The Allure of Woo: How Self-Help Drifts Away from Science | Being Well

Hello and welcome to Being Well. I'm Forest Hansen. If you're new to the show, thanks for joining us today. And if you've listened before, welcome back. We live inside an attention economy where the loudest and most confident claims tend to become the most popular. The person saying this might help some people some of the time under certain conditions might be accurate, but most publishers are not exactly lining up to give that person a book deal. This secret changed my whole life in 30 days. Now we're talking big simple stories about one root cause or one magic method usually spread a lot faster than the careful language that we used about evidence and effect sizes and limitations and you know exciting things like study design in our previous episode in this miniseries that creates a pretty messed up incentive structure particularly when we're talking about mental health and medicine and how to live your life. It pushes even well-intentioned people, therapists, coaches, and creators toward overclaiming, building soft cults of personality, and selling specific tools as if they are silver bullets. In this episode, we're going to be talking about how that happens, how authority gets manufactured, and why even good approaches can start to drift into what I'll call woo. We'll also talk about how to recognize some of the patterns that show up in more cultish or exploitative corners of the self-help world so you can stay open to new ideas while also being able to protect yourself in a space that is full of both real help and frankly some real nonsense. So to help me sort through all of this, I am joined by clinical psychologist Rick Hansen. Dad, how are you doing today? >> I'm good. I'm psyched about this material. I think your framing and you know what you've pulled together here for us is truly brilliant and I'm a guy who definitely I would say has one leg in the land of the absence of evidence is not evidence of absence on the one hand >> while on the other hand um being very pragmatic and wanting to see results. So I'm kind of straddling both of those and I'm looking forward to doing this with you. Part of the reason that I wanted to try doing this conversation with you as opposed to just having it be like Forest gets on a on a soap box and monologues about things that bother him for an hour, which you know there there's a place for that is because you have a slightly different perspective on some of this than I do. Both as somebody with kind of a um a more spiritual bent yourself and somebody who frankly like grew up around this stuff. You you came of practice age in the ' 70s and at a particular moment of time in California. Yeah, it was all it was all happened, baby. And that uh that could give you maybe a different perspective on some of the things that we're going to be talking about. >> That's right. >> So, okay, in the first episode that we did on this, we talked a lot about evidence. What's evidence? What does evidence mean? Different types of evidence, all of that. Now, evidence-based approaches, and we focused on on therapy as our example, but you can expand this out to evidence-based approaches to almost anything. They tend to have a lot of complexity and nuance to how they communicate. There's a lot of conditional statements. We talked about complexifying a lot during that episode. Lots of yes and thinking. And we also did that in the context of these two different tracks. You know, medicine on the one hand and personal growth stuff on the other. And if you're making a big claim, particularly a big medical claim, you want to have pretty good evidence to back it up. You want to really feel like you can point to something and say, "Hey, this is why I'm telling you to do that." For the personal growth stuff, for, you know, I found that going for a walk is helpful. you know, the standards for evidence are understandably much lower. Now, talking in the way that I'm talking right now, this kind of like nuance distinctions kind of way is great if you want to be accurate, but it's generally not going to lead to the best performing, you know, Instagram reel or Tik Tok video or whatever else. And what gets really popular both on social media and therefore increasingly these days out in real life is generally going to be the person who, as I said during the intro, is doing the um as you said way back when to me, dad, if you could find a way to write a book that was uh how to make money and get a six-pack while you sleep, that would be that would be your your ticket to superstardom, you know, your absolute fame. And engagement in this way is really the currency of the realm. So getting engagement up if you're a content creator like me is really really important. This creates a really problematic tension for people and it's a tension frankly that I've lived in my own life. If you want to get really popular, make a lot of big claims, build a big audience and then sell to them. All of the incentives push people in that direction. And this is problematic even more so when we're talking about medicine, when we're talking about big life advice, when we're really trying to influence how people are spending their time and the practices that they're taking on, all the stuff that we talk about on this show. It is a big deal. And that messed up structure is kind of a fundamental problem for evidence-based people inside of any community, psychology, self-help, fitness, you know, whatever. If you act carefully and thoughtfully, you're kind of frankly at a disadvantage. And so if your livelihood depends on this thing on on getting more engagement, on growing your method, on building up your approach to therapy, you know, whatever it is, there is a lot of pressure to kind of drift from that first group, highly evidence-based, and toward that fuzzier second group. Um, I'm wondering if it's something you've had to think about much, Dad. I think that you've actually had a an unusually um I just put my butt in the chair and write what I write and I hope that it goes well approach to this whole thing that that I think is actually like quite uncommon. Uh but hey, as the business has grown, you know, we do more stuff on social media these days. We do more stuff that is designed to kind of get up engagement or push people toward your your courses and programs and things like that. And how do you think about all of this? It really is a deeply personally important topic and it's one where I've been burned by leaning into people who overclaimed and it was cultic and and I I went in the wrong direction. Uh and on the other hand, I've seen uh people who have beautiful wonderful uh offerings that can very very helpful to people who are just Yeah. and it doesn't reach. And then are there other times where I'm hanging out with people who shall be nameless, uh, who, you know, are famous about this or that, and they're they're they're often articulate and charming and and they believe they're material, they're not evil, they're well intended, and yet when I really look at the anti-correlation between the actual substance, >> the actual stuff Yeah. that they're selling. Totally. >> And the size of their popularity. I just sort of shake my head at that and go, "Oh, well." Um, and this kind of goes to why do we want evidence under some circumstances? And it seems to me that we definitely want evidence if the treatment, if the recommendation has a lot of risks. So, they're like a lot of pharmaceuticals have serious risks. So, you want to be very careful about them and there should be strong evidence for their use. Surgical techniques where they cut you open and do stuff in you. Yeah, that's pretty risky business. Okay, there ought to be evidence for that. Additionally though, even if the intervention doesn't necessarily have a lot of downside risk, it has the risk of crowding out potentially more effective treatments for some pathology of some kind, some really serious source of suffering, dysfunction, disease, distress, disability for somebody. So that's a second kind of reason that we really want to have evidence for this stuff. Just at a personal level, it's so seductive to start overclaiming. You're exactly right. And sincerity is the coin of the realm. And one thing I was telling your mom earlier today, I detest fake authenticity. I don't detest a lot of things. I detest phony sincerity. And yet, you know, there's pressure uh on people to show up in that way. And I think that's really problematic. >> As I was prepping for this uh conversation with you, Dad, one of the things I did was I did a little bit of thinking and looking at the things that become popular cuz I think that's sort of part of what you're saying here like why do some of these things become popular even if you kind of look at them and you go, you know, it's all right versus some things out there that are really fantastic that for whatever reason just don't rise to the top of the pile. And one of the things that I think you'll see is this theme of manufacturing authority and then appealing to the authority that you've created. So if you look at a lot of the most popular, you know, creators, podcasts inside of this sort of self-help space, often those places are doing great work. The production values are fantastic. They've got great guests on these shows. Uh the the people doing the interviewing are are very aerodite, very intelligent, like just really good at what they do. Honestly, I look at it often and go like, "Wow." But you'll also often see a lot of big and provocative claims without necessarily a lot of data to back those claims up. So let's pick a show. And the show I've picked for this example is Diary of a CEO, which is a enormous podcast. It's got 14 million YouTube subscribers. They were ranked fifth among all shows on Spotify's global charts in 2024. Almost every title of their episodes is some version of world's number one doctor says fill in the blank or like world's top habit expert. We got ADHD all wrong. I think that that was a title of a YouTube video of theirs. Uh one of their fairly recent ones included world expert on love was the description for the expert. I have no idea what that means. I would like to be a >> I want to be a world expert on love. That sounds great. >> Is is that like a degree I could get? Like is is there a training program for that one? I I don't know, man. I don't know. So So why are they doing this? Well, there's the immediate construction of authority, right? You should care about this episode because we got this world expert on fill in the blank. >> Yeah. >> Now, to be clear, I actually like a lot of their guests. We've had guests on the show that have also been on Diary of a CEO. I've enjoyed a lot of their episodes. >> Great. You know, if we could get you on there, I would be like, "Hell yeah, it's on this platform." Yeah, >> but the language is just so over the top and so um characterized by by what we're kind of talking about here. So, this is a real description of one of their episodes. What if everything your doctor told you about heart disease is completely wrong. Worldrenowned cardiologist drops bombshells that will make you question decades of medical advice. This video has like 5 million views on YouTube. Okay. >> And the text capitalizes everything wrong. bombshells. It's It's fantastic. Now, now we're hardly the first people to make observations about clickbait, right? And people talk about clickbait a lot. And if you look through every episode of Being Well, you're probably going to find some episodes that use like soft versions of what we're kind of poking fun at here. But let's just take a moment to put our pattern recognition hat on. Okay. >> Yeah. >> What's actually happening in that language? Like, are there some features of it that you would sort of pull out here, Dad, as a hey, a psychologist? >> Very alarmist. So it's