w- w- in, in the examples you just gave of feeling unworthy or unwanted, what's the adaptation there? I don't understand how that is even at an emotional level. I'm not disagreeing with it, I'm just trying to understand what the adaptation is and why it's so-- 'Cause usually when something is so prominent, there's a reason for it, right? Or at least that's my teleologic explanation.

    2. EPEsther Perel1:44:32

       Of course. And, and, and right now, you know, we've just done-- I, I f- with the same information that we just shared, I could do a narrative analysis, an attachment analysis, [laughs] a trauma analysis. I mean, th-this is one lens, one reading of this thing. So I'll give you a personal-- uh, there, there's actually two personal examples that, that, that, that just came to me. One I probably have-- I don't even know when, if, if I've talked of it, but it's I sit with a patient one day who is also a child of Holocaust survivors like me, and he's telling me, "By age eight, I made sure my kids can take a train and be on a bus and all of that." And he says to me, "I'm very protective of my children." And I'm thinking to myself, "You're so lucky you're talking to me, because I too have that same distortion." Protective is not I make sure that I'm not leaving my eight-year-old alone-

    3. PAPeter Attia1:45:38

       Hmm

    4. EPEsther Perel1:45:38

       ... on a plane. I send my seven-year-old alone on a plane because in my parents' book, to be protective was not to be there for you. To be protective was to make sure that you would know to survive if they were not there. And it was the way I was raised, and in many ways, I did pieces of that with my own children as well. It's like I wanted them to be able to manage on their own in case I'm not there. You know, manage on their own really meant survive, you know? We didn't use those words, but that, that's what the legacy was underneath this. My parents also, without ever saying this, you know, but told enough stories that let you think that in the camps, the vulnerable died. And so when my children exhibit vulnerability, it scares me so much. It did, 'cause I've worked a lot on this, that I sometimes wouldn't know how to just respond and just, you know, in a simple, basic, empathetic way. I was so scared. I wanted to toughen them up, that they would say to me, "Why can't," you know-- Like [laughs] they joke now with me that if they, you know, if they were not with, what is it in American? A forty-two-degree fever-

    5. PAPeter Attia1:47:05

       [laughs]

    6. EPEsther Perel1:47:06

       ... then they could go and do whatever they needed to do. If you're not dying, then there is no reason to stay in your bed. [laughs] I mean, you know, I had that mentality that if you have to be really, really, really, really sick to not go to school and things like that, you know? And, uh, and s- and now they laugh, but I know that there were probably moments where they wished I would just say, "Come, I'll put you a cold compress on your head," which I did too, but I didn't do it from that place of, "Oh, my little one," you know? I was more, "Okay, that's what you need to do in order to get you back out." You know, I was grit driven if, if you want in, in, in that sense. So I-- That was adaptive, right? It, it was, uh, it was adaptive for her, and then it was no longer adaptive for me-

    7. PAPeter Attia1:47:56

       Mm-hmm

    8. EPEsther Perel1:47:56

       ... because we're not in the camps, and I don't need to raise them to survive as if we're in the Holocaust 'cause we're not in the Holocaust. And that is the most important piece around trauma work, is to understand that your reaction is the reaction as if the past is happening right now, and in fact, it isn't happening right now. And to be able to then create the ground underneath you, to put a reality, a different way of experiencing yourself, you know, that is not fed by all the horrible things that happened to you then, that is a part of the trauma healing work.

    9. PAPeter Attia1:48:36

       And that transition, I, I think for anyone who's gone through it, is it's really quite a process because it's-- it requires pausing, and for many people who are in adaptation mode, there's no room for pausing, right? Once you have an adaptation to cope with trauma, it selects, right? It's, it's, it's, it's reinforcing itself. It's making you stronger and stronger and pushing you further and further, and you might miss the fact that it's become maladaptive. It's-- The, the, the, the, the transition from it being adaptive to maladaptive can be so far in the rear view mirror, you've entirely missed it. And I think this is where this idea of the relationships with others starts to become the mirror through which you can actually be confronted with something that says, "Hey, there's something wrong here." You know? Y- y-yes, this worked for you before when you had no other responsibility. This maybe worked for you when you didn't have a family, uh, but now that you have a family, this is no longer, uh, adaptive.

