# Dr. K Diagnoses Your Favorite Characters !sexy

## Метаданные

- **Канал:** HealthyGamerGG
- **YouTube:** https://www.youtube.com/watch?v=9pASWaaDuz8
- **Дата:** 07.05.2026
- **Длительность:** 2:46:57
- **Просмотры:** 38,874

## Описание

Dr. K's Guide to Love, Sex & Relationships is coming May 11th! ❤️‍🔥 $5 OFF Pre-orders: https://bit.ly/4cx69iB

This Mental Health May, we're exploring the intersection of mental health with love, sex, and relationships to celebrate the launch of our new Guide! 🎉

As we sell more Guides this month and hit our milestones, we will unlock prizes for the community!

One of the most important pillars of our mission is AOE Healing. Our Area of Effect grows with every stream, every new digital tool we build.

And the more people engage with our resources, the more we can build.

We pour everything back into developing resources that meet you where you’re at and help you heal and grow.

Each of these goals is tied to growing some aspect of our AOE:
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Your support keeps us building and growing, so we can help more people with their mental health. And we're beyond grateful for everything we've done together so far! 💚
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💚 ❤️‍🔥 Join our FREE Heart-to-Heart Community Challenge, May 4-31, to work on your relationship skills and get ready for your journey with Dr. K's new Guide to Love, Sex, and Relationships! Community Challenge is open to all. Win prizes from merch to memberships to guide modules. ❤️‍🔥 💚  More info: https://explore.healthygamer.gg/h2h-community-challenge

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## Содержание

### [0:00](https://www.youtube.com/watch?v=9pASWaaDuz8) Segment 1 (00:00 - 05:00)

of life trophy golden child narcissism extended suicide. — What about Hermione? — Normal. — She's not OCD. — No. — What about Fred and George? — Also normal varants maybe if anything. I mean I don't think they have this but oppositional defant disorder is — Allrighty chat. Let's get started. Welcome to another Healthy Gamer GG stream. My name is Dr. Alo Kenoja. Just a reminder that everything we discuss on stream today is not intended for medical advice. Everything is for educational and entertainment purposes only. If y'all have a medical concern or question, please go see a licensed professional. Um, yeah. So, today we're going to be doing some fictional character diagnosis. I know we're getting a little bit of a late start. Um, and then we're going to have a guest uh coming in just about 40 minutes. Apologies for the late start. Um, you know, basically what happened is I'm a professional streamer. Um, this is what I do for a living now. Theoretically, not really. Sort of a little bit. And then, um, one would expect as a professional streamer with an amazing content team who makes these kinds of things happen, one see this thing is blurring, but I figured out that I have to lean in and then it'll resume. Um, you would think that we would fix these things, but literally what happened is like uh the headphone jack broke off and so we had to fix that, but thankfully I used to build my own PCs, so I know how to fix a couple of things. And then we've got an awesome team that helps. Um, we're going to be hearing from our team a little bit later, but we're going to do some fictional character diagnosis. Um, before we do said fictional character diagnosis, we need Solid Snake and Dante Sparta. diagnose a character that has a gambling addiction. You guys need to tell me who the character is and then I need to watch said anime. I need to bill my boss, Guthy, who is CEO of Healthy Gamer, for my time watching anime. And then I will Yeah. So, we're going to do Walter White. Walter White's on the list. Let me show you guys the list real quick. Okay. Um and then y'all start spamming. Not quite yet. We're going to I'm going to show you all the list. You guys think about it. Think about it and then when we go after we do announcements, we'll decide. Okay. So, I'm leaning in. Okay. No. Okay. Uzzamaki Naruto, Uchi Haske, Aaron Joerger, Levi Acriman, Harry Potter, Seahor Snape, Michael Scott, Dwight Shroo, Creed, Angela Martin, Batman, Walter White, Skyler White. They were like, "Hey, we need to do Walter White. " I was like, "Bro, you got to have Skyler, Jesse Pinkman, Saul Goodman, and Joe Goldberg. " My preference is going to be Joe. Joe is the only one that I want to do for sure. So, these are our options for today. And then y'all let me know who else you want. Okay. Um, and then before we get into that though, so y'all decide and we're not going to do a poll or anything. We're going to just y'all are going to randomly spam chat. And when you randomly spam chat, we're going to decide based on that. Okay. Um, but don't spam chat yet. Let me do my announcements. Chat, calm down. You guys are already any JoJo character. Okay. Jojo's Bizarre I Jojo's Bizarre Adventure is so bizarre. I watched a few episodes of it and like uh yeah, we can we did a Squid Game diagnosis. Yo, you guys know that we did that like four years ago. We have that. Okay, let me do let me do my announcements. Okay, listen. We're going to speedrun these. We made a guide to love, sex, and relationships because, hey, we can diagnose fictional anime characters all day long, but at some point, we need a real relationship with a real human. Okay, speaking of real relationships with real humans, so we've got this counter here at the bottom. All right, we're trying to sell guides. So, here's our thing. I know other channels do subathons, other channels will raise money, things like that, right? But like our thing, we don't do subathons and stuff. reason is because I don't know what y'all get to sub. you get. So, a big part of what we do here is we try to build stuff that we believe is helpful for you and then if y'all are going to give us money, you should get something in return, right? So, we may do donation drives and things like that down the road. I'm not saying we're never going to do that, but a big part of what we do is like we're here to help you. And what you guys need help with is getting into a relationship, improving

### [5:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=300s) Segment 2 (05:00 - 10:00)

your relationship, getting laid, etc. So, um, we hit uh our 4,000 uh goal. Thank you guys so much for all of your support. If you guys know someone who's struggling with relationships and you've already bought one, send the guide to a friend. You guys can do that now because people ask for that, right? the most subtle form of help and or burn that you can do is to send them a copy of the guide. Hey bro, I think you need this. Um, so if we hit 5,000, we we're going to have a uh VTuber stream. I don't understand what that means. I don't know what this is, chat. but that's what has been decided by the powers that be. And then um these other stretch goals are because we at HG want to do stuff. We've been we've presented at the CA Canadian House of Commons. We've gone to the White House. We've done some work with the UN counterterrorism unit. We want to start publishing some of our research in academic journals. We're going to talk about that at the end of the stream today. Um we want to grow the HG Institute and I have a vision for an app finally. Everyone's like, "Why don't you build an app? Build an app. Build an app. " And I was like, "Why? Why? What does the app do? Now, we actually have stuff that we think that will be helpful uh if delivered in an app form. And that is basically an evolution of some of the things that we already do like community events. So, um let's accept cookies. Um so, the heart-to-he heart community event we have going on, y'all can join on the Discord. Uh we are going to start by writing a postcard to your future self. Get honest with yourself. Get brave. So set boundaries, be vulnerable, have the conversation, get closer. Um we're going to nurture connections and sharp sharpen your social skills and then keep growing. Right? So then at the end of the event, we're not we don't want to just this just disappear into the ether. we want you guys to actually like continue growing. Um, and so these community events have been incredibly successful. Like we've done like the touch grass campaign a while ago. We did a right in the fields campaign which improved people's emotional awareness and reduced their alexathy and things like that. Name their emotions, sit with emotions, all that kind of good stuff. So there's like content that we do. We educate y'all, which is fun, but we also want to build stuff that will help you. Okay, so now I'm going to turn to um what do y'all want? So, okay, every people who are saying Luffy. Okay, so I don't know how many episodes of One Piece do I have to watch to understand Luffy's psychology? Can y'all tell me this one? Nice. Sounds like his character development arc is fantastic and full of depth. Okay. Ang from Avatar the Last Airbender. Okay. So, Hunter X Hunter is on my list, so I want to watch that. Okay. They don't have to be, by the way, they can be fictional. They don't have to be anime, bros. Okay, you guys want to do Aaron? Let's do Aaron. Okay, do the horse. Okay, I'm going to do Aaron. All right, Aaron Jerger. Okay, so here's the thing with Aaron. Okay. Um, so if we look at Attack on Titan, so let's start by like doing a quick sum summary of Aaron. Okay. So defined by Oh, I could do Ted Lasso. You guys want to do Ted Lasso? Oh man, we can do Ted Lasso. Okay. So Aaron is like, okay, so let's just talk about Aaron for a second. Okay. All right. Ed and [ __ ] So is a part of this. Oh, I'm blurry again. My face is blurry. Okay, so let's talk about Aaron. So Aaron is a kid. Okay, so there are going to be some spoilers. Okay, chat. So if you guys haven't watched Attack on Titan, there's some spoilers. So Aaron is injected with some stuff, right? Um and then Aaron grows up when he's a child. He experiences a lot of trauma. sees his mother, I think, being eaten by a titan. Um, and then they're in this ensconce little area, right? And then there all these titans and the world is a very scary place. There's a lot of trauma. Okay? And then what happens is as Aaron starts to become heroic, he starts to become more powerful, he has more power

### [10:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=600s) Segment 3 (10:00 - 15:00)

he realizes that uh the Marians are the bad guys. And so then he's going to inflict upon them the pain that has been inflicted upon him, right? So he's kind of got this sense of vengeance. Okay? But it it's not really vengeance. I don't think he wants vengeance. So we're going to um I'm going to show you guys. So um there's a form of trauma So Aaron has been traumatized. Okay. But I think the most interesting thing about Attack on Titan is how there's no way to get the train off the tracks. Okay. So if you listen to Aaron, he's like, you know, even when he's talking to what's that guy's name? The Armored Titan, right? And he's like, "Look, you guys came here to try to destroy us and like you didn't have a choice. like you were just doing what was supposed to be done because remember the Eldians are like evil people, right? We're the bane of existence. So you Marley was concerned because we've got a bazillion titans in our walls and we can release the rumblings. So you showed up here and you did really bad things for the right reason. You didn't have a choice. Okay, Reiner. Okay. And so if we look at this, there's a lot of definitiveness. There's a sense of powerlessness. lack of control. Like we're not really responsible for our actions, right? We're not allowed to say no. The world exists in a way where you're doing what you think is right. I'm doing what I think is right. really fascinating about this is how this has been explored psychiatrically. So there is a new form of PTSD that got basically like got sort of finalized in the DSM called moral injury. Okay. So these are individuals who are exposed to traumatic events that violate their moral values may experience severe distress and functional impairments known as moral injuries. Um over the last decade moral injury has captured the attention of mental health providers. Um, so, uh, hold on. Okay, I'll just explain it. So, basically, there's a new form of trauma. I mean, this has always been there, but there's the trauma of having something done to you that is traumatic and then there is human beings being forced into situations where they have to do bad things. Right? So, and when so we see this a lot with like soldiers, right, who go to some of these war torn places and you like shoot some guns because you launch a missile or whatever. You're like bombing something with a drone and it turns out that it was supposed to be a military target, not a military target, turned out to be civilians in there and now you have become the bad guy. And this is traumatic. This is like really damaging for you to be forced into the role of bad guy. And now the interesting thing is if we look at moral injury, it's a form of PTSD that is debilitating. Okay. So the really interesting thing about Aaron is that is he debilitated? Is he mentally ill? Is he nonfunctional because of what has been happened done to him traumatically? And this is where like I remember I was in med school actually and uh I also have a master's in public health. So, I was in a dual degree program and one of the most shocking things that I remember learning uh in my M. PH in med school was that everyone who goes through genocidal conflicts does not have PTSD, which is a weird thing, right? So, when I was um in residency and stuff like that in Boston, there was a large uh population of I think Cambodian refugees. And so like if we look at like refugee populations, not everyone has PTSD. And the question is why not, right? The intervention, the thing that they experience is the same. Everyone is running away from genocide. Some people end up debilitated with PTSD. Some people do not. And I think what's actually really good about Attack on Titan, I think it's actually a psychologically in-depth anime because it shows what someone has to do to not fall apart from the trauma that they've been to. And one of the scariest things that I've seen for people who commit vile acts is the justification of I don't have a choice. Right? So, in order to not be hurt by his moral injury, because when you do something evil, because this is what's so confusing. You'd think that, oh my god, Aaron, his family, his friends got

### [15:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=900s) Segment 4 (15:00 - 20:00)

eaten by Titans. They were hless victims of the aggression of somebody else. You would think that in that situation, and we see this in Attack on Titan, right? We see that some people on Aaron's team have compassion for the Marlians and they're like, "Hey, bro, they did this to us. Killing innocent people is bad. How about we don't do that to them? " And what's really interesting is, so that's one way. So this is what I think is fascinating about Attack on Titan. It's like when you have a genocidal conflict, what are the different psychological ways that people respond to this genocidal conflict? And this is what's fascinating as a psychiatrist, right? When I work with people, something bad happens to you. How do you rise to that occasion? How do you adapt? How do you respond? And I mean, literally, how do you adapt? So, adaptation number one is, hey, this is bad. This hurts. This is bad. Let's not do it to anyone else. Let's have compassion. Option number two is vengeance. Right? This is like, you hurt me, therefore I want to hurt you. the reason I'm hurting you is because you hurt me. There's no sense of like overarching moral stuff beyond, hey, eye for an eye. You deserve what you get. But that's vengeance. It's a very noticeable it it's a discreet motivation that some people have. I'm going to do this because it's vengeance. But what we see with Aaron is something else. So when he's committing bad acts, right? So there's a moral injury diagnosis that could be made here, but he doesn't have because he's not impaired. He's not non-functional. He's the opposite. He's hyperfunctional. And how does he attain that hyperfunctionality? By dehumanizing. Hey Reiner, you didn't have a choice. I don't even blame you. There's no desire for revenge. Right? Reiner did all these bad things. Is he angry with Riner? Not at all. He does not walk the patch path of uchihas. He's like, "No, actually, I don't blame you. " And here's the beautiful thing. Here's the really scary psychological thing. If I don't blame you for doing bad things, guess who else I don't have to blame? Not my fault. I'm about to do some terrible things. And this is just the way of the world. This is just what happens. Nothing can be done. Okay, I haven't seen the end of the anime, so I'm I need to watch it, but into season 4, like episode 12, season 4. So, this is what's going on with Aaron, right? So, I think we're seeing a moral injury kind of picture, but the way that he responds to this evilness, right, is by saying, "Hey, like I'm not responsible. You're not responsible. No one's responsible. " And that is a really, really powerful way. I've seen this and it's like, you know, I saw, you know, a I don't even know what the right word is, a heavy episode of South Park with where I think it was Jimmy starts using steroids and then he starts becoming abusive and then he's like, "Why do you make me do this to you? " Right? So what's really scary about abuse is that what people who commit abuse, which is I think what we see in Aaron, what they will do is they will rem they will depersonify, depersonalize themselves and the other person in the relationship. Why do you make me do this to you? You know, I don't want to do it. You're making me do it. This is I understand this is wrong, but I can't control myself. It's really, really scary. Like sitting with these people is one of the creepiest experiences I've had as a psychiatrist because what really scares me when I sit with these people and it's kind of like sociopathic. Okay, which is another thing that we can talk about with Aaron in a second is that like you kind of get the sense that once this person makes a calculation, if I'm on the wrong side of that calculation, there's nothing I can do to change their mind, right? I have no protection from their empathy. Like they're they won't think that this is wrong. Or even if they know that's wrong, they the wrongness will not affect them. Which is where we get to another really interesting aspect of when people get traumatized, why do they respond in different ways? So if we look at sociopathy or psychopathy, this is a scale. Okay? So we'll say like, okay, this person is a sociopath. The reason they're a sociopath is because they're high up on the scale of sociopathy. So they're in the top fifth percentile. Okay. So if you look at human beings and the features of sociopathy, one of the features of sociopathy is a lack of empathy

