#79 - A Psychologist's Guide for Social Anxiety and Depression [Dr. Daniel Maitland]

Hey, hey, hey, welcome to the Talk to People Podcast.

My name's Chris Miller.

This video features a conversation I had with Dr.

Daniel Maitland.

He's a researcher, clinical psychologist, and professor at the University of Missouri, Kansas City.

I saw him in the New York Times.

I thought it'd be cool to have him on the podcast.

A few weeks later, here we go, we have a whole entire conversation.

He runs the, let me grab my phone, I wanna make sure I get this right, the Psychotherapy Research or Study of Connection, Intimacy and Loneliness, the Pro Social Lab.

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Without further ado, Dr.

Daniel Maitland.

Welcome to the Talk to People Podcast.

I'm here with Dr.

Daniel Maitland from UMKC.

You just made the long drive.

I did.

From Overland Park.

A lot of people, I found you in New York Times.

Congrats, by the way.

Thank you.

Big deal.

I found you in your research in the New York Times, but there may be a lot of people who haven't heard about your research and didn't see the article.

So tell everybody what you do.

Essentially, I try to understand how close connections form and how that impacts your physical and mental health and how your physical and mental health impact your ability to make connection with others.

And why do you do that instead of like math?

Personal values, so I was a comp sci major.

I was interested in artificial intelligence, and the idea of working in a cubicle, making someone money kind of turned me off.

Got really into a form of therapy that is characterized by a really intense connection between the therapist and the client.

And got really passionate about it.

I value, I have few friends, but they're really close.

So I connected with this kind of closeness generating stuff.

Would you say you're entrepreneurial?

No, not at all.

I wish, I wish.

If anyone has any ideas, let me know.

Given to you, Senator, because I feel somewhat similar.

I don't want to be in the office all day, and sometimes I get this feeling of like, I don't want my time to be fulfilling someone else's dream.

Like, I need to go out and build my own business and build my own dream.

But then I'm partially like, well, it's also really nice whenever people tell you what to do.

Yeah, there's definitely that.

For me, I'm just curious.

Like, that's really like the joy of being a researcher is you say, hey, I wonder about this.

You look it up and if no one's answered it, you dedicate a year of your life, two years of your life to doing that.

And for me, that question turned into like a career.

Like, you know, I'm 10 years in and still going strong.

Would you say you're innately curious or did that grow over time?

Um, about certain things.

I get really into stuff.

So once I find something that kind of peaks my interest, I'll try to like learn everything about it.

And so I think that's kind of where I'm at is I'm trying to explore all of these little details and every time I ask a new question, and the answer leads to 20 more questions.

And do you ever find a point where you're like, okay, I've sufficiently answered this question?

To state my curiosity, yes.

But really, it's more of a pragmatics thing of where am I spending my time?

And I work with PhD students.

So if they're interested in something, I'll start dedicating more energy one direction over another and then circle back years later when a new student shows up.

I think curiosity is one of the best things in particular in conversation because with podcasts, if you notice the podcast host is following their curiosity, it just seems more tangible and a lot easier to listen to.

Do you think people can grow in curiosity?

Yeah.

Oh, absolutely.

I think it is a skill.

I think it also, you know, to kind of center on one of the things that I think we're going to talk about today.

I think there's vulnerability in it.

To be curious, you have to say, I don't know.

You have to show interest in others.

You have to really have something that you're like, I'm willing to not be the expert.

I'm willing to say, I don't know anything and either go out and discover it or appeal to others.

So I think there's a lot in there.

So there can be insecurity that has tension with curiosity, because maybe someone, because I say follow your curiosity, but then I'll hear people say, well, it's just not that interesting.

Yeah.

So I actually say that my research isn't that interesting to a lot of people.

The reason for that is that you don't hear a lot about it.

And so there's kind of this inference of like, oh, maybe people don't care about what I'm doing.

Sure.

But I think that the flip side of that is that, like when you get academics who are experts on stuff, most of us think we don't know anything.

Like I find so many people who are at the top of their field, and that's not to say I am, but who go out and say, I really don't know a lot.

There's a lot of humility.

Because your knowledge of what you don't know expands and expands.

Yeah.

One of the things that we talked a lot about was your research and in particular, therapy.

Okay.

So did you want to become a therapist or did you want to become more of an academic?

What was the?

I wanted to be a researcher.

But what I wanted to research originally, the way I framed it is I wanted to make sure people didn't get bad therapy.

Fascinating.

Yeah.

There's so much bad therapy out there in my opinion.

And I saw that.

And so I wanted to train clinicians to implement the skills better.

And I wanted to really refine how we understood what good therapy is.

So make it just science based.

And what, why is there so much bad therapy?

A lot of it is theory and theory that can't be measured.

And so when, for me, I'm a diehard scientist.

Like I've always had kind of that logical thinking.

And what you'll end up seeing is that there are fields of psychology or theories of psychology where you can't measure what they think leads to change.

And so they didn't have a way to get from suffering to alleviation.

They had a theory that you couldn't really measure.

For me, I wanted to find ways to measure those things.

And I wanted to kind of tweak it.

I also, you know, the training models are so different in different places.

And the amount of like hands-on supervision you get varies.

And the word therapist is actually not like a protected word.

So you have everything ranging from life coaches, who I don't know what the credentials are there, but I think you can pretty much call yourself a life coach, probably.

Um, to PhD level licensed psychologists who, you know, my training, my education is longer than med school.

Um, so, you know, we, there's a lot of variability there.

Wow.

And if a life coach and a PhD psychologist is lumped under the same term, therapist, that can get messy.

Yes.

Yeah.

Uh, and I think it does.

And I think, you know, there's even tension amongst professionals who are researchers, um, just because the fields differ so, so much.

Um, but yeah, it's hard when, you know, someone who read a few books is proclaiming to have the same expertise as me.

Um, and we have, we have different skill sets, and I have no doubt that they're helping, uh, in some capacity, um, usually.

But, you know, if, if I can get someone in and out of therapy in four weeks compared to, you know, a lifetime or, you know, multiple years, I think there's something to be said for that.

Do you think some therapists will, it may not be an intentional thing.