    10. EPEsther Perel1:49:49

        Yes. I use the word generally, it was useful then. You badly needed it, but it's not, it, it's not serving you now. You-- The-- Your reality has changed, and you're still holding an umbrella even though there is no rain. You know, another way of saying it is A lot of people, this is if you go to the survivors, but I think you can translate it, often felt that it was very difficult for them to get close to their children. They had lost children. They had lost parents.

    11. PAPeter Attia1:50:21

        Mm.

    12. EPEsther Perel1:50:21

        They had lost siblings. On what basis will I allow myself to get close to anybody or love somebody again? Now, here they had these kids, but they couldn't get close to them because if I don't get too close, then I won't be in such pain when I lose you. Now, that never, you know, it didn't keep the dead closer. It, it didn't create a good relationship with the children, who constantly felt like, "There is nothing I can do to win your love because I will never replace your dead ones." And so this idea that when you've had loss and massive disruptions and, and, and, and injured attachments, that you protect yourself by not coming too close to the other people. Now I'm gonna go back to your original question. It may even have been adaptive for you, but in your relationship with your child, it's become a m- a m- it's been a major lack. So intrapersonally, I understand it. Interpersonally, it's problematic. It's not adaptive interpersonally. Hence, I need the parent or the whoever is on this side to understand the effect of how you protect yourself on your child, and I need you, the child, to understand that what your parent is doing isn't actually because of who you are, but it's because of what happened to them. This is... Do, do you get this? This could be-

    13. PAPeter Attia1:51:59

        I, I-

    14. EPEsther Perel1:52:00

        ... a couple now too

    15. PAPeter Attia1:52:00

        No, no, I, I-

    16. EPEsther Perel1:52:01

        I just did it with parent and child

    17. PAPeter Attia1:52:02

        ... I, I completely get it, and I now wanna ask a, a question about the ability of the person who is able to make that transition versus that who is not. So if you look at 100 women with breast cancer, um, who all receive comparable standard of care, depending on the stage at which they're diagnosed, it's very clear to predict how many will live and how many will not. And truthfully, it really comes down only to the biology of their cancer, and I know that's a very unpopular thing to say, um, but I really do not believe that the person who lived wanted it more and the person who died gave up. I, I've seen too many people who fought like hell who died, and I've seen too many miserable sons of bitches who didn't give a damn who lived. So the reality of it is, uh, survivorship in cancer comes down to a lot of luck and a lot of biology of the tumor and things like that. But in your line of work, in what you're just describing, very specifically for this, this transition, right, that person who goes from having traits and narratives and coping mechanisms that protected them at a time and are now either hurting them and/or hurting their relationships, why are some people able to do the hard work that's necessary to make the change and others not? What are the predictive factors of that?

    18. EPEsther Perel1:53:44

        I think this is one of the most difficult questions, and why in the same family did one person land here and the other person with the same circumstances took all of that? For this person, it became everything that drove them, and for this person, it became everything that broke them. It is a question I ask myself so often, so I, I can riff on it, but honestly, I do not know. It's one of the mysteries. It's multifactorial is for sure. It's, it, it's not the same thing each time. Uh, your example is so nice and

13. 1:54:25 – 1:58:44

    The role of willpower in one’s ability change their behavior and improve their relationships

    1. EPEsther Perel1:54:25

       clear. [laughs]

    2. PAPeter Attia1:54:26

       Well, and I, and I should clarify in my example. Uh, I think there are lots of things the patient can do. I think their nutrition matters, exercise matters, management of stress. I think the point I wanted to make is their will I don't believe matters. You know? I, I, whereas I wonder how much willpower or desire to improve by itself is the, the critical ingredient here, or if in times that's insufficient.

    3. EPEsther Perel1:54:52

       But interpersonally, will doesn't just exist inside one person. So-

    4. PAPeter Attia1:54:59

       But you have once said that the key to c- maybe I'm, maybe I'm wrong on this, but-

    5. EPEsther Perel1:55:03

       Yeah, yeah. Come on

    6. PAPeter Attia1:55:03

       ... didn't you once say that the key to couples therapy is the moment that each partner is less interested in what the other one is doing wrong and more interested in how they can be better, or something to that effect?

