Sanity and Society

Jeremy:

I’m so glad to be here with Dr. H, ready to talk about the whirlwind film that has been such a topic of recent debate. It opened very limited release. Of course, we’re talking about you can see everything. The Nathan Fielder and Lance Oppenheim film where Nathan Fielder interviews the embattled Elizabeth Holmes and her partner Billy, which I learned is not her husband. They’re not married, which of course there’s conjecture to keep his finances disentangled from the various legal ramifications of Theranos.

Irene:

Yeah, I didn’t realize that.

Jeremy:

Yeah, I didn’t really either. And I posted a long tweet about my thoughts on the case. And then someone said, Hey, they’re not actually married. And I dug into that. It just seemed like they were

Irene:

Yeah.

Jeremy:

for various reasons. But I guess that makes sense. So for anyone out there, Elizabeth Holmes was indicted and recently went to prison for eleven years for massive investor fraud in starting her company Theranos and promising blood testing devices that could test one drop of blood. The famous picture of her with the mini vial. It’s not even a vial, it’s a thimble of blood. Well the nanovile.

Irene:

The nanovile or something? Nanotube. The nanotube.

Jeremy:

Imagine how easy it would be to lose those, by the way. So anyway.

So the tech didn’t work. It became a massive scandal in the 2010s and dragged out into court. And then Nathan Fielder and her had conversation and she thought he would be great to interview her. And she was not familiar with his comedy work. So I found that interesting because that’s all the movie comes off very comedic. So just a little bit of an intro. It’s all about trying to get, she believes that she can tell her side and make things make sense about the entire Theranos debacle. And I’ll leave viewers to decide if it does that, but you can find a lot of conversation about it. So I wanted to get your thoughts on this pseudo-comedic quasi-biopic, whatever we want to call it. It seems like a postmodern documentary in many ways.

Irene:

Yeah, I thought it was so fascinating and I have just a ton of thoughts and I don’t know if you want me to just spew all of them. But the question of truth versus lie, right? Reality versus fantasy,

Jeremy:

Right.

Irene:

deception versus self-deception, these are all themes in the documentary. And then of course, Nathan Fielder is not a neutral party. So he’s a very interesting man to himself. So I think that the movie’s rich for lots of reasons. Elizabeth is one.

Her partner Billy is another who, I’m sure he’s not thrilled about how he was portrayed in the film. But,

Jeremy:

Right.

Irene:

I think the Nathan is a third. And so this is a documentary where one of the questions I have is, who’s the real subject of this documentary? Is it Elizabeth or is it Nathan?

Jeremy:

Mm-hmm. That’s brilliant. That’s a brilliant question. Because you get to see so much of his processing and as therapists, both of us can realize his aftermath of the encounters with her turns into him questioning his memory.

If you notice, and I find that to be very interesting because, and spoiler alert, he has a certain person help reconstitute scenes as Elizabeth. And he’s prompting her, like, Well, you said her line this way that Elizabeth said to me, because there’s certain times he can’t film her, right? Like when he’s talking to her in prison, he has to get a reenactor. And I won’t spoil it, but it’s phenomenal. It’s easy to talk around that. We don’t have to, but

And so when he has this person reenact Holmes’s lines, he says, when you say it that way, it sounds a lot more conclusive. But she actually said it this way. So just even questioning one’s own experience and how one feels, cluster B personality, we know people with those tend to make us feel how they’re feeling and have an effect on us when we question our own perception.

And so I wondered what you thought about that, after hearing her speak and after hearing the reenactment, what’s going on? What that almost the theatrical countertransference, you could call it.

Irene:

Gosh, there’s so much counter-transference. So, obviously we are having—is it a counter-transference? We are having a fantasy-like relationship with Elizabeth.

Jeremy:

Yes.

Irene:

And so is Nathan, right? And Elizabeth with Nathan and Nathan with Elizabeth.

Amanda Seifried?

Jeremy:

Yeah, absolutely.

Irene:

Yeah,

I’m gonna just say Amanda, who then reenacts these scenes with Nathan when Elizabeth can’t be on camera. Well, she’s also having a relationship, a transferential relationship, both with Nathan and with Elizabeth. So there’s just so much richness in there. I think one of the reasons that it is such a provocative and compelling movie is in part because there’s a lot of raw emotion there.

And I don’t know if you had this experience, Jeremy, but it didn’t feel that dissimilar from a therapy session to me in terms of my own emotional engagement and then also depletion.

Jeremy:

Yes, you felt depleted after watching it because of the effort and trying to construe and understand what happened.

Irene:

Yes. And also because I am being drawn into all of these enactments. Mentioned personality disorders. So the cluster B personality disorders. And we’ll get to that, but I’m drawn into all of these enactments that are happening on screen. And I am really in it. And I was trying to maintain some objectivity because I knew we were gonna do this. So I didn’t want to just totally lose myself in it. Sure.

It was so difficult because emotionally it was incredibly charged the whole thing, right? And yeah, so at the end I was like, I’m exhausted. I need a nap. Right.

Jeremy:

Yeah. Well it is very charged subject material. And the film opens somewhat innocuously. It very much toes the line between a more warm character or portrait biography or documentary and then something that’s almost like a 48 hours or a true crime. It’s a very interesting genre mashup. Yeah. And

One of the stories, so when Nathan Fielder was talking to Elizabeth before they filmed and started and agreed to filming her and Billy, her partner and father of her children, he told a story about, I don’t want to forget to say this, that a magician who I’m gonna edit this and remember his name. The magician who was in the block of ice that time, I know who it is. It’s the guy.

David Blaine. So you remember the story about he thinks that David Blaine was putting the actual ice pick through his hand and it just looked like so

Irene:

That’s right.

Jeremy:

that was very interesting and that resonated with Elizabeth.

Irene:

Mm-hmm.

Jeremy:

So as if the appearance of something was all a trick, but it was all legitimate.

It’s very interesting that that would resonate with her and be something like, no, this was all real and it was painful. Because it’s a fascinating story for it was something so visceral.

