Kind: captions
Language: en
where the darkest places you've ever
gone in your life
the following is a conversation with
carl deisseroth professor of
bioengineering psychiatry and behavioral
sciences at stanford university he's one
of the greatest living psychiatrists and
neuroscientists in the world
he's also just a fascinating human being
we discuss both the darkest and the most
beautiful places that the human mind can
take us
he explores this in his book called
projections a story of human emotions
i highly recommend it it's written
masterfully
this is the lex friedman podcast to
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in the description and now dear friends
here's carl that's roth
you open your book called projections a
story of human emotions with a few
beautiful words that summarize all of
humanity
the book draws insights about the human
mind for modern psychiatry and
neuroscience so if it's okay let me read
a few sentences from the opening
you got to give props to beautiful
writing when i see it
quote
in the art of weaving
warp threads are structural and strong
and anchored at the origin
creating a frame for crossing fibers as
the fabric is woven
projecting across the advancing edge
into free space warp threads bridge
deformed past to the ragged present to
the yet featureless future
yet featureless future well done well
done sir
the tapestry of the human story has its
own warp threads rooted deep in the
gorges of east africa connecting the
shifting textures of human life over
millions of years
spanning pictographs backdrop by
creviced ice
by angulated forestry by stone and steel
and by glowing rare earths
the inner workings of the mind give form
to these threads creating a framework
within us
upon which the story of each individual
can come into being
personal grain and color arise from the
cross threads of our moments and
experiences
the fine weft of life
embedding and obscuring the underlying
scaffold with intricate and sometimes
lovely detail
here are stories of this fabric fraying
in those who are ill
in the minds of people for whom the warp
is exposed and raw
and revealing
what have you learned about human beings
human nature and the human mind from
those who suffer from psychiatric
maladies
for those for whom this fabric is warped
and one thing we learn as biologists is
that when something breaks
you see
what the original
unbroken
part was for and we see this in genetics
we see this in biochemistry
it's known that when you have a mutated
gene
sometimes the gene is turned up in
strength they're turned down in strength
and that lets you see what it was
originally for you can infer
true function from dysfunction
and this is a theme that i thought
needed to be shared
and needed to be
made communicable to the to the lay
public to everybody people who
which is i think uh almost all of us who
think and care about the inner workings
of our minds but who also
care for those who have been suffering
who have
mental health disorders who face
challenges
but then more broadly
it's a very much larger story than the
present there's a
a story to be told where the protagonist
really is the human mind and that was
one thing i wanted to share as well in
projections is that broader story but
still anchored in the moment of
patience of people of
experiences of the moment
is there a clear line between
dysfunction and function disorder and
order
this is always debated in psychiatry
probably more so than any other you know
medical specialty
i'm a psychiatrist i'm i treat patients
still
i see
acutely ill
people who come to the emergency room
where there's no doubt that this is not
something that's working well where the
manifestation of disease is so powerful
where the person is suffering so greatly
where they cannot
continue as they are
but of course it's a spectrum and there
are people who are closer to the to the
realm of being able to work okay in
their jobs but suffer from some small
dysfunction and everywhere in between
in psychiatry we're careful to say we
don't call it a disease or a disorder
unless there's a disruption in social or
occupational functioning
but of course psychiatry has a long way
to go in terms of developing
quantitative tests we don't have
blood draws we don't have imaging
studies that we can use to diagnose
and so that line ultimately
that you're asking about between order
and disorder function and dysfunction
it's operational of the moment how are
things working
can we just like linger on the terms for
a second so this uh disease
uh dysfunction
how careful should we be using those
words can we just even in this
conversation
um from a
sort of technical perspective but also a
human perspective
how um
quick
should we be
in saying that schizophrenia
uh depression
autism
as we kind of go down this uh
across the spectrum of different
maladies like
just to use the word dysfunction and
disease
i would say to give ourselves license to
capture the whole spectrum let's say
disorder because that that captures
truly i think the essence of it which is
we need to talk about it when it's not
working when there's disorder and that
that's the fairest and
you know most uh inclusive term to use
so is it fair to assume that basically
every
member of the human species suffers from
a large number of disorders then
well and we just have to pick which ones
are are debilitating and for each person
you know if you if you look at the
numbers
there are
uh
you know if you look at how our mental
health disorders are currently defined
you can uh look at population prevalence
values for all these disorders and you
can
come up with estimates that
somebody
will have a lifetime prevalence of
having a psychiatric disorder that
approaches 25 or so and so that's
and in some studies it could be more
some studies it could be less now what
do we do with that number what does that
mean and in some ways that's the essence
of what i was hoping to approach with
uh the book is to reflect on this
spectrum that exists for all the
disorders there is
and taking nothing away from the
severity and the suffering that comes at
the extreme end of these illnesses but
nearly every one of them exists on a
spectrum of severity from
nearly functional to completely