    7. EPEsther Perel1:55:15

       Yes. Yes. Absolutely. Absolutely. Um, so now I come to therapy, and I've decided that I want, I do wanna talk about what I have been doing, or I wanna talk about the ways in which I have stayed far, or the ways in which I've never said to you, "I love you," or the ways in which I even tell you about how I've lost so many people important in my life, I don't even know... I don't really know what it means to love. I don't trust that when I love, it's there to stay. I actually even have developed a view that when I love someone, he dies, or they des- if I love something, it breaks, it destroys, it disappears. You know, it, this can go very far, this notion, right? This is, now my will is I'm coming to talk to you about this whole part. But my will now, the moment I have said something, is now public domain. And now it will all depend. The, the shape of my will from here on is going to be in part what I'm holding, and in part how you are responding. If your response to me is, "Now you're telling me all of this? Why? Be- is it because your, because your wife is about to leave you? Is it because I put you an ultimatum? Is it because your son hasn't talked to you in two years? Is it, you know, now you're telling me?" That instantly is gonna do something to my goodwill-

    8. PAPeter Attia1:56:49

       Mm-hmm

    9. EPEsther Perel1:56:49

       ... let's even put it like that, my ownership, my responsibility, my vulnerability by just putting myself out there. If instead you say nothing, and I'm like, "Are you hearing this? How are you receiving this?" "I need to sit with this for a while. This is... Thank you, but I do need to sit with this. I'm not prepared to just say I forgive you. It c- it takes a little more for me, you know?" Or number three, I say, "Everything you've just said was all about you, and I appreciate that, but you haven't said much about how that you think that this has had an effect on me, and I need to know that you have a sense of what that did to me, your being absent, or critical, or belligerent, or violent, or, you know, too little or too much of something." Version four, I really appreciate your saying this. Then this, by the way, can be in one session or over four months, right? It's a... But in the next version I say, "I've been wanting to hear you talk about that. I, I, I've done my own work, and I know that a part of your distance from me is because of what happened to you, and that it's not because I had an A or a B or a C, that this is not any of this." All four responses will shape the will. This will is not, uh, you know, one fixed, what you call the predetermined gene, you know? This will is completely malleable and will change and pre- and express itself differently at the mercy of the response of the other person.

14. 1:58:44 – 2:06:28

    How your relationships impact longevity and the importance of being capable of sitting in uncomfortable emotions

    1. PAPeter Attia1:58:45

       And obviously why all of this matters is, is something you and I have spoken about in the past, which is e- everything we're talking about factors into longevity, not just in sort of a biochemical sense, right? Where in theory if your relationships are better, your hormone levels would be better and cortisol levels would be lower and all of these things would be better. But in just a more fundamental stark manner, what advantage is there to living longer if your relationships are poor, and the quality of your relationships therefore determines the quality of your life? Now, I, I, I'm a full convert to that, right? That's something that, you know, five years ago I would have never given a thought to. I mean, not for, you know, just was not even in my, uh, ballpark of thought, and today of course I believe it emphatically. W- to me one of the things that's been interesting is learning that if that is true, there needs to be a new comfort in sitting with uncomfortable emotions, that the ability to sit in discomfort must be a new trait. So I, I think if I use myself as an example, historically any time I felt uncomfortable I had a tool to numb it, to get away from it, to distract myself from it. So anything that I didn't like emotionally I had a very quick Band-Aid for such that I never had to sit in discomfort.

    2. EPEsther Perel2:00:32

       And what would you do?