Irene:

Can I just jump in for a second? So one of the things that we all couldn’t help but notice was how wide-eyed, innocent, naive maybe Elizabeth looked on camera. She looked like she was a child. She had a very childlike quality to her. Did you get that as well? Everyone comments on that unblinking stare and the big eyes and filling with tears and it was not a vacant expression, but it was like a innocent, almost empty expression on her face, like confused maybe, right? And I was like, okay, I have to keep reminding myself, she’s a very bright woman, right? So after that was over, after I watched it, I watched the 2019 documentary that’s on HBO right now, The Inventor, which is about the Elizabeth Holmes story. And that was super interesting because of course I got to see all of these clips of her, in her heyday, right? Very bright, very quick, doesn’t take a second to respond to things, and able to charm and then ultimately deceive some very experienced people. I mean Henry Kissinger, General Matthew, I mean scientists, she had the department chair or something of the chemistry department at Stanford left his tenure track position to work at Ther…

Sometimes we aren't chasing a person; we're trying to prove that we can obtain a love that was lost to us.

Why do we sometimes want the person who is least available to us?

And how do you know whether the urge to leave a relationship is wisdom or an old attachment pattern coming back online?

In Part 2 of my conversation with Dr. Nicole Ohebshalom, we move from trauma therapy into the psychology of relationships, dating, intimacy, shame, and repair.

Even though you can listen to this episode completely independently without any confusion, part 1 is right here if you want to give it a listen.

We talk about:

* Avoidant and anxious attachment.

* Relationship anxiety.

* When breaking up is healthy versus defensive.

* Red flags and relationship dynamics.

* Affair recovery and rebuilding trust.

* Emotional availability.

* Hypervigilance and catastrophizing.

* Why anxiety destroys curiosity.

* EMDR negative cognitions.

* Self-criticism and the inner judge.

* Ego states and parts work.

* Perfectionism in high performers.

* Why not everything comes from childhood trauma.

* Limerence and obsessive romantic attachment.

* Intermittent emotional availability.

* Repetition compulsion.

* Dating apps and micro-rejection.

* Modern dating culture.

* Money, status, and gender expectations.

* Changing ideas about masculinity and femininity.

* Desire discrepancy.

* Sexual intimacy.

* Performance anxiety.

* Feeling desired versus simply having more sex.

* Playfulness and emotional safety.

* Why your partner cannot realistically be everything.

* And why curiosity may be one of the most important relationship skills we have.

One theme runs through almost the entire conversation:

We tend to confuse our predictions with reality.

Trauma can make the mind certain that an old danger is happening again.

Limerence can make emotional inconsistency feel like profound love.

Perfectionism can make an ordinary mistake feel like evidence of inadequacy.

And modern dating culture can train people to interpret every imperfect moment as a red flag.

The antidote to this is curiosity.

The ability to pause long enough to ask:

What is actually happening here?

Show Notes, Chapters and Timestamps

00:00 — Trauma, attachment & the urge to leaveHow do you distinguish an avoidant trauma response from realizing a relationship genuinely isn’t healthy?

01:10 — Relationship red flags & your role in the dynamicLooking beyond simplistic red-flag culture to understand how both people may contribute to a relationship pattern.

02:18 — Affair recovery, betrayal trauma & relationship repairWhat does the hurt partner actually need after infidelity?Being heard. Accountability. Emotional presence. Repair.

05:31 — Contempt, emotional availability & infidelity riskWhen partners stop feeling accessible and responsive to one another, something important begins to erode.

07:10 — Avoidant attachment, anxious attachment & emotional withdrawalWithdrawal doesn’t always mean someone stopped caring. Sometimes fear makes people quieter.

07:42 — Curiosity as an antidote to relationship anxietyInstead of immediately assuming rejection:Why are you moving away?What is happening between us?

08:29 — Anxiety, catastrophizing & the loss of curiosityAnxiety narrows perception.We begin treating assumptions as facts.

09:18 — Trauma & predictive processingHow past experiences shape what the brain expects to happen next — especially when the cost of being wrong once felt enormous.

10:08 — EMDR negative cognitions & the stories we tell ourselvesThe beliefs underneath our reactions.The “lie” we repeatedly tell ourselves about who we are.

10:46 — Why you shouldn’t believe every thought you haveSelf-critical thoughts. Worst-case scenarios. Rumination.Sometimes the mind is warning you about something that isn’t actually happening.

11:39 — Agency, identity & choosing who you becomeWe often forget that we have some capacity to choose which thoughts and identities we strengthen.

12:29 — Perfectionism, high performers & fear of failureWhat happens when competence becomes part of identity?Trying something new suddenly becomes psychologically dangerous.

13:42 — “Failing up” and high-achiever psychologyLearning through failure versus needing to remain ten steps ahead of everyone else.

15:13 — Shame, childhood & the inner criticWhere does chronic self-judgment come from?

15:48 — Ego states: the judging part vs. the wise partA simple parts-work framework for recognizing self-criticism without becoming consumed by it.

16:47 — Mindfulness, dopamine & changing self-critical habitsNotice the judging part.Pause.Ground.Then create enough space to respond differently.

17:57 — Imposter syndrome, introjects & EMDRCritical parents, teachers, internalized voices, and the possibility of building a more adaptive internal resource.

18:23 — Not everything is childhood traumaAn important corrective to pop psychology.Sometimes personality is personality.Temperament matters too.

20:05 — Rumination, analysis paralysis & changing the channelWhy endless analysis can reinforce the very loop you’re trying to escape.

20:57 — Psychological agency & the observing selfYou may have more room to respond differently than your emotional state initially suggests.

21:35 — Humanistic therapy & seeing more than pathologyA person isn’t merely a collection of trauma responses.Strengths, temperament, history, and personality matter.

23:38 — Is judgment learned or innate?Self-criticism, threat detection, temperament, hypervigilance, and the possible adaptive function of judgment.

26:08 — Intrusive thoughts, honesty & what love requiresYou can notice a thought without obeying it.The conversation turns toward honesty, kindness, and mature love.

27:26 — Attachment vs. limerenceFeeling seen and emotionally received is very different from romantic obsession.

28:51 — Serial limerence & idealizing unavailable peopleWhat are we actually chasing when we repeatedly fall for people who cannot fully meet us?

29:35 — Childhood attachment & intermittent loveA childhood doesn’t have to be overtly abusive for love to feel unpredictable.

31:08 — Repetition compulsion: trying to finally “win” unavailable loveWhy emotionally inconsistent partners can feel strangely familiar.

32:24 — Creating secure attachment in datingHow do you create steadiness when your own perception of relationships feels difficult to trust?

