The state of psychoanalysis today

0:00informed dissent the intersection of health care and politics with Dr. Jeff Markey board certified primary care physician and Dr. Mark McDonald board certified child adolescent and adult psychiatrist we are rolling well listen we're here with another great episode of informed dissent my podcast co-host Mark McDonald right now is missing an action but I bet he'll join us any minute he's probably caught up in L.A. traffic so we'll see what happens but like we always try to do on informed dissent we try to bring you really interesting guests with super interesting topics and we got one of them tonight and that is C.C. Evans Pugles I pronounce that right if you were speaking in a tail again you would say pull the AC but the American version is Puglesi okay very good well C.C. welcome to informed dissent thank you for

1:03having me it is my pleasure little circuitous route how you got to me I'll tell a quick little story I was blessed to be the co-founder of a wonderful charter school out in the city of Orange called Orange County Classical Academy we're affiliated with Hillsdale College and we opened during the pandemic of all times and so annually we have a gala to try to raise some money we bring in interesting speakers last year we had Kirk Cameron who's become a dear friend of mine and somewhat of a mentor and during the gala we auction off stuff somebody suggested that I auction off a morning message appearance for the kids and there are a few people that bought them and one of the people that bought them did a bait and switch they texted me and said hey I got this thing at the auction but I want you to meet my friend who also happens to have kids at the charter school because she's got a new book coming out that I think it would be fantastic to talk about and that's how we

2:07ended up with C.C. on informed dissent did I get that about right yes you sure did so first first of all before we talk about your book that's coming out soon yes well tell us about what you do my understanding is you're a psycho analyst is that right yes I am I'm a psycho analyst in a concierge mindset coach and what does that mean explain what that means psychoanalyst so a psychoanalyst is really interested in the unconscious mind and how if unconscious is does not become conscious it can direct your life Carl Jung had a quote and he said if the unconscious does not become conscious it will direct your life and you will call it fate one more time if you do not make the conscious unconscious conscious it will direct your life and you will call it fate wow well that's most people

3:11isn't it yes it is most people don't spend any time trying to dive into the bowels of their mind to figure out what they're unconscious is talking about maybe they should well it's a very interesting field but you really can pick up what people are the stories the narratives they're telling themselves and they're still unconscious and they're often on such repeat that people aren't even aware of it but you can feel someone's narrative you can feel someone's narrative you what do you mean you can feel it you can feel by the way if you listen to if you really listen well you can hear what people's inner dialogue is like you can hear they're in a world when you're really listening meaning you can you can feel and hear that they're saying things that are coming from the subconscious and they may not even be aware of it that's precisely what I'm

4:12saying aha so you must be super fun at a party because you hear this thing and you just have this urge to grab them by the scruff of their neck and say dude you got so much work to do you need my help no I actually never do it unless I'm on the clock it's too it's tiring but it's important work I'm very mission-minded I believe that what we tell ourselves dictates how much of our calling our mission will live out and we have slow we have subtle we have undermining stories that change our narrative yeah and help people I believe that everybody's here on a call they have a destiny they have a purpose and we can get in our own way and we need help do you think there's anybody that that anybody without help that just naturally is able to connect the unconscious with the conscious yes but I think it takes some work I think it takes some self

5:14reflection I think it takes solitude I think it takes a lot of the disciplines that we live in a culture that tricks us out of discipline our phone our smartphones they trick us out of attention and so and there's this slowness that's required to really consider how we're moving our life how we're moving the needle or how we're not takes the consciousness it takes an awareness and but it's an important one it's the most important one when you say it takes some work I mean do you think there are people that they wake up one day and they go you know I got all this unconscious stuff going on in my mind and I want to work on it to bring it to the level where I'm now aware of it and I can actually do something about it is that what you mean yes well I think we can get in our own way we can just get in our own way when I think of Katrina who is the reason why I'm here when I I had a real revelation a decade

6:19ago Katrina the hurricane no Katrina Munoz who had set this up for us oh got you got it okay yeah yeah yeah so we've been childhood best friends since we were 13 uh-huh and I had a total epiphany a decade ago it was 2016 and in 2016 I was always identified as a therapist and there's something in me that almost refused the label I didn't like it because I didn't want to be associated with people's problems I really wanted to be associated with a potential okay well well well I'm glad that Dr. Mark McDonald had the time to join us today he must have been caught up in traffic in LA or was abducted by some alien or what have you Mark welcome welcome to inform a descent glad you could join us it takes a lot of time to put a whole group of people in a 51-50 so CC we we have learned is a psychoanalyst and helps people as she describes it

