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The state of psychoanalysis today · Cultural Wars | America Out Loud News

• 0:00
  Informed dissent, the intersection of healthcare and politics with Dr.
• 0:05
  Jeff Barkey, board certified primary care physician.
• 0:09
  And Dr.
• 0:10
  Mark McDonald, board certified child, adolescent, and adult psychiatrist.
• 0:15
  We are rolling.
• 0:17
  Well, listen, we're here with another great episode of informed dissent.
• 0:22
  My podcast co-host Mark McDonald right now is missing in action.
• 0:28
  But I bet he'll join us any minute.
• 0:30
  He's probably caught up in LA traffic.
• 0:32
  Um so we'll see what happens.
• 0:35
  But like we always try to do on informed descent.
• 0:38
  We try to bring you really interesting guests with super interesting topics.
• 0:44
  And we got one of them tonight, and that is Cece Evans Puglis.
• 0:50
  Did I pronounce that right?
• 0:51
  If you were speaking in Italian, you would say polyacy, but the marathon version is Paglisi.
• 0:58
  Okay.
• 0:59
  Very good.
• 1:00
  Well, Cece, welcome to Informed Descent.
• 1:03
  Thank you for having me.
• 1:05
  It is my pleasure.
• 1:06
  Little circuitous route, how you got to me.
• 1:10
  I'll tell a quick little story.
• 1:12
  I was blessed to be the co-founder of a wonderful charter school out in the city of Orange called Orange County Classical Academy.
• 1:20
  We're affiliated with Hillsdale College, and we opened during the pandemic of all times.
• 1:26
  And so annually we have a gala to try to raise some money.
• 1:30
  We bring in interesting speakers.
• 1:33
  Last year we had Kirk Cameron, uh, who's become a dear friend of mine and somewhat of a mentor?
• 1:39
  And during the gala, we auction off stuff.
• 1:42
  Somebody suggested that I auction off a morning message appearance for the kids.
• 1:47
  And there are a few people that bought them.
• 1:49
  And one of the people that bought them did a bait and switch.
• 1:52
  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.
• 2:06
  And that's how we ended up with Cece on informed descent.
• 2:10
  Did I get that about right?
• 2:12
  Yes, you sure did.
• 2:14
  Katrina.
• 2:15
  First of all, before we talk about your book that's coming out soon.
• 2:18
  Yes.
• 2:19
  Tell us about what you do.
• 2:21
  My understanding is you're a psychoanalyst.
• 2:23
  Is that right?
• 2:24
  Yes, I am.
• 2:25
  I'm a psychoanalyst and a concierge mindset coach.
• 2:28
  And um what does that mean?
• 2:31
  Explain what that means.
• 2:33
  Psychoanalyst.
• 2:35
  So a psychoanalyst is really interested in the unconscious mind.
• 2:41
  And how if the unconscious is does not become conscious, it can direct your life.
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  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.
• 2:57
  One more time.
• 2:59
  If you do not make the conconscious conscious, it will direct your life, and you will call it fate.
• 3:08
  Wow.
• 3:09
  Well, that's most people, isn't it?
• 3:12
  Yes, it is.
• 3:14
  Most people don't spend any time trying to dive into the bowels of their mind to figure out what their unconscious is talking about.
• 3:22
  Maybe they should.
• 3:25
  Well, it's a very interesting feel, but you really can pick up what people are the stories, the narratives that people are telling themselves, and they're so unconscious, and they're often on such repeat that people aren't even aware of it, but you can feel someone's narrative.
• 3:44
  You can feel someone's narrative.
• 3:46
  You what do you mean you can feel it?
• 3:48
  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.
• 3:57
  You can hear their inner world when you're really listening.
• 4:01
  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.
• 4:11
  That's precisely what I'm saying.
• 4:14
  Uh-huh.
• 4:14
  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.
• 4:26
  No, I actually never do it unless I'm on the clock.
• 4:29
  It's too it's tiring, but it's important work.
• 4:34
  I'm very mission-minded.
• 4:36
  I believe that what we tell ourselves dictates how much of uh our calling, our mission will live out.
• 4:44
  And we have slow, we have subtle, we have undermining stories that change our narrative.
• 4:51
  Yeah.
• 4:51
  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.
• 5:00
  Do you think there's anybody that that anybody without help that just naturally is able to connect the unconscious with the conscious?
• 5:09
  Yes, but I think it takes some work.
• 5:12
  I think it takes some self-reflection.
