EPISODE #1003: Why Youth Mental Health & Suicide Matters to Everyone – Dr. Mark Goulston

Today, as usual, we have our live audience from the Upgrade collective. Go to daveasprey.com if you'd like to be part of the live audience and ask me questions and help me ask questions of our guests. Today's guest is going to talk about something that's not very comfortable but something that is more real than some of the things you may have heard about in the news over the last couple years, and that is a major, major epidemic of teen mental health problems and even suicide. So we're going to go deep with an expert today. Guys lived a very long and learned life about what's driving this. And as a father of teenagers myself, this is something that I don't want affecting my kids. I don't want affecting their friends. I don't want it affecting anyone on the planet because I was a pretty miserable teenager. To be true. So if you're a parent or just an adult who cares about teenagers, this episode's for you. We're not going to pull any punches. We're going to call it like it is and tell you what to do about it. The bottom line is you are going to learn how to listen to teenagers and help them realize their emotions in a way that was probably way more useful and direct than you learned, because probably no one ever taught you that. So we're just going to teach you how to help the kids understand without telling them what to do, without giving them advice. Because as you might already know, teenagers don't want advice from their parents, but they'll oftentimes take it from someone else. Our guest is Dr. Mark Goldston, retired psychiatrist, former UCLA professor of psychiatry, who had a subspecialty focused on suicide prevention. Oh, and he's a FBI and police hostage negotiation trainer from earlier in his life. The technique we're going to learn today is called surgical empathy, and it's an approach that helps people reach into the core of their pain. You don't have to go all the way with teenagers on that, but we're going to talk about it. And I will tell you because I was on his show. Mark's a wizard. He goes deep and he can see things just by looking at you the way you'd expect from someone with more than three decades of work helping other people see the invisible inside themselves. Dr. Mark, it's an honor to have you on the show.

Well, thank you for having me on. And maybe between the two of us, we'll ease a little bit of mental health issues that are going on in our youth and our teenagers. Young Adults and maybe even save a life. You just never know. And there was a video clip that I wanted to show. Can I tee that up? And then, yeah. A friend of mine, Jason Reed, he's a serial entrepreneur. He's a black belt. He's. He started 25 businesses. Many of them failed, but many of them succeeded. But four years ago, his son Ryan, just after his 14th birthday, died by suicide. And Jason has never been depressed, so he didn't understand this. And in fact, the backstory is he was on vacation with his wife and enjoying how good their life was. And they got a text message from Ryan that said, don't blame yourself. I'm so sorry, Goodbye. And Jason started screaming. And they called home and his mother in law was there and he said, go find Ryan. And she went around the house and up in the attic, Ryan had hung himself. This changed Jason's life. Ryan left one note, a couple notes. One was the. The code to his computer, and it looked like he was looking for ways to kill himself for months. And another post it note said, tell my story. So Jason did a documentary called Tell My Story, which is on Amazon Prime. And it's heart wrenching and riveting. And Jason went up and down the west coast and spoke to parents, experts. I'm in the last 10 minutes of it. And spoke to teens who had been suicidal but were now doing okay. And what he discovered is that what was most riveting about that was the teens talking about their low points. So he has a new documentary called what I Wish My Parents Knew, because it's what he wished he had known, but he was too late. And in it, he interviews 10 teens who are doing okay about their low periods. And I've been looking for 25 years for something that will help parents and teenagers communicate differently. And so we're showing this to audiences of parents and teens in high schools and junior highs because you can't help but care about these teenagers and see your own teenager in them. So can we play the trailer to it, please?

My kid, he'll be fine. He just needs to toughen up.

Honey, it's your first crush. There'll be others. Just get over it.

You go talk to her. She's just gonna yell at me again.

Besides, she'll cool off by morning.

You don't wanna eat? Fine, starve yourself.

Those other kids are just playing around. You just need to loosen up.

It's all a little fuzzy on what was going through my head at that time. I honestly don't really remember. It's Very fuzzy to me. But I just remember I was just upset, angry and just done. And I guess it all just kind of built up to that moment.

So somehow in your head you thought.

Being dead was better, being alive?

Correct.

I felt like I wasn't supposed to cry. I felt like I wasn't supposed to tell people how I was feeling. I felt like that was weakness. So what I did instead is I tried to show strength by never crying, by bottling everything up, by making sure that nobody knew how I felt. That was my sole goal. Because I didn't want to be a burden to anyone else.

I think I held in a lot of like what I was going through. Like I would share with people my like, external life circumstances. Like I would say, yeah, like, you know, my dad's going through a hard time or things are like difficult at home. But I would never tell people the extent to which, like I felt internally or like what thoughts I was getting.