7:28gets their subconscious to a conscious level because those that don't do that tend to be slaves of things that they're unaware of sounds like 80% of the women in Los Angeles who are all we think is just women or men too well the men are more functional but they're they're they're they're equally troubled but for different reasons I don't think it's personality disorders as much as it is a loss of good role models and masculinity I think the women are just personality disorder for the most part narcissism and borderline is really sort of the the norm in Los Angeles where I live you're not here I assume you're in a different city she's in Orange County oh you're in Orange County oh what's much better down there it's probably only 40% I was telling Dr. Barkey Dr. Mark that I the Jung quote which was that I'm sure you've heard this but he said unless you make the unconscious conscious it will direct your life and you

8:31will call it fate sounds about right to me and so we're kind of unpacking that a little bit before you got on well that's something that I studied for quite a number of years but for Dr. Barkey it may be a little bit more more novel is you're unconscious conscious Mark let me let me check in and see it's one of those it's one of those things that you you don't really often know what you don't know which is kind of the challenge and that's why we use you know therapists of different types particularly psychoanalysts who have more in-depth training to help elicit that because this is the problem isn't it really with with therapy in general especially therapy today in my view is that most therapists really are only trained to work with the conscious mind and although it can be helpful problem-solving and hand-holding and being

9:32you know emotional receptacle for patients it doesn't generally aid in overcoming really long-term embedded difficulties especially those that occurred early in development and childhood because those are definitionally unconscious and solving the surface problems is just playing whack-a-mole and I think that's what most therapists do right now as they just focus on cognitive behavioral therapy and other forms of intellectual problem-solving rather than getting to the core of the identity which is really as we said in our and our training years ago we don't really generally have to treat the adults in the room we have to treat the children the inner child yeah essentially that's where most of the problems come in because the adult problems you can probably hash out with your friends at the bar sure so definitionally is the unconscious mind a trauma created mind could be not

10:34definitionally but it could be sure well we all have that right is that the mind that we where we have an inner dialogue a non-stop inner dialogue that just keeps talking to us well I'm being I'm being a bit jokie here only because I think the word trauma has been over overstated you know not being able to find the right milk at the grocery store is not traumatic and yet that's the way that people talk about you know you're probably dumping today maybe it is for some people listen when they're out of raw milk pretty traumatic for me for my daughter too my daughter Jordan is the same way she's come home crying that sprouts is out of raw milk exactly so what what is the definition of a psychoanalyst and how is that different than a therapist well a psychoanalyst is really trained to listen to unconscious and really figure out how what the person is saying is getting in their own way of what they want to accomplish first for for example someone were really overweight and they want to talk

11:38about losing weight but they can never be not because they keep getting in their own way through their own habits there's a narrative underneath the habits that needs an intervention and I find the best way to intervene and change the narrative is to find out what they're passionate about what they feel like they're called toward what they really want and we really can get seduced into complacency in this culture and forget that we are created to bring purpose to bring meaning to bring mission and so I was telling Dr. Varkey this right before you came but I had a big change about 10 years ago and the change was is I always felt a little bit self-conscious calling myself a therapist I did not want to be associated with people's problems I really wanted to be associated with people's potential and what they could do if they got out of their own way and how they could get out of their own way is by

12:41changing how they talk to themselves and changing how they show up and changing getting a very clear idea of where they want to go and so at that point 10 years ago I really shifted away even though I kept you know as you both know no matter what you do if you changed your title you'd keep all your degrees right you'd keep all your degrees but you can absolutely change your trajectory and what you want to go after and I wanted to go after people that were burning with mission and had a lot of passion but could not figure out how they kept undermining themselves how they kept sabotaging themselves and so I really rebranded myself 10 years ago yeah I get that how do you find clients I have all self all referrals from from clients that I've worked with my

13:42clients drive all my referrals I've never had to advertise which is which is amazing and as I recall I think you told me we were at a dinner party together at weren't we at Kelly Jones's house yes yeah and I think in super interesting for so all you you charge a lot of money and good for you and you work mostly with men as I recall I started off thinking I was working with women I thought I love women I love men but women often have more support than men do they often have more support they more support mean like girlfriends that they can yes yes we can open up we can meet another woman and open up our whole lives over a glass of wine over a cup of coffee and men often don't have that same ability so when I started off with women all the referrals they would send