dysfunctional life-threatening and and
even fatal
and so that that that number 25 more or
less it doesn't capture
uh that that spectrum of
of uh severity to regard that number
where do those numbers come from is it
self-report is it people who
show up and say i need help is it
somebody else that points out that
person needs help
or is it like estimates that even go
beyond that for people who don't ask for
help or suffering quietly
alone when you look at self-report
numbers that then those numbers get even
higher beyond 25 percent or more
those the most rigorous studies are
done with structured psychiatric
interviews where people
who are trained in eliciting symptoms
carefully do complete psychiatric
inventories of of individuals and these
are
time-consuming laborious studies that
not often repeated when they're done
they're they're done well
but
very often you'll see a report or
something in the news of a very high
number
for some disorder or or symptom and very
often
if it's shockingly high that's coming
from a self-report of a person
and so that's another another issue that
we have again take nothing away from the
severity and reality and and biological
nature of these disorders which are very
genetic very you know we we understand
that these are very biological
and yet
we lack right now the lab tests and the
blood draws to make the diagnoses we'll
talk about it just how biological they
are because it's a that too is a mystery
i mean
you know in terms of from a perspective
of how to probe into the disease how to
understand it and how to help it so some
of it could be neurobiological
some of it could be
uh just the the dance of human emotion
and interaction and the
it's like uh
well it is love when it works and is
love when it breaks down uh biological
or is it something else so we're gonna
talk about it but let me just like to
linger in terms of disorder
what about genius
you know that sort of uh cliche saying
like the
madness and genius that they kind of
danced together uh
what about if the thing we see is this
order is actually
genius unheard or misunderstood
well here again the numbers help us and
here's where being rigorous and
quantitative actually really helps if
you look at disorders like autism
and bipolar disorder
and eating disorders anorexia nervosa
for example
these uh you know particularly bipolar
and anorexia these can be fatal
they can cause immense suffering
but they are heavily genetic all three
of these
and
what's very interesting is each one of
these three is actually correlated
positively
positively with measures of intelligence
of educational attainment
and even of income and so you look at
this severe disorders in many cases
causing
quite immense morbidity and mortality
and yet
they are positively correlated at the
population level with positive things
can you say the the three again autism
autism
anorexia and bipolar disorder bipolar
right what's that book forgot the book
name but uh is intelligence a burden
uh
well you know people can get into
trouble when they think they're smarter
than they are i will say that
i don't know
sometimes like
in the deepest
meaning of that statement i think
ignorance is bliss i'm a big fan of
prince michigan from the idiot and um
i learned from brother karmazov
optimism can be seen as naivete and
dumbness but i think it's a
it's a kind of deep intelligence
maybe inability to reason
uh sort of about the mechanics of the
world but instead kind of feel the world
and it seems like that's a one of the
paths to happiness
there is how much you think versus how
much you feel this comes up all the time
in medicine
we encounter this all the time when you
day after day you encounter this you
know the the abyss of suffering from
patients how much do you let yourself
feel
or how much do you
make it abstract and
and objective and try to make it
clinical
and that range how you're able to move
yourself on that on that spectrum
is very important for survival as a
physician
and the way you
you protect yourself and your feelings
turns out to be very important
so you quote finnegan's wake uh mad
props for that james joy's book i took a
class on james joyce in college
i think i read parts of finning and way
i might have been on drugs of some kind
or
i um i somehow got an a in that class
which probably refers to some kind of
curve where nobody understood anything
the only thing i understood and really
enjoyed is the short stories the dead
and then ulysses i kind of uh i think
read a few cliff notes that kind of got
to the point and then finnegan's wake
was just a hopeless person i it's a you
for people who haven't looked at it
maybe you can
elucidate to me better but
i felt like i was reading things
words and the words made sense
like standing next to each other
but when you
kind of read for a while you realize you
didn't actually understand anything that
was said right but did you have a
feeling though that's one that's one
thing i found interesting about
finnegan's week i i never fully
understood it but the words caused
feelings in me which i found fascinating
and and sometimes i i couldn't predict
it from the the semantic you know black
and white context of what i was seeing
in front of me on the page but the
rhythm or the melody would make me feel
certain ways and that's that was what i
always was intrigued by with joyce of
course that was his
he he existed on a spectrum too and he
wrote as you say you know more
accessible uh works you know i learned a
lot about irish history from you know
portrait of the artist as a young man
and there was just
he could be as objective as he wanted to
be but then when he let himself loose
he was in this realm where the words had
their own
purpose separate from from
you know semantic meaning from their
their dry uh you know dictionary
definition you know there's a funny
story that was told it doesn't matter if
it's true or not but they they said that
uh james joyce when he was young when he
was in his teen years would go around
instead of ireland drinking and so on
and telling everybody that he's going to
be one of if not the greatest writers of
the 20th century
and uh he turned out to be
that
so the that i always think about that
little story that somebody told me