### [20:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=1200s) Segment 5 (20:00 - 25:00)

the inability to feel what other people are feeling. So I think what we see in Aaron is someone who is has some degree of sociopathy which by the way is like somewhat genetically inherited which we see from his dad right imagine how sociopathic you have to be to inject your child with Titan serum right there's like a streak of some real madness sociopathic kind of stuff in there somewhere. So when you have a certain personality makeup and you get exposed to a genocidal experience, depending on how that cookie crumbles and the decisions that you make in your mind, you will end up with Aaron Joerger, right? And this is the work that I do and this is why some people like this is why I'm actually hopeful being a psychiatrist because there's a decent chance that you have a personality makeup. Maybe you're a little bit more prone to rejection sensitivity. sociopathic. Right? Maybe you're a little bit more narcissistic. You have a personality temperament. And then as experiences happen to you, we make automatic interpretations. We arrive at conclusions. But the whole point of psychiatry is that those conclusions are not actually set in stone. That you can re-evaluate and reinterpret the conclusions that you come to. Aaron comes to the conclusion that bad stuff happens. There's nothing we can do about it. We are all lifeless people who are basically on this train. We have no agency. And yet, look at what he does. Look at how much exercise agency he exercises. And agency he believes he has. And this is what's really scary when it comes to things like relationships, right? Is we actually have a ton of agency. But if we don't believe we have agency, then there is no controlling our destiny. Right? So I think it was Carl Jung who said, "Until we make the unconscious conscious," uh I forget exactly. Let me figure out what the quote is. Hold on. What's the quote? You guys, you know this one. until you make the unconscious conscious, it will direct your life and you will call it fate. So this is what's really scary when I work with stuff and we cover this kind of stuff in the guide, right? There's a lecture on like and animus and some of these yungian perspectives because sometimes in relationships you can talk about, you know, the dopamine and the oxytocin and stuff, but sometimes like we have to talk about this deeper stuff. And what's happening with Aaron is he's got a lot of stuff going on in his unconscious, but he's faded because he's not aware that he's actually making choices. He's making huge choices. He's making catastrophic choices, but he's not consciously. It feels like he doesn't. He feels out of control. And this is what's really scary about trauma is when we experience trauma, we learn that we have no agency. Y'all get that? So when Aaron is watching his mom be gobbled by a smiling titan, right, when he sees person after person that he knows and loves, he learns that he has no agency. And this is what's scary about trauma. Once you have that conclusion, you carry it forward. So when he was a 12-year-old boy, he had no agency. when he's the founding titan who consumes other titans. He has a ton of agency, but in his head, he still believes he was that thing. He's a 12-year-old boy trapped inside the founding titan, and he doesn't grapple with the fact that he actually has immense power now. And so, he calls it fate. This is the tragedy of trauma is that you actually have way more power than you even realize because you're not the person who got bullied in school. is financially dependent. You may still be financially dependent, but financially dependent at 14 and financial dependence at 24 when you actually have a lot more agency than you realize, right? You are a different person. And just like Aaron, and this is why I like Attack on Time because I've worked with like literally dozens if not hundreds of patients who my job is to teach them that they are not the person that they used to be and that they have more control over their life than they realize. And we'll see. I need to watch the end of Attack on Titan, so maybe I'll have a different answer. Um, but like we'll see, you know, if he discovers this in some way. But so that's what's going on in there. And I think it's a beautiful case of trauma, moral injury. Um

### [25:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=1500s) Segment 6 (25:00 - 30:00)

so there's one. So I want to talk about uh Joe Goldberg for a second. So I think Joel Goldberg is a good example of a principle that we talked about with Aaron. So, if you guys haven't seen You, I think it's a great show. So, spoilers for the show. Okay, not like too big spoilers, but you sort of figure this out early. So, Joe Goldberg is someone who's a stalker, right? And he falls in love with people. So, I think Joe Goldberg is a really good example of when we diagnose a person, the shortcomings of using a single diagnosis So there's uh something called limrance. Okay, we have a whole video about lirance. Limrance is super scary. Limrance is when you develop this idea of a person and that idea is so encapsulating. It's so beautiful. This person becomes a fantasy. They are a fantasy embodied in the earth on the planet. They are an angel who has come down from heaven. And if you look at people who are stalkers, right? We'll get to stalking in a second. If you look at limrance, the idea behind lirance is someone has this vision of someone who is perfect in so many ways. And the really frustrating thing about lirance is you look at this person and your brain tells you, "Oh my god, this person isn't as amazing. They're beautiful. They're the person that I need. " We fall in love with this idea of a person. a fantasy of a person. And a big feature of lirance is that we actually don't oftentimes interact with them in a how can I say we don't interact with them much. So in some cases of lirance that I've seen you'll literally meet someone once and then for the next like 8 years you'll be fantasizing about how this person is amazing. Okay? And then you start to build this fantasy in your head about who this person is. The other really scary thing about lirance is as you engage in a relationship with them, they become a real person and the limrance disappears and can actually transfer to another person. This is common. So limrance shifts the research suggests that liance shifts every like 8 to 10 years. Within 8 to 10 years, your limrance will move on to a different person. So what's really scary if you've got lirance is you may actually succeed in stalking them, dating them, they enter into a relationship with you, but then as they become a real person, that fantasy shifts to somebody else. So here's the cool thing I think about Joe Goldberg is that limrance is something that happens to you. It is not who you are. But depending on your personality makeup, if you have lirance happen to someone who is sociopathic, you get Joel Goldberg. He's not just a sociopath. He's not just lirant. And this is what's kind of like fun and exciting about psychiatry is like it's not just one thing. It is like if you develop limrance, if you stick limrance in a sociopath, it looks one way. If you stick limmerance in someone with dependent personality disorder, it looks another way. Right? That's a much more classic picture of someone who feels or avoidant personality disorder or narcissistic personality disorder or limrance in a borderline personality disorder. Joe Goldberg is lirance in a sociopath. So when he has that limrance his personality I don't know if this makes sense he feels attracted to them he has a fantasy about this person that anyone can have anyone can fantasize and have lirance about a particular person but then his personality organization how does he organize around the lirance that's the sociopathy he starts following them around he has no empathy for them right and this is what's really scary like it it's kind of scary like a lot of dudes and women that I've worked with will be deeply in love with someone like, "Oh my god, this person is amazing. " But what they're in love with is the idea of a person. They're in love with a vision of a person, not a real person. And so this is what confuses these people is because they're like, "I do everything right. I'm so kind. I get them flowers. I'm there for them. I'm there to pick up their I have I express a lot of positive affection. I express love. I express patience. I express compassion. I do everything right. I honor them. I worship them. I sacrifice for them. And why don't they love me back? I'm doing everything. All of these stories that we have about love, sacrifice love, this that, right? This is what someone, if you really love someone, this is what you do. You give them a kidney. You pick them up from the airport. You answer the phone at midnight, 10 in the morning.

### [30:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=1800s) Segment 7 (30:00 - 35:00)

Blurred. There we go. This is what you do. I'm doing everything right. Why don't they love me back? What's wrong? I don't know what else I can do. Right. What you're doing wrong is there's no empathy. How does the other person feel? How are they responding to what you're saying? Is there space for another person in your head that is full of fantasy? Does another real human being exist? He has no empathy for them. He has a cognitive empathy. He can predict what they're going to do. He knows how his actions are going to make someone feel, which is why he engineers these scenarios that make people feel a certain way, right? And then they get a flash because they have empathy. So then at some point the scariest thing happens is since they have empathy they see him and when they connect to him it's empty. they begin to realize, "Oh my god, this person doesn't like literally when he looks at me, he doesn't see me, he sees a vision of me, right? " And Joe Goldberg is a great example if you guys see the later seasons, right? So he ends up in a relationship with kids and then his lirance immediately transfers to somebody else. Show has to be written by someone who's either experienced lirance or worked with people who have liance. Really good. But Joe Goldberg is when you have lirance in a sociopath. So then he's willing to do anything for the sake of preserving his fantasy. He has no moral compass at all. He thinks he feels if you ask him, "Do you have a moral compass? " And he's like, "Yes, absolutely. I will do anything for this person. I will kill. I will bury. I will stalk. I will ignore their desire to I will chase them all over the world. " Right? So he feels like he's got a it's like a weird kind of morality. It's like a morality of a pedestal, but it's not like real morality. He's not real empathy. He doesn't actually He's like even when like people are like, "Get the hell away from me. " He's like, "Oh, I don't want to hurt you. " He sort of fantasizes, everything gets twisted by his like obsessional thing, right? So even if he doesn't genuinely understand that somebody wants distance for him, he's willing to make that sacrifice for the person he loves. He's willing to deprive himself of his own joy and passion as a sacrifice for the one that he loves. So this is real narcissistic parent level stuff. Oh yes. Oh my god. It's not that I'm toxic. It's that you're so distorted in your thinking. But as a mother, I have to sacrifice for my baby no matter what. Even when they're wrong. So if you need to cut me off, I will bear that cross. And I won't Oh my god, I'm a victim. But I will bear I will be put on the cross of sacrifice for you. I'm going to be they're telling you, hey, you're violating my boundaries all the time. Please respect my boundaries. And they're like, no, instead of respecting your boundaries, what I'm going to do is twist your boundaries into an astronomic sacrifice on my part so I become the good guy and you become the ignorant, pathetic bad guy. which remember if you guys know this is kind of an older system of diagnosis but there's a system of personality diagnosis that involves something called cluster B and sociopathy and narcissism share certain features so we see that in Joe as well but he's more sociopathic than narcissistic make sense oh wow we've got a raid of 1,916 people bows thanks for the raid welcome everybody body appreciate it. We are doing fictional character diagnosis. Um, and we're going to have a guest on in about 9 minutes. Um, so and it's going to be an expert on OCD. So, if you guys are interested in that, stick around. It's actually a sponsored portion of the stream. Um, so, and we're doing fictional character diagnosis for now. And we just did Joe Goldberg. Um, give me a second. Hello. Oh, no. It's on Bluetooth. Hello. Okay. Does that uh does that work? Are you sure that works? Okay, great. Okay, gotcha. Okay. All right. Bye. So, we're gonna we're going to continue

### [35:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=2100s) Segment 8 (35:00 - 40:00)

doing fictional characters for a little while. Okay. So, for those of you all that have just come, let me show you guys what the options are and then we'll do whatever raiders get to choose. Okay. Fictional character diagnosis. We're So, we've got Naruto, Sasuke, we just did Aaron Jerger. That's moral injury and that was a great one. Uh, Levi Acriman, um, Harry Potter, Seahor Snape, Michael Scott, Dwight Shroo, Creed Bratton, Angela Martin, Batman, Walter White, Skyler White, Jesse Pinkman, Saul Goodman, Joe Goldberg. So, we did Joe. Okay, Raider. So, we're going to prioritize Raiders. Okay. So, um, Hal Wilkerson, Joe's diagnosis. I'll explain to y'all cuz y'all are here. Um, Raiders, Levi. Okay. We're going to do Levi and Saul. Okay. Okay. Let We're going to summarize Joe, though. So, Joe has lirance. Okay. But he So, remember lirance is something that happens to you, but he's a sociopath. So he's a sociopath with lirance which is like the recipe for the worst stalker on the planet, the scariest stalker on the planet. And so this is where you know a lot of times when people talk about fictional character diagnosis they'll be like oh this person has this. We will think of their diagnosis as unidimensional but one of the things that I love about this is some of these characters are written really well and it's not just one diagnosis. This is a really great example of lirance in a sociopath. So he has features of sociopathy. He can kill and dismember people. He can people that he loves. He can keep them in a cage for days on end so that they can be together the way that they're supposed to be. So there's love of a sort, but it's not genuine love. It is lirant. And the other key thing about Joe is that when he finally ends up with the person that he has liance with and doesn't have to butcher them, then his lirance transfers to somebody else, which is a really common feature of lirance. Okay. Um. All right. So, you guys Okay. Saul, Levi, let's do Okay. Oh my god. Uh, okay. We can do Oh, man. I don't know who to do. Okay, just I'm gonna Michael. It looks like people are saying Michael. Okay, we can do Michael Scott. Um, okay. So, Michael Scott's diagnosis is going to be a little bit strange. So, I think he's actually a really good example of someone who is uh developmentally deprived. Okay. So, his core problem so we can look at Michael Scott, right? So, he seeks validation. He's hyper sensitive. Oh, blurred. He's hyper sensitive to the opinions of others. He wants to be everybody's friend. a cool kid. But what's his problem, right? Does he have social anxiety? Not really. Does he have borderline personality disorder? anxious attachment style? Sort of. But his real problem is developmentally stunted. That's Michael's problem. So if we look at Michael, one of the core features of Michael, so he loves relationships. He's all about connecting with someone, being someone's best friend. I love inside jokes. I'd love to be a part of one day. So what happens with Michael is he does not have an actual template for what a relationship looks like. He doesn't know what a friendship really is. healthy relationship is supposed to be. Right? So if you look at Michael, his big thing is he tries to live his life based on the idea of what a life is supposed to be. So if you look at like, you know, he's like, "Oh yeah, I got a flat screen TV and it's like tiny. " And he's like, "Oh yeah, people, humans like flat screen TVs. " Flat screen TV. Good. Let me check that box. Inside joke is something that humans do. Let me have an inside joke. Check that box. And the really interesting thing about that is that, you know, he has this idea of what a relationship is. Relationship is loyalty. Relationship is togetherness. And Dwight is there offering it to him. Let's be best buddies. Let's be together. and he rejects him time and assistant to the regional manager.