Like you said, something may take you four weeks and it may take someone else a long time.

Do you think that some therapists approach things like that as more, uh, like, I want you in here a long time because it's going to build my book of business?

I don't, I don't think so.

I really hope it's not that malicious.

And I don't think that that readily happens.

But I think that some forms of therapy are looking for like resolving inner tension.

You know, if you look at like the, the dynamic therapists, Freudian forward and there, there's still a school of thought, there's still people being trained in those methodologies.

And there are people that will say therapy is a lifetime thing and you just need to be in therapy your whole life.

And fundamentally, I disagree with that.

Now, it also depends on what you're trying to work on.

But for like mental health diagnoses, depression, anxiety, things like that, I think we can get people in and out in a few months, on the longer side, usually.

And again, it's a game of averages.

And that may be a big deal for someone hearing that because I feel like people will cling to diagnoses for years or for, like you said, a lifetime.

Yeah, I think that's one of the tricky things about different fields is I'd say your average clinical psychologists reject the medical model of mental health.

So to me, depression isn't a thing.

It's not a disease.

It's a set of behaviors that we engage in and it accompanies emotional reactions and certain behaviors.

But there's nothing in your body that causes depression.

And that's true of almost every diagnosis.

And again, it's an order of magnitude.

But I think that we view things like diagnoses as descriptive rather than explanatory.

And when you have something, when you have depression, and it goes into remission but never goes away, it's always there.

You always need treatment.

But if it's a thing that you do, we can change what you do.

Could you say it again, like descriptive rather than explanatory?

What do you mean by that?

Yeah.

So if you look at like the diagnosis of a major depressive episode, we would say that is describing your behavior.

So it's a thing that you're doing that we say, oh, when you do these things, we call that depression.

If you use it as an explanation, you say, I engage in these behaviors because I'm depressed.

And it becomes kind of a cyclical reasoning of, well, how do you know you're depressed?

Well, I do these things.

Why do you do those things?

Because I'm depressed.

Right.

And it removes the aid or the locus of control.

Yeah.

In terms of external, right?

Exactly.

And so what I find, even though I'm a behaviorist, which means I really view behavior as a function of your environment, we do things because of the contingencies in our lives and what we encounter.

But for me, that's empowering because it means you can change the contingencies to get a whole new set of behavior.

There's nothing we can't change, I would argue.

So you would approach someone who may be manifesting.

Let me think about this.

So like you said, descriptive.

So like their behavior is depressive or like a depressed person would do this, but you don't have to do those things.

Versus like a depressed person would do this, therefore you're depressed and you're going to need to come to therapy because we're going to have to work on your depression.

And maybe it's going to flare back up and all that jazz.

Yeah, that's exactly it.

So we use our feelings as explanations for our behavior or justification for our behavior all the time.

The example I like to use is like working out.

I used to be an avid cyclist.

I have a toddler now, so hobbies have gone away.

And there were a lot of times where I'd be like, I don't feel like going for a ride.

And so I wouldn't.

But if you don't feel like doing something and then you do it anyways, eventually that desire will come.

And so like with depression, a lot of what comes with that is like, you don't feel like doing something.

And if you engage in that behavior anyways, then the desire can come afterwards and you actually spiral up instead of spiral down.

And you can essentially get active enough to work your way through depression in some capacities.

It's a little more nuanced than that.

Sure.

What are descriptors of depression?

How can someone know they're currently dealing with that?

Yeah.

So feeling low, down, blue, or depressed, a lack of enjoyment and activities that you used to enjoy, eating too much or eating too little, sleeping too much, sleeping too little, feeling like you're moving in slow motion or stuck in the mud.

Those are the ones that come to mind right away.

There's nine different descriptors with two of them being necessary in order to be diagnosed with a major depressive episode.

DSM.

Does that mean anything?

Yeah.

Sorry.

The Diagnostics and Statistics Manual.

We're in the fifth edition text revision.

That's all about depression, right?

That's about every diagnosis.

It is the, I always call it jokingly, the big book of diagnoses.

So it's how we understand and label different behaviors like schizophrenia, bipolar, all of those things are in there.

It's so fascinating to me.

I've had a couple of different therapy experiences.

One therapy experience I had, I remember acutely because I got in this room, it was kind of like a softly lit room, which, and there's a couch and all that stuff, sure.

So I'm sitting there and what was so fascinating was I did, he had me do a lot of paperwork, and then he looked at all the paperwork and he goes, well, it looks like you're a little depressed, and all this other stuff.

So I was like, okay, interesting.

He's like, yeah, we're just going to have to work on your depression.

I was like, okay.

But it just seems so weird that like, okay, I tested into depression, you know, like, like doing a pop quiz.

And it's like, hey, you scored depressed.

Right, right.

Yeah.

And that, you know, different modalities will get there.

I actually, I try to have like the diagnostic criteria come up organically as part of a conversation.

So like a typical first session for me, like, tell me a little bit about why you're here.

And you know, you emailed me, you told, or you know, you registered, so I know broadly.

But that doesn't tell me the whole story.

I'd like to really get to know what's going on in your life.

And you can usually pull all of those diagnostic criteria, which is probably, you probably filled out the Beck Depression Inventory, if I had to guess.

Probably.

And you can go through and get that information through a conversation.

It's probably then build up rapport or relationship.

Yeah.

And that's what was missing, because would you say those things are pretty reliable?

Oh, yeah.

I mean, they're really, they're really good.

You know, the Beck Depression Inventory is the gold standard.

We use it in research all the time.

Yeah.

So it's like he was doing the thing, but it just wasn't.

That rapport wasn't there.

And probably if if you could learn how, like what you're doing to collect the data via, like the person saying it rather than writing it down, you know, I think that was, I still remember that.

Yeah.

Yeah.

And was that effective for you?

Like, did you want to go back or were you like, I guess I have to keep on going?

I had a podcast episode with a guy and he was talking about how maybe you need to drop your therapist, not for me personally, but just this general concept of how, like, hey, be sure to take a moment to consider your therapist, right?

Like, it may not be the right therapist for you and maybe you need to drop yours.

And it was funny because I was coming off the heels of that and I was like, I just don't think this is going to work for me, you know?