14:42me were men important men in their lives that they thought needed my help and so now my practice is predominantly men I do see both but predominantly men Mark do you currently or have you done psychoanalysis yeah I actually was involved in a psychoanalytic training program here in Los Angeles for about eight years actually and I completed eight years of psychoanalysis myself as an analyst and as well as several years of psychoanalytic psychotherapy before that so probably about 12 years of 20 hours a week of time commitment and investment well before I decided to relinquish my entire status and participation at the Institute in 2020 and I did that for one very specific reason although there were others including the difficulty of maintaining a psychoanalytic practice today and actually making money which is nearly impossible I would say

15:44it actually is impossible there's maybe four people in the country that are still doing that and they're all in the East Coast so the reason why I decided to leave was essentially that I lost respect for the analytic community the traditional analytic community because they all shut down their practices and went remote in 2020 and they were the people that in their 70s and 80s a lot of these mentors had been telling me for years how important it is to express courage with your patients we don't in psychoanalysis we don't have clients we have patients and I don't believe what's the distinction what's the distinction clients are clients work for barbers lawyers they hairdressers you know they go in and say dye my hair defend me against a court case here's the money I pay you for your service doctors don't have clients either doctors have patients

16:45and there is a difference because transgendered children are clients of you know surgical mutilators they're not doctors they go in and ask to have their penis cut off and they get the service those doctors don't have any ethical parameters they just they take the money and they cut the penis up so as long as you're a client you can ask for what you want and get it by paying money if you're a patient then the doctor has the right in the obligation to refuse and so does a therapist I'm really troubled by the way that this is this is really a side tangent that's it's redundant right that's a tangent but the the invasion the takeover of clinical care in mental health especially most specifically psychiatry but also in the therapy community by the behavioral therapy model which is social science social services essentially social services has taken over this field which is a client-based you know matching services to clients that's what social services are get a house for the homeless lady she's not a patient she's a client that's taken over therapy so now you have

17:49and you know MFTs LCSWs MSWs all being trained by social workers as well as cites and even to some degree PhDs now who are taught that the people who are suffering on their patients are not actually patients they're just clients that are in need of services and I think that's an abomination I think it's it's destroyed the profession it's it's it's going into medicine as well especially psychiatry I think it's wrong I think it's unethical I don't think that people are coming for services I think they're coming because they're injured they need to be healed but the reason why I left psychoanalysis was that all of the psychoanalysts who had patients they just disappeared shut their practices down and abdicated their role as the provider and protector of their patients to sit with them in the room and actually care for them because they were scared so they displayed a lack of courage they displayed cowardice and I can't respect anyone especially a mentor that is a coward and so I dropped out

18:51of the program I never look back and I'm not really interested in traditional psychoanalysis anymore I think it's it's largely defunct I mean you you as a provider of it or you as a potential patient of it as a member of the community the psychoanalytic community as an as an institution let's say kind of like you know the like pediatrics for example or or surgery or internal medicine those those systems have all been kind of taken over by politics and ideology and I think psychoanalysis has as well I get announcements now I mean I just got one last week for example from an institute in Los Angeles it's a different institute than the one I went to on a lecture series for psychoanalyst and psychoanalysts and training to discuss using psychoanalysis for homeless people are they called in the unhoused I just started laughing I said you can't have a homeless person in psychoanalysis first of all who's gonna pay for it he's not gonna use any money if you don't pay for this for the psychoanalysis

19:51you're not gonna be engaged and someone who's homeless is probably on drugs he's probably got serious mental illness he's failed at every aspect of his life he's living on the street he doesn't need psychoanalysis he needs a social worker so I I really don't think that psychoanalysis today is an institution the way that it's taught and understood expresses a lot of courage or a lot of I think ethical standards I think it's just been taken over by local leftists just like everything else I love the history I love the people who who brought it up and began it a hundred years ago but the way that it's practiced today I think it's a joke so if if if the goal of ultimately being a healthy human being is to get in touch with your subconscious and bring it to a conscious level and psycho analysis is the primary tool to do that what's somebody to do then that wants to get healthy well they don't go to psychoanalyst psychoanalysis is not is not