### [40:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=2400s) Segment 9 (40:00 - 45:00)

Right? So this is a case this is what happens when kids grow up without the appropriate upbringing. They don't know they don't have a template for what a real friendship looks like. We don't know too much about Michael's upbringing, but it seems to me like he's severely deprived. Probably didn't go to birthday parties. Probably wasn't socialized properly. This is like kind of Romanian orphanage stuff where many years ago there were a bunch of Romanian orphans that got basically like they didn't have sufficient caregivers so that while they were fed and stuff like that, no one could play with them, no one could interact with them and they were just developmentally stunted. He doesn't know how to be friends. He's like an alien trying to be human. That's his biggest thing, right? So if you look at the way that he relates to people, why does he put up with who's that guy? Packer, Jan? Right? These are people who are abusive to him and he craves their attention. So, people will say this is low self-esteem. Sure, low self-esteem is a part of it, but it runs deeper than that. What is the origin of the low self-esteem? self-esteem is that he never had connections to begin with. He doesn't know what a real connection even looks like. So, he has this idea, okay, Jane's got big tits, so I want a relationship with this person. Todd Packer gets laid a lot. is misogynistic. That's a real bro, right? Whereas he has loyalty chasing after him in the in the face of Dwight. But Dwight doesn't fit his image. So he lives his life trying to live up to images of what relationships look like and he chases those things. And that's what becomes so hard for him when he's in this like basically toxic relationship with Jan. It takes a bunch of women to kind of tell him time and time again like, "Hey, this is not normal. This is not healthy, right? " And she like sells his car and starts a candle company and like the dinner party thing, which is one of the scariest episodes on the planet. Really hard to watch. Really shows what he's looking for. He's looking to be something great. respected, looking to be admired. That's why he does Scots tots, right? So, this is a good example of he doesn't know what a relationship even looks like really because when he has the opportunity for them, he kind of messes it up and when he has the relationships he engages with are based on his idea of a relationship. And this is something that's like really challenging because like you know we talk about this some in in the guide to love, sex and relationships where you know we all like one of the biggest problems with like dating and mating and making friends today is that we are all trying to live up to our idea. What do you want? I want 6 feet 6 figures 6 in. I want 32 15 32 or whatever. 36 14 I don't even know what they are. Right? This is what I'm looking for in a woman. She needs to be subservient. this. We don't we have this idea. It's like Michael Scott is a prophet of what the world will become. And now we're there. We have these ideas of what friendship are. relationships are. We don't even know how to form genuine relationships anymore. So instead of what we do is we have criteria instead of connection, right? It's really scary. Like this is just one of the interesting things that when I was doing research for the guide, right, where we explain all of this stuff, like how does an actual relationship form? So staggering blind mind-blowing statistics. And I'm not talking about percentage of people who are virgins. Here's mind-blowing statistic. I'm going to ask you all a question. How many hours of contact does it take to make a friend? What do y'all think? Welcome, chat. Right. So, some of y'all have been maybe paying attention, right? Some people are saying one, two, three, five. So, the average amount of human contact to become friends according to research is 50 to 200 hours of contact. Now, there are absolutely situations where you meet someone at an anime convention and you're like, "Oh my god, brother from another mother, sister from another mister. " We are like instant kindred spirits. And I felt those connections, too. But if you look at the research, this is why everyone's like, "Oh, go to like join a hobby group. " And like I joined a hobby group two months ago. I go once a week for two hours. I still don't have any friends. And it's like, yeah, if you go for two hours once a week, that's eight hours a month. That's 16 hours in two months. You're not even at the minimum. It takes 50 to 200 hours of contact.

### [45:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=2700s) Segment 10 (45:00 - 50:00)

contact. That's the other thing is you don't have to have some sort of interaction. You need to be around each other. So, if you look at like making friends at work, you make a friend at work after you go at the end of the month. You're at work for 40 hours a week. about six weeks into work, you make a friend. That's completely normal, right? We don't make friends like within the first week. Sometimes we do, but sometimes, oh, like, yeah, we've been working together for about three months. That's when we started hanging out. And it turns out that we're like actually really then over the next year, we became BFFs. So, a lot of stuff around dating, relationships, how this stuff forms, it's like we don't know the science behind it. So, like once you understand what really creates relationship formation, that's what we're trying to help people with. And Michael Scott would benefit from the guide for sure, right? Because we would teach him the fundamentals of how do you make friends? What is an inside joke? How do you flirt? Right? Michael doesn't know how to flirt. Like what is the We've got a stream coming up, Science of Flirting. We're going to teach people like how to flirt. He needs to be He's actually the quintessential. He He's the one who needs to watch it. We could have helped Michael a lot, but that's his diagnosis. I think he's developmentally stunted. So, his sense of self-esteem, his he's not like he's like a 40some year old dude, right? But he's not a for he doesn't act like a 40-year-old dude. He's developmentally like 19 or 20 or 21. He's like a freshman in college. That's what M Michael is developmentally psychologically. developmentally stunted is his diagnosis. And the cool thing about Michael Scott is that you can be developmentally stunted in one direction and still be amazing in a different dimension. So, he's been a salesperson for 20 years and he's grinded sales and he's leveled up sales. Sales is a specific skill that he's really good at, right? Which is why he can close deals like nobody else. Has one of the best. How can someone so incompetent have such a successful branch? It's because he's a beast at selling. He knows how to sell. And even what's really interesting in the show is when they show him selling things, he is a different human being. He's not the same Michael Scott. He's like a completely different human being. That is also really common in people who are developmentally stunted. Just because y'all are 30-year-old virgins doesn't mean that you aren't amazing at something else. You can be incredibly competent and proficient at League of Legends, at Minecraft, at Dota 2, and suck at something else. Okay. All right. Who do you all want to do next? Um, Levi. Okay, let's do Levi. Okay, we're going to do Okay, Levi and Saul. Let's see. Um, give me a second. Let me just see how long we have. You guys want to do Levi or Saul? Yeah, there's a guest coming, but I think we're since we haven't gotten through enough, we're going to start a little bit later. Okay, Saul. We can do Saul. It feels like people want to do Saul. Okay. Saul is interesting. Okay. Oh man. So, I haven't seen I maybe on season three or four of Better Call Saul. So, I think Saul is the quintessential survivor. So first thing about Saul is that he grows up in a situation where there's a golden boy and a black sheep, right? So he develops a sense of identity of and this isn't just him. This is his older brother too, right? There's the person who's really good and then there's Saul. There's the high-powered attorney and there's the guy who's this Jimmy who's only good at delivering mail. Right? So Saul, first thing to understand is that from like an IQ perspective and capabilities perspective, Saul is just as good as his brother, right? He's got the gumption, he's got the intelligence, he's actually brilliant

### [50:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=3000s) Segment 11 (50:00 - 55:00)

brilliant, but he's been told that he's not. So Saul is a really good example of what like maybe he's got ADHD. I don't know. But I think like I've seen this a lot with like ADHD, right? Where it's like the scary thing if you have ADHD is you can have normal IQ, you can have high IQ and you can even recognize that you're just as smart as everybody else. But you've got a deficit. You've got in the case of ADHD an attentional deficit. I don't think Saul necessarily has ADHD. His frontal loes developed more slowly. That's act absolutely something that he's got. Right. So, we look at Saul. What happened early is that he he's impulsive. He takes risks. He doesn't think through things. He gets enamored with how things could go instead of really gauging the risk of how things could go. Right? So, he's like he sees the gl glasses not half full. He sees the potential of the glass being completely full when it's only 10% full. He bets on the long odds. So if anything, like he's probably got some combination of frontal lobe developing slowly, right? So he makes poor decisions. He may be almost like a little bit of a gambling addict, right? Where his like risk threshold is really low. Like he'll take big risks and hope that things work out well. And this too can be related to his upbringing because when a child is not given love, support and respect, sometimes what they can do is fall into dreaming. And this is Saul's biggest problem. He has dreams. He has dreams and a poor ability to assess risk. So he's always like he's a big dreamer. I'm gonna be with my brother working at the law firm. I'm gonna go to night school. I'm gonna be the good golden boy. He has an image of the golden boy. And if I work hard and if I do this, I can fulfill my dreams. My dreams is going to be the respect of my brother. I'm going to no longer be the black sheep. I'm going to be a somebody. I don't want to be a nobody anymore. And so when you combine this golden boy, black sheep, right? This creates the idea of a dream. I want to be I don't want to be this. I I'm going to bridge that gap. And then what you do is you take that idea and then you add his like basically gambling addict kind of brain, frontal lobe impaired brain. Ability to assess risk is impaired. Ability to see up upside is also impaired. He only sees the upside. So then he makes a lot of bad decisions, but he's smart. He's adaptive. He's capable. He's scrappy. Another feature of ADHD, people with ADHD thrive in chaos. Right? So I don't think he's got ADHD, but he's got he's like subclinical ADHD, maybe where once things get chaotic, right? Normal human beings are overwhelmed by chaos. But Saul is resilient. He finds a way. He'll slither to where he needs to go. Okay. So, and this is what's really cool about Saul, right? Is he is capable. He's brilliant. And so even though he kind of like create like his story is one of creating these situations for himself and then he squeezes out of them and then he creates them again and he squeezes out of them. Saul is a really good example of someone who doesn't learn from his mistakes. His capacity for this is a really interesting he probably has this deficit too. Counterfactual thinking. There are two features that we're going to talk about counterfactual thinking and something called uh reward error reward processing or reward processing errors. Okay. So our brain has a capability where when we make a mistake it goes back in time and hypothesizes an alternative future. Okay. So, a really good example of this is, you know, when you get a meal from your waiter or waitress and they're like, "Enjoy your meal. " And you say, "You, too. " Or when this I do this. I'm boarding my flight. And the gate agent is, "Have a good flight. " And I say, "You too. " They're not going anywhere. They're not eating anything. So, I make a mistake. And when I make a mistake, my brain tortures me that night. Oh my god, you're so stupid. Why did you say that? they're not going anywhere. That's not bad. That's good. That's how we learn

### [55:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=3300s) Segment 12 (55:00 - 60:00)

not to do it again because we feel stupid about it. Right? So there's this capacity in our brain that when we make a mistake, we thought something was going to happen and it turned out something else was going to happen. So our reward prediction error. We predicted a certain reward, we didn't get that reward. So then our brain is like, wait, hold on a second. We miscalculated. We need to adjust our calculation. And people who struggle with addictions, this part of the brain doesn't work well, which is why like when they lose a bunch of money gambling, like they just wake up the next day and they do it again, right? So he's kind of like this closeted gambling addiction kind of person. So his ability to learn from his mistakes is not great. He learns some things, but he doesn't learn some of the fundamentals, which is like, "Hey, Jimmy, just do things slowly. " If Jimmy learned patience, his life would be so much better. And then we see another thing with Jimmy, which is that he doesn't want to be patient, right? And this is the real scary thing. There is what makes us successful, and there is our vision of success. And Jimmy is attached to his vision of success more than he is to actual success. Right? He wants to do it flashy. impressive. He wants to do it. He has this opportunity to be a partner at a law firm. And they recognize they recognize, oh my god, this guy is brilliant. We're going to make you partner. You brought in this huge case. This is really amazing work. Here it is. Everything that you've wanted, respect, support, money. Here it is on a silver platter. We recognize your ability. And what does Jimmy do? Sabotage uses. And so this is where I'm going to try to explain this. This is really important to understand because this happens all the time. See, we have certain psychological needs. And what happens is we think about solving those psychological needs through external behaviors. So what does Jimmy want? Jimmy wants the respect of his brother. That's what he wants, right? And right now in the manosphere, because we're talking about dating and relationships and sexy, right? This is sexy me. I see this all the time in terms of relationships because we, you know, when I I work with some people and they'll be like, "Okay, you know, I I'm a virgin, therefore I'm a loser. And if I get laid, that means that I'm a winner. I want to be an alpha. I don't want to be a beta. " So, what starts to happen is we have a psychological need. I feel like a loser. And we equate it to an external performance. Okay? So if I get laid that means I am a good person. That means I have value. A man's value is his body count. Right? So we have some of these attitudes. But do you guys see how the basic issue here is that there's the action up here and we are associating that action with a psychological need down here. This is what Jimmy does. And then what happens is even if you get that thing, it doesn't solve the psychological problem. And then you end up sabotaging up here. see this all the time in relationships. You are looking for the relationship. So there's a video that we have about you know what basically what are the real problem what are the not red flags what are the risk factors for an unhealthy relationship and one of the key risk factors is the moment that we use a relationship to satisfy needs that are outside of the relationship. So relationships can be a great form of self-esteem. They like financial support, right? But the moment that we start dating someone because we need them for self-esteem because in order to feel like a successful person, I need another human being. Now there is a pressure on the relationship that transcends the relationship itself. You are bringing something to the equation. And if y'all have been if y'all have dated someone who's done this, you felt the emotional baggage, the pressure. You're like, "Hold on a second. You were wanting me to be all of like you're trying to turn this relationship into some vision of your dreams where like that's not what this is. I'm a human. You're a human. We have something beautiful here, but you can't turn this thing into some dream. " Like, it's not working. Like, you have some fantasy that you're trying to play out. This is what I'm trying to say. You have a fantasy that you're trying to play out in this relationship. And Saul has a fantasy he's trying to play out in this job. And so the really cool thing is we feel

### [1:00:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=3600s) Segment 13 (60:00 - 65:00)

trapped in these situations, right? Because nothing makes me happy. This is where the cool thing, this is the great thing. As a psychiatrist, what do I do? I help people with the psychological needs. We actually solve the psychological needs without the surface level actions. Right? So, I help people develop a sense of self-esteem and confidence without getting them laid. And then the really cool thing is once we solve those psychological needs, then the stuff up here starts to work out because we're not putting that extra pressure. We're not self-sabotaging in terms of behaviors because we feel fulfilled in here. There's a beautiful quote that I I saw today. I was reading a book about trauma in the soul and it's written by this guy named Colched. I don't call Shed. I don't know how to pronounce his name. It's K A L S C H E D. And one of the things that he's a psychoanalyst. he talks about is that relational problems must have relational solutions. Emotional problems must have emotional solutions. If a rightbrain has a problem, right brain has to fix the problem. You can't fix a rightbrain problem with a leftbrain solution. There's no amount of intellectualization that will substitute for feeling loved. Core thing. And so for y'all out there, this is what's so scary about relationships is if you've got a psychological hunger, need, if you have a need for self-esteem, build that thing on your own. Right? And relationships can be a very important part of it. I'm not denying that. That's the one of the most important places that we get self-esteem is from our relationships. But his biggest problem is that he's got psychological hungers that need to be addressed. And then he's got some constellation of poor risk assessment, poor ability for counterfactual thinking. He doesn't really learn from his mistakes. Thrives in chaos. That's Saul Goodman. questions. Okay. Yeah. So, your girlfriend is 10 years older than you. She's making you a better, smarter man. Great. Right. So, I think that our romantic partners are often times amazing sources of self-development. Like I certainly know that my wife made me a better man, right? So, what happened with my wife, like my story is really simple. She had her stuff together and I did not. She started working at the age of 16. Her first job was Pizza Hut. And she wor she has been working since she was 16. She took one year off. Maybe she took a year in college off, but otherwise she had internships and things like that. She was like doing PR for authors and things like that when she was like a sophomore in college. And she took one year off from her job when we had our second kid, but she's worked since she was 16 years old earning paycheck. Like was supporting me financially when I was like 25 years old. like not like paying my bills and stuff, but like when we went somewhere like she would pay most of the time, right? And then like I she like didn't dump me and I was like I wasn't doing anything. I was just failing to get into medical school. That's what I was doing. And I was studying to become a monk and all that kind of stuff. So I was like doing stuff but I was like not a functional adult man. And so then my whole thing was like okay she deserves better. And so I started like working my ass off, you know, and it's like, so she helped me become the man that I am today, for sure. I don't know if she I'd say that she made me the man I am today, but she certainly helped. Really supportive. And the other thing that really blows my mind, I was thinking about this. Um, she never gave me a timeline, which is insane, dude. Can you guys imagine? She was never like, "Hey, look, if you don't figure your stuff out in the next two years, I'm out. " Never, not once was she like, "You have to figure it out, otherwise I'm moving on to something better. " She kind of like went all in really early and it was insane when I think about it. Um, yeah. So, so and I think that that's where like, you know, when I think about some of these things and I think about love and relationships and stuff like that, you know, I made this YouTube video a while ago about