    3. PAPeter Attia2:00:33

       It would depend, but it was usually, you know, I, I, I... It could be anything from binge purchasing watches, uh, you know, obs- you know, exercising obsessively. Um, uh, anger, outbursts of anger, which sounds paradoxical. You wouldn't think of that as a tool to numb discomfort, but of course as I talked about on the podcast with Terry Real, anger is very transiently quite numbing, right? There, in the, in the immediate-

    4. EPEsther Perel2:01:02

       Yep

    5. PAPeter Attia2:01:03

       ... in the immediate moment of an outburst of anger it actually squelches the feeling of inadequacy and lo-

    6. EPEsther Perel2:01:09

       Yeah

    7. PAPeter Attia2:01:09

       ... loss, loss of control-

    8. EPEsther Perel2:01:10

       I felt much better-

    9. PAPeter Attia2:01:10

       ... and sadness

    10. EPEsther Perel2:01:11

        ... for a moment. [laughs]

    11. PAPeter Attia2:01:11

        Right. But if you, uh, but, but if you want to move into this, to this, this quality of life where now all of a sudden your relationships are important, you, you, you realize very quickly there are times when you have to be uncomfortable and you have to sit in that. Um, I, uh, there's a, a psychologist, Susan Davis or something. Uh, she gave a TED Talk.

    12. EPEsther Perel2:01:34

        Susan David.

    13. PAPeter Attia2:01:35

        David, yeah.

    14. EPEsther Perel2:01:35

        Susan David. Yep.

    15. PAPeter Attia2:01:36

        And, and she gave a TED Talk, and I really liked it 'cause she said something to the effect of... She said it much more eloquently, but the gist of it is the admission you have to pay to a meaningful life is, is being uncomfortable, is, is being able to sit in-

    16. EPEsther Perel2:01:49

        Yep

    17. PAPeter Attia2:01:49

        ... uncomfortable emotions. And she made a very-

    18. EPEsther Perel2:01:51

        Mm-hmm

    19. PAPeter Attia2:01:51

        ... funny comment in the talk which was, "If you tell me you don't want to feel blank," you know, blank being some uncomfortable emotion-

    20. EPEsther Perel2:01:58

        Mm-hmm, mm-hmm

    21. PAPeter Attia2:01:59

        ... "then I tell you you have a dead person's goals." Um, it, you know, I probably saw that talk three or four years ago. It was very profound to me.

    22. EPEsther Perel2:02:08

        Mm-hmm.

    23. PAPeter Attia2:02:08

        Um, how, how does that factor into your work? How do you-

    24. EPEsther Perel2:02:14

        Couldn't agree with her more. Actually, I, Susan David was a guest on my, on my training platform on sessions recently, and, and when she says it I I couldn't agree with her more, but it's, it's a very basic thought of anybody who does psychotherapy, you know, is, is how... Okay, so the, uh, anybody who does psychotherapy, as I understand psychotherapy, okay? Which is not, my goal is not to make you happy, which is to, to make it look like you're never gonna have any of these feelings, 'cause that's, that person that came in saying, "I'm unhappy," would love to not have those feelings-

    25. PAPeter Attia2:02:57

        That's right

    26. EPEsther Perel2:02:57

        ... sometimes.

    27. PAPeter Attia2:02:58

        Yep.

    28. EPEsther Perel2:02:58

        Sometimes, not always, huh? So the idea that, you know, this is what you feel, and that doesn't mean you have to act on it or do something or chase them away or make it disappear. This is your experience in this moment. Now, we can do a lot of things with this experience. We can understand it. We can name it, first of all. We can name it. We can frame it. We can understand it. We can put it in context. We can celebrate it. We can write about it. We can physicalize it. We can do a lot of things with this experience, these feelings that you're having. And you need to understand that sometimes they will just come through. They will pass through you, and then they will get out to the other side. You don't have to squelch them. You don't have to judge them. You don't have to be contemptuous of them. I don't say it in those words, but this, this is the, the, the idea. You don't have to numb them. That's the thing that you... Because you were numbing them not just 'cause you were numbing them. You were numbing because you were judging because you didn't think you should be feeling those things because what's wrong with you that you have those things? So there was the contempt in it as well. There's a lot of things very, very, very, very quick before you've even gone to buy your next watch or whatever thing you were doing. So sitting, you know, with your inner life and remaining somewhat curious and kind to your inner life, and some call it today self-compassion, but sometimes it's not necessarily always compassionate, but at least it's not, um, contemptuous and judgmental of your inner life, um, or despairing of it, or terrified by it that it will never go away, that it will never leave you, that this is your state forever now, et cetera. Um, this is psychotherapy. This is individual therapy. For me, this, for me, I'm gonna really put myself, uh... The kind of work I do, this is the essence of a lot of the individual work. Um, fascinatingly, when I see somebody alone and then I get to see them with their partner, and now I see how all those things play out not just inside of you, but in between the two of you, it's a whole other story. It's like I've just spent time in one room of the house, and I didn't even know there was a whole annex to that house. And this is when you understand the difference between the relational thinking, which Terry of course is one of the main teachers of, and the individual perspective. And I think that the real importance today is for m- most of us to be able to not just live in one. You know, the, the, the fe- the, the, the mistake of a lot of the systemic thinkers was that they stopped thinking about the individual and the internal life. It was all, you know, system, systems thinking. That didn't go. And the mistake sometimes, or the, the lack in people who have just an individual perspective, is that they're not looking, like you talk about, the gene in context, you know. Um, and that integration is where my, the nexus of my work sits.