playing to the negativity bias right off the top. You know, fear of loss, huge, huge motivator. Daniel Conorman, Prospect theory, you know, people are much more motivated by a theory of loss. The And second, um, I think there's a cultural meme here that Tom Nichols, one of my favorite people to follow, actually, writes about in his book, The Death of Expertise. We live in a culture in which expertise is under assault. Now, it's typically under assault by people operating in bad faith who are using it for political purposes. But it creates a kind of culture in which, oh wow, wow, what if I've been misled? Oh, wow. What if everything now that's everything told me about heart disease is completely not with some qualifications, but completely wrong. Oh my gosh, you know, I could be in trouble now. I really better find out what the truth is, you know. So, those are very powerful motivators uh for people that really get you to sit up and pay attention. And then when it comes from a trusted authority, >> diary of a CEO and plus we have social proofing. Well, if 14 million YouTube subscribers think this is good, well, there's probably something to it. >> So, appeal to authority like you just said, you know, kind of social proof. Y that was another thing you mentioned. uh big claims and a certain amount of maybe ingroup, outgroup >> and fear-mongering. >> Yeah, fear-mongering. Your doctor is lying to you. We know the secret. They don't want you to know all of that. Okay. Now, purely coincidentally, purely coincidentally, I would like to uh read people some of the common features of cults. Cults have a couple of things in common. They tend to be both high control and high demand. And this means that the behavior of the members is closely managed and influenced. So strict rules about how you act, discouraging outside sources of information, and you're giving things up to the cult. So your time or your labor, your money, your identity, taking on new labels and roles of different kinds. And then another thing, forms of thought control, specific ways of talking, and the use of jargon. This includes something that are called thought stoppers. An example of a thought stopper, that's just your resistance talking. Okay? These things remove questions. Then centralized charismatic authority. One person or a small group of people uh knows what the truth is and they kind of own the truth. Totalitizing ideology. This is one framework explains everything. And then us first them or anti-institutional thinking. Big whatever is lying to you. Does this sound familiar to anyone who has spent some time in self-helpy spaces? Right now, I'm not saying that self-help is a cult, but I am saying that there is some cultishness inside of the space. And I think that it's just something that we should learn to flag this kind of language and these kinds of themes so we can have a thoughtfulness about who's telling us what, what are their incentives, why are they telling it to us in this way and what are the tendencies that our brain has that lead to us being kind of prone to this sort of influence. I have personally witnessed uh people who are uh big names in therapy world uh over many many years uh in conferences and and people who've developed approaches in my experience in general I really didn't see the shadow if you will of that much authority I think it's much less in that space than in kind of online Instagram self-help world just to support what you're saying. It's much less common. >> Yeah. I'm just thinking out loud here, honestly. And uh they people wanted to other people wanted to be close to the individual. Uh but it was it was all pretty okay. I I didn't see a lot of weirdness around it. And also, people call all kinds of things cults or say that all kinds of things have cultic features to them. Like CrossFit is an example that people use in fitness as like CrossFit is a cult or like veganism is an example of this, you know, spreading the cult of veganism. And I I would struggle to argue that either CrossFit or veganism is like a bad thing on its own merits in some kind of objective sense, right? So many things, including online self-help content, can have features of cultishness without being evil. >> I'm not saying that this stuff is evil or bad or wrong. I'm just saying that like, hey, these are some things to be aware of. And um, you know, there are aspects of cultishness that could even be right from time to time. Like big tobacco really was out to get you. Like big tobacco really was using advertisements with like doctors with stethoscopes in them in order to kind of convince people that these products were safe when they absolutely were not. So, you know, there there is some kind of a balance here. Now that said, uh in the human potential space, I have definitely uh been on the edges of or witnessed scenes in which it definitely smelled like a cult and acted like a cult. In other words, where there were a number of these future features in ways that harmed people. I'm not going to name any names here, but I would I would say there's certainly a tendency in that direction. And then you have extreme versions of it. Uh there's someone who made a point once that theocracies are really really dangerous forms of government because when you get the intense uh the intensity of kind of spiritual authority combined with the machinery of state control including uh monopoly on the use of violence officially at least uh that's a really combustible mixture and that's why I think our founding fathers in America were so wise to really separate church and state. So in these personal growthy type scenes, when you start bringing in spiritual authority and claims of higher powers and channeling things and having visions, then it gets really, really, really, really tricky and problematic. >> I think you're right on. And I want to loop back to that, put a pin in that and kind of loop back to it toward the end of of our conversation today, I think, because it's a big topic that I think is really worth getting into. So maybe a couple of themes here for people to just keep in their back of their mind as we're talking about everything else today. How is authority being manufactured? Who decides what authority is, what it looks like, and how it's shown up in the room? How much interest is there among those people in that authority in doing the work of validating their thing? And then again going back to last episode, how big are the claims that are being made? Two tracks. medicine on the one hand, personal growth on the other, it's appropriate for the standards in these spaces to be different. Now, in the first part of this little minieries we're doing here, we talked a lot about how evidence can be really messy. And we can see now how all of the incentives here both for outlets like podcasts and other publishing outlets like Hello Being well and also individuals specific experts like you know Rick Hansen or whoever else there's a lot of incentive to set yourself up as the one who knows I know what's really going on. I've got the truth over here and I'm going to now share the truth with you. Now, what happens to otherwise good people and approaches inside of that kind of incentive environment? Because that's the environment that we're living in. So, what happens when we're swimming in those waters? Let's think about a common situation. It's a situation I would imagine you've been in, Dad. Actually, somebody has doctor in their name. Let's say that they have an MD. They specialize in neurology and they're on a podcast. Once that person is in the chair, and I could say this as somebody who hosts a podcast, you start by focusing on their thing. I'm going to talk to that person about their specialty in neurology. But from there, you're having a conversation, right? You're talking about stuff. Probably some of the topics are going to sprawl and you eventually land on, you know, man, what do you think about all of that AI stuff? Now, you've built a badge of expertise. This person is a doctor. They've got a lot of experience inside of their thing. They know stuff about the brain. Hey, maybe they can extrapolate to like AI in the brain. Who knows, right? They're a smart person. And so you take their opinion seriously, but they are not an expert about AI. >> And this is distinctly different from me, Forest Hansen, offering an opinion on something because I'm very loud about being just a guy with a podcast. >> To your credit, >> thank you. You you take the opinion on its own merit. >> Yeah. >> If it works for you, great. If it doesn't, you know, see for yourself. I I'm not alluding to specialized knowledge. When we start having these symbols inside of a field or inside of a group that are applying a lot of authority to statements, regardless of whether or not they're an actual area of expertise, we're just in the world of the slippery slope, man. I think of the fundamental uh oath that people take certainly in medicine. First of all, do no harm. And I think about my own background in you know Buddhist contemplative practice and wise intentions. uh one of the elements of the eight-fold path, wise intent. Essentially, one of the fundamental ele of the three elements of wise intention, it's uh harmlessness toward others and toward oneself. The other two are to uh not u get caught up in ill will, which is a form of harming to others and oneself and to also hold your sense desires lightly. Don't get carried away by them. Those seem like pretty good intentions. Non-harming, it's really basic. So I think about the harms that are done to others and the really the importance of what's called expanding the circle of moral concern to really take into account how we might be harming others particularly based on our self-interested motivations. As soon as you have self-interested motivation, it's a yellow flag to be alert to how you might be harming others. It's a little bit like if you're creeping down the highway at, you know, 1 mile per hour, you're not that motivated. You don't need to be super alert. But if you're really eager towards some benefit for yourself and you're accelerating and speeding up and going fast, then you really need to watch out that you're not bumping into other people. So that's a broad principle in in my mind and I think it really behooves people who have any kind of power whether it's casual interpersonal power in a friends group or network or in a family system or especially if you have any kind of authority conferred or earned or both uh then you have a special duty to other people you know in other words if there's an asymmetry of power there needs to be an asymmetry of moral duty >> in my view and I I think this is consistent with people how people think in ethics and so on. So if you are a professional with or without a license, it's really important for you to be thinking about how people are understanding what you're saying and the authority you're giving to it and the movement toward or away from their own personal responsibility for judging the merits of what you're saying. The more you claim that asymmetry of authority, you know, appropriately people don't superjudge the merits. you know, if I have my doctors tell something to me and there's some technical detail uh about it or in general, I'm going to give them the benefit of the doubt. You know, I'm the kind of person who will investigate later, but at least in the moment, I'll give them the benefit of the doubt. uh in much the same way if I'm going to assert something about AI or medication or some aspect of psychotherapy or some clinical issue or by extension why young men are disaffected in America these days and voting in record numbers for right-wing candidates etc etc you know I'm going to be really pretty careful about what's in my expertise and what's not that was sort of a long-winded way of getting at routinely you and you'll hear me on the pod I'll say well