because i have a lot of people come up
to me including myself i'm a bit of a
dreamer
i and
you know you get into certain moods
where you say i'm going to be the
greatest
anything ever you you get like people
tell you this uh young especially young
people
and it kind of
it makes me feel all kinds of ways but
that story reminds me that
like you just might be
one of the greatest
writers of the 21st century for example
if somebody were to tell me that and
like don't
just don't immediately disregard that
because one of the people that say that
that's almost like a pre-condition
that's like a requirement just to
believe in yourself maybe it's not a
full requirement but it's it's an
interesting story
i think when someone tells you that then
it creates uh
one sees an opportunity and then it
would be a tragedy if the opportunity
weren't captured right and so then that
creates a um some some impetus uh some
motivation to do something
something good i think the mind it's
like uh
you know i guess that's what like books
like the books or whatever i don't even
know if it's a book the secret plugs
into uh they kind of make a whole
industry out of it but there is
something about
the mind believing something making it a
reality it is just time and time again
with steve jobs like
your belief in yourself your belief in
an idea
sort of embracing the me versus the
world
embracing the madness of this idea and
making it a life pursuit
somehow morse reality around for some
tiny fraction of the population for
everybody else you descend into uh
you know all the beautiful ways that
failure
materializes in our lifetime
you know you mentioned love earlier i
mean that's that's a great example of
how belief in something makes it real
right it's it's not reasonable
on the face of it but because you
believe it's reasonable then it actually
does become reasonable and then it is
real and so that's a that's a good
example that doesn't happen i'm also in
a bioengineering department we don't
imagine that a bridge is soundly built
and then it is soundly built that's
something that it doesn't come up in too
many realms of human existence but love
is one of them and and these the ability
to
to have a fixed idea and to say it's
true and then it is true
a bridge is a kind of manifestation of
love so maybe it does work a little bit
but you know they can break down like
chernobyl did you can't just say it's
safe you have to also prove it safe
uh but on finnegan's wake
i think maybe correct me if i'm wrong
you're using kind of finnegan's wake to
give one perspective on what madness is
of what's going on in the mind how much
of that is
uh that we're simply unable
to communicate with the person on the
other side
of of their mind like there's almost
like a
a little person inside the brain and
they have some circuitry that's used to
communicate emotion communicate ideas to
the outside world and there's something
about that circuitry that makes it
difficult to communicate with a little
person on the other side so if you look
at what shows up in schizophrenia with
many cases the
what we call thought disorders what we
call
uh the
the individual speech symptoms of
schizophrenia
finnegan's wake is is loaded with them
and it's it's just full of them we we
talk about uh
clang associations in schizophrenia
where the word that is said is
echoes in some way the previous word and
it's we call that a clang association
because there's no other reason than the
similarity of the sound like a like a
clang of a
of a garage door being hit and it has a
and sometimes it's not even a word and
we call that a neologism a new word
being created and of course finnegan's
wake is is full of that and then
uh we we also in schizophrenia where
there's what we call loose associations
or tangential thought processes of
course full of that where things just go
off in directions that are not linear or
logical
and
you can't read finnegan's wake i think
without um
certainly a psychiatrist you can't read
it without thinking about schizophrenia
and then when we look at
the families of people with
schizophrenia and joyce was no exception
there very often are people within the
family who are on the spectrum some have
it
some are
able to see it from a distance from a
safe distance
there's an association between
schizophrenia and what we call
schizotypal personality disorder where
people are not quite in this
severe state of schizophrenia but have
some magical thinking have some unusual
thought patterns very often those are
family members of people with
schizophrenia so this points to this
again to this idea that that there is a
range even along
this very severe
very genetic biological illness that
human beings dwell on different spots
along that spectrum i should mention
that we have my friend sergey pulling up
stuff young sergei or old sergey i don't
know what to call you but
uh there's drafts of finn can squake
yeah i actually saw pictures of this
from um
i think it was on instagram or something
these are early giraffes of finnigan's
wave and it's so beautiful to see for
people who are just listening there's
just random paragraphs and writing all
over the page with stuff crossed out and
it's great to see that joyce himself was
thinking in this kind of way as
um as you're putting it together how
much do you think he was thinking about
schizophrenia this schizophrenic mind i
think a lot i think you know it's it's
known that his daughter suffered from
from schizophrenia and uh
the this is what's depicted here on the
page is something that i'm sure
he either felt himself and some some
level was able to access this
non-linearity of of processing or had
seen enough in family
that he he knew what it was and was able
to to reflect it down in black and white
on the paper so it was what he was able
to do is was quite authentic in that
sense
of course i don't want to
pigeonhole him he was doing much more
than that it was much more than than
talking about altered human
thought processes and thought disorders
but that was an aspect that he was
so good at representing that it had to
be
intentional to some extent and a tiny
tangent what does your own
writing look like for this book because
it's extremely well written
how many edits