20:52available for poor people so they just go to their coach online who their boss has given them credits to pay twenty dollars for a coaching session or they go to a you know master's level trained supportive therapist or they go to do CBT or now actually I think most of the coaching based therapy and support is going to be completely replaced by very advanced level AI tools all of the coaching can be done online using AI now no I'm not saying I just can AI I can't cycle no that's that's the whole problem that's why it's not you have to have a human being in the room to do psychoanalysis why costs a lot of money because the only way to assist someone in a psychoanalytic frame is to actually be a human being computers are not able to reflect on an unconscious process by definition they can only solve problems psychoanalysis is not about

21:52problem solving it's not the point so CC somebody who wants to get in touch with that conscious part of their body their mind and bring it to a conscious level unconscious to conscious but now doesn't have access to a psychoanalysis because they don't live in Orange County and or they can't afford what you or others are charging what what are they to do well I think it's interesting I would I agree with you actually Dr. Mark entirely the field has always been woke even even in graduate school forever it was always a woke field it was very left leaning and always but and I don't identify with the training because I got great training I studied the masters they pioneered the fields like they were they were revolutionaries in their own right and so well I wouldn't say that that is you and ask me what the definition of a psychoanalyst was Dr. Rocky and so that's what I was ready to but I believe that I walked away I kept the depth I

22:54kept the depth of thought but I don't do psychoanalysis anymore but but I love the depth of it there's there's nothing like it and so I that is what that's the piece that I have taken with me that will never leave me to listen on that level to another human being is the honor of my life and so I you can keep that even that's what you're doing now right is I recall when we were talking at that dinner party you were talking about helping generally men more than women find their purpose and then be effective at whatever that purpose is yes that's what I'm passionate about and I'm really passionate about I'm I believe that there's absolute place for people that don't know their purpose they are not they they have small things or important things that they

23:57want to deal with I'm very attracted to people who know what they want and are clear about it sure so those are the people that I I like to be inspired I work a lot I want to come to work and I want to be inspired by the people that I see and I am when you work with a client what does that look like how many is it once a week more than once a week once a week once a week once a week is generally an hour and a half every week and sometimes vacations change things or I work remotely and I do a lot of things so sometimes it changes but this standard yeah you can uncover a lot in an hour and a half a week for sure and you say you work remotely so do you call them clients or patients and do they physically see you or they on like a zoom call or something of that sort by patients all around the world and so a lot of it zoom some of its call and then if someone's relatively local they come in but the one thing that COVID did do

25:01was open up the forum for all different kinds of work and so it exploded my practice in that time because what I thought how to be done in person turns out I could do it online even though Dr. Mark I want you to know I never I never shut down I never shut down if someone was willing to come in I wanted to see them that did not change for me I think there's something really important about face-to-face contact I totally agree I have a therapist I've been seeing for a long time I really adore the guy he's a Christian you know we've not friends is too strong of a word we don't hang out outside although I would love to do that and seeing him physically in person in his office is so much better there's been a couple times where we've done remote stuff I just I'd rather not even do it than you know not being able to see a person now that being said you know

26:03you know we're gonna take a quick break and when we come back I'm gonna finish that thought about in person versus remote therapy and then we didn't get to this but it's important that CC has a book out about narcissism and I want her to talk to us about that it's coming out soon so we'll be back in just a minute we'll get ready my fellow Americans July 2nd 3rd and 4th America out loud dot news in partnership with Clear and the Wellness Company invites you to Nashville Tennessee for a red white and blue celebration you'll never forget we're saluted 250 years of America and 10 incredible years of America out loud news stand in strong for truth justice and the nation we all love three days of high impact speakers powerhouse voices delivering dynamic unforgettable insights that will fire up your Patriot spirit and on July 4th I'll brace yourself because

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29:16we are back with CC psycho analyst to the stars she's got a book coming out about narcissism called the fog of war unmasking narcissism breaking illusions and becoming victorious in the face of defeat before we talk about the book I just want to finish that thought about online remote work as a therapist a counselor psycho analyst versus in person you know there was several talk radio psychologist there was David viscott doctor famous doctor Laura there's a patient of mine he passed a couple years ago and he did a lot of radio psychology to the point that he believed his name was John Joel of really wonderful man he believed that he actually was more effective by not being distracted by seeing somebody's physical presence and just listening to their voice by doing remote therapy now maybe it was a rationalization I don't know