### [1:05:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=3900s) Segment 14 (65:00 - 70:00)

how red flags are actually like not the worst things in relationships. It's so interesting because working with my patients, one of the most interesting observations I've had is how many healthy relationships I've seen that have a red flag like fentinil addiction, right? And so a lot of times like and this is what's really cool about some of these relationships is like we think about relationships as sort of a calculation, right? So if red flag, I'm going to bail. Whereas I think what makes relationships really successful is not the presence or absence of red flags. I think there's a lot of research that supports this, right? And I'm kind of one of these people that like believes in love. And so what we try to do in the guide is we try to show y'all, okay, like how does all this stuff work from a scientific perspective. Not saying that it's 100% guaranteed or things like that, but there's a lot of good science about what makes what creates love in a relationship. Um, we just talked yesterday about, you know, friend zone and stuff like that. And like a lot of people don't realize that a lot of the stuff that you do in a friend zone actually a lot of the ways that people behave in friend zones where they think that they're going to someone is going to develop feelings actually is not biologically how people end up falling in love with you. And TLDDR for that is falling in love is about shared emotional experience. And often times in the friend zone, we don't have a shared emotional experience, right? So your friend who you're in love with is going through a breakup. They're feeling really sad and you're feeling really supportive and deeply in love, but you're not feeling sad for you're not feeling the same sadness they are, right? You guys don't share emotions. You were supportive and they are hurt or you were resentful and they are content. Right? So there's a fundamental emotional mismatch and the people who transition from friend- zone to relationship zone are people who end up creating shared emotional experiences. And the example that I talked about yesterday is husband and wife are married. Let's say wife passes away. Wife's sister and husband are both grieving and they fall in love. Really common. So shared emotional experience is what creates love. you know, when I sort of think about my wife and I like, you know, we had a lot of shared emotional experience. That was a huge part. We still do. Um, and that's what really sustains love. So, anyway, all right. So, we're going to talk about Levi and then we're going to hop in um with Dr. McGrath. Okay. Um, yeah, fentinyl addiction is a red flag. I want to be clear. You are correct. It is a red flag. But I think there are some red flags that are not deal breakers or if I observe healthy, successful, long-term relationships. Many of them had a red flag very early on, including mine. Mine had two. We'll go into what they are. Well, one was me, which I've talked about, which is like this guy is 25 years old, makes no money, is applying to medical school. What? Wears the green that it's a red flag. Has no career. That's a red flag for a 25-year-old, right? No. Okay. Trauma bonding. Yes. That's what helps people fall in love. Okay. Let's talk about Levi. Okay. So, everyone says Levi has OCD because he's very obsessed with cleaning, right? And I think um Levi is a really really good example of clinical thresholds. So Levi will get bent out of sh No, actually he gets upset like there's this, you know, image of him where he's got his sword or whatever his blade and it's like covered in blood and he's like h this is disgusting. And when he um you know has this house he or this fortress or whatever, right? Like so he has all of his uh pupils like basically obsessively clean it. So he's obsessively clean. Okay. Does Levi have OCD? And we'll ask Dr. McGrath if he's familiar with Levi. But you know my take is that sometimes we forget that a diagnosis involves impairment of function. So everyone has some degree of anxiety.

### [1:10:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=4200s) Segment 15 (70:00 - 75:00)

That doesn't make it an anxiety disorder. Everyone has fluctuations in mood. That doesn't make us bipolar. So the first question that we have to ask ourselves if Levi has OCD. So is he clean? Yes. Is he obsessively clean? Yes. Can he put himself in dirty situations? Also yes. Does he regularly being in dirty situations impair his functions? Absolutely not. He is grossed out by Titan blood on his sword hilt, but he will chop Titans right, left, and center all day. Right? So, I think he's a really good example of sort of like subclinical OCD tendencies. Is he somewhat of a germaphobe? We don't actually know. So, so this is where I think there are like other features of OCD, right? Is he willing to share food with someone? Like maybe. It's not super clear that like, you know, he's clean and he's obsessively clean, but he doesn't seem to have an impaired function, right? So, he can get dirty without a problem. Whereas some of the people, you know, I once worked with a patient with OCD or not worked with a patient, but I was learning about OCD from an OCD expert in residency and they were telling me about a patient that they had worked with where like this person was so scared of insects that they started to like dig a moat around their bed. And then they filled the moat with like toxic stuff so that insects could not physically crawl across. So Levi, I think, is a really good example of someone that when people say he's OCD. I don't think he is. I mean, is he obsessively clean? Sure. But I don't get the sense of compulsions. Right. So, this is where a lot of people don't realize that a compulsion is some kind of ritual you either do in your head or in the outside world that alleviates the thinking in his head. I don't think we see that with Levi. So, I don't know if he meets criteria for OCD. What we're going to do is hop in with Dr. McGrath and we'll see we'll learn a little bit about OCD from him. Um, so let me just hop into this call. Um, can you guys hear me? Oh, hey. Hey, Dr. McGrath. How are you? Uh, I'm going to just switch our overlay so that people can see you. I think they can already hear you, though, so give me just a second. Um, oh yeah, I that's let me just see what Um, okay. So, give me just one second. Um, we're going to just fix this overlay real quick. Give me a second. And then I will, you know, say hello to you. Um, okay. Let's do Um, there we go. Okay, I think we have you now. And then I'm going to just make sure I can hear you, but can you just count to 10 for me? 10. — Okay, me again. — One, two. — Okay, perfect. — Okay, I think so. We we've got you. So, um, welcome Dr. McGrath. So, Dr. McGrath is here from OCD. This is a sponsored section of our stream. I just want to tell y'all a little bit about, um, our experience with NOCD and then I'd love to hear Dr. McGrath talk a little bit about it. So, you know, we don't take sponsors often, y'all. Um, but, you know, we'll sometimes get approached by people and NOCD was actually reviewed by our scientific advisory board, which is full of psychiatrists, therapists, um, academic people from we've got awesome people on our scientific advisory board and they were uh, very impressed with OCD. So part of the reason that NOCD um we accepted the sponsorship is because we really do believe that NOCD is offering specifically OCD treatment and that there is um the number of clinicians who are well trained in specifically OCD

### [1:15:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=4500s) Segment 16 (75:00 - 80:00)

treatment is pretty small and so NOCD seems to really be filling that gap. Um and we're happy to have sponsors on the stream that I think fulfill our mission of like making mental health better on the planet. Um so thank you very much Dr. McGrath for being here. I know we've got like a set of questions but can you just tell us a little bit about yourself and NOCD? — Sure. I'm a clinical psychologist. This is year 26 for me of treating obsessivempulsive disorder with exposure and response prevention therapy. I've done it in various settings from hospitals, intensive outpatient, partial hospital, residential treatment centers, and I came over to NOCD six years ago to help jumpstart their taotherapy network because of exactly what you said. There is a problem out there, which isn't that there aren't enough therapists, it's therapists with specialized treatment for certain conditions and obsessivecompulsive disorder being one of them. So that's really what we do at NOCD is we offer a specialized care called exposure and response prevention therapy for people with OCD and related conditions because you see other things come with OCD like anxiety, depression. You'll see body focused repetitive behaviors like trickotillamania which is hair pulling or skin picking even ticks and hoarding too. — Okay, thank you so much. Um so I know we just did this like fictional character diagnosis thing. I know you have some thoughts about how OCD is portrayed in the media. Um, can you tell us a little bit about that? — It is more than washing your hands. I would like to say first of all that is that is not the only way that OCD comes about. And it also isn't just straightening things. But I think in almost any movie where there's a suspenseful character who's about to go kill a bunch of people, they walk past something and it looks a little out of line and they pause and they put it back where it needs to be. Right. And you see that a lot and I think that it's trying to say that OCD is related to some of these things. So I'm happy to talk about what it really is for sure. — Yeah. I just wanted to double check. So we're getting a little bit of um microphone issues. Do you know if you're on the right microphone? — Uh yeah, I was on this fine test yesterday. — Yeah, this sounds fine now. It just seems to be like kind of coming in and out, but um so no problem. Um I just want to make sure that people can hear your awesome answers. — So you know, you were saying that there's, you know, people talk about washing hands. So what does OCD look like? The way that OCD comes about is it attacks something that's really important to you. So if let's say you love children, it could say, well maybe that's because you want to molest children and that's something we call pedophilic OCD. Maybe you are a very religious person and OCD will say and maybe that prayer you just said wasn't quite right and therefore you're probably going to an afterlife that you don't want because you just goofed it up. Right? OCD always attacks important things. Maybe that was a speed bump, but it might have been someone walking and maybe you just ran somebody over. It might be best if you drive around the block and look for the dead body to see if you just killed somebody. Right. These are the types of ways OCD very commonly attacks people. — Um, I'm going to just double check with chat because I'm still getting a little bit of mic problems. Can y'all — Okay. — Hear okay. Or are we getting I hear him fine. Okay, great. Chat audio is good. Okay. So then it's just my headphones. So we're perfect. Okay. — Okay. — Um so it and so you said that OCD specifically seems to focus on things that people care about. — Absolutely. You wouldn't have OCD about something that didn't bother you. That just wouldn't happen. — Yeah. So, I you know, I've had a lot of um I' I've had some experience with some pretty severe OCD, and I think one of the things that I've seen with my patients is that they're very perplexed and they make almost like moral judgments about themselves based on the thoughts that they have. — Um so, I had a patient who had very inappropriate sexual thoughts. Uh and so he was really plagued by like why not just why this is happening to him, but he almost seemed to be making or theorizing conclusions about himself. He's like, "What is wrong with me that I'm like thinking these kinds of things? " — Sure. Who hasn't had an intrusive thought or image or urge at some point in our lives? And when you don't have OCD, you're very good at going, "Well, that was weird. " and letting it go. When you do have OCD, you're very good at reading into it, wondering why you had it, what it meant about you. Maybe

### [1:20:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=4800s) Segment 17 (80:00 - 85:00)

you're a terrible person. You better do something to undo it. If you don't, and that thing happens, then you're a terrible, awful person because you could have done something and chose not to do it. So, wouldn't it be best just to try to neutralize these things? And the more that we try to do neutralizations through safety behaviors like compulsions, the worse people start to feel because you get stuck in this just loop where you're chasing a dog chasing its tail. Right. You can never do enough compulsions to satisfy OCD and OCD will always raise the bar to get you to do more compulsions. — Yeah. So, can you explain to us um how does why do people do compulsions? Right. So I get that if you start doing compulsions the obsessions actually increase and then you're kind of stuck like washing your hands a second time, third time, fourth, fourth time, right? But can you tell us a little bit about how a compulsion helps? — Right. So the idea is that it reduces the obsessional stuff, right? But how does that work — in the moment? It's a behavior or a mental act that we do to try to bring about some relief from whatever that obsession was. It might only last for a millisecond or two and then we feel the terribleness again. So then we do it again. But the whole purpose of the compulsion is to try to neutralize whatever that obsession might have been and allow a person to feel as if okay I purposely did something to try to make sure that thing didn't happen because if I didn't do it and that thing did happen how terrible would I have been that I didn't take a moment to try to undo that thing. — Yeah. So h how I mean do you have a sense of how that works? How do people kind of get into that cycle? like what's the mechanism of you know almost like the magical thinking of like unless I pray this way the plane is going to crash. — It could be so many things right there are people who uh I can give you one example of someone I know personally was in New York a couple of days before 911 and thought wow imagine if a plane hit one of these buildings. That was just a random thought that they had, right? And then a few days later, boom, it happens. And now, you know what they wondered? Did I manifest that? Did I bring that about? Was that my fault that thing happened? Right? So, you can have coincidences like that. And when you have it, you think, huh, maybe I have powers or magical think. You know, my thoughts are magical, right? They can do things. We call that thought action fusion. thinking something is as bad as doing something or can influence the occurrence of something. And because of that and the powerful thoughts that I have, maybe I better make sure that they don't have that power and so I'll do something to take the power away. And there's the compulsion — and are there particular uh things that you find that people don't So I'm sort of thinking about the subjective experience of OCD and some of the patients that I've had with OCD will be like they'll describe it as anxiety, right? They're because the subjective experience will be like they're worried that this thing is going to happen. — How does um what are some of the common signs that someone has OCD that often times patients aren't aware of? Well, they'll spend so much time in their head trying to think their way out of something. So, uh, and this is important to talk about because most people don't realize compulsions can be mental because TV often portrays them as washing your hands or locking the door. People only think in terms of physical compulsions, but there are people who are just stuck in their head for hours trying to figure something out. I for once went out of the office late at night and someone I had seen that morning was sitting in their car still and I thought that was very strange and I went over and it turned out they were reviewing our session for the last 6 hours and they were wondering had they said this then I would have said that or had they told me enough about it because maybe now I'm treating them for something that's not quite right. Right? So, you can spend hours just trying to figure something out. But, of course, because OCD's nickname is the doubting disorder, you're never going to get it to a point that it won't doubt it because the nature of OCD is to doubt it. So, you'll see people stuck in their head. You'll see people who will be doing things that look to you like it it's ridiculous. Uh there are people that I've been in a parking lot with uh back when I was doing more live work who are laying on the ground looking under their car and they're trying to find the dead body and they want me to get down on my knees and look under the car too. And there's no dead body under the car, but they'll spend an hour or two just trying to make sure because they don't even trust their own senses well enough to believe that there isn't something there. OCD is really driven by two words and those two words are what if followed by the worst case scenario you can possibly feel. So I consider OCD to be