I'm not giving medical advice and what I'm aware of is the case and see for yourself. >> My current knowledge is fill in the blank. Totally. >> I I will not give a professional recommendation for or against any medication and it is in the domain of my knowledge and my scope of practice to talk about the activity in some cases of things like serotonin systems in your brain >> or when I talk about research on the podcast. I'm not a researcher. Yeah. But I can tell you what I read on Google Scholar. you know, it's then kind of your your implicit duty to investigate that if you if you want to or to talk with a doctor about it or whatever. I'm trying to summarize and simplify and put this in language that a normal person can understand, but that doesn't mean that I'm an expert in it. Yeah. In a way, you're getting at the seductions of oneupness. There's so many incentives to just sort of slide into that oneup. I know more than you. I'm the teacher, you're the learner, I'm the knower, you know, you're the unlearned. Da da da da. And to me, it's therefore counterintuitive, but really important. The more those incentives are present, the more important it is to really lean into going one down and really encourage the listener to take their own responsibility for figuring out um what the facts really are and what they ought to do about them. You know, to me, it it kind of rips people off of their own responsibility if you overclaim expertise or authority on your side of the of the street. >> And just being conscious of that, I think being conscious of the impact of those like two little letters in front of your name, doctor. >> Yeah. >> You know, it carries a lot of weight. It's a big deal. And it's funny on on the show in general and just if people have been listening for a while, what they what they know about what I've said here, right? I love expertise. I'm a huge fan of expertise. big advocate for expertise, but I actually think that this combo of big expertise and like scope creep creates a very specific set of problems due to something that I I'll call modality capture here. So, this is uh the kind of thing that happens when you're the fill-in-the-blank person. >> So, let's say that you're the trauma person, right? People go to you because they know that you're the trauma person. you see a lot of people with significant trauma which is a specific part of the population. Let's say that you're seeing like the most severe 10% of the population with this particular issue cuz those are the people who come to you for help but it's 100% of your practice. So it is very easy to start thinking that everything is about X problem and that your approach to working with that specific population of people will work for most people. The problem is that you're not working with a representative sample. You're working with a very specific sample. This is kind of a classic when all you have is a hammer situation, right? For you, dad, this could be like the everything is about the negativity bias or everything is about taking in the good or what all roads lead back to mindfulness practice like that kind of a thing. >> And these are approaches that can be genuinely helpful, right? like the a rise in a focus on trauma generally has been so helpful for people to understand themselves to see what's going on. Your practices being thoughtful about the negativity bias or being thoughtful about taking in the good or whatever it is so helpful for huge numbers of people. The problem is when these become turned into what I'll call theories of everything, right? the person's identity, the expert's identity, their and their livelihood. It's important to mention here get kind of fused with that modality and the attention economy then rewards these really big you've been lied to monocausal if you just do this thing you'll change your life stories right so we can look at a specific example of this in a little bit more detail to kind of understand what I'm talking about here which is about ADHD and trauma and I want to move through this kind of quickly we can maybe do this in more detail with an actual ADHD expert hey speaking of which on the show sometime in the future But I think this is a really really great example of this, the kind of thing that I'm talking about here. There are a lot of people out there who claim that ADHD comes from trauma. And some people go so far as to say that ADHD is reversible because it is based on trauma. The person just hasn't developed the right skills to deal with our messed up society. And if they had those skills, they would no longer have ADHD. And before I get into this, I do want to mention that due to Elizabeth's experience with ADHD, this is kind of a personal issue for me. So if I start to sound a little like a tense about it, that's where it's coming from, right? I want to be really clear about this. As near as we know right now, that is simply not true. We can argue about the degree to which nature and nurture influence ADHD, but it is simply a documented fact that ADHD has a lot of genetic or brainbased aspects to it. And we know this from both twin studies and gene studies. Interestingly, those two forms of studies actually disagree about the degree to which ADHD is heritable. Uh which has created a lot of like questioning in the field right now about what exactly are the sources of this thing and how much of it is attributable to this versus that and are there kind of like not well understood factors going on here. Uh particularly having to do with specific gene mutations that are not necessarily heritable. They're just due to like random chance. But this is kind of very on the cutting edge right now. Okay. Now, of course, trauma can influence your symptoms or worsen your symptoms. And the symptoms of trauma can look a lot like the symptoms of ADHD, but that doesn't mean that they're the same thing. Somebody dissociating because their parents are screaming at each other does not mean that they have inattentive type ADHD, right? So, it's really easy for these things to become uh blended together and confused for each other in these very complicated ways. And this is why we assess. This is why we do real actual ADHD assessment with people as opposed to just saying, you know, watch these four Tik Tok videos and self-dagnose with ADHD. The idea that trauma causes ADHD has been absolutely blasted by pretty much every prominent researcher, clinician, specialist, all of it, most publicly by Dr. Russell Barkley, who is widely considered to be one of the world's foremost experts on ADHD. But if you go on Tik Tok or YouTube, there are plenty of clips from people with doctor in front of their name that have millions and millions and millions of views talking about how ADHD is just an adaptation to environment, right? I just think this is a huge issue and it's a perfect example of when you become the fill-in-the-blank person, all of the problems start to be fill-in- thelank. I think it also really connects to how we build um we build communities that we're a part of that have sort of an organizing ideology like an organizing ideology of uh it's about nurture it's not about nature or it's about trauma it's not about this or you know it's it's this you know chat GPT style style writing and you start to need to explain everything through that lens as opposed to just letting things be complicated and kind of staying inside of your lane. I don't know if you have thoughts about this in general, Dad, that you would like to to chime in with, uh, whether it's about anything I've said materially about ADHD or just anything else related to this. >> I absorb a lot of content from a lot of sources and I'm just struck forest by the thoughtfulness and the care that you're bringing here and it's really quite routine in the podcast and I that I'm just kind of really struck by that right here. I'm a little speechless just because I'm really struck by it. I do have some things to say about ADHD and I'm I'm trying to connect them if you will to the kind of throughine in our conversation. >> You could just also vibe here for a minute. Okay. >> So in a framework that I think is generally helpful for people whenever you're facing a situation there are three questions that are really useful. What, why, and how. So the what is what's the phenomenon including what's the scale of it? uh including in reference to a group of people. So let's take a six-year-old boy and we're observing that six-year-old boy in terms of four major dimensions. Inattentiveness and distractability, stimulation seeking, um impulsivity and um emotional dysregulation. Okay. And then we're asking ourselves, what how does that boy compare to a 100 loosely comparable six-year-old boys from, you know, this culture in terms of at the 90th percentile or the 99th percentile in one or more of those four dimensions or more toward the 70th or even the 50th or the 30th. You know what is true? So we start with what is true observationally. We just what is true? Why is it true? Well, that's what you're getting at is this particular boy. Um, Bruno. Somehow that name came to me. Uh, Bruno just you look at Bruno and you, yeah, Bruno's, wow, they're, you know, in first grade there 40 boys in his small school and Bruno's definitely the most active, can't sit still, stimulationhungry, distractable, and emotionally volatile boy in the in the group. And gender matters here because there are some some gender differences in terms of this territory these four attributes. So now we've established kind of the what the question is why why is Bruno like that? Well one version of why is that from the time Bruno was born Bruno has been has had this temperament which for in my view is not a disorder per se. It's a normal temperament that was highly adaptive in hunter gatherer times. We've often talked on the podcast about ADHD as an issue of fit. Absolutely. >> Yeah. To have at least a few Brunos in the band. And then at the other end of the spectrum, you think of Bruno as kind of like a jack rabbit, you know, my metaphor. You have some turtles at the other end and some tweeners sort of like I think you and me kind of in the middle. So, okay. So, we have that's one. Now, a different why would be that Bruno was born with a fairly mid-range temperament. And Bruno has grown up in a highly chaotic environment. Poverty, uh, disruptions, uh, demands on parents that pulled them out of the, uh, um, child rearing environment. Didn't get a lot of nurturing child child rearing. So, at this point, Bruno is just like a cat on a hot roof. Hot tin roof. Just like, what's going to happen next? What could come at me? Throw in then a lot of mistreatment. Whoa, no wonder Bruno's always looking over his shoulder. Where's the next attack coming from? I can't rely on anyone. I don't trust anyone. When I trusted, I got, you know, my heart broken and terrible things happened. And I'm looking for stimulation to just sort of manage all this dysphoria underneath the surface. Well, that's a different why. The what's the same. The why is very different, which then leads into the how to help. And the how to help will vary depending on, you know, the why, right? The Bruno who was let's say born temperamentally toward the high end of the the range of these four dimensions could look a awful lot if we could look really closely at the brain of the other Bruno in a parallel universe who came into the world with a very mid-range temperament and yet who had a very traumatic childhood. So traumatic childhoods, you know, psychological factors can lead to an organic result by age six. Uh that might be fairly similar to the nature of of a brain. The hard wiring at that point, you know, of a child who was born with a you know a highly distractable etc etc temperament. >> So in that sense and I'm I'm very interested in this field. It's very complicated. Uh very smart people have thought a lot about this and have made