did you just drink some whiskey and uh
like i'm imagining hemingway style
what's a very different the the writing
is very different i mean it's really
really well written which was like
i
was reading it
it makes you realize because i was
expecting sort of a science kind of
which it is like uh
you know
elucidating something about the human
mind kind of thing but you could also
probably write
really strong like novels
uh so maybe that's in the future but
anyway what is your how many edits how
many what's your style does it look like
that is it more structured organized
unfortunately i used a laptop so i
didn't have this sort of uh beautiful
recorder typewriter cigarette
and whiskey i did explore i was you know
which was there a particular altered
state that would help me to be most
creative and and i
i found actually i i actually did the
best while uh you know sober but
slightly disinhibited in the late hours
of the of the night or early morning
yeah particularly late hours of the
night there
you know i i i have a friend who would
tell me that she thought that very early
in the morning her inner critic was
still asleep and she could write more
effectively before her inner critic woke
up yeah and i actually found that uh
outstanding advice for me that i often
found that there was
i was looser and could write more in the
morning
but the other interesting thing is is
each each chapter each story it's about
a different
uh human being with a different class of
of psychiatric disorder that's what each
story each
each chapter is anchored in
by trying to use words that and style
of writing and
and uh you know diction that captures
the feeling of the disorder and so it's
different in each story in the story
about mania
which is a very
expansive exuberant uh
at least briefly uplifting state uh
where the words come out in a torrent
and they're complex and pressured and
elaborate
i try to capture that feeling with the
the words used in that chapter and then
in the schizophrenia or psychosis
chapter where things slowly fragment
over time and become looser and
and and separated i tried to capture
that in the writing too so for each it
wasn't as if there was a single mode i
could be in for the whole book for each
chapter i had to put myself into a
different mode to capture that uh
inner feeling of the disorder when you
put yourself in that mode does that
change you
yeah i couldn't turn it on and off right
away i had to
first i would start by thinking about
the person uh or the people one or two
people based on real patients and the
stories that are that are put forth uh
the symptom descriptions are real
they're from the patients of course all
details change to protect uh privacy but
the actual symptom descriptions are real
and i would sit with them
and really try to inhabit the space of
the mind of of that
person that i knew
and that's not instantaneous it would
take take some time i needed quiet i
needed to be still that's another reason
late at night is is good
sergey posted that drowsiness gives
creativity boosts according to andrew
huberman
thank you andrew
uh it's not wrong he's not wrong why
projections is it uh
i mean there's some
instead of putting words into your mouth
because i can imagine a lot i mean i to
me
you know i will start putting words in
your mouth despite what i just said
so i mean
to me projections working on neural
networks for example from artificial
neural networks from a machine learning
perspective it's often
that's exactly what you're doing you
have an incredibly complex thing and
you're trying to
find simple representations in order for
you to make sense of it so i was kind of
thinking about in that way which is like
um
this incredibly complex
neuronal network
that is kind of
projecting itself onto the world
through this low bandwidth expression of
emotion and speech and all that kind of
stuff and the way
it's
we only have that window into your soul
the eyes and the speech and so on so
that
in that way we're um
when there's any kind of disorder
we get to only see that disorder through
that narrow window as opposed to the
full complexity of its origins the word
projections
definitely serves that purpose here but
it's it's got a few other
really
appropriate other connotations as well
so the first thing is a projection in
terms of neuroscience is
this long-range connection that goes
from one part of the brain to another
and so it's what binds two
parts of our brain together there are
projections long-range connections of
axons these are the outgoing
threads that connect
one part of the brain to another part
there's a there's a projection that
links for example auditory cortex where
we hear things to reward centers where
we can feel where feelings of pleasure
and reward are initiated
and it's been shown that if you have
reduced
connectivity along that dimension you
are less able to enjoy music and so
these connections these projections
matter they define
how effectively two parts of the brain
can engage with each other and join
together to form a joint representation
of something so that's one meaning it's
pure neuroscience the word projection is
used all the time and it happens to be
something that optogenetics a technique
that we maybe we'll talk about a little
later it works particularly well with we
can use light to turn on or off the
activity along these projections from
one spot of the brain to another and
this is particularly referring to the
long range connections it's particularly
straightforward along these long range
projections that connect different parts
of the brain but it works over shorter
range too but then there's this other
meaning of projections which you were
bringing up which is very relevant which
is
at some point you you can reduce
something from one level of
dimensionality to another you can
project down into a lower dimensional
space for example
and then finally there's a psychiatric
uh
term projections which comes up all the
time which is uh
we
very often uh will
look at our internal states and to
understand somebody else we'll
project them on to somebody else we'll
try to understand someone else's
behavior and and make sense of it by
projecting our own inner feelings our
own
uh sort of narrative onto them