32:54 — Dating apps, micro-rejection & digital disconnectionConstant evaluation.Disposable options.Online self-objectification.And the psychological cost of dating through screens.

34:31 — Rejection sensitivity & why dating endings feel personalSometimes someone else’s withdrawal really isn’t about you.

35:09 — Why closure and honest communication matterA compassionate explanation can completely change how another person experiences rejection.

36:01 — Millennials, Gen Z & “getting your life together” before loveDo we really need to become fully optimized individuals before entering a relationship?

37:44 — Status anxiety, money & the dating marketplaceHas achievement become a prerequisite for feeling worthy of love?

38:22 — Dating apps and the illusion of infinite optionsWhen relationships start being evaluated like consumer products.

39:56 — Who pays for the date? Gender roles & modern dating scriptsChanging expectations around independence, provision, fairness, and being cared for.

42:47 — High-achieving women, identity & authenticityAfter achieving independence, what happens when someone realizes the life she built isn’t exactly the life she wants?

46:11 — Traditional gender roles without the gender warCan couples selectively create roles that actually work for them without turning relationships into ideological combat?

48:24 — Your partner cannot be everythingFriendship. Romance. Hobbies. Sexuality.What should a partner provide — and what should come from elsewhere?

49:28 — Desire discrepancy & mismatched sex drivesWhat happens when one partner wants sex much more frequently than the other?

50:50 — Do you want more sex — or do you want to feel desired?Sometimes the stated problem and the emotional need underneath it are not the …

Introduction

Dr. Nicole Ohebshalom joins me to talk about EMDR therapy, trauma,shame, attachment, the body, and high performers.We get into what happens when insight alone isn’t enough.Why some people intellectualize.Why not everyone experiences emotions strongly in their body.And why good trauma therapy involves much more than simply processingpainful memories.

This episode begins with a conversation about shame, and bridges intomany relevant psychology topics.Dr. Nicole Ohebshalom and I talk about:• How relationships activate old beliefs.• Why knowing your patterns is different from changing them (whyinsight alone can fail to heal)• EMDR negative cognitions.• Attachment wounds.• The body in therapy.• Intellectualization.• High performers.• Parts work.• Resourcing.• Why not everybody experiences emotion somatically (physically)• and also, why good trauma therapy sometimes requires slowing down.We also get into a misconception I hear often:"EMDR is just eye movements."EMDR reprocessing matters, and so does everything that makes thereprocessing possible.This is part 1 of a 2 part series, so keep an eye (or an ear) out forthe next episode, releasing soon.

Do you like mental health content that illuminates, rather than reduces or confuses?To receive new posts and support my work, consider becoming a free or paid subscriber.

Show notes with Timestamps

Chapters00:00 — Dr. Nicole Ohebshalom: EMDR, trauma therapy & sex therapyNicole's background in trauma studies, human sexuality, clinicalcounseling, EMDR, couples work, and women's health.00:44 — Shame, childhood trauma & attachmentWhere shame comes from.How early relationships shape adult intimacy.How shame becomes part of the dance between two people.01:42 — EMDR negative cognitions & fight-flight-freeze responsesThe beliefs underneath trauma."I'm not enough.""I'm too much.""I'll be left."How the body can continue reacting as though an old belief is still true.03:30 — EMDR reprocessing and changing relationship patternsWhat happens after a traumatic memory is processed?Can new relationship experiences help consolidate the change?04:12 — Couples therapy, attachment work, EFT & parts workIntegrating EMDR with relational therapy.Flash Technique.Emotionally Focused Therapy.Attachment figures.IFS and ego-state work.06:10 — Pelvic pain, vaginismus, anxiety & protective responsesHow physical symptoms can become part of a relationship cycle.One person pursues.The other withdraws.The body begins protecting itself.09:50 — The body in trauma therapyNicole's nursing background.Why she became interested in the connection between psychotherapy and the body.10:21 — “I'm not enough”: shame, schemas & negative beliefsThe beliefs people unconsciously organize their lives around.Self-concept.Intimacy.Abandonment.Dependency.The overlap between schemas and EMDR negative cognitions.11:31 — Attachment wounds and what the body remembersWhat message did your body pick up as a child?How early relational experiences become expectations about love,safety, and connection.13:46 — Emotional avoidance, defenses & blocking beliefsWhat happens when someone can't access emotion?Fear of feelings.Shame about emotion.And when emotional avoidance may function as a defense.14:17 — High performers, intellectualization & interoceptionA crucial distinction:Sometimes intellectualization is protective.Sometimes a person simply doesn't experience much sensation internally.Therapy shouldn't automatically pathologize that.15:19 — Is therapy too focused on “feeling it in your body”?The pendulum swing in modern trauma therapy.Why forcing emotional or somatic experience can itself become shaming.16:32 — Integration vs. catharsis in psychotherapyThe goal isn't necessarily to feel more:it's to integrate more.Why highly intelligent and high-achieving clients can understand allof their patterns and still remain stuck.18:12 — Trauma-informed pacing vs. avoidanceWhen should a therapist gently push?When should therapy slow down?How intellectualization can become an escape without becoming the enemy.19:21 — EMDR myths: it's not just eye movementsOne of the biggest misconceptions about EMDR therapy.Bilateral stimulation is only one part of the model.Case conceptualization, treatment planning, preparation, reprocessing,closure, and reevaluation all matter.21:17 — Why therapists shouldn't rush trauma processingThe temptation to immediately target a painful memory.Why good EMDR treatment planning asks what larger network that memorybelongs to.23:22 — High achievers, resilience & strengths-based trauma therapyTrauma survivors often arrive knowing everything that has gone wrong.What happens when therapy also helps them recognize what survived?24:48 — EMDR resourcing & the “positive memory playlist”Calm places.Wise figures.Nurturing figures.Past experiences of competence and strength.Building accessible memories that say: I can do this.25:51 — IFS, ego states & parts work in EMDRManagers.Firefighters.Protective parts.Addiction and emotional avoidance.Understanding what a protective part is actually afraid will happen.26:40 — Parts work, chronic PTSD & stabilizationWhy Nicole increasingly spends more time with parts of the self beforereprocessing.Creating internal resources before asking someone to approachtraumatic material.28:05 — Trauma preparation, containment & the window of toleranceSometimes slowing down makes the difficult work go more smoothly.Preparation isn't avoiding trauma work,It is part of trauma work.28:47 — Somatic therapy & body-based EMDR interweavesMovement during reprocessing.Getting out of the chair.Following physical impulses.Using curiosity when EMDR reaches a stuck point.29:38 — Movement, grounding & deeper trauma processingNicole describes using the environment and physical movement during anextended EMDR session.30:22 — EMDR 2.0, working memory & attention taxationMovement.Changing tasks.Additional attentional demands.And different ways of keeping one foot in the present while traumaticmaterial is being reprocessed.