some of the points that I'm making now. And and then the question becomes how to hell. >> And I think that that's where a lot of this this kind of comes to a comes to a head, right? Because these differences are nuanced and complicated like you're saying. And we don't want somebody who doesn't actually have ADHD on at all. Well, what do you mean have ADHD? That's kind of what we're getting at here. if their current environment is really chaotic and awful. Yeah. And you could just take them out of that environment and suddenly they'd be a lot calmer and more centered and, you know, more able to regulate themselves. >> Then clearly the issue was outside them. >> Yeah, that's what I'm that's what I'm saying. that person will not be served by aderall the same way that the person in the you know reasonably wellreulated environment who has um >> you know the the brain structures associated with ADHD would benefit from >> Aderal >> we also don't want somebody who does have ADHD >> like Elizabeth to constantly be told you just need to try harder when she was a kid or to be told by some of the trauma therapists that she saw as an adult once you do enough EMDR to resolve your trauma your AD ADHD will go away. That is a real thing that people are told. So, we've turned this into a moral issue for that person. >> Totally. >> You're wrong cuz you haven't tried hard enough and you haven't like bought my special program. >> Totally. Part of what you're also getting at is how people get captured by their strengths. You got a great hammer. >> You've got a great hammer. So, everything starts to look like a nail. Trauma is a great hammer. It's not It's not the solution to every problem. Sorry. And it could be that someone is born with the, you know, the phenotype genetically of, let's call it an ADHD. I hate the D on the end of that. I won't put it there. An ADHD profile, attention deficit diet. For me, it's distractability, hyperactivity, whatever. The the DH profile anyway. Um, >> and then that person on Alas is traumatized because very often kids with that initial DH profile are very sensitive. They often are very bright. They're very >> have a life experience that's more likely to be traumatic in nature like yeah absolutely >> they get so much more criticism in school. What can't you focus and all the rest of that. So then at age 30 say um >> treat the trauma history with mean methods that treat the trauma history. Don't expect that treatment to change the underlying normal temperament. That's just at kind of one end of the range and then address that normal temperament at one end of the range through other skillful means. >> Totally agree with you. Complete same page here about this whole thing. So, and I'm mad with you, Forest. I'm mad about this. >> I'm glad you like this pisses me off >> and I'm mad for your, you know, future wife and I'm mad for the kids in the world. And and you want to know how to traumatize a kid? Take a kid who you know genetically let's say you know phenotypically is at that a a where was I the DH uh the AD whatever I forget end of this you know range right >> and not address the normaly of the fact that they just can't sit still in a typical sixth grade classroom totally >> that's traumatizing if you want to traumatize a kid don't address their personal temperament from it when they're young. >> Totally. Or, you know, start asking them weird questions about like what's Oh, how are your parents mistreating you at home because you can't sit still. >> Yeah. >> Cuz after all, ADHD is caused by trauma and now you you can't sit still in class. There must be something wrong going on at home. >> Yeah. >> That's really interesting. Go to a preschool. >> That's just that's screwed up. Bottom line. That's really really screwed up. So, this is why it bugs me about this kind of stuff. This idea of modality capture, right? Like this is my thing. This must be the thing. 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We know that ADHD has a heritable genetic something going on inside of the brain itself aspect that is not just about lived experience. That is a strong statement. I'm making a strong assertion there and I would argue I've got the evidence to back it up. You can go check out the studies. Okay. There are often a lot of natural objections raised typically by people who orient alternatively. And in the previous episode, we talked a bit toward the end of the conversation about some of the issues with largecale studies. And that kind of starts to creep in here, right? Like how do we know that, right? There are lots of reasons that an approach to therapy or even just a statement like ADHD is caused by trauma might not have a large randomized control trial on it. Right? Some approaches to therapy are impractical to study. This is one of the reasons that alternative approaches have become kind of popular. It's easy to say, well, you just can't study it and there are all these limitations to big studies. What about the replicability crisis and you know, studies are what those CBT people do over there? All of that. And part of the problem, kind of the elephant in the room is that science evolves. That's the whole point. It's not static and it's not dogmatic. And much of what is now common sense was once viewed as fringed or alternative or weird. During the episodes we did on psychoanalysis, I talked about how the whole breakthrough concept from Freud was that mental illness could have a psychoggenic origin. At the time, people thought that mental illness was mostly because there was something wrong with your physical brain. So, the idea that your mind could be doing this to yourself was wild and out there and totally French. Now what's kind of funny and sad about this whole thing is that that fundamental feature of science that it evolves that it changes over time is sometimes viewed by people as a kind of reason to not trust science. You know those researchers can't even make up their minds over there. they keep on taking things back, right? Even with those limitations, I don't think that alternative should be like this kind of free pass to skip the evidence stage, right? But for the game to be fair, there needs to be a way for alternative approaches like say psychology as a field, there needs to be a way for those things to become mainstream. >> And this then takes me to one of the big ideas I want to talk about today, which is that things don't win because they're fringe or because they're establishment. They win because you do the work of validating them, right? Evidence isn't perfect. Accumulating is hard. It's complicated and it's still necessary. So, one of the best examples of this is uh barber coats, which I remember reading about in a book that you gave me when I was like 9 years old or something, Dad. It was like a while like history of medicine for Do you remember this? >> Oh, I can't believe that I did that. This one. This is where I read it when I was like, Unfortunately, it titles gendered. It's called Great Men of Medicine. Darn. >> It's probably written in the 60s or something. >> Oh, yeah. 50s, >> maybe earlier than that. Definitely dated, but I remember reading about this back then. So, when I was thinking about this, I went like, "Oh, what about those barber coats?" Like, gosh, when did antiseptic treatment came along? And I think this is actually like a perfect example of how you take something quote unquote fringe and make it not fringe. Right? Yeah. So before germ theory and even through like the 1870s, it was really normal for operating surgeons to wear these like bloodcrusted frock coats as they were in the operating room actually doing these procedures often without washing their hands. Uh because it was kind of a mark of rank essentially. This was the thing that asserted that you were in the trenches doing the real work of surgery, right? And prior to germ theory, there wasn't really an explanation for like why this would be problematic yet. Like sure, there's some contamination of some kind, but like we don't have an explanation for why that's bad necessarily. Now back in 1847, so 30 40 years before this stuff changes, there was a Hungarian obstitrician, his name was Ignat Semlvvice, and he noticed that when staff at his clinic at the Vienna General Hospital, when they washed their hands with chlorinated lime, maternal deaths inside of his clinic dropped from 18%, one in five to less than 2%. >> A nine-fold drop. Wow. >> Dramatic. Yeah. Crazy result. Oh my god. like mindblowing >> big problem. His work was not inside of the medical consensus at the time and other doctors really did not like hearing that they could be a vector for infection. They're healers. >> Yeah. >> How could they be hurting their patients? >> And he lacked an accepted mechanism to explain what was going on. And also, frankly, he was a really bad communicator. His findings were largely ignored and dismissed by other people. A few years later, this other guy, Joseph Listister, he comes along and he was running careful experiments on inflammation. Mid 1860s, he encounters pastor's work on germs. He introduces carbolic acid for hand and instrument cleaning and wound dressings. And he begins to publish detailed case reports. So starting in 1867 in the Lancet, which remains a major major medical journal, he laid out explicit protocols and outcomes that other people could copy and test and report back on. Death rates dropped in hospitals that adopted his methods over time. Listster and pastor become household names. Semlice is a cautionary tale. There's even a term the semlice reflex and this is the tendency to reject new evidence or knowledge because it contradicts established norms. This is how you do the work. You figure out what the mechanism is. You write it up. You make it replicable. You invite other people into the bubble. You invite them in. You say, "Hey, check it out. Try it on. Test it. Here's what I got. What do you got? Oh, how can we change this thing together? How can we figure out what it's good at and bad at?" That's how science works, right? If you want to change a field while working inside of the field, you have to play by the rules. If you think that you found like handwashing for the brain or like trauma x treatment for the brain, fantastic. I love that. But the way to approach that is not to like train up your disciples and create your like three tiered training program for whatever whatever. It's to do this kind of detailed work. That's how you get accepted. And I just think that like framing things in that way is so clarifying in part because the incentives push against that so strongly. There are not a lot of incentives to do this kind of big testing about your proprietary approach to something that you're already making money from because what happens if you do the study and it comes back and it's like not that great. So, we we're in the world of moral hazard and that's like the space that we live in in the self-help, Instagram, Tik Tok world with this huge huge issue, this huge moral hazard, right? Um, and I don't I don't know what we do about it exactly, but it's something that I'm really been banging my head against. >> This is some deep. >> It is. >> Thanks for joining me on this ride, Dad. as I've as I as I hear. >> One detail that I learned reading your notes was poor semivise um a sad story. >> What a tragic end. Tragic end. Yeah. >> Institutionalized, beaten to death in an insane asylum essentially. Like what a terrible fate. I love medicine. Some of my best friends are physicians and okay great. And wow, medicine can be very slow to innovate. Uh there's some kind of um sequence that I've been told by doctors in medicine that kind of goes from step one, that's ridiculous, you should lose your license, step two, this needs a lot more study, step three, we knew it all along. That's kind of how things occur, right? And I just poor some of us. So just keep coming