Like, yeah.

And I let him know, like, hey, you know, this is going to work for me.

And I did feel a bit bad though, because this person was, he had very low affect and he seemed like he was actively going through depression.

Interesting.

Right, so during our therapy session, it almost felt like I was, I would, there were a couple of moments where maybe I would reciprocate a question, which you'll have to tell me, like, if that's kind of like against the, like the standard, but I, and he would disclose and like, it seemed like he was processing through stuff.

And I remember telling my wife, like, you know, it kind of feels like I'm the one giving therapy.

That's wild.

Yeah, I mean, and I think it depends, right?

Like, you can share if it's going to help build up a relationship.

And that would be totally fine.

But the second that you're sharing for your sake, it kind of starts pulling at some of our ethics code.

So, like, the therapist should be able to distinguish.

They should, hopefully.

But I always tell people it's kind of like any other profession, right?

Not every plumber is amazing at their job.

And I think that's really hard because everyone that has, you know, these credentials usually has a graduate degree.

They've gone through a lot of education.

But there's still a distribution of skill in our field.

And I think it's we want to be careful not to say, well, your education means you're good or you're bad.

There's actual skills here, too.

And I think that's one of the things we kind of don't want people to know is like, yeah, there's people that barely got through the hurdles and are still therapists.

Yeah, like they scraped by.

They weren't going to make it, and you're getting therapy from them.

Yep, yep.

And if you don't know what to ask, and even me, like I'll read someone's like, you know, Psychology Today profile, and it's hard to figure out like, do they have these expertise?

I usually like, I'll start doing like a lit review of like, what did they publish in grad school?

I'll look at like, are they members of professional societies that I trust?

And even then, it can be a little dicey, because just because you're a member doesn't mean you're good.

But like, I'll do detective work for my friends when they're looking for a therapist.

Wow, that's fascinating.

If someone's currently dealing with depression, how do they get out of it?

It depends.

So that's the easy answer is, not all things work for all individuals.

And then we call that concept, equifinality.

There's many different paths to one endpoint.

My easy go-to treatment is what's called behavioral activation for depression.

It's based on research from like the 1970s.

A functional analysis of depression, essentially trying to understand how does depression operate in your environment.

And the idea is that depressed people tend to get into a cycle where they're engaging in behavior to avoid things they don't want rather than acting to come in contact with things they do want.

And so the treatment for that is essentially try to get them more engaged with the things that they do want.

Even if they're not coming in contact with it right away, over time, eventually they'll start engaging in more behaviors.

So what would be an example of that?

So it starts out usually with like activity scheduling.

So what you know, but there's a far range.

So I've done like phone coaching with someone who couldn't get out of bed, right?

Very typical kind of cliche depression symptom.

And I'll just be like, okay, can you lay in bed and just take off your covers, right?

Like just starting point.

And then eventually we get them out and we say, okay, can you get dressed and go get something you want to eat?

And then maybe you get them working out or talking to friends or joining a club.

Like you're just trying to build activities back into their life that they used to enjoy.

Is depression something that's been around the whole time or is there things saying like hunters and gatherers didn't deal with depression?

I think they did.

I mean, it's hard.

You certainly see like evidence in writing of people experiencing depression.

I don't know of any kind of psychology historians that have delved into that.

I also think it's a lot harder to be depressed when you're constantly doing stuff for your survival.

Like when I think of like hunters and gatherers, like you stop doing stuff, you're out of the game.

You can't afford depression.

Yeah.

Yeah.

So I think there was probably more activity.

And I think the question is what do you do?

I think you could also make the argument of we're in a much more like existential place with activity in our own lives.

We're not always looking to survive so much as we're trying to add meaning to our life.

We're kind of in the late stage of humanity in some ways, where at least in the United States, and that's not, I think the flip side of that is there's so many people who are struggling with basic survival needs, but there's a lot of expectation of like, you're working to add meaning, and we're searching for meaning in different ways.

Yeah, do you think that the digital age and digital immersion increases rates of depression?

I think it can really easily.

I think that like doom scrolling, right?

You kind of get these like little things that keep you engaged.

I actually, so like one of the earliest things I think of is, do you remember in like the earlier days of like Facebook, there's the game Farmville?

Yeah.

All right.

Right.

And like everyone had it.

And essentially what they did is they figured out, we call them schedules of reinforcement.

They found out like the most addictive pattern to just keep you constantly engaged.

They check back in four hours.

Yeah.

And social media essentially does that, right?

Like you refresh, it gives you a whole new batch.

You scroll down, the algorithm, right?

The algorithm's omnipresent.

It's figuring out, like if you look at it, they will look at like how long did you pause on a certain thing measured in milliseconds?

And then it factors that into what are we going to feed you next?

And so you're constantly just telling the system, what do you need to show me to get me to stick around?

And I think that that doesn't lead to many rewarding outcomes, right?

Like you're just going to sit there and then all of a sudden you're like, oh, it's been four hours.

And I think that aspect of it's really unhealthy.

I think there are good parts of it.

I think that there's a lot more community building and organization.

You know, I was telling you that I collect whiskey there, like I could go to a whiskey meetup and just run into random people and chat with strangers.

And I think that could be really good.

So I think it's not about is technology good or bad.

I think it's about how do you use technology?

Yeah, me too.

The other day I was vegging out on TikTok and I can't even recall like most of it.

So it's so fascinating because it's like over exposure and stimulation and we're not able to remember it, yet we still love doing it.

Yeah, yeah.

And that's the whole point of it.

And I think that's the troubling thing for me is I think there are some ways we could really find meaningful stuff on there.

I think of like post secret and some of these earlier adapters.

And I think what we've switched to is kind of a consumerism model.

And I think that consumerism model is really harmful.

What's post secret?

Essentially, people will mail in secrets to a person in New York and he will publish them anonymously.

Wow, sorts of confessions.

Yeah, essentially.

And they can be everything ranging from like the complete mundane of like, you know, I was the one that ate all the donuts at work to things like, you know, people talking about affairs that they've had and things like that.

And I remember that from, you know, 2007 when I was in college, this was something that was kind of around.

He would publish it online?

I used to be in a blog format and now I think it's on social media.