TopicsEMDR therapy • trauma therapy • PTSD • shame • attachment • childhoodtrauma • couples therapy • emotionally focused therapy • negativecognitions • fight-flight-freeze • somatic therapy • high performers •high achievers • intellectualization • emotional avoidance • IFS •Internal Family Systems • ego states • parts work • resilience •trauma processing • trauma-informed therapy • EMDR resourcing •nervous system regulation • window of tolerance • pelvic pain •psychotherapy

I wanted to talk about the new Spider-Man movie, Spider-Man: Brand New Day: grief, trauma, how those things mix together and resolve. I want to also address resilience, and how women and men have to work together for trauma recovery. Even if you have not seen the prior movies, you should be able to understand what I address in this article.

Several years after No Way Home, Peter Parker lives alone and works almost exclusively as Spider-Man. That is his whole gig. Aunt May is no more after the attack by the Green Goblin. MJ and Ned are alive, but Doctor Strange’s spell has erased Peter from their memories. In order to protect the people he loved—his girlfriend and his best friend—Peter asked Doctor Strange to make everyone forget who he was.

So he lost his support network.

Peter visits Aunt May’s grave, watches his former friends from a distance, and channels nearly his entire existence into crime-fighting. He has become extremely effective as Spider-Man. But Peter Parker, as a human being, has almost ceased to have a personal life.

The movie gives us three responses to traumatic grief. Peter throws himself into work that helps others. Frank Castle throws himself into work that avenges and punishes. Jean Grey throws herself into personal vengeance. Super-sadness versus super-anger: that is complexity. That is the human experience.

Highlights from my conversation with Dr. Joshua Coleman on estrangement, recovered memory, and the validation vendor.

Dr. Coleman has a saying: when an adult child cuts contact, “dads get mad and moms get sad.” The anger and grief are the same emotional pain routed through different defenses: externalization in one, rumination in the other. He pairs it with the reminder that, “you can be right, or you can be reconciled, but you usually cannot be both.” Please listen to/watch our latest interview for the rich conversation that addresses the nuances of estrangement, as well as a variety of other relevant psychotherapy topics, such as how therapists can better address trauma. A longer essay will be forthcoming, but as this is a podcast post, the video is the main course, while these notes function as garnish. Browse our menu of topics below, to get an idea of just how much we address:

Timestamps for section chapters

00:00 Understanding Family Estrangement

02:48 Parenting Styles and Their Impact

05:24 The Shift in Family Dynamics

08:18 Generational Differences in Estrangement

11:11 The Role of Therapy in Healing

13:59 Memory and Trauma: A Complex Relationship

16:22 Navigating Parent-Child Relationships

19:16 Ethics in Therapy and Memory Recovery

20:04 The Complexity of Parenting and Mental Health

22:48 The Role of Therapists and the Importance of Choice

26:11 Accountability and Growth in Relationships

28:47 Understanding Estrangement in Family Dynamics

32:37 Radical Acceptance and Hope in Estrangement

35:54 Building Self-Compassion and Identity Beyond Parenting

37:42 Emotional Intelligence in Parenting Boys

40:28 Navigating Parental Investment and Modern Parenting Challenges

40:43 The Evolution of Parenting and Child Development

43:33 Differentiation and Emotional Boundaries

46:25 Cultural Perspectives on Parental Influence and Identity

Thank you Megan Against Injustice, RN, PsyPhi, Geraldine A. V. Hughes, Brenda D, Sandi, and many others for tuning into my live video with Joshua Coleman, Ph.D. Join me for my next live video in the app.

Stephen Seidel is a PR/media agency founder who believes in prioritizing connection, in a world that says “say it in a sentence or move on.” This healthy authenticity is a balm for modern masculinity, which is adrift in awful platitudes and misunderstandings. Please take a listen to our interview, in which Stephen addresses his “Reconnect, Rebuild, Reclaim” model for forging strength out of grief, both honoring the departed and fortifying our inner sense of self and purpose.

Voices on Grief, Connection, and Showing Up (Quotes from our Podcast)

Steve: “Vulnerability is invincibility. And only when we share our story do we allow ourselves to step into our power.”

Steve: “When you get to a place where you’re willing to let go and take your fists and undo them and you can put your hand over your heart instead of being stuck in your head.”

Jeremy: “Trauma was never your fault, but healing is always your choice and responsibility.”

Jeremy: “Bitterness really slows you down, not the person who hurt you.”

Steve: “It’s not what you do for people, it’s how you made them feel that they’re gonna remember the most.”

Jeremy: “When kids know you’re there and that you care, at their core, they know that nothing’s gonna shake them. That buffers like a probiotic, a force field from trauma.”

Steve: “Who do I identify with? Somebody who’s going to let the past dictate who I am, or somebody who’s going to lead by example for my daughter.”

Jeremy: “What you practice, you become. We build ourselves through habit.”

Steve: “On the deathbed, a lot of people who talk about their regrets, they just wish that they spent more time with their family.”

Steve: “People are gonna say no. Try anyway.”

Jeremy: “Being mindful means becoming the forecaster for the weather in our mind.”

Steve: “Those fries at the bottom of the bag, which we overlook so much, those are the special moments that we look back on to savor.”

Steve: “Goodbyes are for those who love with their eyes, because for those who love with their heart and soul, there is no such thing as separation.”

Note: an essay that aggregates our conversation into a compendium of choice quotes is forthcoming, as well.