So when I was 7 and 8, I would say that's when I first realized that something with me was different than what I was told to believe. And I started having a lot of self hate roll in because I thought I was something wrong. I thought I was something out of my control. I knew it was something out of my control. So because that I was wrong and basically just not a human in ways.

I don't feel like there is one like exact point, but once I started like getting closer with my friends because when all of this was happening, I wasn't talking to anyone. I was just kind of distancing myself. I wasn't going out, hanging out, going to play basketball at the moment, park nothing. So I feel like once I started making an effort to be around people that I knew liked me, I guess I feel like once I was around them and I was happy and I felt like safe, I feel like that was a turning point that I realized.

That I kind of matter, you know, Dave, as I listen to that, I'm reminded when I was practicing, I would occasionally ask people what seems to help, let's do more of that. And I'll never forget there was this one young man and he said, what you don't realize is I'm a burden to everyone. I scare my parents, my brother and sister think I'm manipulative, which I am. I don't like anything about my life. And so I think, why don't I just relieve the world of this burden? And what helps is when I started seeing you, Dr. Goulston, you smiled and you were glad to See me. I remember I looked over my shoulder because I didn't think you were looking at me. You know, I thought you were crazy. I still think you're a little crazy, Doc. But I wasn't a burden to you. And you were like an oasis. And when I'd seen other people, and they were very good and they were professional, but it was always kind of serious. Are you taking your medicine? How's that going? You know, you're having side effects. And that really stuck with me that a lot of these young people, they just feel like they're a burden to everyone. Wow.

How is that different than 10 or 20 or 30 years ago?

Well, look, I think the Internet is wonderful, but there's a downside to it. I think something. And I'd love you to weigh in on this, because I think to a certain extent, the Internet has addicted the world to adrenaline rushes. And what's happened is there is a chemical called oxytocin that is atrophying. And oxytocin is the chemical that underlies emotional connection. And most of your audience, and I'm sure you know that high cortisol is connected to high stress. But what a lot of people don't know is that high oxytocin counteracts high cortisol. And so when people feel felt, not just understood, oxytocin goes up and cortisol goes down. The blood flow that their amygdala has hijacked to their lower brain goes up to their upper cortex, and they can begin to think. And here's an example. I don't know if you'll be able to sort of catch the nuance. Here's the difference between clinical empathy and what I'm calling surgical empathy. So my definition of surgical empathy is that when you've been traumatized and you just feel awful about life, you form a. Psychological adhesion to death is something that will take the pain away. And it's an adhesion. It's not an attachment. You can sometimes reason through attachments, but an adhesion is like something that happens after surgery when some of your organs adhese together and you have to go in and break the adhesion. And surgical empathy causes someone to feel felt, which is different than feeling understood. So here's an example of clinical empathy, responsible empathy, and surgical empathy, and see if you can detect the difference. So clinical, responsible, checking the box as empathy might be. Have you been depressed? Yes. How long have you been depressed? Six months. Have you had thoughts of hurting yourself? Occasionally. Do you have a plan? How Far has that gone? I don't have a gun, but I do have pills and that's responsible and you're doing it and you're kind. That's responsible. Check the box is clinical empathy. Here's surgical empathy. It's clear when you're coming in, you're not a happy camper. See if you can feel the difference, you know. And Dave, you had mentioned to me that sometimes the feeling side of life eludes you, but you come in and you're feeling low. And what the therapist says is you've been depressed, haven't you? Yeah. You've been really depressed, right? Yeah. You've had times when you didn't know how you were going to make it through the day.

Are you saying that the therapist is kind of putting words or putting thoughts in the person's head or are they just empathizing?

Well, I think it's a combination of both. But what you're doing is, see, when you ask questions to someone, there's a certain challenging to them, you know, well, if I say I've been depressed, if I say I've been suicidal, are you going to lock me up? You know, I may be depressed and suicidal, but I don't want to go into a hospital. And so you're asking questions, which makes sense. But when you make a statement and you're asking them to try it on, you're non judgmental, you're sharing something and they can come back and say, no, I haven't felt that. So in a sense you're connecting with them in their pain. I know we have a fair amount of time. Can I share an anecdote that really changed everything for me with one of my highly suicidal patients?

Please do share it.