### [1:25:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=5100s) Segment 18 (85:00 - 90:00)

a whatif disorder. — And one other thing on what you said, the DSM kind of got it wrong on OCD because it talks about anxiety or discomfort, but it's also driven by shame, disgust, guilt. Any emotion that is so uncomfortable OCD will use in order to drive you to do a compulsion. So, so I mean you're using a really interesting language. You're saying OCD will use. So, you're almost like personifying it, right? As if it's its own entity. Can you say a little bit more about that? — Yeah. I mean, it's outside of the logic that you and I use. When you and I are having a conversation, we're using a certain level of logic. OCD uses a different logic which always has one more yeah, but what if than we can give an answer to. So, we can't have a conversation with OCD where we'll come to a conclusion because OCD will always want more. So, I talk about it like that, that it's this other thing that says, "No matter what you give me, it's not enough. No matter what you tell me, it's not good enough. I still need more. " It's like filling a bucket without a bottom. You'll never get it to the top. — Wow. Kind of reminds me, I you know, I have two kids and they've recently gotten into this why thing. I don't know if you've seen that before, but you know where they ask you a question, you give them an answer, and they're like, "Why? Why? Why? " — And so, how does someone know? I'm trying to really gra w wrap my head around this, right? So, it makes perfect sense that there's always an additional what if, which is why you will spend hours — thinking about something and no amount of thinking will ever do the trick. How does someone know which whether OCD is in the driver's seat of their mind or they are mind? — That's a question that people with OCD want to know, but it's not actually the most important question because I will never give you an answer that will satisfy that question. — Yeah, it it's so self-referential. It It's like kind of reminds me of an MC Asher painting where there's no answer. So, how do you address that with patience? — We talk about teaching people to learn to live with doubt and uncertainty, which frankly all of us do in our life. You know, uh I have no guarantee when I go down the stairs after this interview that I won't fall down the stairs. I will make it to the bottom. It might not be in the most painless way. It's a possibility that something could happen. So, I accept that doubt and uncertainty. And OCD says, "Yeah, that's fine because OCD isn't concerned about that. So, we're just going to help you learn to live with the question. " So, one thing I've said recently to everybody is, "My job is to help you live with questions, not to give you answers. " — Interesting. And so, I imagine people are quite reluctant to engage with that solution, right? Because it feels somewhat unsatisfying. Yeah. — And how do you navigate that with people? Well, we talk about all of the things that OCD has done to their life so far and how much time they've spent searching for answers and how they've never actually achieved it. And the idea is maybe the search for answers and the lack of achieving it is a sign that there isn't an answer to give you, but there is another way out of it. So, you can choose to fight OCD two ways. You can go up against it and lose every time or you can choose just to say, "Yeah, okay, whatever. " and move on and live your life. And that's what we want people to do is learn how to do that. It's not that you won't have an obsession ever again in your life. Just like if you have an addiction, you've been treated. It's not that you won't ever have urges or cravings in your life. You'll just learn to live with them and to live your life even though they're there. — And so what does treatment look like? So it sounds like you do exposure response prevention or — Yeah. So, it's two parts. Purposely exposing people to their obsessions, which is the exposure. And the response prevention is teaching people how to not engage in what OCD wants you to do and all the safety behaviors and compulsions that it wants you to do. And that's the difficult part. But that's the curative part, right? You can expose people all day to things, but that's not curative. OCD is constantly exposing you to obsessions. If that cured people, they wouldn't need therapy, right? they were just always being exposed. You have to teach people that once the obsession occurs, you have a choice. And the choice is do the safety behavior or compulsion or do the response prevention. And we want to take you down the road of response prevention so that you learn how to live life with OCD instead of trying to satisfy OCD. And can you share with us like what does what is the subjective experience of successful treatment look like? Right? How does what and you may not be able to say because you can't see

### [1:30:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=5400s) Segment 19 (90:00 - 95:00)

into your patients minds, but I'm wondering if you have kind of an idea of, you know, what is being in their head look like after they after treatment starts working. Sometimes they're shocked because they're amazed to learn that not everybody is thinking 247 about all of these things that blows their mind that people aren't always trying to figure something out or answer a question and go down these rabbit holes. So sometimes the quiet is actually really weird for people when they stop engaging in what OCD wants and they start to recognize unfortunately it can be kind of sad how much they've lost of their lives trying to satisfy the unsatisfiable. So, it's not uncommon to also see some depression with OCD. Be why if you think about what's the definition of depression? One, I feel depressed. Or two, I've lost interest or pleasure in things I once enjoyed. If OCD attacks things that are important to you, it attacks the things you love and enjoy. Well, what if you stop doing those things now because of OCD? Now, you're going to feel pretty down because you don't have those things in your life anymore because OCD's attacked them. So, we're often also helping people deal with the depression that can come with this and help them start to do behavioral activation. Go back outside, live your life, do things that you used to do that you haven't been doing anymore because now hopefully the influence of OCD on those things is decreased significantly. — Yeah. So, I mean, I'm really appreciating I see this a lot. Uh I have I mean, I've treated a fair amount of OCD. Um but you know I think patient population wise I'd say less than 5% of my patients have had OCD and um or at least that have been a major part of my active treatment. So one of the things that I it's really interesting to hear because I see this a lot with like ADHD where you know it comes with a comorbid depression. It's like the illness itself, the con there's the illness itself and then there's the consequences of the illness on your life which are almost a separate thing that has to be addressed. — Yes, for sure. And there's also with that sometimes a frustration with the entire mental health system. You know, we have people come in and say, "Well, I was on Zoom and I was told I couldn't have OCD because my house is messy. " — Well, you can have OCD and have a messy house. So unfortunately, many people are often misled into thinking it's something else that's going on or they're misdiagnosed and they're giving more of a talk therapy treatment which OCD eats for breakfast. I mean, it's just like, oh, can we talk about this more? Yeah, that would be amazing. Let's do more talking about this. OCD would love to talk about OCD. It's its favorite topic is So, we're also trying to get the trust of people and it's why we spend so much time in our sessions at NOCD trying to just build rapport with people because uh we know that there have been people that have been misdiagnosed. I mean, our CEO Steven Smith went through five therapists misdiagnosing him before he met a therapist who did ERP. He spent thousands of dollars and hundreds of hours of time doing things like uh snapping a rubber band on his wrist every time he had a thought that he didn't want to have. Or he moved away from his family because one therapist said, "Your family's such a trigger for you, you should just not be at home with your family. " So, he moved a thousand miles away from them. Or people said, "Well, when you have a thought you don't like, replace it with one that you do. " Well, that's a compulsion, actually. So, — wow. — So, yeah. I mean, that that's scary. I mean, because I'm hearing that, you know, a lot of the things, and I've seen this before. I don't know if you're familiar with misophonia. Um — Oh, yeah. — But you know, I had a patient who had misophonia where it seems like half of what we were dealing with was the trauma of misophonia treatment, right? Someone tried an almost like ERP kind of approach with her and it seemed like it just hurt her way more than it helped. What's your sense of why so many therapists do get the diagnosis wrong? — Well, it takes a lot of training for OCD because again, a lot of people just think of it as what they see on television. The other thing that I think is really disturbing is there are several I won't disparage anything, but there are several publications out there where therapists can list themselves. How many of them have you seen have checked off that they specialize in 30 different things? — Yeah. Yeah, there's mood disorders, eating disorders, sexual dysfunctions, you know, fictitious disorders, schizophrenia, personality disorders. Can you actually specialize in all those things? No, I don't think so. So, people go to their insurance or they look up a therapist. The therapist has clicked off everything and so they go to someone because it says you know how to treat OCD and that person is likely doing a general talk therapy for OCD

### [1:35:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=5700s) Segment 20 (95:00 - 100:00)

which does not help OCD. — Interesting. So, I'm kind of curious. So I know that there are like psychonamic or psychoanalytic perspectives on OCD. Do you have any thoughts about those? like I'm not so familiar with what you know what it is but I know there you know there's — psychonamic — there are haven't seen them uh better than weight list controls uh in terms of outcomes that they've had because again they can spend a lot of time talking about OCD or trying to figure out where OCD came from. Well, if you're OCD, he's like, "Yes, let's figure out where we came from. " And oh, but I doubt if that was really where it came from. Could we do this some more just to see if there's another place where it came from? Right. — Yeah. — That's a problem. — So, so that that's a bit scary because it almost sounds like, you know, people with OCD are happy to indulge in thinking about it, talking about it, and maybe a psychoanalyst will also be happy to indulge that. — Correct. Um, and so that that's just curious because, you know, it seems like you're very like ERP focused. So I was curious about that perspective. — Um, and one of the things that we're focusing on this month is actually relationships. So, one of the things that I' I've kind of learned the hard way as a psychiatrist is — um there is so much work that I can try to do with a patient that is basically almost trying to substitute for you know we call it like a corrective emotional experience and there's transference dynamics and things like that but like so many of my patients as I started to help them just get into relationship ships. I noticed that there was just a such a profound impact on their mental health. Um, and I understand that OCD can show up in relationships in a very specific and profound way. Can you tell us a little bit about that? — Sure. I if OCD is, as we talk about it being doubt and uncertainty and being in a relationship is a very important thing to you, OCD is going to say, "Is this the right relationship? How do you know for sure? Is this really a soulmate for you? Could there be somebody that's better? Uh, oh, they laughed at your joke last week a little bit more than they did this week. Maybe they're mad at you. Why don't we spend several hours discussing that? It seems the neighbors hold hands more than we do. Do they love each other more than we love each other? Hm. Let's also talk about that, right? OCD will find anything to compare your relationship against and you'll lose. And so then you can even see in relationships testing. Well, I'm going to test my partner to see how they react to this. And then the partner could get frustrated. It's like, "Oh, no. Now they're frustrated at me. Oh, you know, and now OCD will grab on. Oh, now they're mad at you. There's this might not be the right thing for you. They that shouldn't be happening. " So, if you can throw doubt into a relationship, that's what OCD will do. And people will come in and they'll want to know that this is 100% the right relationship and the best relationship. And of course, nobody can give you that guarantee that the relationship you're in is the right or the best one. — Yeah. So, how do you tell the difference between, you know, an cuz like you said, everybody has doubts, right? And some of the things that you said are really scary because I see that a lot in social media, like people are testing their partners all the time. Um, people are also making comparisons all the time. I think social media has really amplified the comparisons that we make. So, what I'm kind of trying to tease apart is where do you draw like how do you know whether you're someone who's got OCD that has not been diagnosed or whether you're just someone who's indoctrinated by social media. — Yeah. Very often the people who might be indoctrinated by social media could get an answer to something or feel some level of satisfaction with an answer. But I don't see that in OCD that level of satisfaction rises to the challenge where now I don't have to go down that road anymore. Right? And so that's one of the ways that I will take a look at it. The other will be that you know maybe something can pass. Right? OCD although doesn't really let things pass. OCD likes to hold on to things for a very long time. You know, I've treated people who didn't even get into relationships out of a fear that they might do something that would ruin a relationship. And somebody I treated, it was in their 90s before they had their first date actually out of a fear around how they would approach relationships. Uh so I mean I was thrilled someone in their 90s finally having a date. I was like this is the most amazing thing ever. — It's never too late. It's never too

### [1:40:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=6000s) Segment 21 (100:00 - 105:00)

— It's never too late. But to OCD, uh, it's never the right time either. There's always maybe tomorrow, maybe tomorrow will be better than today. — Yeah. I think some of the stuff that you're sharing, the way that you're putting like words to this, I think is incredibly helpful. Um, so things are not maybe tomorrow, right? So that then that gets me thinking a little bit about like procrastination. — Oh yeah, sure. So, so can you say can you tell us a little bit about how OCD and procrastination intersect? — Procrastination can be a big safety behavior, especially for people who are perfectionistic. If I get something done early, I'm going to go back over it and I'm going to keep evaluating it and wonder if it's right or I could wait till the very last minute and do it and then have to turn it in because if I don't, I'm going to fail it. So procrastination can be a safety behavior that people use to avoid having to review and review things. — Yeah. So can you um and you mentioned perfectionism. Does that connect with OCD in some way? — 100%. There's a one theme of OCD is called the just right theme of OCD. So that can also go with relationships, right? Is this the perfect relationship? Is this the just right relationship for me? How do I know for sure if it is or isn't? And since we can't know something like that, uh, OCD says, "Well, we need to keep finding it. " There there's this notion that I see with my patients, my we call members at OCD, with the members that I work with where even though they wouldn't expect anybody else to get the answer and they wouldn't give the advice to any of their friends who had a similar problem to do what they're doing, there's something in them that says, "But I need to know. " Right? So people often live with two different sets of rules. It's fine not to know about all these things, but in this area I have to know. And that sets you up for failure very often. And so if you have to know if your relationship is the perfect relationship, but you're never going to get an answer to that, it's very hard then to be in the relationship because and I don't mean this in a negative way, but people with OCD will use their partners for reassurance. I want you to confirm for me that this is the right relationship. I can't trust my own judgment of this relationship. You're my external conscience. You need to prove to me that we're in the right space. And thank you for that. Oh, and now that just wore off. Now let's do it again because now I'm feeling like it might not be the right thing again. And couples get in a real rut in this kind of situation where they feel like they're without knowing it serving the OCD instead of serving each other as partners. — And what does that rut look like? Like how would someone know, you know, I'm just trying to imagine someone's listening to this and they're trying to figure out, okay, like how do I know if I fit this criteria? — Yeah. Uh I can give it as a homework that I give. One of the homeworks I give to couples is I'll say to the partner, I want you to get a notebook and put it on the dining room table. And if they ask you a question they've asked already, I want you to write the question down and then down the answer. And if they ever ask you the question again, I want you to say that's in the notebook, right? Because these are the kinds of things that happen. I hear couples constantly report to me, we have the same conversations over and over and they go a little bit longer every time because reassurance is kind of like a drug. You build up a tolerance to it. So today I'm going to need a little bit more than I got yesterday. And I still have a lingering doubt about the conversation yesterday. Even though it went on for hours, I'd like to revisit it, but today we're going to have to take it one notch up from where we did yesterday. — Interesting. So that you know I I'm thinking about a patient of mine that I'd love to get your thoughts on. So this was a patient that basically was engaged and she — um learned that her fiance was basically living a lie. um and so fabricated a career um would pretend to leave the house or would leave the house every day but would actually go to his um his parents' place and I'm changing this is somewhat of a chimeal patient presentation but would go to his parents' place um from his fictitious job parents would deposit money into their account. So like he was really maintaining, you know, this illusion. And then um one day, basically what happened is she got lucky. She stopped by her prospective in-laws place and saw him playing video games on the couch. And she was like, "Oh, like what what's h you know, what are you doing here? I thought you were supposed to be at work. " So things kind of unraveled. And so then she almost had, you know, a I would kind of call it. So my understanding of her was like a traumabased anxiety where she