30:17but that was his stick that he actually felt more effective by talking to people from far away and he had clients around the world et cetera I don't know what what's your thought about that mark I'm a little how would I put it more accepting now of remote consultation and therapy but with a sort of caveat that there's information that you miss that you can't get when you're not in the room with someone and so I think your expectations have to be more measured I think coaching can be done really well over the internet sure psycho analysis no psychotherapy to some degree sure what's the difference well psychotherapy if it's pure psychotherapy and not even psychoanalytic informed it's not really dealing with unconscious processes it's dealing with what's on the surface what's conscious you can talk about what's conscious very easily

31:17you don't really need any other cues but as soon as you start focusing on unconscious processes you really have to have a much more in the moment exchange to have the full spectrum of information you can gather some but I think you're going to miss something when you're just looking at a screen people sitting in a chair so you need a whole thing you need tears welling up you know patient expressions no you get all that from the screen I'm talking about motion movement what people's energy is how they're shifting in their chair what they're looking at in the room that's being shared between the two of you you don't have any shared experience when you're sitting in front of a screen in different parts of the world you might not even be in the same time zone so you're going to miss a lot that's the problem with it but I do think you can certainly talk and see expressions on people's faces certainly better than a telephone call and do really good work remotely I just think people's expectations need to be tempered and I think what upset me in 2020 was

32:18that a lot of professionals because they were more concerned about maintaining their their social status not their not their health they couldn't care less about that it was a joke their social status their professional status they all of a sudden turn their backs on what they had been professing for decades especially analysts which was if you're not in the room with the patient then you're not doing real work and then suddenly they said well fake doctor Barbara Farar in Los Angeles who has a doctoral degree in social work and has never had one therapeutic interaction or life she told us that we all have to and can work with our patients remotely over a video interface so we're all going to do it and suddenly 150 years of psychoanalytic tradition just went out the window sure and nobody said boo about it and I was so upset and disappointed by everyone including the analysts involved in the institutes that I just left as I said earlier so I I do I do think we can use these interfaces we can use video we can I'm not against it I just think we have to be honest about what we're

33:20what we're using it for and what it's what's lacking rather than suddenly pretending that a political stance can can can just supplant all of our as you were saying earlier you know decades a century plus of masters of teaching who all taught us one thing and suddenly we just pretend like it doesn't exist because Anthony Fauci said it doesn't you know like a magic wand and I I I don't like deception I don't like lying I don't like rationalizations and and I felt I just found that to be all very offensive from top to bottom what did you do what did you do with your own practice like what happened inside of your practice mm-hmm I kept it open for one thing and I told patients that I insisted that they come in unless they had an actual medical reason not to and that would be that they're sick and I said that that hasn't changed I said if you're sick I don't want you in my office I've always said that if you're not sick then you have to get your butt in the door and patients that refuse to come in for no rational reason I said look I'm here to treat your mental illness

34:25and if your expression of mental illness is refusing to come in then we're avoiding the whole the whole reason why you're here because staying home is a form of mental illness so I just refuse to see them and I mean I didn't refuse to see them I told them I wanted to see them but they refuse to come in so they just left and the ones that stayed were the ones that came in physically and I kept seeing patients that way and kept my practice open the entire time at that point I was no longer seeing psychoanalytic patients although I was still in the program and so for me most of my patients were either weekly therapy patients or they were medication management patients and the ones that wanted in-person treatment stayed and the ones that didn't they just left and went somewhere else so it was kind of like a filtering effect sure what did you keep from the psychoanalytic world that form of thought all your training you were you were steeped in it what did you end up keeping what

35:27did you take away well at the beginning what I maintained was the psychoanalytic stance which was the lack of personal investment objectivity listening listening to myself as much as the patient feeling my own reactions and emotions to patients as you know when a borderline walks in the room you can feel it immediately that's their biggest sign that the person is borderline or narcissistic cluster B types of disorders so for patients that had unconscious problems that were personality disordered I maintained that stance of being able to be a sounding board to them through myself but after a while and I would say in the last few years maybe the last two years what I've decided and this is a conscious decision in my part is I'm just not dealing with personality disorders anymore I'm not going to try to work with them or treat them I just don't have the energy or the patients I think that people today who come in with expectations from their therapist that they're going to