So one of my early mentors when I trained at UCLA in psychiatry was a fellow named Dr. Edwin Schneidman. And if you look him up, S H N E I D M A N he was to suicide prevention what Dave is to biohacking what Peter Drucker is to management. And he was one of my early mentors, but he was also one of my early referral sources. And what would happen is after I went out into practice, he would go do consultations up in the inpatient units and he would see patients that needed to be discharged who were still suicidal, but they weren't acutely suicidal. And sometimes people would be in the hospital for a month or more back then. It's not like it is now. And so he'd be called upon to do a consultation and in order for them to be discharged, he needed to make a referral. And one of those main referral sources was me. And he would always make the referral in the same way. He would meet with the young man or young woman or an older man or woman, and he call me and page me, and he'd say, mark, this is Ed. I'm with this handsome young man. I'm with this lovely young woman. They're in a lot of pain, Mark. You could help them, see them. And then he'd put them on the phone and they'd be discharged, and I'd see them. One of those patients, I'll call Nancy. And she had made several suicide attempts prior to my seeing her. And she'd been in the hospital several times over the years before. And I was seeing her for about six months, and I didn't think I was helping her at all. But she came, and that was probably the longest she'd gone without a suicide attempt. And she didn't make eye contact, Dave. So if you're looking at me and I'm Nancy, this is her. She's not exactly catatonic, but she's not all there. And in those days, I used to moonlight at a state hospital, Metropolitan State Hospital in Norwalk, California. And I would cover for other psychiatrists. I'd do admissions. I'd be called to the. The inpatient wards, the right orders. And sometimes I wouldn't sleep for 24, 30 hours. And when you're sleep deprived and you can tell us the science behind this, your physiology kind of acts up on you. Your teeth get a little loose, your sphincters get a little loose. I won't get any more graphic than that. And so there I was, having moonlighted for one weekend, and I hadn't slept for 24 hours or maybe longer. And there's on Monday, it's Nancy, she comes in just as she always did. And as I'm seated with her and she's not looking at me, all the color in the room went to black and white. So I'm looking at the room, and it's not color anymore, it's black and white. And I'm feeling these chills. And I thought I was having a stroke or a seizure. So I'm a psychiatrist and did a little training in neurology. So I did a neurologic exam on myself to see if I was having a stroke or a seizure. So I'm sticking my finger out to see if I'm seeing double. I'm tapping my elbows, tapping my knees, and I'M all there. And I thought, I'm not having a stroke or seizure. Then I had this crazy idea that as I was looking out on the world, I was looking at the world through her eyes, feeling what she felt, black and white and cold. And so I leaned into it and it got colder. And then, because I was sleep deprived, I said, nancy, I didn't know it was so bad. And I can't help you kill yourself, but if you do, I will still think well of you. I'll miss you, and maybe I'll understand why you had to to get out of the pain. And I thought to myself, did I think that or did I say that? And I thought, I think I just said it. I just gave her permission. And that was the first time, Dave, she looked at me and she was kind of like this, you know? And then she locked on my eyes and I got a little paranoid. I thought she was going to tell me, thank you for understanding. I'm overdue. And I said, what are you thinking? And she locked onto my eyes like I'm locking onto yours. And she said, if you can really understand why I might have to kill myself to get out of the pain, maybe I won't need to. And then she smiled and I locked under her eyes and I said, I'll tell you what we're going to do. I'm not going to give you treatments unless that you've been on that haven't really worked unless you ask for them. Is that okay? And she looked at me and nodded with a nod that said, keep talking. And then I looked into her eyes and I grabbed onto her eyes and I said, what I'm going to do instead is I'm going to find you wherever you are. And when I find you, I'm going to keep you company there because I don't want you to be alone. Would that be okay? And then her eyes got a little watery and she nodded. And I think we turned a corner. Now a lot of you listening in will say, you know, this guy's given me the ewee gees, we can't do this. We're just regular people. So I want to give you tactics that you can use if you're worried about someone. And if you're a parent and you're worried, or you're a sibling of someone you're worried about or a spouse. Here is the script. You can modify it, but this script will work pretty well. If you're a parent and you're worried about one of your kids, do this when you're doing an activity. Do not do a heart to heart talk with your teenagers. That they don't initiate is nails on a chalkboard. If you have a teenager and you do that, they don't like it. So when you're doing an activity together, here's the script. Hey, honey, all of us parents are worried about our kids. I'm worried about you. You know, the school's open, school closed, school masked. You know, we're all kind of worried. Can I run some things by you? Hopefully they'll say, okay, and there's four prompts. And I'll give you a little another taste of surgical empathy. At its worst, how awful are you capable of feeling about your life or yourself? And they're going to go, what? Because this is an unusual conversation. At its worst, how awful are you capable of feeling about your life or yourself? Pretty awful. Surgical empathy. Pretty awful or very awful? Okay. Okay, very awful. Prompt number two. And when you're feeling that, how alone do you feel with it? Pretty alone. Pretty alone or very alone? Okay, very alone. Third prompt. Take me to the last time you felt it. What? Or they're going to say, WTF? Yeah. Was it 2:30 in the morning the other night we heard you walking around in your bedroom and sounds like you couldn't sleep. And the interesting thing is when you get someone to tell you something specifically that you can see with your eyes as the parent or the listener, they re feel it, but they're not alone. Yeah, I woke up, I couldn't get to sleep. And you know, yeah, we heard that. What was going on? Well, I couldn't get to sleep and. Well, what'd you do next? Well, I hit the pillow and I thought of kicking the wall and I just wasn't able to get to sleep. That sounds awful. What'd you do next? I started looking around for cough medicine. I just couldn't find any to knock myself up. And then what happened? It just wasn't working. And I knew I had a test the next day. And then what happened? The sun rose. I felt a little better. Here's the fourth prompt. If you're lucky, you will have earned the connection. And you say, look at me and they'll look at you and you say, here's the fourth. It's a request. It's a favor. It's more than a favor, but let's keep it as a favorite. Whenever you're feeling that way or you're heading down that road, I want you to do whatever it takes to get your dad, your mom, or My undivided attention because we got a million things going on and there's nothing more important than helping you feel a little less alone when you're feeling that awful. So will you do that, please? So could you track with that at all, Dave?