### [1:45:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=6300s) Segment 22 (105:00 - 110:00)

was sort of paranoid about this in her future relationships. She would demand a very high level of transparency and you know location tracking and things like that from her future partners. Um, — sure. — Thinking about it now, you know, I had assessed her during the intake for like OCD, but didn't really see anything like that. — And then also, you know, quickly discovered that the things that she would do for reassurance were only amplifying the problem. And so she ended up getting engaged a couple of years later and the fears started to creep in. She started to um invade her partner's privacy. uh would like be checking his cell phone um without his knowledge and then you know so he's kind of figured that out and that that's why she presented for treatment. — Um a and so we were able to work through that. I kind of had conceptualized it as a traumabased anxiety kind of thing. — Um also worked in I'm not sure how familiar you are with like transdiagnostic factors. Yay nay — a little bit. — Yeah. So, so there's actually a transdiagnostic factor called intolerance to uncertainty. — And the idea behind some of these transdiagnostic factors is that they're kind of — um they're not quite uh as phenomenological. They're almost like more biological. They're like the way that our brain tolerates uncertainty or doesn't tolerate uncertainty. And intolerance to uncertainty is with these various transdiagnostic factors. As your score on these transdiagnostic factors increases, your risk for a diagnosis that could be OCD, could be anxiety also increases. If that kind of makes sense — and I haven't seen this with OCD, but perfectionism is another transdiagnostic factor. — Okay? And studies will show that if you do like CBT around perfectionism, you will see a comparable reduction in anxiety symptoms, if that kind of makes sense. — Absolutely. Um, and so I had sort of conceptualized her that way and we worked heavily on intolerance to uncertainty, but I'm kind of curious about, you know, so I had conceptualized it as traumatic experience followed by anxiety followed by repetitive behaviors that reduced her anxiety. Um, and so as we worked on intolerance to uncertainty, that seemed to work well and she got clinically way better. But I'm kind of curious about, you know, your take on this. Do you think this was like basically OCD that was missed or h how do you tease apart trauma induced paranoia versus something like OCD? — Yeah. And it's interesting you say that because OCD is kind of a glamon disorder. So if somebody's had a traumatic experience, OCD again to personify it a little bit, but OCD will say, "Hey, I can prevent that from happening again with these compulsions. Just so you know, I'll keep you safe forever. " So do these things and then you'll never have to worry about that thing happening again. So in the end uh was it OCD? Maybe was it also a lot of reassurance seeking? Because I talk about five safety behaviors. So I like your trans diagnostic and I talk about five safety behaviors. So there's avoidance, there's reassurance seeking, which I think a lot of that checking was for sure to satisfy her doubt and uncertainties about if this was person was lying to her like the previous one. There's distraction where and you know we all have a phone and within a foot of us, right? There's the greatest distractor ever created in the history of the world. There's substance use — and then there's compulsions. So, I always look at anybody from a series of what safety behaviors are being employed in this situation. And my go-to for anybody who's employing safety behaviors is going to be exposure and response prevention. So, I think of ERP as transdiagnostic also because I use it for all anxiety disorders and trauma. You we can do prolonged exposure for trauma. We can do an interosceptive exposure for panic, which is things like running in place, hyperventilating, breathing through straws, creating symptoms of panic one at a time to teach people that they can handle those symptoms without jumping into a panic attack. So to me, ERP is really transdiagnostic. So that presentation that you said, I may not be as concerned on what the actual diagnosis is as making sure we do the absolutely right therapy. And to me, that would be ERP. Yeah, that's very similar to what we ended up doing, you know, which is notice that, you know, you have and we got to a point where it was even she was able to vocalize her anxiety and her fiance would, you know, they she would share it with him. She's like, "Hey, I'm like feeling distrustful. " And he's like, "Do you need to look at my phone? " And then she would tolerate that. — And and so, you know, sometimes she

### [1:50:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=6600s) Segment 23 (110:00 - 115:00)

would say, "Yes, I do. " And then we'd kind of work on that. — Um — Mhm. So, so that's interesting. Can you So, I'm curious. I mean, you mentioned that, you know, we have cell phones, which are like the ultimate distraction tool. Can So, have you noticed — a correlation between cell phone access or technology access and worsening symptoms or increased prevalence of OCD? — I've seen it. I can't give you a research study on it yet, but I can definitely anecdotally see that when you have at your fingertips the ability to answer your health anxiety questions and look things up constantly or you can now go to chat gtp and said, "Hey, I do you think this could have been this? " And it can give you an answer. What OCD loves an immediate answer, right? And so absolutely people want to diagnose themselves. I'm sure you've seen this too. I mean, how many people come into an office now and say, "I think I have this because I looked it up on WebMD or ChatGpt and it told me that I did. " When I do lectures in other countries, they say, "You Americans are kind of nuts with your drug uh ads on television because they don't have them. " But they're like, you know, they've heard that people come into doctor's office and say, "I want this drug because I have this thing because this commercial told me that I have it. " And they don't have that in their country. It doesn't exist. Right? So, uh, these immediate gratifiers that we have available to us, I think can definitely do good, but they can definitely do not so good, too. And when you're anxious and you're using these, I've seen them do more not good than good. Yeah, that's kind of scary because I mean, you know, you mentioned chat GPT and I'm just the way that you framed OCD as, you know, almost a personified thing that then I can totally see people spending a lot of time with their chatbot getting reassurance over and over again because in relationships, I think the challenge is that your partner eventually will become exhausted with your need for reassurance. And what's kind of scary listening to you is there are so many terms or situations where people will like not necessarily clinically diagnose, but they'll say, "Okay, my partner has really low self-esteem, — right? — And so that's why they need so much reassurance. They lack self-confidence. reassurance. " What's actually really scary listening to your examples is how many of those things could be OCD. — Um — they could. Yeah. — And — absolutely. And so it's just interesting. I I'm kind of curious about I have sort of two directions that I'd love to hear more about. One is it seems like you've got a couple of frameworks. So like this is the classification of five safety behaviors. Do you have other frameworks that you utilize on a regular basis that you could kind of share with us to give us some insight into either diagnostics or you know coping mechanisms, maladaptive coping mechanisms? Just what other frameworks do you have? Ah, I love stories. Okay, — I love to tell stories or use analogies. So, I will describe OCD to people in ways that hopefully they understand it. So, one way is OCD is Lucy holding the football and you're Charlie Brown hoping this will be the time that you kick it. — And I saw an amazing interview with Charles Schultz one time where he said, "People ask me all the time if Charlie Brown will kick the football. " And the answer is no. Because it is in the nature of Lucy to always pick the football up every time Charlie Brown goes to kick it. And it is in the nature of OCD to doubt whatever you give it, no matter what you give it. So you could be Charlie Brown hoping this will be the time that you give it the thing that you need to do to kick the football. You ain't kicking the football, right? And it just isn't going to happen. So, I love stories and I like how you even look at some characters because I like to look at characters like that too and use that to show people your attempt to satisfy OCD is like Charlie Brown trying to kick the football. — Wow. Okay. Yeah. I love that imagery. Um I'm kind of other frameworks or stories that you want to share. — Yeah. I think that the other thing is there's a lot of therapists out there who teach coping strategies right away to somebody in a session when they're anxious. They teach diaphragmatic breathing and muscle relaxation. And when I do lectures to therapists, I say the most common question that I get is what if my patient has a panic attack during a session? That seems to be the number one fear that therapists have that a patient will have a panic attack in a session. And so they do these things like diaphragmatic and muscle relation. I believe not only for the therapist's benefit, but for their own benefit because they're scared to have somebody be scared in their session. I don't teach diaphragmatic breathing or muscle relaxation. We don't do 5 4 3 2 1. We live in the anxiety and the doubt and the uncertainty. We allow it to be there and we let people learn. You can

### [1:55:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=6900s) Segment 24 (115:00 - 120:00)

handle it. — So, another story I'll tell is how much diaphragmatic breathing, muscle relaxation, and closed eye visualization did you do when you learned how to drive? None. — Probably none. Right. What did you do instead? You created a hierarchy. You started with getting in the driver's seat and turning the car on and then you put your foot on the brake and then you shifted it into gear and then you slowly left your foot off the brake. Well, if you could do all that without any safety behaviors whatsoever, maybe a parent saying you're doing well or something just to give you some kudos or but it's not that you needed that. If you can do driving like that, you can approach anything you're afraid of in a very similar manner and not have to do all these other things in order to be able to do them. So, this is one of the hardest things for therapists and you know, this is my framework now for therapists. One of the hardest things for therapists is to give up teaching safety behaviors out of their own fear of being with somebody who feels anxious. Yeah, that that's I I think um that's something I've experienced front and center and have worked through in supervision, which is, you know, how much of my anxiety am I managing through therapeutic interventions, right? Whether it's increasing medication dosage or things like that, especially when I have patients who have chronically elevated risk of things like overdose and stuff like that, like managing your own anxiety becomes a real challenge. Um, yeah. So, I kind of have sort of two other questions or two other directions. So, I I'm still sort of struck by this — personification of OCD. I I really like the framing and I I'm almost like waxing a little bit philosophical. — Uh, so can you tell me like what is OCD? Because you make it out to be an entity. — Yeah. I to me OCD is the unanswerable question that you keep trying to answer. So I think that's just one very simple way to describe it and there's a drive in you to try to answer it even though logically you know that you're not going to get the answer but emotionally you feel so compelled to do so that you do it. So, uh, one thing that I'll say to people, and this is very crude, and I know you're on the psychiatry side, so forgive my crudess here, but I'll talk about, uh, when you talk to OCD, it's I'll go back to Charlie Brown. It's like Charlie Brown's teacher talking to you. It's just blah blah blah blah, right? It OCD loves to hear it, but it gives it nothing really. It still wants more. Um, if you think about a talk therapy response to OCD, where does talk therapy occur? In the cortex, right, in that part of the brain where there's language and everything, where does OCD occur though? More in the midbrain, that emotion center of the brain. And guess what? The midbrain doesn't have a language center, which means the midbrain hears blah blah blah blah. And why do we do an exposure and response prevention therapy? Because it targets the emotions instead of targeting logic. And when if you want to fail at treating OCD, just take a logic approach toward it. But if you want to win at treating OCD, take a behavioral approach toward it. Yeah, you seem very behaviorally grounded to me because I I would push back a little bit that talk therapy works at the cortex because I think if you look at I'm not saying that people have failed epically at treating OCD through talk therapy, but I think if you look at you know most mechanisms of talk therapy, — a effective activation is critical, — right? and so I think the purpose of using talk therapy is to get to that limbic response and then managing those. But I don't know if the pathophysiology of talk therapy really applies to OCD, — right? And and that's kind of where I'm really curious like what do you think what is your understanding of what causes OCD? Uh so there's a lot of ideas around this. Uh there's overvalued ideiation on certain aspects of things that we think about. Uh there's friends of mine like Fugen Zaruglu who's done some work in that area. You have notions about ideas. Uh I thought this was interesting that I heard in a lecture once. We have indirect pathways or direct pathways in the way that we look at things. So on my indirect pathway now is like the birds in the background or noise that but and then on the direct pathway might be a siren going by that suddenly I'm paying more attention to and maybe some things get slipped into the more direct pathway off of the indirect pathway and so therefore we think we have to pay attention to them you know so there's these interesting ideas about that uh there's pans or pandis which is uh these ideas

### [2:00:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=7200s) Segment 25 (120:00 - 125:00)

of pediatric autoimmune syndromes that as a reaction to maybe Lyme disease or strep. People could go to bed and then wake up in the morning with OCD or ticks or Tourette's or something like that. — Yeah. So, I I think I've seen papers about this about kind of sudden onset OCD following viral infections, right? there's some inflammatory hypothesis and my sense is just as a clinician is like — some psychiatric diagnosis are more psychological and some are more neurological and OCD definitely feels more neurological to me like there there's something going on with the way that the brain generates thoughts there's something going on the way in the way that the brain is unable to regul ulate itself, — right? Where you have some kind of amygdala activation where your frontal loes just aren't able to — to work on it. So I I was kind of curious if you have um I mean but what I'm really getting from you I think you sort of already answered it is that you know when it comes down to it where OCD comes from it's certainly it's almost like some one of these illnesses where our solutions to it is what sustains the problem right where our reactions to it the way that and that's what's what I think is kind of interesting about OCD is it's one of the illnesses where I feel like patients feel the most powerless, but that good treatment can really revolutionize the way that they live life. — 100%. — Um, so I want to just Yeah, go ahead. — I was just going to add one more thing about we just to go back in the moment about technology. In the past, I've had patients who have heard there was a hit and run on the radio or television, so they call the police on themselves to come to their house to see if it was them. Now, with the technology that we have, they're going online and they're watching video to see if their car was the one that went through. Even if they didn't drive that day, they're still checking to see if it might have been them. — Interesting. Yeah, that that's so scary. Um so I was wondering so yeah so some people in chat are uh you know surprised by this idea of OCD from infection but yeah there are some papers that actually show uh specifically pediatric papers like new onset OCD. Um so I guess uh are you comfortable I just want to turn things over to chat for a second and see if they have any questions just because you're here and we have a very engaged community. Um — wonderful. — Yeah. So one person Hello. — Um so man there's so many questions. So one question is do you have uh so people are asking about meditation and OCD? — What's your understanding of the connection between the two? Can one be used as a treatment? How does it work? There's the there's not necessarily that meditation is a treatment for OCD, but in the terms of mindfulness work, we want people to be mindful of whatever their obsessions are and allow them to be there without having to try to push them away. — So the more you try to get rid of a thought, what happens? The more it's the pink elephant effect. Yeah. And I liken this to if you have a song stuck in your head that you don't want to hear anymore, the best thing to do is listen to it about 20 times and you'll just get bored with it. Instead of trying to make the song go away and that's exactly how we would approach it with ERP, let's dive into that thought and keep saying it over and repeating it instead of trying to run away from it. — Yeah. So, and so your take is that meditation is a way to embrace and accept those things as opposed to running away from them. Absolutely. And sometimes people will use meditation in treatment. I'll say I don't mind if people do meditation, but in the midst of ERP, we're really working on allowing something to be there uh without, you know, going into mantras or things of that nature that people might use during meditation. — Um, okay. So, thank you. We've got a couple other questions. One is, uh, one person is sort of saying, "I've always claimed atheism cured my OCD. Do you think that's possible? So if somebody had more of a scrupulous nature to their OCD, scrupulosity is OCD about morals or ethics or religion, there is a chance that with now not believing in something, you can walk away from having the doubts or uncertainties about if you've done a religious practice correct. However, just keep in mind I've treated atheists who have religious scrupulosity who have said to me, "I know there's not a God, but in case I'm wrong, I'm going to say a bunch of prayers anyway. " and they still do hours of prayers just in case. — Yeah, that sounds like Pascal's wager, is it? Where I'm going to