• 5:15
  I think it takes solitude.
• 5:17
  I think it takes a lot of the disciplines that we live in a culture that tricks us out of discipline.
• 5:24
  Our phone, our smartphones, they trick us out of attention.
• 5:30
  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.
• 5:40
  It takes a consciousness, it takes an awareness.
• 5:43
  And but it's an important one, it's the most important one.
• 5:49
  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.
• 6:04
  Is that what you mean?
• 6:07
  Yes, well, I think we we can get in our own way.
• 6:10
  We can just get in our own way.
• 6:12
  When I think of Katrina, who is the reason why I'm here.
• 6:15
  When I I had a real revelation a decade ago, a Katrina the hurricane.
• 6:21
  No, Katrina Munoz, who had set this up for us.
• 6:24
  Oh, gotcha, got it.
• 6:26
  Okay, yeah, yeah, yeah.
• 6:27
  So we've been childhood best friends since we were 13.
• 6:30
  Uh-huh.
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  And I had a total epiphany a decade ago.
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  It was 2016.
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  And in 2016, I was always identified as the therapist.
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  And there's something in me that almost refused the label.
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  I didn't like it because I didn't want to be associated with people's problems.
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  I really wanted to be associated with a potential.
• 6:53
  Okay.
• 6:55
  Well, well, well, I'm glad that uh Dr.
• 6:58
  Mark McDonald had the time to join us today.
• 7:00
  He must have been caught up in traffic in LA or was abducted by some alien or what have you.
• 7:07
  Mark, welcome.
• 7:08
  Welcome to informed uh dissent.
• 7:11
  Glad you could join us.
• 7:12
  It takes a lot of time to put a whole group of people on a 5150.
• 7:18
  It does.
• 7:20
  So Cece, we we have learned is a psychoanalyst, and uh helps people as she describes it, gets their subconscious to a conscious level, because those that don't do that tend to be slaves of things that they are unaware of.
• 7:38
  Sounds like 80% of the women in Los Angeles who are all you think is just women or men too.
• 7:45
  Well, the men are more functional.
• 7:49
  They're they're uh they're they're equally troubled, but for different reasons.
• 7:53
  I don't think it's personality disorders as much as it is uh a loss of um good role models in masculinity.
• 8:00
  I think the women are just personality disordered for the most part.
• 8:02
  Narcissism and borderline is really sort of the the norm in Los Angeles where I live.
• 8:08
  You're not here, I assume you're in a different city.
• 8:10
  She's in Orange County.
• 8:11
  Oh, you're in Orange County.
• 8:12
  Oh, it's much better down there.
• 8:14
  It's probably only 40%.
• 8:17
  I was telling Dr.
• 8:18
  Barkey, Dr.
• 8:19
  Mark, that I uh the Yoon quote, which was and I'm sure you've heard this, but he said, unless you make the unconscious conscious, it will direct your life and you will call it fate.
• 8:32
  Sounds about right to me.
• 8:34
  And so we were kind of unpacking that a little bit before you got on.
• 8:39
  Well, that's something that I studied for quite a number of years.
• 8:42
  But for uh for Dr.
• 8:44
  Barkey, it uh it may be a little bit more uh novel.
• 8:49
  Is your unconscious conscious mark?
• 8:51
  Let me let me check in and see.
• 8:56
  It's one of those, it's one of those things that you you you don't really often know uh what you don't know, which is kind of the challenge, and that's why we use you know therapists of different uh types, particularly psychoanalysts who have uh more in-depth training to help um elicit that because this is the problem, isn't it?
• 9:16
  Really, with with therapy in general, uh especially therapy today, in my view, is that most therapists really are only trained to work with the conscious mind.
• 9:26
  And although it can be helpful problem solving and hand holding and being uh uh you know emotional receptacle for patients, it doesn't generally uh 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 uh just playing whack-a-mole.
• 9:52
  And I think that's what most therapists do right now is they just focus on cognitive behavioral therapy and other forms of um.
• 10:00
  Intellectual problem solving rather than getting to the core of the identity, which is really, as we said in our in our training years ago, we don't really generally have to treat the adults in the room.
• 10:09
  We have to treat the children.
• 10:12
  The inner child.
• 10:14
  Yeah, essentially.
• 10:15
  That's where most of the problems come in.
• 10:17
  Because the adult problems, you can probably hash out with your friends at the bar.
• 10:22
  Sure.
• 10:23
  So definitionally is the unconscious mind a trauma created mind.