here. >> Totally. No. And and he was right. Yeah, >> the guy was right, you know, but there were these things that that he wasn't doing as skillfully. He wasn't doing as effectively, unfortunately. He was clearly a great doctor, and there were those other pieces to the puzzle. And and I think that it's it's an example of both what we kind of have to do to get mainstream credibility and also an example of how there are always going to be some ideas out there that are in that more alternative woo universe that end up being 100% right on. Hey there, thanks for watching and sorry for the brief interruption, but it turns out that over 60% of the people watching this right now are not subscribed to the channel. So, if you could just take a moment to hit the subscribe button, it would really help me out. I'd appreciate it a lot. All right, back to the show. Forest it's it's also true that um the I think JAMAMA Journal of American Medical Association published a thing and I think Lancet had a similar thing that literally something on the order of roughly half of all the various particular procedures that are done by licensed well-intended physicians and other healthc care providers do not have a single published study backing them up. >> Sure. I remember hearing this where I'm going to get out over my skits a little commenting on it because I'm I'm not familiar with the specifics of it, but but go ahead. Yeah. >> Yeah. And uh it's not malpractice. Why do they do it? Well, it's because they work. Uh you know, medicine a lot is kind of an oral tradition in terms of how people are really trained and you see that it works again and again. So that's a kind of direct evidence it works and also uh the underlying mechanism of action is plausible. It sort of makes sense. So, let's move over to psychology. If you think of the really broad range of, let's say, inputs you've received in your lifetime, let's say at the point you turned 18, we'll kind of take it from there. Or in my case, what fraction of those helpful inputs? You would say, you know, from the direct inside out, it actually was helpful for me. I could see that. What fraction of those have some kind of study behind them? Probably a pretty small fraction, maybe even a lot less than 50% just by the nature of the domain of the humanities and life al together. It's just a bigger domain. Okay. >> Sure. >> So how should we be about that? >> And so I want to ask you a question. What standards do we use? What standard do you use? And I'm reflecting on this myself. What standard do you use for new suggestions, new ideas, new new techniques, new perspectives, etc. coming in? How do you evaluate them as whether you should internalize them and adopt them or giving advice? I give a lot of advice on the show. How am I validating it in a world where I'm not not running a study on film? Yeah, we could look at it from that standpoint, but let let's do first on the receptive side. >> I think this is a great question and it's really a crux question, you know, like how are we evaluating stuff when to your point a lot of stuff does not have a large scale study or whatever else. It's just kind of common sense advice or somebody maybe more to people's direct experience. Uh they're browsing through their Tik Tok feed or their Instagram feed and some authoritative looking figure pops up on it making some pretty radical claims about stuff. So, there are a couple of things I would I would name right off the bat that I just want to mention here. First is that there's kind of a difference between trying to fit your cool idea into some kind of a pre-existing structure versus creating a whole other explanation for something. There's a difference between like mindfulness-based cognitive therapy, which was looking at cognitive therapy and going, how do we how do we soften this a little bit? How do we include those tools? Uh, and somebody saying that, oh, you know, you've been lied to about fill in the blank. You've been lied to about ADHD, and what's really going on is this thing over there. That second category, I'm much more innately skeptical toward than the first category. Uh, because in the first group, there's more of a natural explanatory framework for why something might work, right? So, just my standards would be different for these two groups. And I just want to kind of name that up front. I actually think that a lot of how I think about this is based on what they're this is so me like what they're not doing or what they're willing to disclose about the vulnerabilities of what they're doing. So So here's what I mean. Does this person ever change their mind publicly? >> Can you look through their stuff and see an example of them going, "Hey guys, in the past I said X. Now actually I think it's Y. Here you go." And also, what kind of evidence would change their mind? Does evidence exist out there in the world somewhere where if it appeared, they would say, "You know what? My bad. I missed the boat on that one." Or are they so bought in to their explanatory framework that they cannot change their view in some kind of a public meaningful way? Uh, contributing to this, do they mention data that doesn't entirely support their approach or like unanswered questions? you know, well, we really we're really not sure about this and I'm I'm advocating for this part of it, but honestly, like how big of a difference does that make in a complicated world? It's a little a little unsure, but it's worked for me. That kind of a stance. Uh, do they distinguish their personal experience from like broad population data? You know, most people don't go to that level of granularity, but even sort of implicitly, do they say things like, "Oh, you know, this has worked for my clients." Or are they making an ontological claim about like this is the way reality is or are they saying this should work for everybody who does it, everybody I do this with, bam, snap, they just get better. So those are all the things that I would be thinking about if I bumped into this video on my feed and I started going, "Wait a second, like how how much stock do I want to put in this?" Also, frankly, I think there's a tone thing. I think there's a tone to clickbait. And if somebody is using the clickbait tone, even if they are actually doing it with like really good underlying data and like a really good reason to to advocate for that approach, I just personally recoil from that kind of stuff almost instinctively because the odds of it being are just so high. >> This is great Forest. Um, so we have the messenger and the message, right? Mhm. >> And how is it for you when think two cases when a virtuous messenger is offering a message that just doesn't ring true for you? Kind of like how does that work? And on the other hand, do do you ever have situations where a flawed messenger says something that huh you you judge on its own merits and maybe find some value in? Well, I think that all the time I have experiences of something not being for me, but thinking that the person does really have their stuff together. >> I I think a lot of um mindfulness based and spirituality based approaches feel that way to me actually. >> For example, a podcast that I like is Alex O' Conor's podcast and he's a skeptical guy. He's a very smart guy. you can check out his stuff and and I think that he's really great and he often has people on the show who have a very different uh his perspective is pretty rationalist and he's sort of a well-known agnostic and he has like public conversations with religious people talking about God and religion and like what do we know, what do we don't know, all of that. >> You will often have people on the show who I disagree with on like the material of what they're saying about like the onlogical claim about the nature of reality, but it's so clear that they are smart. They're trying to be ethical about it. They're speaking from the heart. You know, what they're doing is helping a lot of people out there. Hell yeah, man. Like, I I might disagree with you. >> Yeah. >> But I appreciate how you're approaching this kind of content and rational people can have can have differing views about this particular issue. Does that make sense as as a a category? >> Oh, completely. And if we just kind of sort this out that we're carving out uh medical issues, mental and physical, where there's a real pathology, there's a lot of distress, there's dysfunction, they're high stakes, high stakes issues. Okay? Instead, we're talking about the run-of-the-mill breadand butter everyday issues of stress, anxiety, irritability, uh, you know, some learning and tendencies from childhood brought into the present, but not anything that would fit a DSM5, you know, category in terms of some kind of psychopathology. Okay. which I think actually certainly in the majority of the population is the largest possible pool of stuff that people are looking for help with. All right. And then in the context in which the help or purported help uh in most cases does not have a lot of schmancy evidence for it. That's just the reality of it. So then how do we judge it? We judge it to some extent on the credibility of the messenger. And then the credibility of the message itself. So you've talked a lot about, you know, judging messengers. >> I mean, this is you're you're judging both. You're judging the messenger and the message. I think that's right. >> The judgment of both of them is kind of intertwined in a way. Yeah. >> Yeah. Yeah. I think these days in our like food blender psychospiritual culture, so many of the messages come decoupled from a messenger. It's just like a suggestion or somebody's routinely misqued. The Buddha said that hamburgers are bad for you. Well, actually, he probably never did. Uh, you know, but then you judge it on some merits. Gee, what are hamburgers good for, bad for? Blah blah. So, um, here's where I I really do kind of want to, I guess, name the value for me on the classic advice from the Buddha, which was to see for yourself. You know, okay, start with the messenger. All right, that reduces your uncertainty a little bit in a basian kind of sense, but after that, really see for yourself. Does it have the ring of truth? Does it hold value for you over time? Does it make sense? Does it actually benefit you when you watch other people using it? Do they actually seem benefited over time? You know, that kind of metric. I guess >> I appreciate your kind of libertarian sensibility here, Dad. And this is one of those things where I generally do agree with you. Um, as we've talked about a lot, this stuff is really personal and we don't have silver bullets and what works for you might not be what works for me. And we're all trying to find a good fit out here, including a fit with the kinds of things that we try on in life, right? Evidence-based versus, you know, alternative, however we want to think about that. But for me, this is like a consumer protection issue, right? And we've had these two tracks of medical on the one hand and not medical on the other. And I've I've done a lot of setting that up, but I think that the reality is that it gets really blurry really quickly when you're actually engaging with this stuff online. Um, sure maybe somebody's not giving you advice about like this is how you treat your cancer, but they are saying, "Hey, try this on for your ADHD or like,"Hey, take these vitamins or these supplements because you're deficient and fill in the blank." Um, or just like the general psychological advice that that people give and receive online that can have a huge impact on how people actually live their lives. Like, this stuff is a big deal to me. And of course, I want people to have freedom of choice about what they orient toward, right? But see for yourself only really works when the game the person is playing is fair. Like this is the same to me as putting uh smoking causes cancer on packs of cigarettes. Just