15. 2:06:28 – 2:15:13

    Esther’s definition of resilience and the dangers of believing everything you think or feel

    1. PAPeter Attia2:06:29

       Would you agree with the following statement? So, um, a, a, a, a very, very close friend of mine, Jim Kochelka-

    2. EPEsther Perel2:06:35

       You know what's very weird, Peter?

    3. PAPeter Attia2:06:37

       What?

    4. EPEsther Perel2:06:37

       I'm used to hearing what you have, what you think about what I say, [laughs] and this time it's like you move on to the next-

    5. PAPeter Attia2:06:44

       Well, I-

    6. EPEsther Perel2:06:45

       ... question, so I'm kind of left with like-

    7. PAPeter Attia2:06:45

       'Cause it, it ma- it made me think of this other thing, right? It made me think of this, this, this idea that I've been really internalizing, and I'm curious if you agree with it. So, um, so this is a, a friend of mine, Jim Kochelka, who's a, a, a wonderful psychologist, though I've never worked with him in that capacity, he's a friend, said something to me once of the effect, "You can't believe everything you think. You can't believe everything you feel. The mind is a very dangerous organ." And I had never contemplated that until he said it, right? I, I had, I had contemplated the first half of it, because that's what mindfulness meditation teaches you, that you can't believe everything you think, right? As you, as you separate yourself from your consciousness, you begin to realize that you have a constant internal monologue, and it is not the same as you. You are not your thoughts. But it's when he layered on this second piece, which is, and you can't even believe everything you feel, and then, then he pointed out basically, look, the mind can be very dangerous sometimes. And it then takes me back to things that you've said, which is, a lot of these narratives that we have about ourselves and others are surprisingly well-worn, and they're not novel, even though for any individual in the throes of pain, they feel incredibly unique. No one else could possibly feel the way I feel right now.

    8. EPEsther Perel2:08:16

       I completely agree with him, um, because the mind creates narratives. [laughs] You know? Um, it's a different way of saying, of saying the same, you know, um, of saying the same. I, I You know, it's, it's a play on when you say you're not your thoughts.

    9. PAPeter Attia2:08:41

       It's shorthand.

    10. EPEsther Perel2:08:41

        But subjectively-

    11. PAPeter Attia2:08:42

        It's a shorthand, yeah.

    12. EPEsther Perel2:08:43

        Right. At the same time, I could say, but subjectively, y- you know, you produ- you manufacture your thoughts and your thoughts define you. But it's not immutable. These are constructs. What I mean by construct is it's, it's creations, and creations can be changed with new creations. You can't totally believe what you feel because sometimes your mind is making you believe a feeling. For example, your mind can make you f- believe that you feel, at this point, nothing. A, you can feel nothing because you're frozen. B, you can feel nothing because you're trying very hard not to show anybody how upset you are. Three, you're trying to make it look like you, you're not attached to this person at all, and if you don't-- if you wanna break up with me, no big deal, I was never that in love with you anyway. Um, and this is the mind trying to pretend that it knows my feelings and it wants to convince me that I'm not hurt. "I'm not hurt. I'm not hurt at all." [laughs] And the more a person says something like that to me, and the more I wanna go and hold them and press right there on those places, those bony handles where so much of that sad, fragile, hurt wound sits and then just... You know, I've had people in my room where the tears are literally streaming down their face and they're saying, "I'm not hurt." And I'm looking at them and I'm saying, "Ah, the fracture inside, the-- You know, one part of you doesn't know the other part of you in literal terms. Your eyes don't know that they're tearing. Your heart doesn't know that it's aching." This is our work.