• 10:31
  Could be.
• 10:33
  Not definitionally, but it could be.
• 10:37
  Sure.
• 10:37
  Well, we all have that, right?
• 10:39
  Is that the mind that we where we have an inner dialogue, a nonstop inner dialogue that just keeps talking to us?
• 10:44
  Well, I'm I'm being I'm being a bit jokey here only because I think the word trauma has been overstated.
• 10:50
  Uh, you know, not being able to find the right milk at the grocery store is not traumatic.
• 10:56
  And yet that's the way that people will talk about trauma dumping today.
• 11:00
  Maybe it is for some people.
• 11:02
  Well, listen, when they're out of raw milk, that's pretty traumatic for me.
• 11:09
  For my daughter too.
• 11:10
  My daughter Jordan is the same way.
• 11:12
  She's come home crying that sprouts is out of raw milk.
• 11:16
  Exactly.
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  So what is the definition of a psychoanalyst and how is that different than a therapist?
• 11:23
  Well, a psychoanalyst is really trained to listen to the unconscious and really figure out how what the person is saying is getting in their own way of what they want to accomplish.
• 11:33
  First, for example, if someone were really overweight and they want to talk about losing weight, but they can never can because they keep getting in their own way through their own habits.
• 11:44
  There's a narrative underneath the habits that needs an intervention.
• 11:50
  And I find that 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.
• 12:02
  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.
• 12:13
  And so I was telling Dr.
• 12:16
  Barkey this right before you came, but I had a big change about 10 years ago.
• 12:22
  And the change was I always felt a little bit self-conscious, calling myself a therapist.
• 12:27
  I did not want to be associated with people's problems.
• 12:31
  I really wanted to be associated with people's potential.
• 12:36
  And what they could do if they got out of their own way and how they would get out of their own way is by changing how they talk to themselves and changing how they show up and changing getting a very clear idea of where they want to go.
• 12:53
  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?
• 13:05
  You'd keep all your degrees, but you can absolutely change your trajectory and what you want to go after.
• 13:11
  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.
• 13:25
  And so I really rebranded myself 10 years ago.
• 13:31
  Yeah, I get that.
• 13:33
  How do you find clients?
• 13:35
  I have all self, all referrals from clients that I've worked with.
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  My clients drive all my referrals.
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  I've never had advertised.
• 13:48
  Which is which is amazing.
• 13:50
  And most I recall, I think you told me we were at a dinner party together at uh weren't we at Kelly Jones's house?
• 13:58
  Yes.
• 13:59
  Yeah.
• 13:59
  And I think in super interesting, first of all, you you charge a lot of money and good for you.
• 14:06
  Um, and you work mostly with men, as I recall.
• 14:10
  I started off thinking I was working with women.
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  I thought I I love women, I love men, but women often have more support than men do.
• 14:20
  They often have more support.
• 14:22
  They more support.
• 14:23
  I mean, like girlfriends that they can talk to and so forth.
• 14:26
  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.
• 14:35
  And men often don't have that same ability.
• 14:38
  So when I started off with women, all the referrals they would send me were men, important men in their lives that they thought needed my help.
• 14:48
  And so now my practice is predominantly men.
• 14:51
  I do see both, but predominantly men.
• 14:54
  Mark, do you currently or have you done psychoanalysis?
• 14:58
  Yeah, I actually was involved in a psychoanalytic training program here in Los Angeles uh for about eight years, actually.
• 15:07
  And I completed uh eight years of psychoanalysis myself as an analysant, as well as several years of psychoanalytic psychotherapy before that.
• 15:17
  So probably about 12 years of 20 hours a week of time commitment and investment.
• 15:21
  Wow.
• 15:22
  Before I decided to relinquish uh my entire status and participation at the institute in 2020.
• 15:32
  And I did that for one very specific reason, although there were others, including um the difficulty of maintaining a psychoanalytic practice today and actually making money, which is nearly impossible.
• 15:44
  I would say it actually is impossible.
• 15:45
  There's maybe four people in the country that are still doing that, uh, and they're all on the East Coast.
• 15:51
  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.
• 16:07
  And they were the people that uh 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.
• 16:17
  Um we don't in psychoanalysis, we don't have clients, we have patients.
• 16:21
  And I well, I don't what's the distinction?
• 16:26
  What's the distinction?
• 16:27
  Uh clients are clients work for barbers, uh, lawyers, the uh hai dressers.