trusting people to make good decisions is understandable a lot of the time, but I don't think that this is one of them in part because of how easily our brains are manipulated by this kind of stuff. We just know that that's not how you do consumer protection at this point. And I think that it's okay to be honest about that and to be honest about the fact that we can be manipulated and that that what we see with our eyes is not always what is exactly true. And that's part of why having these other standards like evidentiary standards or just some of the guidelines that we've been talking about today and uh the last time that we had this kind of a conversation I think are so important. And my hope is that by doing this, by airing this episode, we're both calling out some of these practices and giving people the tools that they need to recognize these problematic patterns. Like, I care about people being exploited. I don't want them to be exploited by this stuff. And that's the spirit that I hope people can feel that I'm bringing to all of this. I'm not trying to finger shake at people who are engaging with an alternative form of practice or an alternative approach. I use alternative approaches in my life. There are a lot of understandable reasons that a person could be drawn in that direction, including very practical ones like I tried the mainstream one and it just didn't work for me. The real question for me is how we can help somebody make good choices about what's on the table for them. And also are content creators like us being being thoughtful and careful about how they are frankly manipulating attention. And for me, this is really more the problem with spaces that are kind of openly dismissive or or just really turn down the value of material evidence in general and like scientific materialism in particular because the standards that we're using for figuring out what we should pursue or what we should not pursue become much fuzzier. Um, and they become much more susceptible to the forms of influence that we've been talking about. you know, well, for example, I can't prove astrology, but I just feel that it's true. >> Sure. >> And hey, there are all these other things out there that uh, you know, we can't can't seem to prove, but those people say that those are true. Well, may maybe they're like astrology. Maybe they are true. >> And so there's this kind of movement, this sort of slippery slope into a movement away from just valuing what we can prove materially. And I think there are some domains where that's really kind of okay. I I don't mind if somebody, you know, reads their horoscope at the start of the day. I we joke about astrology regularly on the podcast. I joke about my Libra trades, you know, whatever it is. Fine. Great. Yeah. I'm so balanced and rational. Exactly. There it is, baby. It's great. I'm such >> only committed to fairness. >> Totally. Totally. Like all of that. Like, okay. You know, you can have fun with it. >> Yeah. Yeah. That's right. But if we just act like, oh, haha, it's just for fun and there are no there are no knock-on effects >> right >> associated with just kind of moving away from material evidence, I think we've just kind of lost the plot. >> Um, and then you get into the identity politics of this whole thing. The person starts identifying as >> a as spiritual person or an alternative person >> and you know us alternative people are over here and those other people are over there and so now we've established a bucket of like what's in alternative and so it's easier for me to buy the other stuff that's in that bucket. >> I think it's good that we are going to get into a lot of bad trouble with this episode in general. Gosh. Okay. So, I think you and I share a principled stand that if someone is contemplating a treatment for a genuine medical condition, including a genuine mental health condition, that the prevailing advice from you and me would be that people would look for um fairly well evidenced through schmancy evidence intervention ions particularly if uh the interventions have significant risks in and of themselves andor there's a risk in less well-ec interventions being less effective and crowding out well-ec. >> Yeah. For for me, it the moral hazard in it is like what are you selling people and is the thing that you're selling actually helping them out in like a meaningful way? >> Yeah. Now, to confess, I'm annoyed at the huers and artists and phony authentic people. I griped about that earlier. Uh who just are taking money from people. >> Sure. in a really commercialized way. And these are very often people who could spend that money better elsewhere and they don't tend to have a lot of money to spend and um their own vulnerability and sincerity and virtue makes them easy prey for a certain kind of charlatan. So I'm annoyed by that in the broad personal growth, human potential, self-help space. That's true. For me, it really goes back to this thing of first of all, do no harm. And second, have the humility to recognize your privilege. >> And the more asymmetry you come in with, the greater duty of care you have to other people. Yeah. And I would much rather uh have teachers who are truly humble and truly unattached to whether you have any interest in their book or their program or their meditation retreats really really and uh move the the ball of responsibility and power endlessly toward the consumers, the students, the people coming. Those are the people that I really am deeply interested in. >> Yeah. And I'm going to kind of put you on the spot here, Dad. And if you want to plead the fifth, you can plead the fifth. What do you think about what I was describing about that kind of slide? This sort of like ascientific slide and a material evidence, the proliferation of that is like a stance and some of the knock-on effects of it. Do you think I'm exaggerating? Do you think it's not that big of a deal? Do you think it's a big deal? How do you how do you relate to it? >> I think you're naming something that's really interesting. And the a deep question is why? Uh why is there this kind of interest and motivation uh that swerves away from all kinds of mainstream evidence, people who won't even think about universities around the world who investigated COVID and vaccinations for it. and they're not all lying. You know, what is that vulnerability in people that makes them really, you know, basically drawn to paranoia in a certain kind of way. A B to go further with this, boy, you see it in politics too. you know, there's a certain uh tendency, I think, for uh people who are drawn into the space that you're describing, which, you know, isn't always in the more newagy territory, but, you know, is people also who've kind of really drawn to right-wing movements, you know, around the world. So, I I I agree with you about that, and I think it's really interesting. Now that said, I think it's also really important to be careful when people like you and I have the privilege of, you know, training and education and good universities, a lot of authority. We kind of come from a frame of scientific materialism as sort of a worldview. >> Yeah. >> And gosh, I'm just thinking of people I've met in other parts of the world who are just receptive to a different worldview. and they drive their cars safely, they have a mortgage on their home, you know, they raise their kids, they coach little league, uh they vote, they're responsible citizens, you know, they'll go see a doctor for this or that. Uh and I'm just kind of leerary of sneering. Not that we are, yeah, but I just want to stay on the other side of sneering. And I've detected a lot of to me obnoxious sneering from dogmatic atheists and people just wedded to a scientistic tradition who look down their noses at people who, you know, are just tuned into something that's real for them and might be. And nobody's getting hurt by that. >> To your kind of macro point about these two tracks. >> Yeah. No, no one's getting hurt by the guy who's like, you know, I've got a personal connection with fill in the blank. >> Yeah, that's right. >> Not a lot of downside to that. Um, what I do think is the case is that when we create structures that downplay the value of what we can actually like measure and observe in in real life, there are some knock-on consequences of that. I I think that's a knock-on consequence, frankly, of uh spiritual spaces and forms of religious practice that's pretty well documented. If you look at susceptibility to different kinds of forms of influence or uh beliefs that people have about, you know, well doumented scientific facts, how old the earth is, whatever it is, uh there are just populations of people who believe those not true things at a much higher rate. And what you find is that those are the populations of people that tend to be the most spiritual and the most religious. >> Yeah, fair fair generalization. >> Yeah, that's a generalization, but it but it is what it is. And the reason that I'm saying that is not cuz I'm to your point, I'm not trying to dunk on anybody here. >> I'm trying to say that this is a vulnerable population. This is a population that is susceptible to a certain kind of influence when it's misused. And I think that it's one of the reasons that if we're going to occupy that kind of authoritative seat, it's so important to be careful and thoughtful and clear about the degree of claim. >> I think that's really true for us and I just want to say it publicly because I sit I sit in both seats, right? Got a license as a clinical psychologist and some reputation is a Buddhisty Buddhisty uh teacher. And you're exactly right. Exactly right. Now, if I were also a Hall of Fame Pro Football Player and we and a rockstar and we threw in those two other forms of authority these days, I should be really, really careful. >> Really, really careful about it. Totally. If you were fabulously overwhelmingly wealthy, for example, you should be really, really, really careful. >> Yeah. Or if I were male or white or heterosexual or American, I really, really, really, really >> you should be careful, you know, about all of these things. I was not referring to you, by the way, as somebody who's fabulously wealthy, although I suppose, you know, it's all it's all relative, but you know, um, so anyways, okay, let's kind of bring this to a close here, Dad. We've been talking for a while here, and >> I've I am so far out over my skis with this episode as a whole. Uh, you know, I hope that we have a show by the end of uh of this one. I I think we might. So, okay, I've been doing a lot of talking about what the problems are. essentially a lot of overclaiming big megaphones, people taking their narrow knowledge and extrapolating it out to all kinds of problems even when it doesn't fit. So what's what's the alternative to all of this? Right? There's a famous story from astronomy. In 1991, British astronomer Andrew Line and his colleagues announced in Nature, this is one of the biggest most important scientific journals out there that they had found a planet that was orbiting a pulsar. And this was a totally wild finding. It was a huge deal. It was a big deal for their career. Before presenting the next year at the American Astronomical Society, one of the big conventions inside of this space, Lion rechecked the analysis and realized that their team had made a mistake. There wasn't a planet there at all. And this happened because they hadn't really properly corrected for aspects of the Earth's orbit. So, it messed with their measurements in some kind of a way. So, what happened? What do you do? 1992 walks on stage, explains the mistake, publicly retracts the the article. Room of several hundred astronomers gave him a standing ovation. Why? Cuz that's how you do it. That's how you do it. That's the energy I want us to bring to this whole self-help space. Publicly correcting an error did not end this guy's