    13. PAPeter Attia2:10:46

        To me, this makes sense, and it stands in a bit of a contrast to, I think, something that, that Susan David once said, which is, "The key to resilience is the radical acceptance of all emotion." And do you see those as compatible beliefs?

    14. EPEsther Perel2:11:05

        The key to resilience is ac- is the radical acceptance of all our emotions. Um, so the-- to me, there's a lot of truth in that statement, but it presumes a certain definition of the word resilience. And it, it is a view of resilience as internal traits, personality traits, and that's a very individualistic perspective on resilience. Like, you are a resilient person. You know how to face adversity, you know. Uh, there are many definitions of resilience, actually, you know. This is one, but, uh, resilience is also our ability to f- to, to face adversity in a way that allows us to rebound and then to reengage with life. That would be-- When I say my parents were resilient, that would be another definition of resilient. It wasn't about just the things inside of them. It was a combination of what I said, the collective support, the community, the people who helped them, the luck, you know, what they had experienced before the war, how they grew up, you know, lots of different things. A collective definition of resilience is our ability to tap into the collective resources. It's actually not what's inside of you. It's what's around you. That, too, is resilience. Sometimes resilience is actually the ability to know and to go and ask for help. I'll give you a very beautiful example that, that my husband was telling me recently about a, a young man. Um, basically... I forgot the details now, but it, it's something about how guilty he feels. This is an, a, a, a... I wish I, I will not mess up. It's like telling a joke when you know the laugh to the end, right?

    15. PAPeter Attia2:13:02

        [laughs]

    16. EPEsther Perel2:13:03

        Um, but the, the man feels tremendous guilt because he ha- he actually went to call the police at a neighbor's house because of the violence that was in the house, and he has carried this as the ultimate betrayal all the time. What he didn't take into consideration is that it actually prevented the father from doing something even worse, and I forgot what that thing was. And when the therapist just said to him, "You know, you-- what you think was about, 'How could I run out of the house at that moment and leave my mother with my father?' You actually, by calling the police at that moment, were able to bring other people in that could do more than what you could do as a nine-year-old, and what you did was one of the most loving things you could have done for your mother." Now, that's a reframe. Now, is it true? It only depends if the person bites. If they, if they take that story in and that story replaces another story and gives them a completely different sense of what they did and what it meant and what the consequences were, therefore, it is true. Not because it has any truth in absolutes. That's what I mean by narrative. That person now leaves the session and is thinking about, "What I thought was the worst actually was probably the kindest." I have not been that bad person. I was young, and I tried to do this, and blah, blah, blah. It goes, it goes on like that. And I... That is a different description of resilience, you see, and a different description of the power of narrative in resilience than just to see it as, um, it's the radical acceptance of all emotions. I think it's a truism. It's, there's a truth in that statement, but it, it doesn't capture the, the way that I like to define resilience, is probably a better way of saying.

16. 2:15:13 – 2:22:34

    Questions about the human condition that Esther wants to explore

    1. PAPeter Attia2:15:13

       What problem about the human condition are you still most curious about? You know, when you think about the... Y- y- you're, you're a person who, you know, is endlessly curious and is constantly evolving. Um, what is the next frontier for you clinically?