Timestamps:

00:00 Introduction to Grief and Connection

02:55 Transforming Grief into Action

05:46 The Ongoing Relationship with Grief

08:43 Finding Glimmers in Grief

11:39 Men’s Mental Health and Balance

14:19 The Power of Connection and Legacy

23:15 The Importance of Male Emotional Connections

24:47 Exploring Masculinity in Modern Times

25:39 The Journey Deck: A Tool for Self-Discovery

26:35 Healing and Responsibility in Trauma

28:10 The Role of Journaling in Emotional Healing

29:32 Navigating Childhood Trauma and Parental Influence

31:39 Creating a Safe Emotional Environment for Children

33:15 Understanding Trauma and Identity

35:43 Overcoming Medical Trauma and Identity

38:47 The Impact of Medical Experiences on Mental Health

40:04 Curiosity vs. Judgment in Emotional Connections

42:34 The Power of Eye Contact and Connection

43:48 Mindfulness and the Present Moment

45:16 Creativity and Boredom: A Path to Self-Discovery

47:10 Fries at the Bottom of the Bag: Cherishing Moments

49:31 Creative Exercises and Their Impact

52:24 Lessons from the Entertainment Industry

57:02 The Importance of Connection and Community

59:49 Mindfulness and Mental Health

01:02:21 Reconnecting with Purpose

01:05:17 Experiences with Impractical Jokers

01:13:24 Upcoming Projects and Community Engagement

The Sentence Every CBT Therapist Repeats Without Knowing It

I recorded a podcas tinterview with Donald Robertson (see above), the cognitive-behavioral psychotherapist who has spent two decades arguing that Stoicism is the unacknowledged parent of modern CBT. Robertson (2019) opened the case with a clinical detail most therapists have never heard. Albert Ellis, in the 1950s, used to hand patients a single line from Epictetus during the orientation phase of treatment and build the entire ABC model around it.

“He said, read this quote from Epictetus, one of the main stoic teachers, it’s passage five of the Enchiridion, a handbook of Epictetus that says, it’s not things or events that upset us, but our opinions about them. And Ellis taught that, because it encapsulated what he called the ABC model.”`

Read that again. The cognitive model of emotion, the load-bearing assumption of every CBT manual on the market, was lifted intact from a Greek slave who died in 135 CE. Beck (1976) was equally explicit when he traced the philosophical origins of cognitive therapy to the Stoic school. Robertson (2019) documents both attributions in detail in his Philosophy of Cognitive-Behavioural Therapy.

The mechanism is the same one our patients are running every minute of every session. Stimulus arrives, appraisal fires, autonomic state shifts, behavioral output follows, downstream consequence locks the loop in place. Epictetus interrupts the loop at the appraisal step. Beck interrupted it at the appraisal step. The technology is identical. The licensure paperwork is different.

What follows is an argument I have been making in clinical consultation for the better part of a year, and which Robertson sharpened across two hours of conversation. The cognitive model has a documented prior author. Modern psychotherapy has systematically forgotten the prior author. The forgetting costs us decades of clinical refinement, and I can name the specific decades.

How a Therapist-Friendly Philosophy Got Sidelined Anyway

Robertson noticed the asymmetry early. Laypeople found Stoicism. Therapists did not.

“When I first started getting into stoicism, it was really a nerdy thing. And I didn’t have any little stoic friends at the time… weirdly, they seem to have kind of lagged behind a little bit the wave of popular interest in stoicism, which kind of surprised me.”

Two explanations sit on top of each other. Robertson (2019) attributes the first to clinician reading budgets. CBT practitioners spend their professional hours inside outcome research and treatment manuals, leaving the philosophical literature to specialists. The second is linguistic. The lowercase English adjective “stoic” means emotionally shut down, which reads as the opposite of what therapy is supposed to deliver. Most clinicians I have consulted with carry that conflation without noticing.

The conflation does material damage. Robertson made the corrective explicit in our conversation:

“What they call a value, which is an intrinsic quality of action and character, seems to me a weirdly convoluted way of just referring to what any student of philosophy would immediately recognize is arete or virtue… They’ve kind of reintroduced it as it were. Right now it’s like a hot topic again in psychotherapy.”

Hayes, Strosahl, and Wilson (2012) built acceptance and commitment therapy around values clarification as a third-wave innovation. The construct of values in ACT is arete in Stoicism. The framework was waiting on the shelf for two millennia, and Hayes rediscovered it under a new branding cycle without ever having to credit the source.

I will name the pattern at the center of this essay. I call it the Citation Amnesia Problem: a discipline that re-derives its own techniques every two generations because its institutional memory only reaches back as far as the most recent peer-reviewed manual. The pattern is not aesthetic. It is iatrogenic.

Why “CBT Already Does This” Misses What Got Left Behind

The standard pushback when I introduce Stoic frames in clinical consultation runs like this: the relevant techniques are already inside CBT, so the philosophical scaffolding is decoration. Robertson conceded that Ellis and Beck imported pieces of Stoicism into the clinic. He also named what they left out.

“There’s a difference between a bunch of techniques, or therapy is more than that, but it’s kind of moving in that direction and generalizing the whole thing so it becomes part of your identity and way of life… nowadays we’re more interested in prevention rather than cure. Resilience building is kind of the holy grail of psychotherapy… it’s dawning on people that if you want to do that, then you need to re-conceptualize the whole thing more in terms of a philosophy of life rather than a group of techniques or an intervention.”

Stoicism delivers cognitive technology inside a coherent meaning structure. Modern CBT, in its lean evidence-based forms, delivers the same technology inside a fifty-minute reimbursement code. The patient learns to dispute automatic thoughts, scores lower on the PHQ-9 at termination, and drifts back to baseline at six months because the technique was never embedded in anything that asks why a person should bother regulating affect at all.

Robertson framed it in evolutionary terms without quite using the word. Stoicism was designed as resilience training for a population that expected catastrophe as a baseline.

How Behavioral Activation Got Lost for Forty Years

The pattern of rediscovery has a specific, traceable case study. Beck, Rush, Shaw, and Emery (1979) published the standard treatment manual for depression with three major components stacked on top of each other: activity scheduling, automatic-thought disputation, and core-belief work targeting underlying schemas. Jacobson et al. (1996) ran the canonical dismantling study, randomizing 150 outpatients with major depression to the full Beck protocol, the protocol minus schema work, or behavioral activation in isolation. Across termination and six-month follow-up, Jacobson and colleagues found no advantage for the multi-component treatment over behavioral activation alone.