Absolutely. I was taking notes on it. That's profoundly good advice. And it's different than what you hear. It's quite different. And the psychology of being seen for that is, is similar to some of what happens during 40 years of Zen or during almost any group transpersonal psychology experience where being seen talking about something like that, being heard and then not being, you know, violently ejected from the group usually is, which is what people feel like is going to happen if they admit vulnerability or whatever. That in and of itself is probably oxytocin inducing, but it, it's clearly healing in and of itself and it, it seems to repattern the trauma. But if you try to do the trauma repatterning all by yourself, it's very difficult to do it without at least one witness. And it seems like ideally at least two or three others. Does that, does that work within your context or is one person enough? And it may be different if it's a parent, but you know, if, if this was both parents, is it going to work better or it might be different for teenagers?

I don't know. Well, I think it's the context of the relationship. If they have a modicum of trust that you can actually hear them. And also if you're listening in and they start to cry, don't panic, that's good because they're crying with relief. They're crying because of the oxytocin surgeon and they're feeling relief at not feeling so alone. After Anthony Bourdain and Kate Spade died by suicide, I wrote an article which you can still find called why Do People Kill Themselves? It's not Depression. So it got 400,000 views in a couple weeks because that's kind of a dicey title. And what I talked about is that there's hundreds of millions of people who are depressed who don't kill themselves. There's many people get divorced or lose a job that don't kill themselves. It may contribute to it, but in my work as a 40 year specialist in this area, one of the things that I've observed that nearly all suicidal patients or people feel at the end is they feel despair. So you might want to write this down too, Dave. If you break the word despair into D E s hyphen P A I R des pair, they feel Unpaired unoxytocin. They feel hopeless without a future, helpless, without the ability to get out of where they are. Powerless, useless, worthless, purposeless, meaningless. And when they all line up together, pointless to go on. And so they pair with death to take the pain away. It's like the sirens calling out to the sailors, Come on, sail onto the rocks I'll take your pain away. And I'll tell you, people who have been suicidal on more than one or two occasions, they still carry it in their minds. They just don't talk about it. But in their minds they feel, if worse comes to worse, I can always take myself out. And so what we're talking about with surgical empathy is pairing with them so that if they feel, felt like Nancy did and not judged, that maybe they let go of the death as the only way out and hold on, grab hold of the empathy. I want to share something. It's a little bit of a tangent, but I write for the Newsweek expert forum. If you look up Newsweek Gulston, you'll see a lot of my pieces. And I just write about a lot of different things. And I want to run something by you. I don't want to get into politics, but I. I wrote up a fantasy conversation between an anti science anti vaxxer and a pro science pro vaxxer how empathy can maybe bridge the divide. So this is a fantasy conversation where the pro vax or pro science person says to the other person, how come you're not taking the vaccine? Well, I hear a lot of mixed messages and I don't think I need to take the vaccine. But putting other people in danger in your family, and there's a lot of proof. Yeah, I still don't want to do it. So in the fantasy dialogue, the provaxer says the other person. And by the way, here's another technique. In surgical empathy, it's called the five Reallys, where someone says something, you can say, I understand that, but what's really going on? Well, I don't know all these scientists. I'm not sure that I really sort of trust them. No, I understand you don't trust them, but what's really going on? And in the fantasy conversation, what the anti vaxxer says is, well, what's really going on is people like you have been talking down to me my whole life. I'm not some dumb f redneck. You know, you've been arrogant, you're better than me, you're holier than thou. And you know, and I'm fed up with it. Do you get It. So in the fantasy dialogue, see if you can track with this. Dave, the pro science, pro vax, a person says, you're absolutely right.