and use that as a way to help us
understand them better and we'll do the
reverse too we'll take things we see in
the outside world and we'll bring them
into ourselves and see how well they map
how will they align that's called
introjection so projections is a turns
out to be a really rich word then
finally of course there's the very
common
sense of it as as a projector that that
illuminates by conveying information
across space with
light
so for english for english language
perfect word to use for this book but
what's funny is
not every
there are a lot of international
translations now and and all those rich
connotations aren't captured in other
languages and so for some
translations uh connections is used uh
instead of projections in fact even in
england the british version is
connections instead of projections
because apparently projections doesn't
have the full connotation i was told you
have to sacrifice some of the rich um
ambiguity of meaning
uh with connections that's interesting i
mean connect
and words are so interesting they have
so many i love language and how much is
lost in translation i'm very fortunate
enough to be able to speak i'm not good
at languages i was just i guess
forced to by life circumstance to learn
two languages
russian and english and it's just so
interesting to watch how much of culture
how much of people how much of history
is lost in translation
the poetry the the music
the history the pain the way the
scientists actually express themselves
which is funny i mean just
it's so sad um
to see
how much brilliant work
that was written in russian there's a
whole culture of science
in the soviet union that is now lost it
makes me wonder
in the modern day
how much incredible science is going on
in china
that is lost in translation and i'll
never i mean that makes me very sad
because
i'll never learn chinese in the same way
that i've learned english and in russian
maybe
whenever i say stuff like that people
are like well there's still time but uh
you know uh yeah that's it's that's
actually fair that uh i think the 21st
century
both china and us will have very
important roles in the scientific
development
and
we should actually bridge the gap
through language and that that doesn't
just mean convincing chinese to speak
english
that means also learning chinese well we
need these bridge people who can do both
you know the
um you know nabakov for example writing
in english beautifully uh uh you know
one of my favorite poets porques who you
know mentioned earlier he wrote both in
english and in spanish i think you know
beautifully in both we need those people
who can serve as
bridges across cultures who really can
do both
you mentioned borges so
you open your book with a few lines from
a poem by
jorge luez borges a love poem i'm going
to read parts of it because it's a damn
good poem yeah it's called two english
poems i mean there's i'd like to
understand why you used it and the
specific parts you used which is
interesting but then when i read the
full thing
so i think you used it
as as
a sort of beautiful description of what
it means to delve deep into
understanding
uh offering yourself to the task of
understanding another human being but if
you look at the full context of the poem
it's also a damn good description of
being hit by love and overtaken by it
and uh
uh sort of
and trying to
trying to figure out how to make sense
of the world now that you've been uh
stricken by it
it says a bunch of things
uh about
chatting and significantly with friends
and all those kinds of things and then
the poem reads
the big wave brought you
i get this is the moment
i guess of the universe where the two
people you fall in love maybe i'm
totally misreading this poem by the way
it doesn't matter you can't misread a
poem
so it goes on words any words you're
laughter and you're so lazily and
incessantly beautiful
we talked and you have forgotten the
words
the shattering dawn finds me in a
deserted street of my city your profile
turned away the sounds that go to make
your name the lilt of your laughter
these are the illustrious toys you have
left me
so these little memories of these
peculiar little details he remembers
those are the illustrious toys
i apologize to mix my own words of the
poem but you should definitely read it
i turn them over in the dawn i lose them
i find them i tell them to the few
straight dogs into the few stray stars
of the dawn
your dark rich
life
i must get at you somehow
i put away those illustrious toys you
have left me
i want your hidden look your real smile
that lonely mocking smile your cool
mirror knows
i want your hidden look your real smile
i am so i this is the first part of the
poem and then it goes on which is some
of the parts that you reference
second part is what can i hold you with
i offer you lean streets desperate
sunsets the moon of the jagged suburbs i
offer you the bitterness of a man who
has looked long and long in a lonely
moon
i
offer you my ancestors my dead men the
ghosts the living men have honored in
bronze my father's father killed in the
frontier of buenos aires two bullets
through his lungs and so on so on i
offer you whatever insights my books may
hold whatever manliness of humor my life
i offer you the loyalty of a man who has
never been loyal i offer you that kernel
of myself that i have saved somehow the
central heart that deals not in words
traffics
not with dreams and is untouched by time
my joy and
adversities
and i think this is where the part they
include in the book
i offer you the memory of a yellow rose
cena sunset
years before you were born
i
damn that's a good line okay
[Laughter]
i offer you explanations of yourself
theories about yourself authentic and
surprising news of yourself
i can give you my loneliness my darkness
the hunger of my heart i am trying to
bribe you with uncertainty with danger
with defeat
that is a man who's in love and longing
if i've taken but i just want to go back
to maybe you could say why you want to
include that poem but also
your dark rich life i must get at you
somehow i put away those illustrious
toys you have left me out when you're i
want your hidden look your real smile
that lonely mocking smile your cool
mirror knows what sometimes i meet a
