That didn't go to therapy in the first place.

Because talking about emotions did not work for them.

There's even a really interesting paper.

So there's a lot of exploration into this.

And one paper actually points out that there are two kinds of therapy that you can give.

One is what we call emotionally supportive therapy where you talk about your emotions.

And the second is something called instrumental support, which is like problem solving.

Does this require an entire new type of therapy? To me, based on what I know about the definitions of therapy, almost sounds like it gets into some kind of coaching in a way.

because the brain is connected to the body.

So I think what we were also seeing a lot of brain fog is a symptom of long COVID.

So that further demonstrates the kind of like immune autoimmune inflammation based results of brain fog.

So I think that brain fog, in my opinion, is really probably some kind of low level inflammation that is going on.

So usually when I'm trying to help people with brain fog, it's kind of weird, but it's not much psychological stuff.

Like, I don't think it's like problems with your emotions or psychotherapy.

It's usually more physiologic stuff.

And I can sometimes feel it in my joints, I can sometimes feel it, it's like throbbing, my entire body is throbbing, because I'm just so fucking inflamed and i wouldn't say that i'm hypersensitive to this but you know everyone can push it if you get a bag of haribo tang fast sticks in front of you or something and you go i've just eaten 100 grams of sugar that that's an awful lot

What have you learned from speaking to

them? Wow.

So a couple of different things.

The first is it's not nearly as fun or easy as they make it look.

So oftentimes, and I've worked with a lot of people, so was in Boston for a while and working with people out of startups and stuff out of MIT and Harvard and just really, really hardworking people.

I've worked with people at like Goldman Sachs and Google and whatnot.

And there are a lot of people who work really hard.

And if there is somebody that can out suffer you, if there is someone for whom they can go seven days without seeing sunlight, but you can only go half a day without seeing sunlight, in some regards, they have a competitive advantage.

Why? How does porn use impact a developing brain? What is it about this? Which direction is the arrow of causation going in?

Yeah, so a couple of caveats about that.

So that's like a observation we've made of people in our community.

I don't know if there's actually research on that, but I wouldn't be surprised if there was.

Yeah, that's true of all the other addictions, okay? So we sort of know why.

And so we know that when you have a developing brain, adding a substance to it makes us more vulnerable to it long-term.

So there's even studies that show that early marijuana usage leads is more likely to lead to addictions of other kinds and it's because when you use marijuana at a young age it actually alters how your dopamine circuitry is formed and leaves you vulnerable to other addictions so my guess is that pornography has some similar neuroscientific mechanism where something is going on where even if you're because these people are prepubescent usually when they're exposed which means that they don't get aroused like usually, right? So they don't even understand what they're seeing, which is the most common thing.

Why is it? that we get so motivated in the middle of the night instead of first thing in the morning? Why did nature decide that it was going to curse us so that our brains can't shut off when we're about to go to sleep? And yet when we want to wake up first thing in the morning, our brains don't want to start.

That didn't go to therapy in the first place.

Because talking about emotions did not work for them.

There's even a really interesting paper.

So there's a lot of exploration into this.

And one paper actually points out that there are two kinds of therapy that you can give.

One is what we call emotionally supportive therapy, where you talk about your emotions.

And the second is something called instrumental support, which is like problem solving.

Does this require an entire new type of therapy? To me, based on what I know about the definitions of therapy, almost sounds like it gets into some kind of coaching in a way.

Pleasure.

You guys would make an amazing podcast together.

I have to say.

This would be a crazy conversation.

Okay,

cool.

They were of the mind that you thought that therapy wasn't very effective.

I'm a psychiatrist.

Mm-hmm.

That this is a quantifiable thing, that we can sort of see at this table people are sort of, like, at different places.

And so the first thing that I kinda wanna point out is I don't know whether there's purpose or not, but as a human condition, there is something that each of us feel or experience that gives us an answer, right? So you're, like, a 10, but what that means is that y- something is going on in your mind, something is going on in your heart, something is going on in your body, where you wake up and you feel like you have purpose.

Steven wakes up and he's, like, at a five out of 10.