• 16:33
  Um, you know, they go in and say, dye my hair, defend me against a court case.
• 16:38
  Uh, here's the money I pay you for your service.
• 16:41
  Um doctors don't have clients either.
• 16:44
  Uh, doctors have patients, and there is a difference because um transgender children uh are clients of you know, surgical mutilators, they're not doctors.
• 16:54
  They go in and ask to have their penis cut off and they get the service.
• 16:57
  Those doctors don't have any ethical parameters, they just they take the money and they cut the penis off.
• 17:02
  So as long as you're a client, you can ask for what you want and get it by paying money.
• 17:06
  If you're a patient, then the doctor has the right and the obligation to refuse.
• 17:10
  And so does a therapist.
• 17:11
  I'm really troubled by the way that um this is this is really a side tangent.
• 17:16
  That's that's redundant, right?
• 17:18
  That's a tangent, but the the invasion, the takeover of clinical care and mental health, especially more 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, uh, which is a client-based, you know, matching services to clients.
• 17:42
  That's what social services are, get a house for the homeless lady.
• 17:45
  She's not a patient, she's a client.
• 17:47
  That's taken over therapy.
• 17:49
  So now you have uh, you know, MFTs, L CSWs, 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 and their patients are not actually patients, they're just clients that are in need of services.
• 18:06
  And I think that's an abomination.
• 18:08
  I think it's it's destroyed the profession.
• 18:10
  Um, it's it's in it's going into medicine as well, especially psychiatry.
• 18:14
  I think it's wrong.
• 18:15
  I think it's unethical.
• 18:16
  I don't think that people are coming for services.
• 18:18
  I think they're coming because they're injured, they need to be healed.
• 18:20
  But um 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.
• 18:41
  So they displayed a lack of courage, they displayed cowardice, and I can't respect um anyone, especially a mentor that is a coward.
• 18:50
  And so I dropped out of the program and I never looked back.
• 18:52
  And um, I'm not really interested in traditional psychoanalysis anymore.
• 18:56
  I think it's um it's largely defunct.
• 18:59
  Um you mean you you as a provider of it, or you as a potential patient of it.
• 19:04
  Uh as a member of the community, the psychoanalytic community as an as an institution, let's say, kind of like uh, you know, the like pediatrics, for example, uh, or or surgery or internal medicine.
• 19:19
  Those those systems have all been kind of taken over by politics and ideology.
• 19:23
  And I think psychoanalysis has as well.
• 19:25
  I get announcements now.
• 19:27
  I mean, I just got one last week, for example, from an institute in Los Angeles that's a different institute than the one I went to uh on a lecture series for psychoanalysts and psychoanalysis and training to discuss using psychoanalysis for homeless people, or they call them the unhoused.
• 19:43
  I just started laughing.
• 19:43
  I said, You you can't have a homeless person in psychoanalysis.
• 19:46
  First of all, who's gonna pay for it?
• 19:47
  He's not gonna he's any money.
• 19:49
  If you don't pay for this for the psychoanalysis, you're not gonna be engaged.
• 19:53
  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
• 20:00
  Street, he doesn't need psychoanalysis, he needs a social worker.
• 20:03
  Uh, so I I really don't think that psychoanalysis uh today as an institution, the way that it's taught and understood expresses a lot of courage or a lot of um uh I think ethical standards.
• 20:17
  I think it's just been taken over by woke leftists, just like everything else.
• 20:20
  Um I love the the history.
• 20:22
  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.
• 20:28
  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 psychoanalysis is the primary tool to do that.
• 20:42
  What's somebody to do then that wants to get healthy?
• 20:47
  Well, they don't go to psychoanalysts, psychoanalysis is not it's not available for poor people.
• 20:53
  So they just go on a market on this.
• 20:56
  Uh well, they go to their coach uh online, uh, who their boss has given them credits to pay $20 for a coaching session, or they go to a um, 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 um AI tools.
• 21:21
  Um all of the coaching can be done online using AI now.
• 21:25
  Um, I'm not saying I just can AI can't psychoanalysis.
• 21:29
  No, that's that's the whole problem.
• 21:30
  That's why it's not you have to have a human being in the room to do psychoanalysis.
• 21:34
  Why it costs a lot of money because the only way to assist someone in a psychoanalytic frame is to actually be a human being.
• 21:44
  Computers are not able to reflect on an unconscious process by definition.
• 21:48
  They can only solve problems.
• 21:50
  Psychoanalysis is not about problem solving.