I have to just put a little pause in there because when you say pro science, pro vax, you're doing that to many listeners right now. The listeners who you would label as anti vax are also pro science, which is pro curious. So you can't do that and simultaneously say what you're saying because it doesn't work.

Okay, so use a different dividend. Okay, so imagine there's a conversation. So forget science, forget vaccine. Forget what? But imagine you're in a conversation with someone who's always pushing back, who's always resisting you. Okay? So imagine that and thank you for the correction for the audience. But what happens is the person who was talking down to the other person says, you're absolutely right. I've been talking down to you all my life. I've been putting people like you down all my life because I'm scared. And you can say this too. You can say this too, about another issue in your marriage. I'm scared you're going to go off the deep end. I'm scared instead of yelling at them. So what happens in the fantasied conversation? And please accept Dave's correction. You know, don't go down a rabbit hole. He's talking about this. Just think of a conflict where someone's talking down to you or you're talking down to someone. So what happens is you apologize and you say, I've been doing that forever because I'm scared and I'm wrong. And so in this fantasy dialogue, the person who's been talked down to looks back at this person and says, no one like you has ever apologized to me in my life. And then the person who was arrogant is saying, look, yeah, yeah, you know, we have different beliefs. But that doesn't justify how I've been talking down to you. Like, you're stupid and you're, I'm wrong. I'm sorry. And what happened in this fantasy dialogue is the person who's been talking down to the other person owns up to it, and the other person still says, no one's ever said that to me. And then that other person is so taken by the power of an unsolicited heartfelt apology that they say, I don't think you're trying to hurt me. Why don't you run by me what it is you want to talk to me about? Can you see the dynamic there? And thank you for correcting the context.

I do see the dynamic, and it's super powerful. And I've actually used that in discussions on abortion. The whole situation pisses me off because both sides are intractably angry at the other side and it's a solvable problem. And. And I'm not going to go into politics and that I've done it on social media, but. But the reality is by admitting something to the other side that you made a mistake, then you can move forward. But what I'm curious about is how does that apply towards suicide prevention in teenagers? I'm missing that connection. And by the way, I'm going to grab. I can hear the. I got to grab another power supply because both of my batteries are dying and I don't have my main one. So just keep talking and I'll be off the camera. But the camera's gonna be focused on you in the main episode. So tell me right now before I lose all my power. Keep going.

Well, how it applies is. And I'll recommend a wonderful book by Oprah Winfrey and Dr. Bruce Perry. It's called what Happened to you? And what they talk about. They have a conversation about trauma, informed therapy. The idea being is that none of us are born destructive. None of us are born evil. Maybe there's a few, you know, but it's very rare. So their view is, no matter how someone is acting, something happened to them to cause them to do that. So if you can get in your mindset, if someone's acting up in a way that's destructive to others or destructive to themselves, that there's a bunch of things that happened that push them in that direction. Yesterday I have a blog out. It's actually on my website, markgoulston.com I'll probably post it on medium. You and it's called Reverse Engineering Violence, Part one, Violence to Others. And the idea is that if you walk back a violent act, usually there's a daisy chain leading up to it. And I go backwards from violence to what might be happening before the violence happens. And it's what I call fulminating grievance. Plus an inciting incident, fulminating grievance. So you're really aggrieved about something. You feel really done wrong. And then there's an inciting incident that pushes you over into violence. And then before fulminating grievance and an inciting incident before you feel that the step below that is you're enraged about something, you're just enraged about something. And then if you go backwards from that, you're Outraged about something. So I make a distinction between outrage and enrage. In fact, I wrote an article that talks about the outrage enrage, bifurcate. And what that means is when someone outrages us, if we don't have self control, it can cross over into enraging us, which can then lead to violence. But instead, what most people will do is they do something that I call the outrage enrage bifurcate, meaning they will clamp down on being enraged before they act on it. But there's a cumulative effect, by the way, if people are treating you in a way that's outraging you all the time, it's building feelings of being enraged inside. And so that can push you over the edge. And then if you go backwards before that, and it's all in this article, reverse engineering violence. If you go backwards before outrage is infuriated. So when someone cuts you off in traffic, you may not be outraged, but you can be infuriated. And then before infuriated is just plain angry. And then the most important thing, which we don't get to before anger is there's been an injury to you. You feel hurt, you feel hurt and you feel afraid. But what happens is you cover up feeling afraid with anger so that you don't feel vulnerable.