So he's getting some signals in that area, some signals are not in that area.

You have some signals in that direction, too.

You know why you're showing up at this podcast.

I don't, I don't think they're unanswerable.

Right.

So I think what we're also seeing a lot of brain fog is a symptom of long COVID.

So that further demonstrates the kind of like immune, autoimmune inflammation based results of brain fog.

So I think that brain fog, in my opinion, is really probably some kind of low level inflammation that is going on.

So usually when I'm trying to help people with brain fog, it's kind of weird, but it's not much psychological stuff.

I don't think it's problems with your emotions or psychotherapy.

It's usually more physiologic stuff.

so fucking inflamed and i wouldn't say that i'm hypersensitive to this but you know everyone can push it if you get a bag of haribo tang fast sticks in front of you or something and you go i've just eaten 100 grams of sugar that that's an awful lot

What have you learned from speaking to

them? Wow.

So a couple of different things.

The first is it's not nearly as fun or easy as they make it look.

So oftentimes, and I've worked with a lot of people, so was in Boston for a while and working with people out of startups and stuff out of MIT and Harvard and just really, really hardworking people.

I've worked with people at like Goldman Sachs and Google and whatnot.

And there are a lot of people who work really hard.

And if there is somebody that can out-suffer you, if there is someone for whom they can go seven days without seeing sunlight, but you can only go half a day without seeing sunlight, in some regards, they have a competitive advantage.

Why? How does porn use impact a developing brain? What is it about this? Which direction is the arrow of causation going in?

Yeah, so, so a couple of caveats about that.

So that's like a observation we've made of people in our community.

I don't know if there's actually research on that, but I wouldn't be surprised if there was.

You know, that's true of all the other addictions, okay? So we sort of know why.

And so we know that when you have a developing brain, adding a substance to it makes us more vulnerable to it long term.

So there's even studies that show that early marijuana usage leads, is more likely to lead to addictions of other kinds.

Why is it that we get so motivated in the middle of the night instead of first thing in the morning? Why did nature decide that it was going to curse us so that our brains can't shut off when we're about to go to sleep, and yet when we want to wake up first thing in the morning, our brains don't want to start?

Right.

So I think what we're also seeing a lot of brain fog is a symptom of long COVID.

So that further demonstrates the kind of like immune, autoimmune inflammation based results of brain fog.

So I think that brain fog, in my opinion, is really probably some kind of low level inflammation that is going on.

So usually when I'm trying to help people with brain fog, it's kind of weird, but it's not much psychological stuff.

I don't think it's problems with your emotions or psychotherapy.

It's usually more physiologic stuff.

so fucking inflamed and i wouldn't say that i'm hypersensitive to this but you know everyone can push it if you get a bag of haribo tang fast sticks in front of you or something and you go i've just eaten 100 grams of sugar that that's an awful lot

What have you learned from speaking to

them? Wow.

So a couple of different things.

The first is it's not nearly as fun or easy as they make it look.

So oftentimes, and I've worked with a lot of people.

So I was in Boston for a while and working with people out of startups and stuff out of MIT and Harvard and just really, really hardworking people.

I've worked with people at like Goldman Sachs and Google and whatnot.

And if there is somebody that can out-suffer you, if there is someone for whom they can go seven days without seeing sunlight, but you can only go half a day without seeing sunlight, in some regards, they have a competitive advantage.

Why? How does porn use impact a developing brain? What is it about this? Which direction is the arrow of causation going in?

Yeah, so a couple of caveats about that.

So that's like an observation we've made of people in our community.

I don't know if there's actually research on that, but I wouldn't be surprised if there was.

That's true of all the other addictions, okay? So we sort of know why.

And so we know that when you have a developing brain, adding a substance to it makes us more vulnerable to it long-term.

So there's even studies that show that early marijuana usage leads is more likely to lead to addictions of other kinds and it's because when you use marijuana at a young age it actually alters how your dopamine circuitry is formed and leaves you vulnerable to other addictions so my guess is that pornography has some similar neuroscientific mechanism where something is going on where even if you're because these people are prepubescent usually when they're exposed which means that they don't get aroused like usually, right? So they don't even understand what they're seeing, which is the most common thing.