### [2:05:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=7500s) Segment 26 (125:00 - 130:00)

be — um and yeah, so I I'm glad you mentioned scrupulosity. So, I was prepping for, you know, in our stream today, we were doing like fictional character diagnosis and uh, you know, some people have suggested that Batman has a form of basically like moral OCD that he's very kind of justice focused, um, quite obsessional, intolerant of certain people. Can you tell us a little bit more about what is that scrupulous form of OCD look like? — Yeah, that moral OCD. I would if we were doing Dungeons and Dragons, I would say Batman might be chaotic good if we were gonna give him a class. Yeah. You know, — um — yeah, we can do D and D, by the way. If you want to use D and D to teach OCD, I think we've got we're well grounded in that. — You and I are good. We could get our Magic cards out. We could do some D and D. — Fantastic, bro. We've been taking the wrong direction. Why didn't you tell us you were a nerd at the get-go, bro? — We're suddenly best friends. What happened? Anyway, so — with moral — please. — Yeah. With moral OCD, you you're dealing with people who are afraid that they might have somehow been offensive to somebody, that you might have not done enough for somebody. I've had people who have waited outside of grocery stores for six months looking for the person that they're afraid that six months ago they held the door open for them, but what if they let it go too soon and it hit the back of their foot and it might have caused them to be in pain somehow. So now they just whenever they're off, they're hanging out at that grocery store hoping that person will come back through. And then six months later they do and they go up to them and say, "Hey, just so you know, six months ago I held the door for you. I don't know if it hit your foot. I just wanted to make sure you're okay. " And of course the person looks like, "Who the hell are you? What are you what are you talking about? " Right? Just kind of go away. You could see a moral aspect, too, where I've seen people with those pedophilic OCD concerns who if a family's walking down the street, they start saying, "Don't come near me. I don't want to harm your children. " Well, guess what happens when somebody screams that to a family — rage from the family, right? They're trying to be as moral as possible and helpful and everything and it's a backfire when it happens. So, people with moral scrupulous issues won't even uh throw out something that could be recycled into a regular garbage because what if they're contributing to the destruction of the earth? even if they have to carry that thing for four miles on a trail until they get back to the trail head where there's something that they can recycle, but there's other garbage cans along the way. You know, the these notions of extreme responsibility toward the welfare of other people. Uh it goes above and beyond. I hope we're all about the good welfare of everybody else. OCD takes it to a level that it's unattainable though. So, so I mean it sounds like what you're saying is, and this kind of fits with my understanding of it, but that they're concerned about their own moral shortcomings. — Is there a form of OCD that is concerned like obsessional about the moral shortcomings of others, — or is that not something you've seen so much of? — Not so much. That might go more into OCPD, right? obsessivecompulsive personality disorder where you're always finding the moral shortcomings of other people because you're doing things better than they are. — Um, and I think this would be a great time to, you know, just highlight for a moment OCD versus OCPD. Can you just give us uh pretend I'm a psychology intern. — And so OCD is obsessions. you know, these intrusive or unwanted thoughts, images, or urges that people have that are neutralized by compulsions, which are mental or physical acts. Obsessivecompulsive personality disorder is more of a way of living in the world that doesn't have to have obsessions or compulsions. So, it's kind of an odd name in first of all, it probably should have been called anal retentive personality. If we're going to go back to our psychoanalysis days, like we said earlier, anal retentive personality disorder might have been better. But uh I heard it described once by a patient I had that I treated who said, "My concept of the world is I'll do it. You sit in the corner and color because you can't do it as good as I can do it. And even if you do it the way I do it and follow my directions, it's still not good enough. So I need to be the one to do it. " And so they held they hold things to such a standard that it's difficult for anybody to ever attain that standard. And there can be a resentment against people for not attaining that standard. even though like an OCD it's an unattainable standard for anybody else to achieve. — Yeah. So, so I think so one of the things that I'll when you know when I do some public education often times what I'll tell people is that you know when you think somebody is OCD what they are is OCPD right and that often times OCD looks

### [2:10:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=7800s) Segment 27 (130:00 - 135:00)

very different from the way that media port portrays it. Um, OCPD is like control freaks. I think exactly kind of what you're alluding to. — Um, and so I think it's a very important distinction that like, you know, if someone's like anal retentive, I think is a really good term. — Um, you know, if they're just really just control freaks about it needs to be done this way, uh, even some of like the organizational kind of stuff where it's like this pen goes in this place, this pencil these notebooks go here. One thing that I'm a bit curious about um and we can maybe make this our last question, but uh is um so what's been your experience of children who have or I children who have parents who have untreated OCD? What does that look like? — Uh yeah, that could be difficult. I actually have a friend, John Hersfield, writing a book about this right now. Uh John is a therapist. He has OCD. He's writing about being a parent. His has been treated though, but he's writing about being a parent with OCD and raising children and how you do that. So, uh I think it could be a very difficult experience for the children, especially if it is around the safety of the children because OCD, I'm going to personify it a little again here, maybe has the best intentions for protecting the children and in doing so bars the children from really living the life that they want to live. and they're only living the life that OCD allows the family to live. And that could be a very isolated life, right? You can't go to the neighbor's house because what if they serve peanut butter and you suddenly develop a peanut allergy and then you'll die. So, you can only have your friends come over here, but they can they have to take their shoes off and they can only be on the wooden floor, not on the carpet, and they can't use the bathroom here. They have to go back home because they could leave a germ or you know, just these are the kinds of things that you're not allowed to live your life. And I've seen it's the reverse too where untreated OCD in kids runs a household. You know, I've gotten calls where the family has to take their clothes off in the garage and put on a robe and then go to the bathroom and take a shower and then put a new robe on and then can go to their room so they don't bring germs into the home. So OCD will, if it can, take over everything. — Yeah. So I mean it's so sad, but I' i've seen that time and time again, actually, how it the whole family, you know, the person with OCD, their um emotional experience is so profound that they'll rope everyone around them. And I've certainly seen kind of like uh more in like almost like trauma work what you're kind of talking about which is kind of why I asked is like you know I've seen children who grew up with parents who I suspect have untreated OCD — and just how deprived I think that's the right word like they were just really deprived of a normal life because there was just this like monster that was completely like you know this is the way that things have to be. um a lot of really interesting psychotherapy around — uh actually anger at the non-ill parent for — Yes. — Right. — Yeah. — Oh, yeah. for allowing that to even how did you let dad or mom do that? — Exactly. Right. So, so one of my supervisors once told me it's the parent that they don't complain about that's really the problem. That's where you have to go. Um and sort of just because you can to a certain degree, okay, like this parent had OCD, this parent was drinking, this parent had an addiction, but it's this other parent that was my loving parent that I feel really conflicted towards because they were the positive parent, but I also blame them. So yeah, thank you so much for coming today. Can you tell us a little bit more about where people can learn more and um you know what NOCD is offering? Yeah. So, NOCD offers exposure and response prevention therapy for OCD and related conditions. And we are an online platform for this. We work in the United States, the UK, Canada, and Australia. And we take most insuranceances. So, we're and we're always working on getting more because we want this to be an affordable experience for people. We believe that people deserve to have evidence-based care and we want to be the best providers in the world for that. So, if you're looking for help for OCD, you can go to nocd. com or you can even download our free app. It's the NOCD app and you can engage the largest community of people with OCD in the world on the NOCD app and find just thousands upon thousands of people who are there to support each other and help each other through their OCD. — Awesome. Thank you so much, Dr. McGrath. — And next, a blast. — Next, next time we're gonna have to launch into D& D earlier, bro. Oh yeah, I'll roll for paladin. We'll see how it goes. Yeah, it'll be great. — Speaking of scrupulousness, I'm sure a paladin would be at the top

### [2:15:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=8100s) Segment 28 (135:00 - 140:00)

of the list. Thanks a lot, Dr. McGrath. Take care. — Good to see you. — All right. Um All right, team. That was great. So, yeah, I think uh you know, I think Dr. McGrath is right. I think like this is one of these things where scariest thing about listening to him is like how many things you know I don't think if you're in a relationship and your partner tests you um you know that doesn't mean that they have OCD but what really scares me about this is like I think this is we didn't really maybe I'm just connecting these dots now but you know we have a media portrayal of OCD but procrastination tests in relationships, all this kind of stuff. This all could be OCD, right? And and one of the I'd say OCD is probably the at the top of the list of diagnoses that I misunderstood when I came into psychiatry training. It is the thing that is the most different from what people think it is. Um, and then I think that's it's kind of scary, but that's also why I think we see some of these things like inappropriate OCD treatment even though you're in therapy, right? Because it's easy to conceptualize it as anxiety even for a therapist. Um, and so it I was kind of thinking about that case that, you know, I' I've shared on stream before about, you know, the person who was like anxious after this traumatic experience. And for me that was pretty clear because I you know and I think it's really interesting to see that we sort of ended up in the same place which is in intolerance to uncertainty is the goal. Um but a huge shout out to NOCD for sponsoring um you know our stream today and uh shout out to Dr. McGrath and the work that they do. Like I said y'all we don't take sponsors often um and so NOCD was vetted by our scientific advisory board. uh they do evidence-based treatment. Um and I would imagine that their outcomes are pretty good. So, and I think we've got uh I think they've got a quiz that y'all can take, right? So, a big question is um you know, do I have OCD or not? Do I is it procrastination? Does my partner have OCD? And so, they've got a quiz that y'all can take. I think we're linking it in the chat right now. So, if y'all are curious, check it out. Okay, I think the last thing that we're going to do today is um we have uh a team member who's just going to showcase something. Um so let me just hop in because I think we want to show y'all what we've been doing. So I don't know if you guys remember. Hold on a second. Um let me pop this out. Hello. — Hello. — Let me mute stream so I'm not hearing you twice. — All right, cool. — But I want you to listen to me twice, Brandon. — Um, — think I get enough of that. — Okay. So, uh, for those of y'all that don't, so Brandon's going to show us some stuff. So, as you guys know, you know, we have, um, we built a new guide, Dr. K's Guide to Love, Sex, and Relationships. And am I driving, Brandon? Am I screen sharing with you? Yeah, you screen share with me and then you can share it on stream, too. — I'm going to screen share with you and then um so I'm going to give you all just a little bit of background before we go into this. Okay, so many years ago. Oh, we're lagging. Dude, what's going on with this lag? — Shut down. — PC need an update, — you know? I honestly wonder if it's because I installed Star Citizen. This stuff started when I — Okay. — The game that will never end. It's uh crowdfunding. — Yeah, dude. Speaking of projects that never end. Exactly. Oh, this is laggy af. Um so I get I think it's um thing because I uh — maybe with this — um let's see. Okay, let's do this. I'm gonna call you uh I'm gonna set up a different um I'm link not used to score still lagging still lagging it's getting better. Okay. So I think it is okay. Okay. Let me do give me a second chat. this.

### [2:20:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=8400s) Segment 29 (140:00 - 145:00)

Um and then Okay. No, still lagging. What? What is the deal? Okay. Uh almost. I got to fix one or two other things, but I think we're getting there. Okay, count to five for me. I said Okay, they can't hear you. So, I'm going to fix that real quick. Um, say something. — I'm saying something. One, two, three. — Perfect, perfect. Okay, okay. I I think we finally got this. Okay. So, I'm going to go over here. I want you to count to five one last time. — All right. One, two. — Okay. We got it. We got it, Chad. Okay. — Nice. — So, we're going to give you all a quick background. Okay. So, look, — many years ago, I was I made the fateful decision to I got done with work early. A couple of patients canceled. I remember I think it was like 2:30 p. m. on a weekday and I opened up Reddit and I posted an AMA and I said, "Hi, my name is Olive Kenoja. I'm a psychiatrist or training to become a psychiatrist focused in video game addiction. " And the AMA hit the front page of Reddit. And there was a group of people who were like, "Hey, can you like teach us some stuff? " And so this is where HG was born. It was actually born out of an AMA. and Brandon, who's here with us today, is one of the original people. We had a Discord. So, I started a Discord server and we used to meet once a week and we would just like talk about stuff. So, I'd like teach stuff basically like what I do on stream. I'd offer like a little bit of a lecture, teach some meditation, we'd learn about how our mind works. And Brandon's been with us from the beginning. Um, and so Brandon is good at technology things. So Brandon's going to walk us through some stuff. So Brandon, what do we need to understand, bro? — Yeah. Um, so could you do a quick refresh for the page? — Okay. I Okay, I'm going to refresh in a second, but I want you all because this could be gone. Okay, so hold on a second. Opt in. — Okay, — opt in to QI. — Yeah, sure. We'll start with that then. Um, — no, it's not gone. — Yeah, we saved it. Okay, cool. Um yeah so one of the big things we're doing at HG is uh we're working for improving our research and expanding our research division and one of that one of the parts of that involves you know you guys chat people who use our products people who engage with HD every day um and we've gotten a really awesome research team now and we are actively wanting to assess how people are improving when they're using our products especially with guide and memberships. Um, so whether or not you're a new guide purchaser, a veteran guide user, um, this feature where you can opt into getting just occasional surveys. — Yeah. Um, opt in to get occasional surveys and stuff, um, will show up on the live coaching platform or just our platform in general. And it allows you to just receive occasional surveys that'll pop up just to get a check-in on your on where you're at. And most of this information if not all of it is just used to um improve our products, see how people are doing, improving over time and things like that. So yeah, once you opt in, you'll see that research tell me tell us a little bit more about yourself for science and there's just some surveys there that you can take. It'll come back periodically like once every four weeks and they're not very long. Um, but they're really informative for us to get a good baseline and really um get a lot of research backing behind our products and services. — Is there other stuff that you want to share, Brandon? — Uh, nothing about that re QI stuff, but yeah, uh, we just want to give a preview of the LSR module. Um, so this is currently our devs are working hard to put this up uh, and get this ready for, um, live release on Monday. Um, but this is just our staging environment. um gets you a good overview of like what you're going to be seeing, what you can expect once you kind of purchase and unlock this module. Um so here on the homepage, as usual, just like the other modules, there are seven different playlists um that span different topics all from, you know, starting the beginning of like why dating feels so hard today all the way through um to building and actually maintaining relationships and breakups and recovery. So a lot of the stuff that Dr. K has already talked about on stream um yesterday if you guys were there. Um I guess Dr. K, do you have any you know insight into why these seven topics what you decided to go through? — So I want to talk about QI for a