Wow.

Is he still actively doing it?

Yeah.

Yeah.

Wow.

What an interesting life.

Yeah.

You get to read people's most intimate stuff.

Yeah.

Yeah.

It's really cool.

Yeah.

Do you think anxiety is similar to, like you said, depression isn't some chemical orientation or something like that.

It's behaviors that could go away.

Do you think anxiety is similar?

Yeah.

I mean, I think there's different like baseline levels.

So we all have seen like an anxious baby, like who's kind of easily startled.

So we all start somewhere.

But for me, anxiety is about avoidance of essentially removing yourself from situations.

So I think a lot about social anxiety.

And if you've ever been in like a social situation where you feel really uncomfortable, one of the things people do will just remove themselves.

So I'm not the most social person all the time.

If I'm at a party, I'm probably just hanging out on the wall.

And that to me is avoidance, right?

Like I'm avoiding that situation.

But there's also situations where like you've encountered like judgment or perceived that the other person's judging you.

And so you're like, oh, I think I hear my wife in the other room.

And you just like excuse yourself.

And what that does is it actually, from my perspective, reinforces your anxiety.

It makes your anxiety more likely in the future.

And it also reinforces your removing yourself from the situation.

And so it means the next time you're in that situation, you're likely to feel just as anxious or more anxious, and you're more likely or as likely to remove yourself from the situation.

So it becomes a self-perpetuating cycle.

So then the exposure therapy is the answer for that too.

Yeah, yeah.

And exposure therapy is really misconstrued in, like, popular media and the literature.

It's like the snake around you or something like that.

Yeah, it's actually this really compassionate thing, and it's led by the client.

And so like the snake climbing on you, that's a real thing.

And we'll definitely do that, but only once the client tells us they're ready for it, and only when they say this is what they want to do.

It's not like they walk through the door and I'm throwing a snake at them.

There's some great videos online of Erst, O-S-T, and whatever the dot's over the S, I forget.

Yeah, me neither.

And so he has a snake phobia treatment video.

That's amazing because it just shows how compassionate this treatment is.

And he takes a client or patient from being deeply afraid of snakes to being able to interact with one.

Yeah, in about four to six hours, I want to say it was.

It went from that she was convinced she was going to have a heart attack when he had told her there was a snake in the building to her having the snake in her belt loops over the course of like one day.

That's incredible.

And with social anxiety, that would look like, say, you know, you show up to the party and then you're like, oh my gosh, I feel anxious.

I need to leave.

If you leave, then the next time you show up to the party, you're like, oh my gosh, I'm feeling anxious.

Last time I left, this is the same feeling.

I need to leave because that's how it was dealt with last time versus, oh my gosh, I'm feeling anxious.

And then recognizing that and saying like, okay, like what would be a healthy response to that?

Yeah.

So it's staying in the situation because our body like physically is not meant to stay anxious forever.

Okay.

So eventually your anxiety is then a naturally drop.

Oh, that's fascinating.

And there's some potentially cognitive mediation, like you think about it and that can do stuff.

And then in exposure, you actually over-correct, you do things you wouldn't normally do.

And so social anxiety is kind of evaluative in nature.

And so you might go to the party and like pour a drink on your pants.

So you have like a red stain on your pants and then just stay and interact with people, even though like now they're judging, like they think I like wet myself.

And you just stay with them because that anxiety is going to go away.

And you're like, you know what?

I'm taking this head on.

Rather than fearing whether or not people are looking at me, I'll give them reason to look at me and still stick around.

Yeah, I mean to a degree and just recognizing that it's like eventually you're just to have an interaction with someone and maybe you even choose to share of like, yeah, like I'm doing this thing.

I'm trying to like really kind of put myself in a situation where I could be really embarrassed or people could judge me.

And I'm hoping that will help with my anxiety.

Like you could just own it too.

I like that.

I remember in college, I had this huge pimple on my nose and it was on the tip of my nose.

I already have a big nose, so whenever I get a big pimple on there, I'm like, oh my gosh.

And I had to make this decision because I was like, I can hide in my room, but I couldn't really hide because I had to go out of my room.

And I was an RA at the time, so I had to walk around the hall and all this jazz.

Or I'm just going to show up and I'm going to be very intentional about going straight up and talking to people.

I know people are going to be looking at my pimple, but it was almost like a rejection therapy type deal, right?

Like, I know this isn't ideal, but I'm going for it.

And that was really good for me because it was like, no matter what I look like, I can still survive and initiate interaction and be a part of the social fabric.

Yeah.

So let me flip this around on you.

So when someone approaches you with a pimple, or even back in the day, how much did you fixate on that versus like notice it and then just like be like whatever, they have a pimple and start talking to them?

Yeah.

I wanted it.

I wanted to fixate on it, but it was funny because I had some residents in my hall who are from South Korea, and the culture is way different because they would be like, oh my gosh, your pimple is so bad.

I was like, oh man.

And they'd be like, you need so much more sleep.

I'm like, you know what?

You're probably right.

I probably do need more sleep.

I probably do need to be eating less sugar.

And I probably am stressed.

That's probably why I have a pimple.

But it was kind of, I was glad that they kind of did that right, just because it's like, they were very direct, but then they probably didn't fixate on it.

So same thing.

Yeah.

Yeah.

And I think that's like part of it is like, we worry about that, but we can't always perspective take of like, when I encounter someone with a similar situation, like sure, it catches your eye, you notice it, but then you engage with the person and you kind of forget it's there.

Yeah.

Why do you think a lot of people right now say there's like a loneliness epidemic?

I think so.

Yeah, that that started with the Surgeon General and a Harvard Business Review article, I think was actually his first mention of it.

I think it's because we don't feel close to people more than ever, is we're in this hyper-connected world, but we don't feel it.

So I think that's kind of driving the bus, and from there, engaging in the things that do build connection, we don't do anymore, overwhelmingly.

Why do you think that is?

Because it sucks.

I mean, so the theory I work from is the idea of you have to do something that's vulnerable, and then another person responds well to it, and when they do that, you feel connected to them.

And being vulnerable is awful because it means you could be hurt.

Right.