In fact, I would argue that every single time that you're experiencing anger, it always has fear behind it. And that's kind of a core teaching at 40 years of Zen. It's just, it's not visible to you. Like, it feels like anger. But if you, if you go deep on it, you, oh, look what was inside there. But you're not going to know what's inside an egg until you crack it. So I'm with you there. But how do we take that to kids? Our kids are feeling angry. If they're really feeling afraid, what are they afraid of now that they weren't afraid of 20 years ago when they weren't all doing this?

Well, I think if you lead with some of the examples I'm giving you, if you go to your teenager and say, and I'll tell you, there is a real power to an earnest, unsolicited apology, there are hundreds of millions of people in the world who have never received an unsolicited heartfelt apology. And if you go to your kid and say, and there's something that I call assertive humility, I like to juxtapose terms, as you can imagine, and it goes like this. I need your help with something. You say that to one of your teams and they Say what? I need your help with something because I've screwed up. What? Yeah, I've screwed up bad. What? You know, how we interact like this and you don't do something and then I lecture you and then it escalates and you say, leave me alone, et cetera, et cetera. Yeah. I am not pausing to think of what's going on underneath that caused you to do that. I just jumped on your throat and I've made it worse. And I think it's been going on for a long time. In fact, I'd like you to tell me as far back as you can remember when it started where you felt hurt or scared about something and it didn't come out as you were hurt or you were scared. It came out with you being mouthy at me and then I, you know, jumped down your throat. I'll share something sometimes. My kids are now pretty grown, 40, 36 and 32. And I'll share an intervention I made with my oldest child when our youngest child was born, who was six years younger. And our oldest child didn't like sharing mommy with her younger siblings. They never do. I'm seeing that with my grandchildren. And she was going on, because now we had a third child and she was just being outrageous and obnoxious. And my wife would say, you got to handle her. I'm dealing with so. And so you handle her. And to appreciate what happened next, you need to realize that I am a third born child and my wife's a middle child. Third born, a middle child. And I'm dealing with my firstborn. So there we are in the den of our house. And here's a side note that's going to send some of you people down a rabbit hole. They filmed the movie Super Bad in my house. So I'm in the room that they had the super bad party in in the last 10 minutes of the film. So you'll see the room and other people saying, let's talk about that, Mark. I don't care about the rest of this stuff. But anyway, I'll finish the story. So she's there and she's. And she's using some choice language and she's acting up. And, you know, if I was just a regular sort of dumb shit dad, I would have said, I think you need a timeout. You got to get a hold of yourself, young lady. I could have said that. But I knew something was going on underneath her anger. And so I kept. I didn't call it surgical empathy back there. I'd say, what's going on, honey. And I hate my life. I hate this. Yeah, I know that. But what's really going on? I did that four or five times. And then she looks at me, Dave, so remember, I'm the third born. My wife's the second born. She said I was the first to be born, I'll be the first to die. You're right, I didn't understand that. I'm a third born. And with that, she runs across the room, jumps on the coffee table, throws her arms around my neck and she just starts sobbing. And I looked up at the ceiling and I said, God, thank you. Thank you for helping me to get it right because of what was going on inside her. And you might think, ah, it's a shrinks kid. No, you know, dogs are dying, grandparents are dying. But it is a shrinks kid also. But imagine that if she's being punished, that what is driving that behavior is some terrible feeling alone. And she was alone. She is the. Hopefully they're going to live a long time. But can you see how that would have happened?

It makes so much sense. We talked about anger hiding fear, which it does. And fear is ultimately always fear of death when you unpack it to its completion. So of course, as a kid's prefrontal cortex is coming online, they're learning how to think the deep thoughts about the universe, like, oh my God, I'm going to die. That's an ungrounding thing because you didn't know about that when you were younger. But if that's what's causing your kid to mouth off to you, how the hell would any parent know that? But that's, that's been going on forever. You know what's going on now? Is it, is there a parasite? Is it the crappy fake food they're trying to feed kids? Is it blue light exposure? Is it social media? I mean, you've got 40 years of watching change happen as a professional. I mean, stack rank, what are the things that maybe are biological or environmental?