    2. EPEsther Perel2:15:29

       You know, there's two... I could answer it in, in, in topic, and I can answer it in, in, like yesterday I did a session, and I-- at the end of the session, I said to the person, "It took us three years to get here." I feel like we finally, you know, doing... Like we, it's not true, but it is true. It's both end. You know, the one hand, no, we've had many very important sessions, but on the other hand, there was a level at which we got that I thought, "Man, some things take time." And, um, and sometimes I'm impatient, and I sometimes forget. It's like a painter, you know, till the end of your life, the next painting will be something different than the one before. It's like a session is, needs to be something different than the one before. You know, there are times when I think, "What more can we talk about?" And then we just open and stumble on something that, um... So in that sense, it's less about what I want to learn about the human condition as how deep can I go? How deep can we go in a conversation in understanding the vast continent that is the human being? And then there is the thing you said before, which really is a question that fascinates me, which is why this one yes, and that one no? I, I, I'm very intrigued by that, you know. Um, why is this one, you know, why this, um... What, what-- And by the way, that is a different definition of resilience. The vast majority of people who could... And then this is a question that you can ask yourself, too, you know, the l- that, that really had conditions of life that could have left them in very dire circumstances, and who actually turned it, uh, turned those things around and became driven and ambitious and creative and successful in the multitudes of ways that people can be successful. And I think one of the things that I always ask, and I think that that is a piece of resilience, is was there a teacher, a coach, a neighbor, a family member or friend that saw that thing that nobody else was seeing, not because they didn't care about you, but because they were too busy with their own craziness? And they s- the person saw them, and they could let that person help them, mentor them, teach them, connect them, give them the first job, you name it. That piece seems to be a big, big, big difference between those who are living more richer lives, maybe is the best way of saying it, and those who just the struggle remained at the center of their life all the time. That doesn't mean that the other ones don't struggle, but they were able to put some of the pieces together, and I find that an incredible thing, that it, it sometimes hinges really on... It is about connection. It is about relationship, but it's not just a relationship with your parents or... It's someone in your ecosphere, you know, that l- that l- put that hand out, and you took it. It's not just because there are many times people put their hand out, but the people don't take it, or they take it, and then they let it go, and then they drown. It-- They held it. They held it when there was absolutely s- overtly no reason to wanna hold onto it. Um, I find that a very important moment in our life, and many of us have had moments like this.

    3. PAPeter Attia2:19:39

       Esther, I wanna, I wanna thank you for, um, for sharing so much today and for all of your work. Uh, it's, it's, it's touched the lives of many people, myself included. Um, and I hope that there are a number of people who maybe aren't familiar with you, uh, who have become more familiar with you now, and maybe people who were familiar with you through one very narrow lens who can now appreciate sort of the breadth of your, um, both your interest and your expertise.

    4. EPEsther Perel2:20:06

       Thank you. Thank you very much. [upbeat music]

    5. PAPeter Attia2:20:11

       Thank you for listening to this week's episode of The Drive. If you're interested in diving deeper into any topics we discuss, we've created a membership program that allows us to bring you more in-depth exclusive content without relying on paid ads. It's our goal to ensure members get back much more than the price of the subscription. Now, to that end, membership benefits include a bunch of things. One, totally kickass comprehensive podcast show notes that detail every topic, paper, person, thing we discuss on each episode. The word on the street is nobody's show notes rival these. Monthly AMA episodes or Ask Me Anything episodes, hearing these episodes completely. Access to our private podcast feed that allows you to hear everything without having to listen to spiels like this. The Qualies, which are a super short podcast that we release every Tuesday through Friday highlighting the best questions, topics, and tactics discussed on previous episodes of The Drive. This is a great way to catch up on previous episodes without having to go back and necessarily listen to every one. Steep discounts on products that I believe in but for which I'm not getting paid to endorse, and a whole bunch of other benefits that we continue to trickle in as time goes on. If you wanna learn more and access these member-only benefits, you can head over to peterattiamd.com/subscribe. You can find me on Twitter, Instagram, and Facebook, all with the ID Peter Attia MD. You can also leave us a review on Apple Podcast or whatever podcast player you listen on. This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice. No doctor-patient relationship is formed. The use of this information and the materials linked to this podcast is at the user's own risk. The content on this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice from any medical condition they have, and they should seek the assistance of their healthcare professionals for any such conditions. Finally, I take conflicts of interest very seriously. For all of my disclosures and the companies I invest in or advise, please visit peterattiamd.com/about where I keep an up-to-date and active list of such companies. [upbeat music]

Episode duration: 2:22:34