stranger
and i just
it's like it's like a double take
it's like who are you
have we met before somewhere who's that
person behind there
and i want to get at that whatever that
is and of course maybe that's what love
is because maybe
uh maybe that's the whole pursuit like a
lifelong pursuit of getting at that
person maybe that's what that is and
like that uh insatiable sort of
curiosity to keep getting like who's
that person then you're on private life
yeah so that absolutely i think that it
was a beautiful description of what you
just said when there's that first moment
and then you want to dive deeper you
want to know what the what the hidden
mysteries are
in a way it's it's a it's a love poem
as a as a scientist though it also
it's a bit of how a scientist can love
science and and
that
wanting to dive deeper is
it's almost like again where the it
could be a love affair with
investigating the human mind for example
and and that was one reason it spoke to
me also
again thinking about
the broader sweep of where the human
mind came from uh
the steps it took
to get where it is today what was given
up along the way what compromises were
made and here's where the darkness of
the poem starts to come in a little bit
too it doesn't shy away
from the negativity
from
the confusion from the danger
and then at the very end
the board faces offering up
scenes from his life parts of himself
and this is how we connect with people
we offer up parts of ourselves just here
it is and then we see how well does that
map on to what you have and it's it's
that offering up
that i liked and not not the good stuff
or not only the good stuff the yellow
rose is nice but but he's offering up
the bad stuff too
and that that to me was important for
the for the book because
i'm offering up hard stuff too and in
fact a lot of it and also hard stuff
from within me from my my own personal
side too and that was there's a lot of
vulnerability that comes with that but
that's
that comes with love that comes with
writing you have to be open you have to
be vulnerable and so
i thought that reflected what i was
trying to do and i thought it was a as
an epigraph it kind of
made it clear
how vulnerable
i was in taking this step but also
what what could come out of it and also
in a meta way because i was not familiar
with this poem
it uh
it made me curious
of the poem itself to pull at that
thread of finding out more
so you picked a very particular part
that kind of made you want to um
pull at that thread and and then and see
where did this
where did these few lines come from
because i i read it as a curiosity of a
scientist those lines were
alone and also
as a desperate
uh human being
searching like offering himself for an
understanding or connection with with
another human being and then because i
wasn't sure if it's a love poem or not
or if it's desperation or if it's
curious whatever it is and then you see
the love poem i mean i don't know that
that's gonna stick with me for a while
the
your dark rich life
and then a few lines in here are just
i mean those are i'm going to just use
them as as pick up lines at a bar i
offer you the memory of a yellow rose
seen at sunset years before you were
born
now that's a pickup line i've never if
if i've ever heard one anyway sorry but
this is universal you know you see it in
so many forms of of art you know like
you know we're in texas now you see this
in country uh country and western songs
it's it's often a list of things like
here's how i describe myself there's
this and there's that and there's the
other thing and here you are these
things matter to me and i hope they
matter to you too it's a it's a pretty
universal form but it's but he did it in
this very
artful uh
and very
vulnerable way it was it was both both
beautiful and you could you could feel
the hurt coming from him too and that
was important
the dark stuff too i offer you my
ancestors my dead men the ghosts the
living men have honored in bronze and
talking about two bullets through his
lungs bearded and dead
wrapped by his
[Applause]
soldiers in the height of a cow my
mother's grandfather just 24 heading a
charge of 300 men in peru now ghosts
on vanished horses
so all of it the whole history of it
um since it is a love poem
what do you think about love
carl what's what's the role of love in
the human condition we'll talk about the
dark stuff yeah but uh maybe love is the
dark stuff too i mean it's it's the most
powerful
connection we can form and that's that's
it's
that's what makes it so important to us
it's the it's the strongest
and most stable connection that we can
form with another person and that
matters immensely
it matters for
for the human family to
have evolved to be
something that could survive against the
odds that that that we've faced over the
years that
un
reasonable bond that becomes reasonable
by virtue of its own existence
and of course
that joy the the wild raw joy of love is
not a bad thing either
so you put these together
the four the strongest bridge we can
form
and the reward and the joy that that it
brings that's that's what love is to me
and
from you know my perspective this is
something that you know
it can be hard to capture fairly because
you want to talk about
the positive and the negative sides at
once they need to be wrapped up together
for full honest description of what it
is
and that that's hard to do in a in a
compact form and so
you have to take time to talk about love
you have to take time to
to do it justice um it takes a book or
at least a poem
or several thousands of them i don't
know so is there could you pull up
there's a video i saw
yeah like right here so can you pause
for a second
uh so so there's march of the penguins
so you always see like penguins huddling
together
against i i mean sorry if i see just
metaphors and everything but uh them
huddling together against the harshness
of the conditions around them that's
very kind of
that's like a metaphor for life like
finding this connection that's kind of
what love is it's like it allows you to
forget whatever the absurdity whatever
the suffering of life is together you
get to like
huddle for warmth and that's why i love
the uh sort of just the uh the honesty