Why is it that we get so motivated in the middle of the night instead of first thing in the morning? Why did nature decide that it was going to curse us so that our brains can't shut off when we're about to go to sleep? And yet when we want to wake up first thing in the morning, our brains don't want to start.

Yeah.

There's even a really interesting, um, paper.

Uh, uh, so there's a lot of exploration into this and, and one paper actually points out that there are two kinds of therapy that you can give.

One is what we call emotionally supportive therapy, where you talk about your emotions, and the second is something called instrumental support, which is like problem-solving.

And what we tend to find is that men prefer problem-solving.

But if you look at therapy training, we are actively disincentivized to problem solve with our pa-patients.

We're not there to solve your problems.

Does this require an entire new type of therapy? It, it almost, to me, based on what I know about the definitions of therapy, almost sounds like it gets into some kind of coaching in a way.

Yeah.

And that's because you can't duplicate the solution that someone else has.

The best chance you've got, and I- I'm methodologically this is sound, outcomes-wise, scientifically this is sound.

We can get into the research.

You have to play from your position, right? So you can look at somebody else who wins a hand of poker with a royal flush, but if you've got like a three seven of hearts, it's not that you can't win, but the fastest way to lose is to use the strategy of the other guy.

So your model of like diagnosis first is exactly where I go, and a big part of that is what is really driving you? How does ego enter the picture? And how are you being shaped by your perceptions?

Mm.

So 70% of, of therapists are women.

Yeah.

And that's because you can't duplicate the solution that someone else has.

The best chance you've got, and I- I'm methodologically this is sound, outcomes-wise, scientifically this is sound.

We can get into the research.

You have to play from your position, right? So you can look at somebody else who wins a hand of poker with a royal flush, but if you've got like a three seven of hearts, it's not that you can't win, but the fastest way to lose is to use the strategy of the other guy.

So your model of like diagnosis first is exactly where I go, and a big part of that is what is really driving you, how does ego enter the picture, and how are you being shaped by your perceptions?

Mm.

So 70% of, of therapists are women, 70% of patients, this is changing now thankfully, but you know, 70% of patients are women.

Mm.

Um, you sure you don't wanna go?

No, please.

[laughs]

So, so I, you know, like Joe, and I'm sure like you guys, uh, you know, I had a series of rock bottoms, and then there's, like, the classic rock bottom that I, that I sort of share with people, which is a rock bottom that looks like a rock bottom.

Um, so I, you know, I'm, I'm failing out of college, um, you know, spending every day playing 16 to 20 hours of video games a day.

And I remember, like, waking up one morning and sleeping through my Spanish final.

Mm.

That didn't go to therapy in the first place.

Because talking about emotions did not work for them.

There's even a really interesting paper.

So there's a lot of exploration into this.

And one paper actually points out that there are two kinds of therapy that you can give.

One is what we call emotionally supportive therapy, where you talk about your emotions.

And the second is something called instrumental support, which is like problem solving.

Does this require an entire new type of therapy? To me, based on what I know about the definitions of therapy, almost sounds like it gets into some kind of coaching in a way.

But what is brain fog? Have you ever looked at this clinically?

Oh, yeah, a ton.

So we had a YouTube video about this that that went really well.

So I think the tricky thing about brain fog is as a clinician, like we see it frontline and people don't really know what to do.

So this is where, so it's interesting.

I mean, I guess at this point I'm an expert in technology usage, but My actual historic expertise is in evidence-based complementary and alternative medicine.

And so what we're really seeing in brain fog, first of all, I think we have got to understand that your brain exists within a body.

so fucking inflamed and i wouldn't say that i'm hypersensitive to this but you know everyone can push it if you get a bag of haribo tang fast sticks in front of you or something and you go i've just eaten 100 grams of sugar that that's an awful lot

What have you learned from speaking to

them? Wow.

So a couple of different things.

The first is it's not nearly as fun or easy as they make it look.