And I think that's really at the root of it, is I think we as a society are less willing to do things that could lead to us getting hurt.

Okay.

Do you think we've just gotten softer?

I think that would be a very strong way of putting it.

I think that we are products of our environment and what we do make sense.

And that's all like I start from a place of like, what we do make sense.

And if you're, you're taught that like experiencing some of the emotions that we don't want to have is bad and that people that your interaction with them led to having those emotions, that makes them bad mean whatever it is.

I think that creates a lot of problems.

So I also think that we're scared of rejection, overwhelmingly, and that makes sense.

But like, you know, there was always like the saying of like, never talk about like politics or religion when you first meet someone.

And I think now we just don't talk about it because this like, I would say that 50% of the country right now, if I talked about my political viewpoints, I would be rejected from them.

And so it's easier to not bring that up and have some semblance of relationship than it is to potentially lose someone.

Do you think it's always, I'm like really fascinated as to like, why we are worse at that connection building now?

I think, yeah, no, I think that's great.

And so I think it kind of depends.

So one of the things that I've been thinking a lot about is like as someone who's like cisgendered male, masculinity and the exposure we get to masculine norms and enforcing those norms.

So when you think of like media exposure, you used to really have to seek it out, right?

And so like, sure, you could read magazines or watch TV, but like our feedback about what is masculine is everywhere now.

And so I think we're getting very shaped.

And with masculinity, I highlight because it comes with a lot of like stoicism.

You don't show emotions.

And if you show emotions, you're either weak or you're mean.

And with men, it usually manifests as like those push away feelings rather than the bring people in feeling.

So it's usually like anger, hostility, like those bigger things.

So I think we're socialized into it as one.

And then I think that we as a society have deemed certain things just like really inappropriate.

And we've pathologized normal human experiences.

So what I mean by that is like what we kind of talked about earlier around like depression and anxiety, like those are feelings that make sense.

But right now we view it as like if you're experiencing those things, well, you need a medication.

And so we're kind of taught not to feel.

And except for like the good things.

And anything that you feel that isn't good, I think is kind of viewed as pathology almost.

And so I think we just have evolved in a society or as a society that we don't tap into those feelings that build connection because like those are the things that bring us together.

Like the things that we don't want to share with people that people accept us for.

Yeah, this is encouraging to me because I feel somewhat controversial because sometimes I'll think about depression and anxiety as more of, like you said, parts of the human experience and even in the language of it's not a bug, it's a feature, right?

Like it's a cue to you, you know, like your depression is a cue to you that something's up, you know, like we need to adjust this just like with loneliness, right?

It's a cue to you that the hunger, the thirst, like, hey, you need more social connection.

You need to build your social infrastructure.

Yet I feel like lately there's been more of this, like mental health, mental health matters, like speak, speak about mental health.

So then if I say that, like, hey, this is part of the human experience, people are like, you are discounting my experience, you know, like, no, this is something I have and something I struggle with.

Therefore I am going to take the medication or therefore I am going to do X, Y and Z.

And it just feels at odds.

Yeah, yeah, there's a great book called The Happiness Trap that talks a little bit about this, where we're kind of expected to only have that experience, right?

You're supposed to be happy all the time.

But like, how weird would it be if you were just like happy all the time?

Totally.

Yeah.

So I am more sympathetic to your viewpoint.

And for me, I think when I was younger, I would like take a dogmatic like anti-medication perspective.

And I think now it's really about like whatever works for you.

But I think that we have to be really careful because what works for us in the short term isn't what works for us in the long term all the time.

And I think with like human experience and emotions, yeah, I don't want to feel shame, right?

Like that's like one of the big ones, like shame and humiliation.

And those are the big feelings people never want to have.

Those are adaptive and it's okay.

And what's even better than okay is like, if I can share something I feel shame, embarrassed or humiliation about, and the other person says, yeah, like I can see why you felt that and I still care about you.

I'm still like ride or die with you.

Like what a rewarding experience.

And so I think we're constantly in this tension of like, we don't respond well to those feelings.

And so we try to get rid of them, but we also have to learn how to let them be.

It's not necessarily like acceptance in like an embracing way, but it's not tolerance either.

It's just recognizing that they're there and that's part of being human.

Can you point to any particular thing or moment that caused you to go from anti-med to whatever works for you?

Just really talking to people and really understanding like how much it made a difference for some people.

I think one of the things that we also see is when you're like in grad school, just out grad school, you tend to be more black or white.

And so I think like I was learning all about how to change behavior through conversations.

I'm like, we can do anything.

And I think nowadays it's a lot more just like, hey, if that works for you, I want you to do that.

And let me let me tell you, there is another way.

I think there's also, I don't think we know everything about medication.

That terrifies me.

So like the the number of like longitudinal studies on medication is fairly limited.

And and we're like having new drugs out there, not that they're not safe in the short term.

Like, I really trust research.

But like, we aren't testing all of the parameters of something.

And it's something that I'm really curious about, like, what's the impact of taking an SSRI for 20 years?

Well, we've only had them around for a little over 20 years, you know?

So like longer than that now, I suppose I'm getting older.

But but we haven't been able to answer those questions.

Sometimes we have animal models, sometimes it's not great.

But I think so for me, there's hesitancy on some end, but also like, I don't want to endorse the medical model.

I don't want it to be like, oh, I have this thing and I need this medication to treat this thing so much as like, yeah, these things can add flexibility to to what you do.

And if that works for you, great.

If it doesn't, there's alternatives.

My brother has, he was diagnosed with schizophrenia and he was, whenever I was what, like 13, he was 17 and it was wild.

I don't know what happened.

He was a skateboarder doing really well, crushing school.

I was always in his footsteps.

I'd go to school, first grade, he was in fourth grade.

I think we were three years, second grade, fifth grade.

I finally got to go to middle school and he was there.

And everyone was like, oh my gosh, you're his little brother, you're his little brother.

But there was something that happened and it may have been drug induced or alcohol induced because he was getting to, he had a group of friends and they were kind of experimenting with different drugs and he was drinking, but his social circle began to shrink.

He would isolate himself.

We shared a bunk bed and there was like days where he would just land the bottom bunk with his hood on.

He quit school.