• 21:53
  It's not the point.
• 21:54
  So CeCe, 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.
• 22:12
  What are they to do?
• 22:15
  Well, I think it's interesting.
• 22:17
  I would I agree with you actually, Dr.
• 22:19
  Mark, entirely.
• 22:20
  The field has always been woke.
• 22:23
  Even even in graduate school, forever, it was always a woke field.
• 22:27
  It was very left-leaning.
• 22:29
  And always, but and I don't I identify with the training because I got great training.
• 22:34
  I studied the masters.
• 22:35
  They pioneered the fields, like they were they were revolutionaries in their own right.
• 22:41
  And so while I wouldn't say that that is you and asked me what the definition of a psychoanalyst was, Dr.
• 22:48
  Barkey.
• 22:48
  And so that's what I was referring to.
• 22:50
  But I believe that I walked away, I kept the depth.
• 22:54
  I kept the depth of thought, but I don't do psychoanalysis anymore.
• 23:00
  But but I love the depth of it.
• 23:02
  There's there's nothing like it.
• 23:06
  And so I that is what that's the piece that I have taken with me that will never leave me.
• 23:11
  To listen on that level to another human being is the honor of my life.
• 23:19
  And so I you can keep that.
• 23:21
  Even though that's what you're doing now, right?
• 23:24
  Is I recall when we were talking at that dinner party.
• 23:27
  Um you were talking about helping generally men more than women find their purpose, and then be effective at whatever that purpose is.
• 23:41
  Yes, that's what I'm passionate about.
• 23:43
  And I'm really passionate about I'm I believe that there's an absolute place for people that don't know their purpose.
• 23:51
  They are not, they they have small things or important things that they want to deal with.
• 23:58
  I'm very attracted to people who know what they want and are clear about it.
• 24:03
  Sure.
• 24:04
  So those are the people that I like to be inspired.
• 24:08
  I I work a lot.
• 24:09
  I want to come to work, and I want to be inspired by the people that I see, and I am.
• 24:14
  When you work with a client, what does that look like?
• 24:16
  How many is it once a week, more than once a week?
• 24:19
  Once a week, once a week.
• 24:22
  Once a week is generally an hour and a half every week.
• 24:26
  And you know, sometimes vacations change things, or I work remotely and I do a lot of things.
• 24:32
  So sometimes that changes, but this standard, yeah, you can uncover a lot in an hour and a half a week.
• 24:39
  For sure.
• 24:39
  And you say you work remotely.
• 24:41
  So uh, do you call them clients or patients?
• 24:45
  And do they physically see you, or they on like a Zoom call or something of that sort?
• 24:49
  Well, I have patients all around the world.
• 24:52
  And so a lot of it zoom, some of it's called and then if someone's relatively local, they come in.
• 24:58
  But the one thing that COVID did do is it opened up the forum for all different kinds of work.
• 25:06
  And so it exploded my practice in that time because what I thought had to be done in person.
• 25:12
  Turns out I could do it online, even though Dr.
• 25:15
  Mark, I want you to know I never I never shut down.
• 25:19
  I never shut down.
• 25:20
  If someone was willing to come in, I wanted to see them.
• 25:24
  That did not change for me.
• 25:26
  I think there's something really important about face-to-face contact.
• 25:30
  I I totally agree.
• 25:32
  I I have a therapist I've been seeing for a long time.
• 25:34
  I really adore the guy.
• 25:36
  He's a uh Christian, you know, we we've not friends is too strong of a word.
• 25:42
  We don't hang out outside, although I would love to do that.
• 25:45
  Um seeing him physically in person in his office uh is so much better.
• 25:53
  There's been a couple times where we've done remote stuff.
• 25:56
  I just I'd rather not even do it than you know, not being able to see a person.
• 26:01
  Now, that being said, um, you know, you 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.
• 26:12
  And then we didn't get to this, but it's important that Cece has a book out about narcissism, and I want her to talk to us about that.
• 26:20
  It's coming out soon.
• 26:21
  So we'll be back uh in just a minute.
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  All right.
• 29:16
  We are back with Ceci, psychoanalyst to the stars.
• 29:19
  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.
• 29:32
  Before we talk about the book, I just want to finish that thought about online remote work as a therapist, a counselor, psychoanalyst versus in person.
• 29:41
  You know, there was several talk radio psychologists.
• 29:45
  There was David Viscott, Dr.
• 29:47
  Famous Dr.
• 29:48
  Laura.