Well, I think, as I mentioned earlier, I think the Internet has addicted us with a stimulus response, kind of hyperactivity to excitement and adrenaline and testosterone. They all make us feel powerful and excited. And oxytocin has really taken a hit. I'll share with you. I was blessed. I had eight mentors. They all died. The last one was Larry King. I used to go to breakfast with him every morning for two years with a quirky breakfast group. But the mentor before him was a fellow. You may know the name, Warren Bennis. Big leadership Guy, big leadership guru from usc. And I remember I went to dinner with Warren Bennis and Norman Lear. Norman Lear. And also I was coaching the CEO of Concord Records, which is a big jazz label, and Norman Lear was involved with it. So the four of us were there. And I remember I asked Norman and I asked Warren, I said, what is the greatest danger to the future? And without hesitation, they both used the same word. They said, expediency. They said, when you're in a rush everywhere, you miss important stuff, and you don't take care of important stuff. Speaking of that, I want to you allow me to meander one of the other things that I hope people take from this. So I'm sharing. You know, I had a pretty long life. I used to do house calls to dying patients, and I would try and help them make peace at the end of their life. And one of the people. So, you know, I was a death and dying person, suicide. You know, house calls. And when you're doing house calls to dying patients and they share some insights they're having, you're an idiot if you don't listen to it. So I'm visiting this one guy, and I can't mention his name, but he was beloved by all of America, you know, had a great public Persona. Very funny. But, you know, a number of marriages, number of divorces, and yada, yada, yada. And so there I am meeting with him, and I said, what's the matter? You look like crap, and you look like. And I don't think it's because you're dying. You've been dying as long as I know you. What's the story? And he liked that someone could be that direct with him, you know, as opposed to, oh, he's so powerful. And he looked at me and he said, I don't know that I've ever done anything important in my life. I said, what? He said, yeah, I don't know if I've done anything important. I said, you got a hospital named after you. You've created jobs, you've done all this stuff. And he smiled at me, and he was really known for his sense of humor. And he said, don't con a con man, especially when he's dying. I've got all the love that money can buy. That's all it's worth. And he said, what I realized is everything I thought was important is unimportant, and everything I thought was unimportant is important, and I've run out of time to fix it. So, you know, you learn from Things like this.

That's why it was so important to have you on the show because you've accumulated a great amount of wisdom from other wise people and that's how wisdom gets passed down and gets shared. And you talk about dying though. Is there something that's motivating you at this age? A lot of people slow down, but you don't seem like you're slowing down.

I won't go into it. I have a health condition that's going to shorten my life, so I won't go into it. But I am told that I have a bunch of years left, but I don't have time to waste. I just don't have time to waste. And I'll tell you something that I realized. Relationships are really important. Someone I had on my podcast, I had you on my podcast and you were wonderful. I had a fellow named Robert Waldinger and he gave a TEDx talk in Boston, has 43 million views about what makes for a good life. He has a new book coming out, the Good Life, and he is overseeing a 75 year story started by George Vailant from Mass General about and they followed people for 75 years and what the research shows beyond everything. And you may take issue with this because you're the biohacker, he said, at least in the study, what they realized is that the most important factor is positive loving relationships and that you can have a long relationship, but if it's bitter, that's not good. But loving, positive. So what I just told you is relationships mean everything to me. Now.

You are correct. From the perspective of biohacking, it's just changing your environment around you so your body will work better and relationships are a major part of your environment. So we talk a lot about leadership around, you know, personal dynamics with your primary partner, if you have one. And the people you surround yourself with, they're one of the biggest environmental variables. Just like, you know, good food and clean air and sunshine and things like that. If you have good food, cleaner and sunshine and your friends are all punks who are constantly taking you down, you're probably going to be calling a therapist and talking about why you hate your life. Life, you got to get that one right. So absolutely true. And that's probably the hardest thing. But you do something weird. It appears that during your life you took your time, you didn't practice too much expediency as you're accumulating this wisdom. But now that you're in your later years, you're actually doing expediency. As much as you can. Is that intentional that it changes just happen that way? Because it's pretty different than the way people do it now.

Oh, it is intentional because I never scaled anything. I know. Because researchers would sometimes want to send me their kids, you know, researchers from big universities. And I'd say, do you have any interest in. Because none of my patients died by suicide. And I said, do you have any interest in trying to figure out what it is that I'm doing, help me to understand it? And they said, well, if it's not evidence based and you don't have a control group, we can't look at it. And I'd say, well, why don't you just send your kid to your university? It's pretty famous. And they'd say, we don't have your track record. And so then I would just default to send me your kid. So I learned a fair amount. I'm trying to get it out there because I hope it's valid. I hope you found something of value in it, Dave, that added to your wisdom, hopefully. And I'm just trying to get it out there.