He quit going to work.

And then he became a lot more reactive.

And for a long time, for a couple of years, I was the subject of his paranoia.

And he would be like, you're doing this or you're doing that, or you and mom are saying this about me.

And I was like, no, dog, I'm just trying not to get by you because he'd also get aggressive.

And it was so fascinating to see because I had been around him a couple of moments where I'm not the expert, but I would say he was definitely in a phase of psychosis.

Like it was, everything was bizarre.

I remember a moment where I'd gone to the backyard and I could just feel aggression.

Like my intuition was like, this isn't right.

So I had left the house.

And I remember him yelling and punching the window and breaking glass in his hand, bleeding and all this stuff.

I was like, screw this.

And I ran.

And there were moments like that, that I look back on.

But they got him on medication.

Okay.

And this medication is, like he just became catatonic.

And it was so tough for me because like, one, I couldn't explain what had happened with him initially.

And then he's catatonic.

And I remember then he'd come home and he wouldn't take his medication.

So I would go and I see him and his eyes would be sunken and he'd look like a skeleton.

There'd be nothing.

He'd be talking to himself and be like, shoot.

And it's, there's a lot for me to say on that.

And I've done a couple of podcasts about it because it's like really important to me and impactful.

But sometimes I have so many questions about that.

But like one of the things I think is like people like mental health matters, like I just have a hard time putting that in the same bubble as like other stuff.

And like, there just seems to be a whole bunch going on.

And even that medication, it's not doing the job.

Like they are just doping them up, right?

And he lives in this house now that state mandated because he was going through this time of psychosis and a whole bunch of police showed up at his door.

And they say that he struck them or he felt threatened or something.

So he went to the justice system, then the court told him to go to the state mandated house, but it's these men who, 30 of these men, and they are just drugged up and just walking around.

There's a TV on, they don't even watch it.

So it's crazy and it's sad.

And that's given me a bit of, and I know it's not limited to this, and I need to be a bit more comprehensive, but it does give me a little like, about some of this medication that we use to treat mental illness.

Yeah, yeah.

And it's hard.

So like, I'll preface this as saying like, my expertise in the domain of like, psychosis, schizophrenia is very limited.

So, you know, books I read 10, 15 years ago.

Yeah, it's hard.

And we don't have amazing medications for that.

They're getting better.

But I think that's one of the hardest things for treating like the positive symptoms of schizophrenia is finding that that right balance that allows people to be human.

But maybe doesn't like can still prevent some of the worst parts of that.

And you'll see a lot of people stop medications because those side effects are so awful and so severe.

And that's actually surprisingly common.

So it's really hard to find that balance, and it's hard to nurture relationships, and it's hard to think about that.

Like as you said, like it, mental health is a huge spectrum, and we need to care about all of it.

But the things that there's terminology is sometimes called SMI, serious mental illness, schizophrenia, bipolar one, some of the things that kind of feels bigger, we quantify that way or phrase it that way.

And I think really it's a balancing act.

And there's like, it's more akin to an art sometimes than a science, which is like, you know, we can't take a measurement of the brain and say, oh, this is the right dose of the right medication and come up with an answer.

It's a lot of trial and error and context and things like that.

Yeah, it's so fascinating.

And it frustrates me sometimes whenever I see, like, Chad GPT came out with this new model.

Like, we are crushing it in so many different places regarding computer processing and AI and, you know, like, look at all the cameras we have here, right?

The iPhone Pro 16.

Like, there's so much happening.

But then a lot of the practices are still pretty archaic with things like this.

And they say mental health issues are growing and there's more of them and all this jazz.

So, and I also know that people like, have you heard of this, the loneliness economy?

I have not, no.

It's like people who quote unquote profit off of loneliness, right?

Like their business model is to get people alone, to get people to pay $50 for tender gold.

Sure.

So that they can swipe more, right?

And creating a platform that people who are lonely are more likely to utilize, therefore, loneliness is like a commodity that gives them business success.

Yeah, it creates a context where certain products are in demand.

That's terrifying.

I am definitely in the camp of like firmly against late stage capitalism and everything that comes with it.

And like the question is, is like are like this is the context?

Do we condemn people who are kind of saying, well, this is the context where we have a product people want?

Um, or is it our job to as a society, enforce standards on everyone and trying to nudge it back different directions?

And I don't think either of those is the right answer.

I don't have the right answer.

Um, but I would love, like, like you asked me if I could like, kind of find a way to profit from what I was doing.

That was one of your earlier questions.

Um, what I really want to do is figure out how to like, coach people through connecting on a large scale.

And the problem is, is like, it requires so much individual feedback that like, I can't conceptualize it.

Um, but that's-

What would that look like if you did it really, really well?

I don't know, but I think what it would be is like, you know, I think of, um, there's a bar I really loved in grad school that had like a large communal table.

And I think it sat like 20 people or something like that.

And you would just sit and start talking to strangers and teaching people to be willing to share who they really are.

And it's weird, because I'm using these like kind of middle-level terms.

Like it doesn't really mean anything.

Like what does it mean to share who you really are?

But I think of like, I can think of like a whole score of things that I would never share on a podcast, right?

Maybe if we like had a one-on-one conversation, we could get there.

And even in our like pre-interview or whatever, like there are stories that came up that I was like, oh, I can like connect with that.

You were telling me about remembering like a band, a t-shirt your wife was wearing and how that was like a big part of you.

And I actually had a really similar experience with my wife where she was wearing like a band of this kind of obscure Canadian indie post-punk band.

I was like, oh, you like that band?

And it was just like this moment that's like crystallized in my mind.

But like, that's only the start, right?

And then where does that go from us?

Like, if I asked you, like, when was the moment you realized you loved your wife, right?

Like, we're starting to get at more of that like soft stuff.

And like, that's the stuff that like really interests me.

So that like when I'm feeling kind of jaded, people ask me, why do I do the research I do?

I say, I'm trying to get people to be people I like.

Yeah, that's a great goal.

Yeah, and like, that's what it is, is cause like every time I meet, like I meet lots of people, some of whom I don't connect with right away.

When I can get people sharing like their human side, I like everyone.