career. It enhanced his credibility. It improved the field. This is the response to the natural criticism that is often leveled at science communicators, but the studies are retracted all the time. Why should we trust them? You know, uh, replication failures, we thought it was this, it's actually that. Why are you so sure? I get it. But those things are actually proof that the process is working. When you update your view as the evidence changes, that that's the whole point. That's what we're doing here, right? And that's how we get to the stuff that I was saying to you before, Dad, about like what my markers are for who to listen to. Is this person willing to do that? Do they change their mind? Do they acknowledge when they were wrong? Um, there are plenty of times on the show when I've said like, "I've updated my thinking about this." Or like, "I used to think X, but I learned why." You know, I I just think that that's a really good barometer for this kind of thing. You know, people want to believe that there's something out there that can help them. People are drawn into these alternativy, self-helpy, Instagram, Tik Tok, our podcast, whatever spaces in part because they often haven't been well served by more mainstream approaches to whatever whatever their problem is. Uh they are in a lot of pain. They feel dismissed. They feel ignored. And that person is looking for something that can help them. I get that the message that that person wants to hear and is very susceptible to is I can take your pain away and we just want to be very careful with how we apply that kind of messaging and how broad we are and those kinds of claims. I think this is great because one of the things it does is it's it just surfaces bias and you can't because life is uncertain and we're just surrounded with so many things we don't know and things are so complicated and multi-namic and good news and bad news can come from left field or right field at any moment. We we must function with certain rules of thumb. It's okay to have certain biases. And my bias to a fault is I'm just a deep believer in the autonomy and the dignity and the worth uh of the individual and therefore the responsibility of that person. So I tend to tilt toward wanting on the one hand as I think I've been really clear about maybe this yeah this is clarifying u to be super careful about your authority if you have authority and super careful about the privilege you carry and you're not even aware of your impact on others because you don't have to take it into account. Uh Tanahi Coats talks about privilege as not having to take something into account. You have that kind of a privilege. So the more privilege you have and the greater the asymmetry of power with you and others. To me it's more um you know incumbent on you, you're more beholden to be very careful to minimize the harms you're doing and to bend over backwards to avoid those harms. Especially when you've got self-interest in the motivational structure for yourself. You especially need to be careful about that when there's money on the line. you really need to be careful about it on the one hand. On the other hand, I guess I see people if they're adults, you know, it's kind of up to them to figure out the value grounded in the validity of what's being offered to them and a kind of willingness for people to try different things, you know, to explore. And if it makes you happier in your day >> to say a prayer when you get out of bed in the morning, >> I'm for it. And I'm not going to say there's no Gaia who's listening. I don't know enough to say that. You know, as as I talked about in the first episode we did on this, it is well researched that spiritual religious people are happier than ones who aren't. Like I mean that that is a kind of evidence, right? So there's some upside there's layers to this. Oh yeah, exactly. Between between between getting married over the next, you know, little while here and hey, maybe converting to fill in the blank religion, I could really up the odds of becoming like a like a happy, reasonably, you know, lifeenjoying person, cuz those are are two well doumented things, marriage and religion, man. >> Yeah, that's right. So that's kind of it. Yeah, that's a good summary. >> I think that's fair. And I think that part of what I'm saying in all of this is I'm mostly doing criticism of the field, not criticism of people. >> Yeah. >> And it's less even criticism in a way and it's more observation. This is a thing that you can see if you go on Instagram or Tik Tok or you scroll frankly through the top 50 podcasts in the world. Most of those shows, they do great work, don't get me wrong. They're well produced, well put together most of the time. Most of the time. Um, nonetheless, you scroll through the titles and you're like, I get why this is popular cuz they are really good at manufacturing interest. >> They are really good at pulling the levers inside of all of our monkey brains that get us really excited to push the button. Like, that's what they're good at. And so, part of what we're trying to do here is we're trying to equip people with the tools to exist in that world. to exist in a world where there are all of these people trying to push all of these buttons inside of the monkey brain to get you to buy their thing or give them your attention or whatever else. And that's what we got to uh you know be really careful about here. And and I hope that something in this long sprawling I I hope interesting series of episodes that we've done uh has has better equipped people to do that because that's just what I'm trying to do here. I think it's wonderful and I want to share an example of someone. >> Sure. It is Shaku Okumura who wrote one of my absolutely favorite books in the space of psychosspirituality and the book is called realizing Genjjo Kawan and I'm searching for it right now and can't find it. Yes, realizing Genjokuan. This is an unexpected plug for forest. And the thing about Okumura is that you can find a YouTube clip which I'm also going to call out here as a Zen teacher in which the title is Zazen is good for nothing. And to me now, maybe there's a skeleton in his closet I don't know about. He's such a great example of someone who's lived in relative poverty. has been extremely sincere as a Zen teacher and offers it freely and uh is continually undermining. That's an that's a very interesting qualification for a good teacher that they're undermining the tendency and the longing even sincere sweet tendency in their followers to put them up on some kind of a pedestal or to kind of write them into the guru role in the in the script. And I love teachers, Joseph Goldstein, uh, uh, Sharon Saltzburg, Tar Brock, other teachers, I'm sure, in other traditions as well. They they undermine the tendencies of people to kind of put them up. To me, that that increases the credibility of the messenger uh, and makes me more willing to open to their message. >> Yeah, absolutely. Well, thanks for going on this ride with me, Dad. I hope that we have a podcast by the end of these these two episodes. I I hope that we have not, you know, exploded our listener base with with this uh provocative stuff that we're tossing out there, but hey, who knows? It is what it is. Um, and also, I expect to get plenty of mail and comments and feedback and so on about these episodes. I look forward to them, honestly. And maybe, hey, maybe we'll do a mailbag in the future where we just kind of unpack some of the things that people are saying about this. I think that could be really interesting. >> Yeah. Fantastic. I had a great time talking with Rick today in the second of two episodes that we've done focused on science versus self-help, the uh kind of therapy wars between these different schools of therapy, the difference between alternative approaches and more evidence-based approaches. And today we took a real turn into talking about the attention economy and the ways that that attention economy can put pressure on people, on creators, on outlets like being well to talk about things in a certain kind of way using intense language, overclaiming, generalizing from our specific experience, whatever it might be, because that's what tends to be rewarded on social media. If I publish an episode that says most people could benefit from this thing a little bit, that's probably not going to do very well, right? Not a lot of people are going to want to click on that. And there have been plenty of people who have talked about the issues with clickbait. But the problems become a little bit bigger here when we're talking about medicine and psychology and giving people a lot of specific advice and how they should be living their lives. And when you combine the responsibility there with the kind of messed up incentive structure that's been created by all of these algorithms, you get a real problem. You get an easy slide into overclaiming, overgeneralizing, and frankly not being really willing to change your thing, whatever your thing is, when the evidence changes. At the extreme, these self-help spaces can start to look a bit cultish. And I talked during the first part of the episode about some of the features that cults have in common. They tend to be both high control and high demand. This means that the behavior of people inside of the cult is tightly constrained. They tend to have a centralized or charismatic authority. They usually use totalitizing ideology. This means that one framework explains everything about the world. And they usually have a lot of us versus them language and thinking. If you think about alternative therapy spaces, they have some characteristics that start to wander in this kind of direction. I also want to give a quick shout out here to Amanda Montal and the Sounds Like a Cult podcast on the 1% chance that somebody who works with uh with that show or with Amanda is listening to this, we would love to have you on the show. That would be amazing. Now, it's not a total cult. At least I don't think it's a total cult, but this kind of cultishness is definitely present in those online self-help social media spaces. And things can get really messy here when we bring a lot of different factors together. On the one hand, this kind of messed up incentive structure where the loudest, biggest, most audacious claims are normally the ones that are rewarded. Then we've got a lot of authority, like clear authority. This is an expert inside of a their specific field or their specific industry. and they're really an expert in their thing. They're kind of one thing. And then the big incentive is that well eventually, you know, you want to sell your book, you want to make some money, you want to you want people to learn about your thing, not just cuz you want to make some money, but because you think it's a good thing, you think it'll help a lot of people. You know, a lot of the motivations here for people who work inside of the space are extremely altruistic. But there are some problems with expertise as well, particularly when you become such an expert that you're going on podcasts or, you know, doing TED talks or whatever else, right? True expertise tends to be very specialized. And it's a well-known finding that people are often captured by their knowledge. They lose beginner's mind. They become a kind of slave to their habits. And they are very subject to what are known as sampling issues. The people that they work with or the field that they work in is their experience. Those are all of the people that they know. And if you work with people like that over and over again, you start to think that everyone is that way. And this is how we get to situations where the trauma person thinks that everything is about trauma. The mindfulness person thinks that everything is about mindfulness. The, you know, the taking in the good person to poke some fun at Rick thinks that everything is about taking in