Absolutely. Mark, scaling wisdom is very difficult to do. And I mean, you've spent a lot of time, it sounds like, not just with patients, but because you're at a big university, you were teaching, right?

I was a supervisor, so I didn't do research, so I was an assistant clinical professor, which meant I supervised residents in psychiatry.

Okay, so you were working directly on helping people learn to be great psychiatrists. And for me, I. And when I worked in tech, I taught three or four nights a week at the University of California and I learned to be a teacher. And then I've learned to have knowledge worth teaching. And that's the hardest part. But I think you've already got enough of that in your career. Now it's teaching and then marketing. The value of the teaching in a place that's increasingly noisy. That's the hard part. The good news is you've done some very work worthy things in your life that if people pause even for a second, go, what? 42 languages, nine books, 40 years. I bet I could learn something in an hour of Mark's time. Certainly that's how I would see it. So I, I appreciate you taking the time to come on the show and to share this knowledge. I think those four questions are profoundly important for parents. I'll definitely try them out on my kids. And I think there's a lot more wisdom that you have on your show as well, which is not a suicide Focus show. It's. I just call it a wisdom focused show. And I would invite people to check.

That out as well.

So thank you. That's my wake up call. So you can find that. And Dave's will be going. Can I end with I collect quotes? And. And again, this is sort of a tangent, but you've invited me to be a little tangential, so hopefully there's some way of connecting the tangents. As I said, I collect quotes. And there's a quote that I collected from a Dr. Shani Duperon on forgiveness. She has something called Project Forgive, and she refined it so I don't think she's the originator of it. But it's. Forgiveness is accepting the apology you will never receive. And I'll just share it. When she told me that, my head just spun around. And I'll just end with an anecdote because both my parents have died, and my father could be a little bit on the critical side. And one of the things that he would often say to my brothers and I, if we brought up something, especially for me, if I brought up anything creative, was what makes you think you know anything about anything? It was a pretty dismissive kind of comment, but I applied the apology as soon as I heard it from her to him. And he's been dead for 25 years. And this is the apology is. Remember when I used to tell you you'd come up with a creative idea what makes you think you know anything about anything? And I said, yes, that's why I'm having. That's why we're doing this exercise and you've been gone. He said, I knew numbers, but there's a lot about life I didn't know. And you brought up things that I didn't know, and it made me nervous. And instead of being curious and letting you teach me or sending you over to some other parent who knew what you were talking about, you made me feel less than I was talking about myself. And what you've done with your life, how you've spent it, lives you've saved, I'm not only proud of you, I don't deserve you as my son. And here was the interesting thing when you apply this. I then apologized to him for having a chip on my shoulder. I said, you know, I should have known better. I'm a shrink. And you did the best you could. You did the best you could with what you had, and you provided for us. You know, you were worried whether you could provide for us, and you did that. You were a little Bit critical, but you really didn't beat us too much. And I'm sorry I held it against you. And I just want you to rest in peace.

That is a profoundly powerful forgiveness. And forgiveness is at the heart of, of turning off all the notifications that pop up in the voice in your head. And to do it right as you did, you got to forgive the other party, but you also forgive yourself for your role in it, which is what you did there. And that's what permanently turns off the voice in your head that got installed without your permission. And teaching people that knowledge is as important, I believe, as the suicide prevention stuff. Because if you walk around for 100 or 150 years, like some of us are going to do, and the entire time half the voices in your head are things that are unforgiven, you didn't really succeed in living a long time because you weren't doing it right. So there's always room for more forgiveness when you identify what needs to happen. And that turns off the anger and turns off the fear. So what a. What a profound story and what a profound way for a parent to forgive their living children or a parent to forgive themselves for what they do with their living children and vice versa.

Thank you, Mark. Thank you, Dave.

Your book, by the way, we talked about your show, your book is called Just Listen. Discover the Secret of Getting through to absolutely anyone. And I gotta say, 40 years of listening to Patience, you must have learned how to listen. So that is a worthy book. So thank you again.

Thank you. And thank you for listening and giving me a long leash. I took advantage of it, you know.

That'S what the show is here for. My job is to ask the right questions and then also to learn and to listen. And I don't want to have people on the show who don't have anything to teach anything of value to offer. You've done so much good work for real, and you're sharing in a very meaningful and open way. The comments from the Upgrade collective who are listening are full of hearts and awe and wow. So you're connecting in a way that most people don't do anymore. So keep doing that. And it has a ripple effect, I believe that's much larger than what you'll see.

Yeah, I like that very much, Dave.

It's happening. Thanks again, Mark.

Thank you.

You're listening to the Human Upgrade with Dave Asprey.