and the intensity of the way penguins
just in the middle of like the cold do
this and then this video i saw
a lonely this is this is misinformation
so the name of the video is lonely
deranged penguin i don't know if he's
deranged so if you play it
so he left his pack
and uh
and there's a nice like voiceover and
you don't need to play it but he for
some reason left the pack and journeyed
out into the mountains
and so the the narrator says that he's
deranged he's lost his mind
now i'd like to project the idea that
he's actually
there's so many stories you could think
of he's returning to his homeland he's
an outsider thinking journeying out into
the unknown thinking he may be able to
discover something greater than the
tribe he might be looking for a lost
love
why is he deranged immediately why has
he lost his mind anyway but this you
people should look up this video because
to me i might be the only one who uh
romanticizes this but it's such a nice
kind of it's both a picture of perhaps a
mental disorder which is what the video
kind of describes and it may be some
deeper explanation that's not
that that has to do with the motivation
of a
of a mind
yeah i don't know if i don't know if you
have a deeper analysis on this penguin
well i i
like you as a psychiatrist
i i would i would want to sit down with
a penguin and go
i want to see the notes from his prior
therapist and
but
this this actually is
relevant not knowing what was
that penguin's motivation we have
very clear
situations where there are both within
an individual we go through periods of
time when we
stay in one place
and we
reap the benefits from what we've built
and then we go through periods of
foraging of of of wandering even if
there may be resources where we are we
we
have periods of time in our lives where
we want or where we where we
go in an exploratory mode and different
people express that trait in different
ways this is not a human specific trait
if you go down to to the tiny little
nematode worm
c elegans with 302 nervous system cells
they go through these phases of foraging
and rest and different individuals have
different propensity to forage or to
rest and stay in one place
at the level of the species that's
really good
that there's that
diversity in their willingness to forage
some
stay where they are the species is
somewhat on a firm footing then
but some carry a burden
a risk for themselves but
it's good for the species that they're
explorers and they will venture out
the migration patterns that
different species blunder into and that
turn out to be really good they weren't
logically derived
they
most certainly started from
something like this an exploration
humans do this too you think and we do
it too in fact it's that's something we
do extremely well
let's talk about psychiatry a little bit
so my book you're a a rock star first of
all for people who don't know you're one
aside from sort of um
the neurological view of the brain and
neuroscience view of the brain you're
also one of the great psychiatrists of
our time i've always
not always but when i was younger i
dreamed about being a psychiatrist
um
so it's like it's like getting to meet
your heroes
and also um
you know getting to meet the people who
uh
the best
at the top of the world at the thing
you've failed to pursue so there so
there's i'm getting a free therapy
session on top of that okay so what uh
big picture what is the practice the
goal the hope of modern psychiatry if
you could try to describe the discipline
as you see it maybe historically
throughout the 20th century
in contrasting to what it is today or
maybe if you want to describe to what
you hope psychiatry becomes or longs to
become in the 21st century yeah
it's been an interesting journey uh it
psychiatry started out
pretty firmly grounded in neurology and
pathology some of the initial
founders effectively of the field were
very well grounded in microscopy looking
at cells
working with patients uh particularly on
the neurological side and this certainly
included you know freud and some of his
contemporaries
and
but they rapidly discovered that
what they could work with at the level
of
cells and microscopy was so far
from the realm of what they could get
from a human being
and what they were getting from the
human being was so much more interesting
and had was so mysterious and so unknown
that many of them
just said we're going to inhabit this
domain and we're going to work with the
people with their words
and understand what we can
based on verbal communication because
that was the only tool that people
really had
and
that was
a very
important step for the field i would say
one of the interesting things that came
from the early decades of psychiatry
really was this distinction between the
conscious and the unconscious mind
and paying particular attention
to the unconscious mind is something
that was worthy of consideration uh that
that might be important in explaining
people's actions
and that perhaps even insight into that
was valuable in its own right
and out of that psychoanalysis uh
became a practice that
it was not always focused on
cures or treatment but was more focused
on insight what does it what does it
mean how can we help people understand
why they're
feeling something or thinking something
or dreaming something
and that insight separate even from
treatment was was an interesting thing
as long as
one was honest about that and said you
know we're we're going for understanding
we're going for insight maybe it's
useful to just pause on that let's if
you look at the father psychoanalysis
sigmund freud
what do you make of the ideas that he
had so you mentioned
taking the unconscious the subconscious
seriously
that's like step one like that there
could be worlds we do not have direct
access for we
probe at them
through conversation or
um is it too simplistic to call
psychoanalysis conversation that's not
too simplistic but that's right and i
think that was valuable where where
freud ended up breaking from some of his
contemporaries he was very focused on
this unconscious as being so tightly
linked to libido and and really he
from his perspective you couldn't really
separate the operation of the
unconscious mind from these aspects of