And so it's this really interesting phenomena where like I don't do it maliciously and it's not with ill will, but it's recognizing we're all human on a certain level and we're all trying not to be human a lot of the time.

We're trying to hide our humanity.

It feels like it.

And I think that's really concerning because like that soft side is wonderful.

But like the flip side of that is like it also comes with hurt.

I remember the first time I told someone I loved them.

Like it like it was like the Hindenburg.

Like it just failed horribly.

They didn't say it back.

No, no, not at all.

Like eventually became one of my best friends like years and years later.

But we like hated each other for years like like it was like such a mess.

And like I didn't tell anyone I loved them again for like six years, seven years.

Like like it was like, well, not doing that.

And like I can think of that time in my life and how I reacted to that, how I would put up walls and like not share certain things.

And I think we all do that.

Like we've all been hurt.

And the problem is, is like, we're working so hard at teaching ourselves not to be hurt again, that we're not teaching ourselves like the good stuff that comes with the risk of being hurt.

Man, that's so good.

How do you train people to be better connectors?

You kind of block the opposite.

So, so the form of therapy, I do research on functional analytic psychotherapy.

Essentially, what we recognize is that all of those diagnoses and the diagnostics and statistics manual, the DSM, have interpersonal components to it, right?

So, depression shows up in our interactions with someone.

And you can see it, right?

Like, you talk to someone, they're like averting eye gaze, they talk slower, they share certain things.

Like, low affect.

Yeah, yeah.

Like, you can kind of read that.

And so, what we do is we kind of look at how does depression show up in the space between us.

And from a therapeutic standpoint, when they do that thing, we essentially say, you know, I feel like you're doing that thing.

Can you try something else?

Because that doesn't really work with me.

And so, you get them, you know, instead of someone being like, oh, you know, like, I do this, but I'm just a loser and I'd fail at it.

Right, the very common thought in depression, you might say, you know, I'm finding like it's hard for me to connect with you when you're putting yourself down.

Can you find a different way of framing that?

And they might say, I'm really scared that I'll fail again.

And I'm worried about how that will impact me.

And that's vulnerability.

Yeah, yeah, yeah, exactly.

And so if you can kind of block the problems and gently get people to do the connection building stuff, I think that's kind of where the magic happens.

What do you think about third places?

Like people say, you know, there's not many third places nowadays.

Yeah.

So first of all, I love public libraries.

I think they are like the last place that you can exist for free and just like be.

So I think that's really important.

Um, when I was a kid growing up, um, I would spend every afternoon I could at our coffee house.

And there was a group of us there.

And like that was like one of the best things for Connectant.

Like, like I remember that vividly fondly.

What's the coffee house?

It was like, like what is a coffee house?

Yeah, yeah, yeah.

Like it was just like a coffee shop.

Yeah, it was a coffee shop.

And they had like a couch in the back room.

You paid 75 cents for a cup of coffee, a good cup of coffee, and then you could get refills for a quarter.

And so like as a pretty broke, like middle slash high schooler, I could just like sit there, drink copious amounts of coffee with friends and like, hang out.

Yeah, and like they put up with us.

I don't know why, like I'm sure we were like disrupting other people.

And you weren't spending that much money.

No, no, we'd probably cost them money in the long run.

But like that was my space.

And as I got older, that space evolved into, you know, someone's basement or stuff like that.

And I feel like the way we are now as a society, like it's expensive to live, like full stop.

I really worry about our young people right now from a just like financial perspective.

But like, where do you gather?

Where do you spend space?

How can you get together in a way that allows you to exist and acknowledges like equity or, you know, like not everyone can afford to do stuff like that.

What do we do about that?

Like spaces for younger people?

I mean, I think at some point, we have to live our values.

You know, I always talk about like, you don't become a professor because you want to get rich.

You do it because you're curious, because you love it.

Like I love mentoring.

And I think we have to see people's values enacted on a larger scale that is beyond profit.

I think that helps.

And then I think we, you know, if you wanted like a government level intervention, it's creating spaces and opportunities that can operate at essentially a like nonprofit level.

I think that would really help in a lot of ways.

I don't know if it's the end all be all because I think, you know, there's a lot of pressure to do other stuff.

But I think, I think we have to create ways and spaces for us to connect again.

I really like the idea of living out your values.

And I've thought about the government intervention because if we have the surgeon general saying there's a big loneliness epidemic and it's clearly not a individual issue, right?

It's clearly a systems issue.

Then it seems like there needs to be an adequate response.

Like whenever the surgeon general says, smoking is really bad for people's health.

Well, you got Obama writing legislation about cigarettes and all this jazz, right?

Like there's a response.

So when the surgeon general is saying loneliness epidemic, it's like, well, what's the response?

And that's so fascinating.

And I know that there's big public health schools like trying to figure out that situation.

But I do think living out your values, and a lot of the people who listen to this podcast are young adults who are either wanting to become better connectors.

And like as we're talking, I'm thinking like, dang, I could do a whole other episode with you, like how to become a great connector, you know, like.

But I always encourage them, like, see if you can create a third space somehow, you know, like whatever your hobby is, whatever you're like, for me, it's soccer.

So Monday, Wednesday, Friday, I host a soccer group, right?

And technically the community center, they give us the venue.

So like, thank you to them.

But I initiated it and I put it on there for people good to be there.

So it's like, what else, what can other people do?

Because my theory is that if I can get the people who are willing to host something, then they're gonna have access to people I don't have access to.

And they're gonna have access to people who aren't willing to host a third space or like a get up or a meeting, but they really need connection.

And it's like my way of getting to a whole bunch of people in like a satellite way.

Right, right.

Yeah.

And like, it's interesting because I like occasionally those spaces kind of exists, right?

Like I used to play a lot of like nerdy board games and stuff like that.

And like Warhammer and you can go to a game shop and play games frequently for free.

Some people rent out tables and stuff.

And so that was a space.

Um, but I think that it's becoming more and more rare, as you kind of said, and even like those social groups, like when I was in grad school, I was in a kickball league, but they charged us.

It wasn't, it wasn't just like someone organically arranged.

Yeah, you're paying.

Yeah.