Dimidjian et al. (2006) replicated and extended the finding in a four-arm trial. Behavioral activation now sits in its own evidence base as a first-line treatment for major depressive disorder. Lewinsohn (1974) developed the underlying reinforcement theory of depression years before Beck’s manual appeared in 1979.

Robertson surfaced the lineage problem this exposes, and his tone shifted when he said it:

“Beck’s seminal book on cognitive therapy, nowhere in that entire book does he mention Peter Lewinson, who developed behavior therapy for clinical depression a few years earlier… We already had like, you know, this was effective in itself. What Beck added to it works, but it didn’t really add anything to the efficacy. And so that kind of blinded us for decades to thinking, CBT for depression is this multi-component treatment that combines activity scheduling and cognitive disputation… We could have had half a century of ongoing research in psychotherapy.”

Forty years.

Patients with major depression received the full Beck package across that span, including the cognitive components that Jacobson (1996) eventually showed contributed no incremental benefit. Researchers who could have spent the same four decades refining the active ingredient spent them tracking redundant scaffolding. The mechanism that produced the drift was citation failure. Beck did not credit Lewinsohn. The field assumed the package was load-bearing in all its parts. The Citation Amnesia Problem then closed the loop.

Robertson made the same point about Dubois (1909), the Swiss psychiatrist whose Psychic Treatment of Nervous Disorders described what we would now call cognitive psychotherapy. Dubois prescribed Seneca’s letters as bibliotherapy. He ran what we would now call cognitive disputation. The field absorbed Freud instead, forgot Dubois entirely, an…

How men can develop confidence, competence, and quests to serve them well for a lifetime.

A quote-driven compilation from my conversation with Brian on what the male nervous system actually needs

Jeremy Fox, LPC

Brian and I have been bouncing observations off each other on X for a while. When we finally sat down on his Sanity and Society podcast, the conversation moved faster than I expected. What follows is a compilation of what I think were the most clip-worthy lines from both of us, organized around the natural arc the conversation took. The framing is light. The quotes are doing the work.

Where It Has Gone Wrong

Brian opened with a wide-angle question: where, structurally, has the relationship between men and therapy broken down. My first answer was about venues.

JEREMY:

“The elimination of third spaces where you don’t have home and work, and now even that’s collapsed into one space. Men do really well with parallel play.”

Brian picked up parallel play immediately and ran a clinical observation through it.

BRIAN:

“You put two men together and they’re building something or they’re chopping, they’re going to get vulnerable. They start talking about that, but they’re not looking at it.”

The geometry of male connection is sideways rather than face-on. The activity is the medium. When the venues for shared activity vanish, the male coalition has nowhere to assemble, and what shows up in my consulting room is the downstream effect of that vacancy. Brian named the somatic component of it next.

BRIAN:

“So much of why men struggle today is because they are deeply, deeply disconnected from their own sense of pleasure, which exists in their body and is actually rooted in deep cultural homophobia.”

I had not heard that exact framing before.

BRIAN:

“The moisture, the moisture, right? So many men are just so dry of the moisture of life, that Eros.”

Coupling Off as the Default Male Strategy

What men do, in the absence of a friendship coalition, is route the entire relational load onto a romantic partner.

JEREMY:

“Your best hope is to couple off, outsource the relational component to your wife, hope that that provides you a good social life, do stuff with other couples, maybe. But that’s not your only route to friendship as a guy.”

Brian flagged the deeper cultural prohibition underneath that strategy.

BRIAN:

“The idea of relying on somebody as a man is such a thing there. We’re about to be the needless man.”

He framed his own location on the cultural map honestly.

BRIAN:

“I’m kind of a 50 percent red pill, 50 percent therapy guy. I kind of split the difference a little bit because there’s a lot in there.”

My corresponding observation was about the asymmetry between the sisterhood and the absence of any comparable brotherhood.

JEREMY:

“Some men, when they marry, it’s the wife and kid, they don’t pay forward or mentor other dudes. Women do that. There’s a sisterhood. There’s old wives’ tales. There’s women teaching other women how to attract, how to drop the handkerchief, so to speak.”

Church culture illustrates the asymmetry at the scheduling level.

JEREMY:

“In the church, you’ll see tons of women’s Bible studies, which is amazing. And then you’ll see men’s stuff is usually sunrise, like start at six or seven, so that they’re not doing it at night and they can be home.”

Self-Esteem and the Test Men Are Not Allowed to See

Brian offered one of the cleanest lines of the conversation on the male route to a coherent sense of self.

BRIAN:

“For men, I feel that self-esteem is built through doing esteemable things. Where I feel like for women it’s way more relational.”

I extended the point through the cultural script.

JEREMY:

“Women get told a lot, sometimes very directly, sometimes very rudely. Men aren’t given the answers to the test. Even if the answers are cruel and superficial, men are told figure out what’s on the test, but if you fail, you’re F’d.”

Brian named the silent killer underneath this script.

BRIAN:

“The lie that there’s nothing expected of men in the world is a huge, huge thing. And it is a silent killer because it is communicated in every other way.”

Anger, Aggression, and Meeting Amorality With Eyes Wide Open

Brian opened the section on male aggression with what he frames as a cultural castration.

BRIAN:

“Men have been culturally conditioned away from their aggression, away from their anger, away from their sword. That fire in my belly, that is the same fuel that burns into my vitality.”

My response leaned on the trauma piece.

JEREMY:

“Trauma teaches us to fear anything unknown or suspenseful. And that’s where fear of all male aggression or male anger or vitality comes from. It is trauma, and it’s curable, full stop.”

The conversation moved to the meekness-versus-weakness distinction. The Christian formulation only works when the strength is real.

JEREMY:

“Meekness is not weakness. Meekness is a decision from strong men to lead in a righteous way. If you’re weak, you can’t really be meek, because you’re just afraid. You can only be righteous when you’re deciding against evil, not when you’re too scared to do evil.”

Brian brought the dark triad framework in, and offered a coinage worth sitting with.

BRIAN:

“I only know true empathy through my own impulse for sadism. I only know altruism through my own instinct to be self-oriented and self-serving. You have to go through the negative polarities of this triangle to flip it on its head to get that light triad lifestyle.”

Then he made the move that I think will travel furthest from this episode.

BRIAN:

“There are amoral men that exist, and a lot of these men run the f*****g world. I believe that there is a necessity for the good men to meet that amorality with eyes wide open. With eyes wide f*****g open.”