the libidinous aspects and that was one
reason
you know sex sexual sexually related uh
you know drives
carl jung who was his you know
uh you know contemporary that's one
factor that led to them separating was
you know carl jung felt there was a lot
more
to the unconscious than than this
libidinous aspect of it and he saw it as
a much more
complete uh
uh alternate representation of the the
conscious self one that maybe reflected
a whole range of different
motivations and and desires
um
and
to to properly treat it one had to
consider all of them rather than the
ones that destroyed us called young chef
thank you
thank you for the high level of uh of
images that sergey is pulling up for
people who are just listening he pulled
up a
as a quote from uh segment four it's a
meme your mom quote uh freud uh so the
the shadow the carl young shadow
encompasses
everything not just the desire to have
sex with your mother
or sex period that's right that's right
if you look at those two folks
on mass i mean there's a kind of
it's almost like a technique for
philosophical exploration of human mind
human motivations
so it's not even like necessarily
it's also doubles as a methodology for
helping people but it's almost like a
it's a kind of philosophical method
right
this is the fascinating thing about
about psychoanalysis and and
it even though it's it's i would say
mostly not considered a treatment today
it persists for a couple reasons one is
it it's it's thought that it gives
people some insight
but
second there's been a huge influence on
on literature on philosophy on art
and the the opening up of discussion
about what was
below our conscious mind was uh so so
fertile in the implications that it it
sort of reverberated and still does
throughout all these different realms of
human endeavor from
our
different artistic
uh you know
experiences that people have can be
colored by this this uh
concept of the unconscious
now the other thing that was interesting
is is is this distinction
you know what what are the parts of the
unconscious and and so there were these
id and ego and superego uh
subdivisions that
you know that that freud for example
would would talk about them and and the
the id was the primary the primal drives
that an infant would have uh or that a
very young child just warmth and feeding
and then then later the you know the
sexual or libidinous aspects and for
freud the later happened very quickly
that's the controversial thing about him
i think i guess he thought like even
children had sexual desires that they're
like dealing with contending with so
it's the full thing hungry wanting to
eat wanting to poop wanting to have sex
yeah and he was extremely focused on
that on on that aspect
but then there was then there was this
the superego which brought on these
later sort of moralistic uh
sort of codes of conduct and and that of
course was very often in intention but
all this could play out subconsciously
and then the ego
this third aspect was mediating and for
its conception mediated this tension
between the different uh parts
now i think that's interesting uh i will
say that
in some ways
it's maybe unnecessary
from the perspective of modern
neuroscience to divide things up that
way from the you know the moralistic
drives and the primal
gratification drives
in some ways they're all drives and
maybe they're even all primal drives you
know the the moralistic drives they're
they're taught and they're taught in
ways that ultimately relate back to
survival and
you could even say selfish aspects of
of health and life for the self and
family and
so this is uh i don't i think it's maybe
an artificial distinction the concept of
the unconscious is very valuable and
very interesting um but
these categorizations
uh of id and and uh superego may not
map onto neurobiology in any particular
way if there's a town hall of competing
drives and desires and there
they
interrelate to each other they involve
different aspects of the of the brain
and the history of the person
and actions and choices come out of the
result of that overall you know shouting
in the town hall so in some sense carl
jung was a step into the direction of
liberating yourself from such harsh
categorizations
do you think
i mean you have daniel kahneman with
system one of system two
there's just these very compelling
categorizations of the human mind that
seemed to be
sticky
in our uh
in the super ego no uh in the you know
the how we talk about these ideas and so
on yeah do you think those are helpful
or do they get in the way is it some
kind of balance in terms of deeper
understanding of how the mind actually
works you know it's from the from modern
neuroscience uh
whenever we
seem to get closer to
addressing a question like this at the
level of cells
it seems to get farther away and i'll
give you an example of what i mean by
that so one thing i'm doing in my
laboratory and many people are doing is
we are listening in on the activity of
cells neurons in the brain of mice or
rats or fish or monkeys individual cells
individual cells exactly of which there
are you know in our brain many billions
and
when we do and we
try to predict what action will be taken
by an animal
to address this question where does
the choice arise where does the
impetus to make a particular selection
of one action versus another action
where does that start in the brain if
you're recording listening in on the
activity of cells all across the brain
where's the earliest spot you can pick
up
a choice being made
well that's so awesome
yeah at one level you might think how
excited would young have been to see
this or freud or the early you know
psychoanalysts to see where this starts
but it's not so simple because
an emerging theme in very recent
neuroscience literally over the last few
years
is that
things sort of all start together all
across the brain and so you can be
recording from the cortex this rim of
cells at the surface of the brain or you
can be recording deeper in a structure
called the striatum which is a little
older
it's more tightly linked to to action
and then structures called the thalamus
other parts of the brain and if you
record from these these
all sort of
represent the action and the choice
more or less al