And so I think that's always like the struggle is like, I think when you look at the shift in like economics and how, like, we're really kind of being pushed to our limits fiscally, that having any cost associated with social connection is a barrier.

Um, and when we, you know, like I remember there used to be able to like talk to co workers and stuff.

And now it's like, well, stop goofing off at work.

Like, like all of these, like spaces that were built in are being taken away.

And that's not universally true.

Um, but I think it's, I think it's hard now.

Um, and it's hard to meet new people.

Um, once you're out of out of, you know, school and stuff like that, like meeting friends at work is, is tough for, for all people.

Um, but I think that's one of the things that I've become increasingly curious about is like, what is the impact of loneliness as you transition out of structured spaces?

Yeah, that's a good way to say it.

I've always thought about the person who graduates from college and they moved to their first job.

Yeah, yeah, exactly.

It's because they've tasted community.

They've tasted what it's like to be a part of someone who's like, what's up, Daniel?

How's it going, Daniel?

How's your mom?

You know, like the way everybody knows your name, the cheers for you.

They've tasted that and then now in the absence of it, they crave it, yet they're unsure of how to re-obtain it.

Yeah, yeah.

And like, it's so wild how just like that forced space and forced freedom used to...

Like one of my close friends in undergrad, I met because of a ringtone.

Like he had the Always Sunny on Philadelphia, like a day man song.

And I was like, oh, I know that.

And like, we bonded over that and it became, I haven't spoken up for years.

Hi, Andy.

But like, what happens when that's gone?

What happens when you can't do that?

And like, what happens when there's expectations?

Like I think of like college as a time where you can like explore who you are.

You can try new things, kind of be silly and eccentric.

Then all of a sudden you shift to the like business world and you're like, you know, khakis and a button up all day, every day.

If I'm moving to a new place, I'm thinking about this right now, I'm doing like a few things immediately.

One, I'm putting on social media, maybe some people don't like this, but this is what I'm doing.

I'm putting on social media, hey, I'm moving to blank.

If you know anybody there, let me know.

You know, like I really value community and I'd love to get connected before I even get there.

That's one thing.

Two things, I'm looking at like my hobbies.

Like I am looking up soccer groups in Dallas, Texas, or Santa Clara, California, or Maine, right?

And then I'm looking for a church.

Some people don't go to church.

I do.

So I'm looking at a church.

And then another thing, like I'm intentional about making friends at work during my first month there.

You know, like the way we enter a work situation, if we're being very interactive and inquisitive, first impressions stick and people will be like, oh yeah, that's Chris, you know?

And it's like, well, it's actually not Chris, but I'm trying to make it Chris, right?

So I'm doing that.

And then I'm talking to my neighbors and I'm being, I want to say excessive, but that's not the best word, but I'm just like being over the top.

I'm being interested in them.

And I feel like if I can maintain those five things, join that soccer group, go to that church, get connected with people who are already there, be intentional about my work relationships and connect with those that I live around, that's a good foundation.

Yeah, yeah.

No, and that's exactly what we did, right?

So we moved here, and then we hung up flyers on all of my neighbor's houses, inviting them to an open house.

That's awesome.

It was just like, I don't know who you are, come over to our house and we'll give you food.

And our work colleagues, we invited them to our son's birthday party.

So much of it is just taking that chance and being like, hey, let's connect or inviting people over.

Or, you know, like, yes, you might get rejected.

And that's not the most comfortable thing, but like, that's also how you make friends.

And so like some of our neighbors, they're like, oh, well, babysit your kid.

And we're like, come over for drinks.

Like it just evolves that way.

Wow, that's awesome.

I feel like we could talk for hours.

Thank you for being here.

I got two questions that I end every podcast with, okay?

And I need to reformat this because it's like they're big questions.

So it's like, maybe you shouldn't end the podcast with them.

But one is, I see, we can look back on our life like days, weeks, years, right?

But we can also look back on it in conversations.

So like big conversations as we look back in life.

And what's been one of the biggest conversations you've had?

Um, the one that first came to mind was, I reconnected with some people I knew from high school, like very, very vaguely, like we kind of knew of one another.

I reconnected with them when I was in grad school.

And one of the first things that like, we just had this like really in-depth conversation.

We were at brunch.

We're really like doing well.

And they lived four hours away from me.

And I just said, come over to my place for a weekend.

And like, it formed, like they stood in my wedding.

It's a couple, both of them were in my wedding party.

It's a wedding party of three people.

They were two-thirds of it.

And I just think of like that experience of just like really bonding with someone so much that you could put that trust.

And that they were like, yeah, like, sure, we'll do it.

So you took a risk to invite them over.

I mean, I think if anyone is inviting you over to their house like in like a first conversation and they live four hours away, like either things are then go really, really well or really, really wrong.

And it just worked out for us.

That is so cool.

So that that stands out as like one of those like meaningful conversations that I've had.

And then what's one thing you wish more people knew about you?

I think that I'm a big softie.

It's so funny because all I do is research vulnerability and talk about sharing feelings all the time, but I think I read as a really intimidating and I think a lot of people would say I'm mean.

And it's just I'm intense.

And so I think if people knew that I really cared deeply about people and want to get to know you, but I wish people knew that about me because I think often times I have to be like, I'm in work mode.

I'm really intense right now.

Catch me outside of work and let's do that.

And that I'm silly.

Being silly is how much we lose that as adults.

And I really miss that of just fun and playfulness.

Thank you for being here.

Is there anything you want to plug?

I mean, I will always, the hard thing is I'm like, plug, join my lab for grad school.

This little commitment.

Right, right.

It's only six years of your life.

No big deal.

But I think what I would really just encourage people to look at is like go out and be vulnerable.

Like do something new.

There's the Global Awareness, Courage and Love Project that is working on this.

It's run by Mavis Tsai who founded the Form of Therapy I do research on.

It's a solid nonprofit all about combating loneliness.

So-

What's that called again?

Global?

It's the Global Awareness, Courage and Love Project, I believe.

So like plug to that, but really just like go out and take a chance today.

Like that's all I want.

Go out and take a risk and it may not work, but hopefully it does.

Yeah.

Okay.

Thank you for being here and we'll see you next time.

Thanks for having me.