I underscored the point from the religious tradition.

JEREMY:

“Anger isn’t a sin. The Bible says be angry and sin not. Great men throughout the Old Testament and the New have had anger. Peter cut off someone’s ear who was trying to arrest Christ on the day He was apprehended in Gethsemane.”

Eros and the Body

Brian returned the conversation to the body, which is where his most original work lives.

BRIAN:

“The people who are most seductive, they’re seducing life.”

He described his own physical practice as a non-negotiable.

BRIAN:

“I have to have like skin-to-skin male contact in my life. Like pickup basketball, like wrestling, like activity. There is something singular that exists within a fully male space that has permissiveness for some of the aggression, some of the anger, some of the loudness, some of the messiness.”

And then he named the political reason this is rare.

BRIAN:

“Groups of men that are cohesive and aligned and together in a group is very dangerous, right? To people. So I think it’s discounted. I think some of it is kind of intentional. They want men alone. They want them stripped away from the Eros.”

My addition was about what happens to men who lose access to sensory aliveness entirely.

JEREMY:

“Men are paying for these retreats to go basically LARP, to live-action role-play as a soldier. They’re transmuting their desire for pleasure into this sort of almost desire for pain. There is a craving that men have to be in touch with sensory experiences, and the men who are the driest make really good defenders in some ways, or really good sacrifices, but they don’t have the Eros, they don’t have the joie de vivre.”

Why Dating Apps Are the Wrong Fishing Rod

Brian made one of the more original somatic observations of the conversation.

BRIAN:

“We’ve all been so trained and conditioned to this visual instinct, this visual impulse, this visual attraction. And I think that it really, really discounts our biology. Attraction is way more pheromonal, energetic.”

My version of the same problem was structural.

JEREMY:

“We’re scaling and optimizing for addictiveness whenever it’s apps. Now that they’ve opened Pandora’s box on the trading-card facet of, get a little card, swipe left or right on it, that’s just the thing now. When that was discovered, that became the arms race tick…

Where Male Ambition Goes When Nobody Wants It

A conversation with Lisa Britton on undirected male energy, male-friendly therapy, and how men can survive and thrive in today’s world.

NOTE: for timestamps of specific mic-drops and imprtant points, go to the botton of this article

Lisa Britton came to the men’s mental health question from inside feminism. She volunteered abroad in Tanzania, the Middle East, and Central America (8:30), helped build a girls’ dormitory in a Tanzanian village where, in her words, they still see daughters being sold for the price of a goat (2:14). She returned to the United States, attended the first Women’s March in 2017, and described the moment that turned her: a small girl on her father’s shoulders, instilling a victimhood mentality in this little girl before she could even spell the word victim (3:15). She has been working on boys and men ever since.

I wanted to interview her because her core observation maps onto my own clinical work. Britton argues that male ambition does not vanish when shamed, but instead relocates. Where it goes, and what it does once it gets there, is the basis of our conversation.

Where the energy goes

Britton’s recent viral piece on the demonization of male ambition came out of a Wall Street Journal article framing the male-dominated podcast space as a sexism problem (11:00). Her response is as follows:

“If we try to shame male ambition and make men and women exactly the same, that might actually hurt our innovation.” — Britton (12:30)

She described watching a friend’s boyfriend channel his striving into video games, raising the question of whether the gaming environment is now the de facto container for male ambition (13:35). I offered the evolutionary frame in reply:

“Sports, when done well, approximate the ancestral male reward loop. You have the fighting and winning instinct that they can pursue. You have physical fitness and exhaustion, healthy exhaustion, healthy feeling of accomplishment. And you have team bonding dynamics.” — Fox (14:41)

And then the clinical concept that names what is happening in the redirect:

“There’s this concept of a super-stimulus, or an exaggerated artificial version of a natural stimulus. We love sweetness as human beings, fruit, other naturally occurring foods. But then you have super sugar saturated foods that we’ve got now that addict us to this new hypercharged version of something. Video games are super gamified competitive stimuli that don’t always add to your ability to earn money, provide for a partner, or climb a status hierarchy as a male.” — Fox (15:18)

Britton agreed the redirect is real. The energy is still there, but the container has changed.

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Capable, not confident

The most generative reframe of the conversation came when Britton substituted the capable in place of confident (17:50). I had raised what I think is one of the most damaging cultural misconceptions about male psychology:

“Men aren’t born confident. There’s a cultural misconception that women have to be taught confidence and boys and men are naturally born that way and need to be tamped down. But many aren’t, especially now where you’re not taught: go for the gold, constantly trying to shine. Men have to know when to lead, but they’re not supposed to practice it. You have to keep practicing this to get that up.” — Fox (17:00)

Britton’s response did something better than agreement. She refused the word entirely:

“You can do this for yourself by just waking up every day and being like, you are capable. You’re capable in almost imagining scenarios and how you would react in that scenario.” — Britton (18:14)

She illustrated with a journalist whose wife went into labor in an ambulance: rolling up my sleeves, guess I gotta deliver this baby (19:30). The point being that capability is not waiting until you feel ready; it is cultiviating an internal belief that one may become competent.

The reframe matters clinically because it sidesteps the cocky-versus-arrogant debate that derails most conversations about male confidence. As I put it in reply:

“The a-hole factor is what we would call in behavioral science an intervening variable. It’s a variable that is not the key one. It’s confounding. It’s actually that competence and that self-assuredness. An after-effect of that is that some men just don’t care how they come across.” — Fox (20:33)

The therapy problem

When I asked what therapists should do better, Britton flagged a structural issue I have discussed for some time:

“We seem to be almost blaming and shaming men... I don’t think we should be telling men they have to change for our mental health system. I think we should be changing our mental health system to better support men’s needs.” — Britton (22:10)

Her argument is not that the feminine model is bad, but that we keep telling men they need to change to fit the system, rather than asking whether the system needs to change to fit them. She volunteered EMDR as one of the modalities that already does this differently, having done EMDR herself for a childhood accident (23:50). She described her therapist’s metaphor of a disorganized file folder, where reprocessing files the memory properly so the brain stops re-living it (25:30). That metaphor is essentially the Adaptive Information Processing model in everyday language.