### [2:25:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=8700s) Segment 30 (145:00 - 150:00)

second first. Okay. — Oh yeah, sure. — So — we're going to ask you all to take surveys and I I'm personally asking you guys if and when you get use our stuff, okay? I want you all to take surveys. Here's why. We have this idea. Okay. So, in terms of how we built this. So, I think we showed you all a PowerPoint yesterday where we're it's like people ask us questions about relationships all the time. Should I go to a prostitute to lose my virginity? How do I get people I'm an incel. I'm short. How do I do this? I've been through a terrible breakup. How do I let myself go back into the dating world without being burnt out? How do I let go of resentment? How do I grieve? How do I let go? I'm becoming an incel. How do I stop? Right? So, people need help in relationships. I have a dead bedroom situation. How do I My partner says that there's no spark anymore and they want to break up. I suggested couples counseling. They said there's not really a point because there isn't a spark. So, people ask like you guys are hammering us with these questions. So then what we try to do and now I have a bunch of help, right? So like it used to be just me, but I'm not a relationship expert, which I know sounds weird because I'm telling you guys to get this guide. I think you all should get this guide, but like I have to learn this stuff because this is what y'all are asking me for help with. So we have people like Clark and we've got a research team and stuff that we're building out quite robustly. We showed you guys some of the questions and stuff from the research, right? So, what makes a successful relationship? How do you successfully what's this healthiest way to break up? How do you stay resilient from breakups? Um, how do you let go of emotional baggage? So, we built this stuff and the topics that we picked are the most important topics. So, it's like my idea is doesn't matter whether you've never been in a relationship or never been on a date or you've been married for 20 years. This is the stuff that you need to know. Okay, so we trim down the topic list quite a bit and we want basically everyone to get through it all and this will equip you with the most — basic and advanced skill set to succeed in relationships. That's how these were picked. So we need to first of all understand what's different everyone is struggling to meet. Why is that? Okay, what has changed? Right? What's the meta right now? Second thing is finding partners is hard. All the good ones are taken, Brandon. They're all taken. Why? What's going on there? All I'm getting is people wanting to send me dickpicks, right? And then a lot of people like screw this up. So, there's like a group of people that's like, "Okay, I can I get one date and then I get ghosted. Two dates then ghosted. Three dates and ghosted. I've been on six dates. I've been on this app for 18 months. Talked to hundreds of people. Only six people went on a date and I can't get a second date. Can't get a third date. Why? How do you fix that? Then choosing the right partner. How do you know who's actually right for you? Right? Because we all want right partners. How do you build and maintain a healthy relationship? Then we're talking about sex and intimacy. Right? So some of the stuff that we talk about here, I don't know if this is like against toos on some of these platforms, but we talk about things in a very like, you know, straight kind of medical way and sometimes that's hard to do on some of these platforms like YouTube and Twitch and then breakups and recovery because things are not always easy. Now, the reason that I want y'all to opt in and take these surveys is it is our hypothesis that this will help y'all. And I know that I'm an influencer on the internet and my job as is to sell you things, right? Because that's what we do. No, but really this is designed to help y'all. And we don't know whether it's going to help you or not. I am this is my best attempt at putting together something that I think will help y'all substantially, but we don't know that. Okay. So, one thing that we're very different about here at HG is we try to collect outcomes on the things that we offer y'all. We don't do Sabbathons. We try to sell you things. I'm going to be super transparent about that. Why? Because we want to help you. You should pay us money. We should provide some value for that. Second thing is we want to do things that work. We're a part of our mission and ethos is to do things in an evidence-based way. But in order to do that, we have to collect data. And that requires you to fill out surveys. The one thing that I can talk about, I'm going to ask you, Brandon, actually, do you know, so I know you know this project that I've been working on for two years. You know what I'm talking

### [2:30:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=9000s) Segment 31 (150:00 - 155:00)

about. — Yes. — Do you know if the surveys that people are taking will be a part of that project? Is there any overlap there? — I think it will go into informing that project. Yes, — informing that project. But what about user data for the connection dimension? Is that is that over? — Okay. — Short answer. Yes. — Okay. So this will populate a user's connection dimension if they take these surveys — when we visualize it. Yes. It'll be visual. — So it is the same backend data is the same. — Correct. It's just the foundations. — So I get into trouble chat because I sometimes will make promises that our team then has to fulfill. I will leak products when they're not ready to be leaked. So, I'm not going to say more than that. Except I can say with confidence we're working on something. The other thing about this survey is that all of the not all a portion a large portion of the surveys that y'all take are not just going to be used by us. They will actually we will give you back that data. Okay? So, we're designing something. I'm not going to go into a whole lot of detail, but the surveys that you take are information about you that you will then get access to which will give you an insight. So, we're trying to measure. So, I'm just I'm going to take my headset off. — Okay, — go for it. — Are you done, Brandon? Are you Is there anything — I mean, there's a few more things to show, but really, I think you can — No, go ahead. Share what you want to share and then I'll rant. — Okay. Why don't you click into the first playlist, — okay? Um, and let's go directly to the second video because that's one that has additional things to show off. — I think it's just re the second video, the why fall in love. Yeah. — Okay. — I think this just goes to show also like to strengthen your points about um just like how researchbacked we are and how we want this guide to be like super evidence based in the references and resources. We're having — like almost every single video will have two or three references. And I think this guide, I've been working through all of the guides and I think this guide is probably one of the most heavily researched ones or at least has the most heavily art uh research articles uh and references. So, um it really is like one of the ones that I think is the most HG uh like direction in terms of like the research. Um, and then the other thing is that I do think that this guide I think is the most information dense and also probably the most applicable to like the most people's daily lives because uh all the other ones are kind of niche with the exception of meditation to specific issues but um the LSR module is really universal to a lot of people. — Okay, cool. — Yeah. Um and last thing I wanted to say is um on release at least this module doesn't have a map view. I know a lot of people are very uh endeared and like really enjoy using the map view but — um — yeah but the problem with the map view is that it's overwhelming. So — yes, that's one thing. And the other thing is that the LSR module itself doesn't — really have a strong connection point like the other modules kind of tie together with each other. And if we were to originally put it on the module onto the graph, it would kind of like surround the whole map because it's like something that's forms like a baseline for everything else. — Yeah. So, so basically like we started this off and I was like, "Okay, we're going to make an FF10 sphere grid — that basically people can scale up in all of these dimensions. " — Um Huh. — You can show it if you want. Go to like the Dr. K's guide menu. — Yeah. So this is like the map, right? — Yeah. — The problem Oh, — I have to purchase this. Okay. GG. Unlock now. Okay. Internal server. GG. Get wrecked. Okay, that that's fine. Um, yeah. So, what we're other stuff that you want to show, Brandon? — No, I think that's it. — Uh, sorry, it's I think my headphones are dying. What's up? Say it again. — That's No, that's it. No, you're good. — Okay. Thanks, Brandon. So, guys, I want to just emphasize um Well, I'm going to go and drop the call. Okay. — Mhm. — Okay. So, I want to emphasize like we're a whole team now. — Okay. So Brandon's with been with us basically from the beginning and um we make changes. So you know we used to have this fear grid kind of thing but I think it's too hard to get the LSR like Brandon was saying. It's too hard to like fit it into this map and it's like more universal. It's also way more linear. So it you know it's like this is the chunk. It's like the tutorial for relationships is what the LSR module is. And tutorial makes it sound basic, but it's like advanced stuff as well, right? So, I would kind of say it's not the tutorial, it's almost like, you know, if you send

### [2:35:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=9300s) Segment 32 (155:00 - 160:00)

someone to boot camp or like when they finish their like military training, they come out as trained soldiers. So, there's like advanced skills in there, which is what the LSR module is, love, sex, and relationships. Um, the other thing that I want to tell you all is I want y'all to take the surveys. This is basically me telling you I want you to take the survey. I'm going to be transparent about that cuz the surveys are cool. They're very cool that we put a lot of work into them. This is not just rate things from one to five. So the surveys are I'll tell you guys what we're trying to do, okay? But don't hold me to this because we're trying to pull it off. We're trying to figure out does this actually help you? Okay. Now, in order to figure out if this helps you, we'll ask you, do you think it helps you? What's your satisfaction with this? That's one type of survey. That's not the only thing we're asking. We are actually asking you questions about your relationship status, about your rejection sensitivity status, about your self-esteem. And as you watch these videos, as you engage with our various services like coaching or whatever, do community events, can we actually move the needle on outcomes? Right? That's what we're trying to figure out. And we can't know that unless y'all fill out the surveys. And the other thing is I've been working on this project for about 2 years. Um, and I think we're we'll hopefully it'll come out later this year. But then the stuff that you guys fill out in the survey, you will be able to see and we'll show you all different dimensions. You guys will see what the survey Let me see if I can just here. Okay, great. I'm gonna just show you all this. Okay. So, um I feel like I'm free to decide for my for myself how to live my life. I really like the people I interact with. Often I do not feel very confident uh competent. I feel pressured in my life. Okay. So, let's just do this. I get along with people I come into contact with. I generally feel free to express my ideas and opinions. I consider the people I regularly interact with to be my friends. I've been able to learn interesting new skills recently. Right? So, these are the kinds of statements. questions that we're asking y'all. Um, in my daily life, I frequently have to do what I'm told. People in my life care about me. Most days, I feel a sense of accomplishment from what I do. And y'all may be like asking yourself, what on earth does this have to do with a relationship? Right? This is not just are you willing to date someone who's over 6 feet tall, okay? Or under 6t tall. People I interact with on a daily basis tend to take my feelings into consideration, right? So there these surveys, I don't know if you guys can tell, these surveys are about certain attributes, okay? character sheet like almost as if we could use scientifically validated instruments to develop a character sheet of sorts. And then we need to see because this is the stuff that's important. So a lot of this stuff has nothing to do with relationships on the surface, but that's not what we believe, right? Why are we making a guide to love sex in relationships? Why have we done so much research and invested all this time and energy and scripting and stuff like that? Why? Because your mental health, okay, this is the thing. Your mental health, so many people on the planet will try to tell you that your mental health doesn't have to depend on relationships. And the basic reason for that is because if I'm like a psychiatrist, I can't get you laid. Right? So as the field of psychiatry, we've like moved away from that outcome. Instead, what we're going to do is we're going to measure your satisfaction. depression. We're going to measure your anxiety. But we as human beings, a basic part of our mental health, arguably the most health has to do with our connections with other human beings. Takatubo cardiomyopathy is inflammation of the heart muscle that happens to men after a divorce. Okay, men are inflammatorily different from women. One of the greatest risks of heart attack or myio myioardial infuction is the 24 hours after a breakup. So at some point direction in life, how fulfilled you feel, the people that you interact with, how they treat you, whether you consider them friends, these things will be

### [2:40:00](https://www.youtube.com/watch?v=9pASWaaDuz8&t=9600s) Segment 33 (160:00 - 165:00)

shaped by your relationships. And our hope is that as we equip you as best as we know how, this is not like a pickup artist kind of thing where it's like, and this is the basic problem with most of the dating advice. People will say, "You should do this. This is how to succeed in dating. Do this. Do this with your hair. Do this. Do this. These are the things that you have to do. That's not what the guide is. The guide is not telling you this is what you blur. Blurring. Okay. Guide is not telling you do this, then do this, and then it'll work. That's not what we're doing. What we're trying to do is teach you guys how it works. So, I'm not saying, okay, first you have to jump, then you have to hit you hit A, then you hit X, up, down, left, right, AB, start. That's what a lot of dating advice kind of stuff is. They're like, do this, do this. If they do this, that means this, and then you should do this. We're teaching you guys the tutorial. This is the jump button. This is the light attack heavy attack button. Some monsters require heavy attacks to beat. Some monsters require light attacks to beat. This is how you tell the difference between a monster that requires a heavy attack to beat. How to monster that requires a light attack to beat. Here are the principles. Here's what formula. Here are the components of charisma. Here are the elements based on our best available research. Here is how people fall in love. We're going to equip you with all the tools, the systems. We're going to teach you the rules of chess. Right? This is how a pawn moves. knight moves. Hey, there's this thing called a fork. It's when you move your knight and you have these kinds of pieces. When do you fork? Well, you have to look at the board. Communication skills, dealing with resentment, emotional processing after a breakup so that you are not carrying emotional baggage into your next date. Right? One of the biggest problems that people have with dating right now is we're all so [ __ ] burnt out that when we go on a date, we're not emotionally like in our best frame of mind, right? We're another burnt out person dating going through a job interview that is basically over drinks where we see if we're a match. I don't know if this makes sense. Falling in love is not about a match. the opposite of a match. Romeo and Juliet, right? And and that's like we're going to try to equip you with this because generally speaking, like genuinely speaking, not genu generally, genuinely, like I'm here to help y'all with y'all's mental health. That's what I'm here for. And sometimes that involves, hey, we're going to do pranai and I'm going to teach you guys agna chakra meditation. And sometimes that means like, hey, let's do fictional character diagnosis and see if we can learn something about ourselves. And sometimes it means like, okay, Dr. K, like I'm lonely, right? Which is like we had to restrict dating posts on our subreddit to one day because if not it would flood everything. So this is our genuine attempt to help you guys with this. It's our opening salvo. It's not we're not accepting defeat. It's not the only thing that we're ever going to do. This is our opening salvo. And it's a strong opening, right? It's something that has been well researched in chess. We're going to do this and we've built some really cool stuff with it. And the most important thing that we built, not the most important thing, I say that way too much, too, way too hyperbolic. I'm excited about it. The big thing that we built is surveys. And these are not these are surveys to assess various aspects of you. And then whether using the guide will actually move the needle or not. Okay? And then we hope to share that with you, right? To where you will like we're learning certain things about you. And right now we're learning it to see if you get better, but then we want to share it with you too at some point, but that requires a lot of dev time basically. And if you guys want to know like where does our money go. So we're sitting at 4,134 uh sales, which is awesome by the way. So 3,000 is what it costs to make the guide. So, we've broken even. Okay. Now, this is where you may say, "Okay, if you've broken even, does that mean that everything beyond that is profit? " Absolutely not. investments into other kinds of things that we want to build, which costs money, right? So, we have to pay. We have we've had, I think, a handful of devs on staff for years that are building things like these platforms. And people like, I want the ability to pause. And so our devs work on that for 30 days. They're like, "Okay, we can now pause. We have researchers. We want to do more research. We launched HGI. " So like the more that we make, the

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more stuff we want to do. And we're super transparent with that. Like we're like 5,000 is going to be VTuber Stream, whatever. That's a reward for y'all. 6,000 allows us to do more research. 7,000 stuff more stuff at HGI. 8,000 allows us to develop Dr. K's next crazy brainchild idea. Okay, which I think we're getting there. We built enough. We've piloted enough stuff. We've got some cool stuff going on in memberships. We've got quests that we give you guys every week. We've got now surveys that are going to assess certain aspects of you. We want to put all that together, but that costs hundreds of thousands if not millions of dollars. So, in order to we're not going to Andreas and Horowits to raise capital. We're coming to y'all, which is what we believed in from day one. So, if you guys can, please support us. Get the high guide. It's there to help. If you guys have already gotten the guide, give it to a friend and insult them by getting them a guide. Okay? And I'm super excited about this. And thank you guys for being here. This is a crazy journey. I had no idea that we would be here six years later. Like we're still doing this six years later. We've grown immensely. Okay, we don't view bot on Twitch, so our numbers are not where they could be, but we have over 3 million subscribers on YouTube. 10 to 15 million people watch us every month. Unique people, right? And that number is growing. So this is the next dragon that we're trying to slay. We started out with depression, anxiety, meditation. People have gotten better. People are improving their lives. Now, we're going to help you find love. Like, that's what we're really trying to do. Okay? So, check it out. Thank you guys very much. and we'll see you all.

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*Источник: https://ekstraktznaniy.ru/video/49890*