36:29magically cure them of their what is ultimately a personality disorder are not worth my time and my energy and I think you do get ground down working with personality disordered patients because they take something from you every time you see them and I think it my own mental health is is I need to prize that above all else and so that's one reason why I don't work with them anymore therapeutically I mean I might see them in medication management but I'm not going to work with them as a therapist I just don't think that they're amenable to treatment and I think that they grind the therapist down when you try to work with them and I'm just not willing to do it anymore makes perfect sense to me so CC let's get into your book the fog of war what an interesting title subtitle unmasking narcissism breaking illusion and becoming victorious in the face of defeat tell us about that okay one thing I have to

37:33tell you is since I told you the book is in final editing stages it's the set pedals change is the fog of war reclaiming your solvent ground very good so that's changed I don't that's a that's a pejorative word is a it's a inflammatory word and I don't want that to be the reason why people pick up the book my hope is that I feel like narcissism was in almost in the bloodstream of my family line and I was as even as a child fighting an invisible war can you define narcissism well the DSM could find define it better than I could but the what the the chief weapon that's used in narcissism is it creates a very destabilizing very disoriented feeling on the other side like Dr. Mark says you can feel them energetically when they walk in the room there's a change

38:37there's a subtle humiliation there's a subtle there are digs and sometimes it's so refined the only someone on the other side of when their comments can feel the blade it is a very is a very sophisticated way that they move and manipulate you and my hope is that I unpack all the ways that narcissists do manipulate us so they feel like I can give you a story sure my old I have five girls such a mark I am my oldest was in jiu jitsu in jiu jitsu I don't know if you know the whole philosophy about jiu jitsu but it's fascinating it is a really fascinating martial art because instead of combating aggression with aggression you combat aggression with posture with position with leverage you

39:41learn how to use opponent strength against them right and so and they call it the the human chess like his human chess you were you were thinking two to three moves above your opponent and I want to train people to really recognize how they're getting manipulated so they have more standing inside of themselves and they are less likely to be manipulated and bullied by them is narcissism a personality disorder it is a personality disorder we all sort yeah and like Dr. Mark said it's a very grand diagnosis wouldn't you agree Dr. Mark it's it's not amenable to change it's it's pretty much not to me I would say in the medical role and you can correct me you can give me a different one but if someone's diagnosed with narcissism it's like saying you have stage 4

40:48pray and create a cancer like there's there's a chance there's a chance of course there's always a chance but it's not good and so my passion is never going to be in changing that so there's you know just webster dictionary on my phone I know that doesn't really do it justice there isn't really a definition it's defined as egotism egocentrism narcissistic personality disorder they don't really define it and then there's love of or sexual desire of one's own body so how how do you define narcissism Mark well I think the simplest definition is an unhealthy obsession with the self but there's also I think distinctions that have to be made because narcissism is not pathologic in and of itself if we don't have any narcissistic tendencies then we just roll over and die you have to be preoccupied with yourself in order to survive so

41:51you're wrong with it yeah to a certain extent but when it's an unhealthy preoccupation then it winds up crowding out the space for you to be involved with in a healthy way with other people and also to see that other people have needs that are not necessarily yours there's I think two kind of specific subgroups of narcissists that that I've seen and that I think reflected back in the cycle in the literature and some are very pathologic one group is a very pathologic harmful explosive narcissists that's the the type that we're most familiar with raging selfish obnoxious nobody wants to be around but the other one that's more subtle that I think creates a lot of injury and pain for people who are good and want to be helpful are these brittle narcissists the people that have these really hollow cores inside no sense of identity very low self-esteem or self-worth and they're so easily injured that people try to be nice to them and crack their shell and then they turn on them they ghost

42:52them they cut off communication and then the injured person says what what did I do why what's happening here I thought I was just being nice and this very very fragile narcissist that gets so easily injured with just a casual critique turns into a kind of hurtful passively sadistic character and I see this very very often in Los Angeles it's very common I think with women this subtype the raging narcissists are more commonly I think men more aggressive but you have very fragile injured creatures traveling from all over the world to come to LA who don't know who they are and they want fame and fortune and they want daddy's love from Hollywood that they never got and these women are they tend to be very attractive very seductive and as soon as they receive some kind of critique or injury or failing their whole shell breaks and they they have nothing inside and they get revealed as being very empty and then they