Then she said something that should be quoted at every continuing education event:

“EMDR therapy for men should be promoted up the yin-yang. You don’t have to talk. It’s logical, it’s scientific. That’s an approach we should be promoting for men’s mental health.” — Britton (26:45)

I elaborated on why and how EMDR fits the male presentation:

“Men have what Roger Kingerlee would call this reflection abandonment mechanism. When they start getting in their own heads, they will push that away, and they experience externalizing symptoms of trauma, addiction, lashing out, anger, stuff that points to deeper hurt, but that doesn’t outwardly say I’m hurting. EMDR helps the person to lock into that signal of trauma, reprocess it with minimal verbalization. The therapy is very gamified. It’s very structured and sequential. You have a clear task there. It’s not pity-based. Pity for men in therapy is the kiss of death.” — Fox (27:25)

This aligns with Kingerlee, Precious, Sullivan, and Barry (2014), whose work on engaging men in therapy through male-specific service design informs my clinical approach. Their argument is that less extreme forms of male distress routinely go unrecognized because men, and the people around them, abandon psychological reflection before symptoms even become visible.

Britton then named the second structural problem. She described a moment when she shared a phrase with her own therapist, the future is everyone, and watched her therapist flinch and then circle back to call it offensive (35:00). She realized the relationship was over because the ideological mismatch had broken trust:

“This must be how a lot of men feel when they go to therapy. If we did have that kind of trusting relationship, I’d have to walk on eggshells. That’s not the place you want to be as a client with a therapist, is to walk on eggshells to make sure you don’t make your therapist upset. That defeats the whole purpose.” — Britton (35:50)

I responded with what I take to be the professional baseline:

“It’s not our job as therapists to get offended. Certainly when someone shares an ideological difference with you as a therapist, it’s not my job to intervene and say, hi, I don’t like that. It’s my job to be respectful of their beliefs and work with them if I can. It’s always about the client needs. It’s not about our needs or comfort as a therapist.” — Fox (34:32)

Holloway, Seager, and Barry (2018) confirmed empirically what Britton intuited experientially: male clients routinely identify systemic barriers to help-seeking that map onto exactly this dynamic. Walking on…

The Manosphere Isn’t the Problem. The Empty Center Is.

What a conversation with Dr. Nathalie Martinek clarified about why young men keep wearing identities like loaner cars.

I sat down with Dr. Nathalie Martinek to talk about the Netflix Manosphere documentary. We discussed gender relations and algorithms, eventually reaching the topic of postmodern absence of identity.

Nathalie said something that sticks:

“There’s a lot of people walking around who have no actual center. They wear these different identities and absorb the belief systems associated with them. Now I’m a feminist. Now I’m an incel. Now I’m a this. They’re largely invisible to themselves.”

That is an entire essay in one paragraph. The Manosphere functions as a vacancy filler, and its mirror image on the other side does the same job. Both keep working because the people downloading them have no stable internal structure to push back against the install.

The Vacancy Came First

Costello et al. (2022) profiled 151 self-identified incels and found 75 percent screened for moderate or severe depression and 67 percent for moderate or severe anxiety, with elevated loneliness and suicidal ideation. Fowler et al. (2022) reported that males accounted for nearly 80 percent of U.S. suicide deaths in 2019, with most male decedents carrying no known mental health diagnosis on record. The Manosphere is scavenging a demographic that has already been abandoned.

Nathalie put it plainly: “There used to be an ecosystem around young men. Family, village, uncles, grandparents, religion. Secularization scattered it. Opportunists fill the void.”

The Resentment Industrial Complex

She has a phrase for what the opportunists sell: the resentment industrial complex. The cousin concept is Rob Henderson’s luxury beliefs, though resentment runs lower on the income ladder and hits its consumers harder. A creator notices what gets engagement, drifts toward it, and sells a worldview he may not personally believe to an audience whose entire life will be organized around it.

I have written about this as digital dissociation and audience capture. Natalie sharpened the point: consumers “buy in, embed it into their identity, and just breed more resentment.” Frustration → algorithmic discovery of resentment-coded content → parasocial attachment → identity adoption → behavioral imitation → renewed frustration → re-engagement with the same source. The loop pays the creator and impoverishes the follower.

The Fairytale Industrial Complex

Halfway through, Nathalie cited a phrase from a writer named Francesca: the fairytale industrial complex. Men get sold the Beast-and-Aladdin arc where confidence plus grand gesture wins the girl. Women get sold the princess waiting to be seen and selected. Both scripts collapse on contact with adult life, and the participants cannot name what went wrong because the script was never visible to them as a script.

This is what I call orphaned instincts. The evolved drives are intact. Men still want to provide and protect; women still want to assess and select. Legitimate channels have closed. The substitute channels (dating apps, parasocial influencers, sports betting, OnlyFans subscriptions) absorb the drive without satisfying it with human contact. Sympathetic nervous system debt does not get repaid by swiping.

What Therapy Got Wrong

Nathalie and I diagnosed the therapist class as the new clergy: pastoral authority paired with credentialing, often without the lived material to back either. The field has positioned itself adjacent to a demographic it has not bothered to learn how to reach. A profession that treats male ambition as suspect and male bluntness as aggression will not be the place where a struggling 22-year-old goes for help. He goes where someone tells him he is allowed to want things and offers him something to do about it.

The Manosphere figured this out. Therapy mostly did not.

What Replaces the Vacancy

Communities are a need, not a luxury. Young men require ongoing relationships with trusted male elders who can correct them without performing it for an audience. Women need the same from women. Both need real friction with the other sex in person rather than the curated frictionlessness of an app.

The Friction Thesis applies. The young man who builds skill, takes rejection in person, and gets corrected by an older man who actually likes him is doing the developmental work the Manosphere monetizes the absence of.

Develop a center. Then the identities stop sticking.

Dr. Nathalie Martinek writes at drnataliemartinek.substack.com. Her work on gurupreneurs and the resentment industrial complex shaped most of what is good in this piece.

References

Costello, W., Rolon, V., Thomas, A. G., & Schmitt, D. (2022). Levels of well-being among men who are incel (involuntarily celibate). Evolutionary Psychological Science, 8(4), 375–390.

Fowler, K. A., Kaplan, M. S., Stone, D. M., Zhou, H., Stevens, M. R., & Simon, T. R. (2022). Suicide among males across the lifespan. American Journal of Preventive Medicine, 63(3), 419–422.