So oftentimes, and I've worked with a lot of people, so was in Boston for a while and working with people out of startups and stuff out of MIT and Harvard and just really, really hardworking people.

I've worked with people at like Goldman Sachs and Google and whatnot.

And there are a lot of people who work really hard.

And if there is somebody that can out suffer you, if there is someone for whom they can go seven days without seeing sunlight, but you can only go half a day without seeing sunlight, in some regards, they have a competitive advantage.

Why? How does porn use impact a developing brain? What is it about this? Which direction is the arrow of causation going in?

Yeah, so a couple of caveats about that.

So that's like an observation we've made of people in our community.

I don't know if there's actually research on that, but I wouldn't be surprised if there was.

That's true of all the other addictions, okay? So we sort of know why.

And so we know that when you have a developing brain, adding a substance to it makes us more vulnerable to it long-term.

So there's even studies that show that early marijuana usage leads is more likely to lead to addictions of other kinds and it's because when you use marijuana at a young age it actually alters how your dopamine circuitry is formed and leaves you vulnerable to other addictions so my guess is that pornography has some similar neuroscientific mechanism where something is going on where even if you're because these people are prepubescent usually when they're exposed which means that they don't get aroused like usually, right? So they don't even understand what they're seeing, which is the most common thing.

Why is it that we get so motivated in the middle of the night instead of first thing in the morning? Why did nature decide that it was going to curse us so that our brains can't shut off when we're about to go to sleep? And yet when we want to wake up first thing in the morning, our brains don't want to start.

Mm.

And so internally, we had this meeting where we're like, "Okay, should we make our free content less good?" And I was like, "Hell no," right? Um, so right now what's going on is, like, human beings fundamentally don't wanna pay the cost of stuff anymore.

This is why we get to things like gambling and stuff like that, right? And everyone is selling, like you were saying from this, this YouTube guy, everyone is selling the idea that, like, you ...

There's a free lunch, passive income, right? Effortless success.

You don't have to pay the price.

We're becoming, and this is what's really scary, is, like, you know, there are so many predatory apps.

Like, I, I saw an ad for a, a gambling app literally yesterday.

Yep.

Yeah.

There's even a really interesting, um, paper.

Uh, uh, so there's a lot of exploration into this.

And, and one paper actually points out that there are two kinds of therapy that you can give.

One is what we call emotionally supportive therapy, where you talk about your emotions, and the second is something called instrumental support, which is like problem-solving.

And what we tend to find is that men prefer problem-solving, but if you look at therapy training, we are actively disincentivized to problem solve with our pr- patients.

We're not there to solve your problems.

Does this require an entire new type of therapy? It, it almost, to me, based on what I know about the definitions of therapy, almost sounds like it gets into some kind of coaching in a way.

But what is brain fog? Have you ever looked at this clinically?

Oh, yeah, a ton.

So, so, uh, uh, we had a YouTube video about this that, that went really well.

So I, I think the, the tricky thing about brain fog is as a clinician, like, we see it front line, and people don't really know what to do.

So this is where...

So, um, it's interesting.

I'm, I'm, I mean, I guess at this point I'm an expert in, in technology usage, but my, my actual, like, historic expertise is in evidence-based complementary and alternative medicine.

If you get a bag of Haribo Tangfastics in front of you or something and you go, "I've just eaten 100 grams of sugar there," that's an awful lot.

What have you learned from speaking to them?

Um, wow.

So a couple of different things.

The first is it's not nearly as fun or easy as they make it look.

So oftentimes-- and I, I've worked with a lot of people, so, uh, you know, was in Boston for a while and working with people out of startups and stuff out of MIT and Harvard and just really, really hardworking people.

I've worked with people at, like, Goldman Sachs and Google and, and whatnot.

And, and, like, there are a lot of people who work really hard.

This is a lens through which I see a lot of very difficult pursuits, that basically it, it, it does come down to a battle of attrition, and if there is somebody that can out-suffer you, if there is someone for whom, uh, they can go seven days without seeing sunlight, but you can only go half a day without seeing sunlight, in some regards, they have a competitive advantage.