43:54act out and they harm people and they destroy relationships and burn bridges so I think we're a magnet in Los Angeles for fragile narcissists for women and sort of raging narcissists for men that's my just first-hand experience having been a resident and a physician here for a number of years I imagine most people that are narcissists are not self-aware that they are I think that's very fair to say and your book it's designed to help victims of narcissism or narcissists themselves to overcome this personality disorder people on the other side of narcissism so they're their parent their child their spouse their brother their sister it's to help the people on the other side because everything I agree with everything you said Dr. Mark the one thing that I think is really a telling degree of it is that almost structural absence of empathy they

44:59lack empathy in such a way that you they do not relate to you as a person with your own needs your own worth your own wholeness they relate to you as an object in their world and so you're constantly being manipulated by them so your work is sort of like the Alan on equivalent for alcoholics I hope it will be an antidote to anyone who's really suffered this kind of invisibility that you can feel on the other side when every argument you craft when every every point you make when anytime you really try to confront them and they're how they injure you you're dismissed you're invisible to them it's almost like how if you're coming if we're going up to see Dr. Marker he's coming down here and you see litter on the side of the freeway you can feel that invisible in

46:02their presence they do not see you as a whole person so this was a big part of your life growing up huge yeah and you were able to overcome it yes I think that there's something really really exciting about thinking that everything we've walked through all this suffering if none of it's in vain and we can learn to help someone else through what we've been through to me that's the biggest gift what role does religion or a higher power belief system have in alcoholics anonymous for example maybe there's narcissistic narcissism anonymous I don't know but an AA giving giving up yourself to a higher power you can't control what's going on and you need to give it up is there is there an equivalent in narcissistic abuse relationships I've not seen an AA model Dr. Marker have you

47:08heard of something like that before I have not because because alcoholics anonymous is is based on an acknowledgment that you have an addiction I don't see any narcissists showing up acknowledging that they're narcissists but the victims of it show up and then oh sure there are groups for the victims of alcoholics and it's called Alan on yeah I don't remember what Alan on stands for but so but equivalently the victims of all personality disorders not just narcissism I imagine there are recovery programs for them as well yes yes but so I guess a couple things I don't know if you were asking me that personally like is there a theological side to what I'm saying were you asking me that or are you staying in general with AA? I'm interested in both I'm you know what role does a higher power play in recovering from being in a

48:09relationship with a narcissist? Well I can only speak personally for me but I would say it's huge I believe Romans 828 that everything that comes at us we can use like everything God can reshape everything we've encountered and write a totally new story so for me that is very huge and one of the main reasons and I don't know Dr. Mark you'll have to tell me because I know you're you were steeped in the literature like I was and but I found except for kind of the founding fathers of psychoanalytic thought there is such grim research there are boring clinical vignettes there are it's it's not it's a dark you're swimming in darkness you're trying to get help people are looking for help and they have this sea of dark literature with people that you read and they don't sound impressive because you're right I think the the brittle narcissism that

49:10you're talking about that's fascinating because you think about anyone who's dominant narrative is victimhood right that's what you're talking about right and with everywhere you talked about what was the analogy that you you said if someone's out of milk it's not trauma but what about like you could you go to McDonald's and you still coffee on yourself and you you you you litigate and you win right there's so much victimization right and but my hope is that I've changed the conversation about what can happen if you let all that has come out you actually forged you into a weapon and so that is the hope of the war I hope that I bring a lot of light and a lot of hope because in my belief God is hope is there a book without hope are there but it's not I got to just speak clear I'm sorry I don't mean interrupt but just you're good my

50:11hope is not for the narcissist my hope is for the person on the other side of narcissists and you tell a lot of stories in your book about people that have gone through this and recovered I have thousands of hours of stories and they are good because I've seen amazing people that have changed my life because of how they show up and so in very disguised detail they're in there is narcissism or common in men or women I think it shows up differently I think I think we have I think we have plenty of folk on both sides what do you think I was just thinking about a quote by Tanner Goosey men's style consultant and also part time philosopher in a real that he posted recently where he said I think that our valorization of ugly is wrecking our society we should be valorizing