the good. When you've got a hammer, everything starts to look like a nail. And when you take that uh hammer holding person and you put them into a situation where they're on a podcast and they're being asked about getting a screw in the wall, what are they going to do? They're probably going to start hitting it with the hammer. This then took us to this example of ADHD and trauma. How there are many people out there who will tell you that ADHD comes from trauma. That is the source of ADHD. It is traumatic experiences. We know pretty conclusively that this is simply not true. This has not led to people who say that changing how they talk about it. Of course, this stuff is complicated. Things have many different causal factors associated with them. Uh, we know that traumatic experiences can exacerbate symptoms or create symptoms that look an awful lot like ADHD. But as Rick laid out really effectively, this means that the treatments for those two different people would be quite different for somebody who was raised and, you know, perfectly validating environment, perfectly safe, healthy environment, and they go to school, they're, you know, 7 years old or whatever, and there are still big distractability issues. Well, if you start doing trauma treatments with that kid, it's just not going to address their issues. Context really matters. Before giving somebody a lot of medication, it's really appropriate to ask, "Is something happening at home that our kid has to disassociate from in order to cope?" So, it looks like they're not paying attention, but there's really something else happening here. As Rick talked about during the episode, the world that we live in looks very has has very little in common with the world that our huntergatherer ancestors inhabited. And inside of that context, we probably wouldn't even have this thing that we call ADHD because it's an issue of fit, right? It's an issue of fit between the person and their circumstances to some extent. But that doesn't mean that temperamental variation is not genetic in nature and that there are some people who regardless of life circumstance, their brain is not a good fit for modern society. The idea that trauma causes ADHD has been blasted by every serious expert on ADHD out there. But that doesn't stop people from continuing to claim that trauma causes ADHD and in fact is the sole cause of ADHD. And this is a great example of that modality capture, right? You're the expert in fill-in- thelank, so everything becomes a fill-in-theblank problem. But for the playing field to be fair, there needs to be some kind of way for alternative ideas or perspectives to get included into the mainstream. And we talked a little bit about how that happens. How you go through a process of research and evidence gathering in order to improve your ideas in order to open them up to critique and criticism from other places and frankly to be willing to change them when necessary. I gave that example toward the end of the conversation about an astronomer who publicly updated the research that they did and were lauded by their peers because of it. And I think that that's the energy that we should be bringing to this. Some people are willing to do that. And I think it's incredible when they do, but a lot of people aren't. And again, there's that incentive structure here. All of the incentives push people toward overclaiming and selling their proprietary idea as the cure all. Like that's how you become exceedingly popular by and large. They also push people away from validating their thing using traditional approaches because what if you do the study and it doesn't come back the way that you want it to? That is incredibly risky. And this is where I think stuff gets kind of messed up because a lot of people fall into more alternative approaches because they have not been well served by the mainstream ones. This is a vulnerable person. This is somebody who is hurting. They have a real problem that hasn't been well addressed by a lot of the stuff that's out there. And they've got somebody who's coming to them telling them, "I've got the secret to making you feel better." There are just not silver bullets. There is not one method that's going to work for everyone that's going to solve all of their problems. If you just, you know, reconcile your developmental trauma. If every person living just reconciled their developmental trauma, the world would just be a perfect idyllic place. That is just not the case, right? Some people will find things that function for them as a kind of silver bullet that really do dramatically improve their life. But for most people, most of the time, we've got pretty good interventions for the middle part of the distribution. And we stack things on top of each other. For some people, that thing is going to be uh, you know, IFS. For some people, it's going to be a spiritual practice. For some people, it's going to be cognitive diffusion and CBT. For some people, it's going to be going for a walk with their dog in the morning. Whatever it is for you, like, if that really makes a difference for you, fantastic. Rick asked me a great question during this conversation. He asked, "What are the standards that you use to determine the kinds of things that you try on in your life?" And I think there are a couple different ways to answer that. For starters, you know, of course, a study's nice, but a lot of stuff out there, as Rick said, does not have studies in support of it. And it's it's a lot of stuff that we do, nor should it necessarily have a study in support of it. It's kind of general life advice, right? But here are a few questions that I would ask maybe to to wrap with this. What's that person's incentive structure? What are they incentivized to tell me? Are they incentivized to get me to uh you know, we sell courses and programs on the show. We're incentivized to some extent to sell you those courses and programs. Now, we do it very weirdly. I often tell people, "Hey, by the way, if you're willing to listen to every podcast episode, you will definitely get everything that we've got in that course out of just listening to the free podcast episodes. But hey, if you want to do it a little bit more efficiently, you can check out this course or program that we have um on my coaching page on my website. You can go to it. I have a whole section about a a page of text that is why you should not work with me. Nonetheless, we got to make a living. We sell stuff on the show. We sell advertising. We do all that. We're incentivized to get you to click on it. And so, you should think a little bit even when you listen to an episode of Being Well, what is Forest's incentive structure here? What is Rick's incentive structure here? Is there is their heart in the right place? Are they incentivized in some funky ways about this content? Because it is wise for you, even as a listener of this show, to view what we say with a little bit of healthy skepticism. Another question to ask is the person who is telling you this, do they ever change their mind? What kind of evidence would lead to them changing their mind? And if the answer is no evidence would cause them to change their mind, I think you can safely toss their opinion. Here's some other questions. Does that person mention data that doesn't support their approach? Do they distinguish anecdotes, personal experience, from other forms of evidence? Are they clear about what their method doesn't do? If you bump into somebody's content and you see them publicly change their mind on stuff, you see them not turning their thing into the only thing that matters. And if you see them being really clear about the things that their method isn't great for, honestly, I'd listen to that person a lot more. Bottom line here, keep your eyes open. Your time, your money, your attention, these are limited, scarce, important resources. You want to make good choices about where you invest them. And there are self-helpish practices out there that we share, including on this show, that are fantastic investments of the time and the resources of, I think, many people, maybe even most people, but probably not everybody. And I hope that some of the tools that we've talked about today can help you just see this whole field with clearer vision, get a better sense for when people are kind of exaggerating. They're kind of amping things up so you can make better, more informed decisions about the content that you consume and about the people that you listen to. I hope you enjoyed today's episode. I'm sure that people are going to have some thoughts about this one. I'm very interested in your comments, your questions. You can send them to contactingwellpodcast.com. If you're watching on YouTube, you can write a comment down below. You can hit the subscribe button. Hit the thumbs up button if you liked it. I hope you liked it. To say something again that I mentioned toward the end of the previous episode that we did on this, these were complicated episodes to do for a lot of different reasons. We wanted to be fair and reasonable in how we engage these topics. I thought it was important that Rick was involved in these episodes to give a kind of counterweight to my perspective. And I'm sure we're going to get some mail and maybe we'll do a future mailbag episode of the podcast focusing specifically on topics related to this episode, thoughts that people had about it, and hey, anything else that you want to throw into the mix here. And if you've listened to both of these episodes and you made it through all of them, for starters, thank you. Thank you for that time. Thank you for that attention that you've given to the show. It really means an enormous amount to me. Um, it's a huge investment of your time and energy. I'm glad that you think it's worthwhile to spend it with us. So until next time, I'll talk to you soon.

@RickHanson and I explore how well-intentioned self-help advice can drift away from science under the incentives of the attention economy, where overclaiming, alarmist framing, and “this one simple trick” outperforms nuance. We talk about how authority gets manufactured, how the algorithm encourages overclaiming, and how “theories of everything” lead to misinformation. We also spar a bit over whether seemingly harmless pseudoscientific practices can create a slippery slope, lowering the importance of material evidence and acting as an on-ramp to more consequential misinformation. Key Topics: 0:00 Introduction 2:20 The attention economy 9:00 The problems with clickbait 18:30 The risks of sprawling expertise 25:15 Modality capture: when all you have is a hammer 27:15 Applying this to ADHD and trauma 39:22 Sponsor 41:07 If science changes, what can we trust? 44:00 How “fringe” can become mainstream 51:40 How do you decide what to trust? 1:07:30 The slippery slope of “woo” 1:13:00 What’s a better alternative? 1:22:41 Recap I'm not a clinician, and what I say on this channel should not be taken as medical advice. Sponsors: Grab Huel today with my exclusive offer of 15% off online with my code BEINGWELL at https://www.huel.com/beingwell. New customers only. Subscribe to Being Well on: Apple Podcasts: https://podcasts.apple.com/us/podcast/being-well-with-dr-rick-hanson/id1120885936 Spotify: https://open.spotify.com/show/5d87ZU1XY0fpdYNSEwXLVQ Who Am I: I'm Forrest, the co-author of Resilient (https://amzn.to/3iXLerD) and host of the Being Well Podcast (https://apple.co/38ufGG0). I'm making videos focused on simplifying psychology, mental health, and personal growth. Subscribe to Rick on YouTube: http://youtube.com/@RickHanson?sub_confirmation=1 Get Rick's Free Newsletters: https://rickhanson.com/writings/newsletters-from-dr-rick-hanson/ Follow Rick Here: 🌍 https://rickhanson.com/ 📸 https://www.instagram.com/rickhansonphd You can follow me here: 🎤 https://apple.co/38ufGG0 🌍 https://www.forresthanson.com 📸 https://www.instagram.com/f.hanson