51:17and pursuing beauty not ugliness and one example of that he gave is our obsession with trauma and its core trauma is ugly yes now it doesn't mean you shouldn't be working on cleaning out the ugly and overcoming whatever your trauma is in order to live a beautiful life but remaining mired in your trauma is the same thing as marrying the ugly and I think we have given far too much support and valorization to people as well as reinforcement like you said money for spilling coffee to remain stuck and not just stuck but actually validating and elevating our ugly i.e. our trauma in the same way that we prayed to the altar of fear for two three four I would say it's even ongoing now number of years since 2020 rather than worshiping the altar of sacrifice and courage and what you worship is what you become and we worshiped fear endlessly for

52:22two three four now even five years ongoing and look what it's got us we're a bunch of pussies and crybabies and the same thing with this trauma we're a nation of victims and that is a expectable anticipated necessary consequence of worshiping the ugly i.e. trauma in the psychological mental health community and I think we need to get out of it I think we got to stop doing it we ought to treat the wounds and move on rather than than holding up our arms and and being proud of all these weaknesses and injuries as if somehow that makes us a better person. In other words what is what is more ugly is not more real the more that we define reality as as ugly and the uglier it is the more real it is the more we get away from a beauty and beauty is an aspiration towards the divine worshipping piss christ worshipping dogs urinating at the museum as a piece of art worshipping cacophonous music praising people for looking cool and hip because they have four colors of

53:26hair scarifications on their face tattoos and rings that is not what we should be doing we should be saying that's ugly make yourself beautiful make everything beautiful and we're not doing it we're debasing ourselves and we're pulling ourselves down we're pulling our humans into the gutter as as an act of worship rather than looking down at the gutter and saying I want to get higher up I want to I want to go above and beyond my circumstances I think this is actually anti-religious I think it's it's actually if you want to call it a conflict that's more spiritual I think it is actually I think we're in a spiritual conflict and I think we're being pulled into dirt and filth and and we're calling it beauty and it's not you know beauty is is up there and I I think this is a problem everywhere and I don't think that the you know mental health community is escaping it what is your hope inside of mental health what do you see what what do you see is the trajectory what your thoughts what do you think it's honestly I think it's over I think

54:28therapy is done I think it's cooked I think therapists are going to be rapidly out of work and most of them are women now so we're going to have a huge contingent of unemployed women because everyone's going to go to coaching which is two or three dollars a month with a very very rapid process or AI tool an agent that knows everything about you and they can solve a lot of your problems not your personality disorders but solve your day-to-day problems on your own and give you support on your phone as you're going down the street giving you creating little messages for you that are very personal so I think most therapists are going to be out of work because right now people don't have the money to pay for it it's a very rarefied group of people that can afford to pay for therapy most people can't the ones that need it are unable to so I think we're going to see a calling of the herd we're going to have a very select group of elite therapists who work with wealthy people on a cash-based basis and everyone else is just going to be left for AI I'm not like trying to be pessimistic I just see that's what's going

55:31already happening I think most women are going to be unemployed in the next two to three years because women generally work in air-conditioned buildings doing work that doesn't require physical labor and almost all of those jobs are going to be replaced by AI in the next one to five years except for obviously nurses teachers where you actually need hands-on care and work where you need a relationship that's where women do great but working in offices doing admin work doing work that requires computers they're all gone and obviously the men are going to be gone too but we still need men to you know to dig holes to build power lines to manage nuclear reactors we need men for police and military no women perform those those labors and if they do they they end up becoming problematic because they end up shooting people unnecessarily and getting kidnapped and raped but we don't have single woman managing power lines in Alaska not not one so men are still going to be needed for those jobs but the other jobs they're going to be fired too so I think we're going to have a huge huge problem with

56:33unemployment and I think therapy is going to be one of the first professions it's going to blow up and very few people are going to be left that's what we're seeing mark we're just about at a time CC share with us how people can find you if they want to either follow you on social media learn more about your book or if they're super interested in the work that you do as a therapist how do they get a hold of you okay thank you for asking instagram facebook my website everything is under cc evan's book leacy i'm just my whole name cc evan evan s dash puglyc p-u-g-l-i-s-e yes perfect but we ran we ran a bit over i apologize for cutting everybody off but we got a run cc it's been a pleasure time went by so fast when your book comes out we're going to have to have you back on and i look forward to reading that book myself thank you thank you both very much for the time today of course thanks for joining us on informed descent

57:33bye have a great night you've been listening to informed descent with dr jeff markey board certified primary care physician and dr mark mcdonald board certified child adolescent and adult psychiatrist informed descent the intersection of health care and politics you