• 29:49
  There's a patient of mine, he passed a couple years ago.
• 29:53
  Um, and he did a lot of radio psychology to the point that he believed his name was John.
• 30:00
  Jolith, really wonderful man.
• 30:02
  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.
• 30:14
  Now, maybe it was a rationalization, I don't know.
• 30:17
  But that was his shtick that he actually felt more effective by talking to people from far away, and he had clients around the world, etc.
• 30:25
  I don't know.
• 30:25
  What do you what's your thought about that, Mark?
• 30:29
  I'm a little how would I put it?
• 30:34
  Um 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.
• 30:48
  And so I think your expectations have to be more measured.
• 30:52
  I think coaching can be done really well over the internet.
• 30:54
  Sure.
• 30:55
  Um psychoanalysis, um, no.
• 30:58
  Um psychotherapy to some degree, sure.
• 31:03
  What's the difference?
• 31:04
  Well, psychotherapy, if it's pure psychotherapy and not even psychoanalytically informed, it's not really dealing with unconscious processes, it's dealing with what's on the surface, what's conscious.
• 31:15
  You can talk about what's conscious very easily.
• 31:17
  You don't really need any other cues.
• 31:19
  But as soon as you start focusing on unconscious processes, you really have to have a much more in the moment exchange uh to have the full spectrum of information.
• 31:29
  You can gather some, but I think you're gonna miss something when you're just looking at a screen and people sitting in a chair.
• 31:34
  So you need rolling, you need tears welling up, you know, no facial expressions.
• 31:39
  No, you get all that from the screen.
• 31:41
  I'm talking about motion, movement, uh, what people's energy uh is uh, how they're shifting in their chair, what they're looking at in the room that's being shared between the two of you.
• 31:52
  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.
• 31:59
  So you're gonna miss a lot.
• 32:01
  That's the problem with it.
• 32:03
  But I do think you can certainly talk and see expressions on people's faces, certainly better than a telephone call and do um really good work uh remotely.
• 32:14
  I just think people's expectations need to be tempered.
• 32:16
  And I think what upset me in 2020 was that a lot of professionals, because they were more concerned about maintaining their social status, not their not their health, they couldn't care less about that.
• 32:28
  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.
• 32:40
  And then suddenly they said, well, fake Dr.
• 32:43
  Barbara Ferrar in Los Angeles, who has a doctoral degree in social work and has never had one therapeutic interaction in her life, she told us that we all have to and can work with our patients remotely over a video interface, so we're all gonna do it.
• 32:56
  And suddenly 150 years of psychoanalytic tradition just went out the window.
• 33:00
  Sure.
• 33:00
  And and nobody said boo about it.
• 33:03
  And I was so upset and disappointed by everyone, including the analysts involved in the institutes that I just left, as I said earlier.
• 33:11
  So I I do I do think we can use these interfaces.
• 33:15
  We can use video, we can I'm not against it.
• 33:18
  I just think we have to be honest about what we're what we're using it for and what it's what's lacking, rather than suddenly pretending that a political stance can just supplant all of our, as you were saying earlier, uh, 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 uh because uh Anthony Fauci said it doesn't, you know, like a magic wand.
• 33:44
  And I I don't like deception, I don't like lying, I don't like rationalizations, and and I found I just found that to be all very offensive from top to bottom.
• 33:55
  What did you do with your own practice?
• 33:57
  Like what happened inside of your practice?
• 34:01
  Mm-hmm.
• 34:02
  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.
• 34:10
  And I said, but that hasn't changed.
• 34:12
  I said, if you're sick, I don't want you in my office.
• 34:14
  I've always said that.
• 34:15
  If you're not sick, then you have to get your butt in the door.
• 34:18
  And if patients that refuse to come in for no rational reason, I said, Look, um, I'm here to treat your mental illness.
• 34:25
  And 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.
• 34:35
  So I just refuse to see them.
• 34:37
  And uh, I mean, I didn't refuse to see them.
• 34:39
  I I told them I wanted to see them, but they refused to come in.
• 34:42
  So they just left.
• 34:44
  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.
• 34:55
  At that point, I was no longer seeing psychoanalytic patients, uh, although I was still in the program.
• 35:02
  And so for me, uh, most of my patients were either weekly therapy patients or they were medication management patients.
• 35:09
  And the ones that wanted in-person treatment stayed, and the ones that didn't, um, they just left and went somewhere else.
• 35:15
  So it was kind of like a filtering effect.
• 35:17
  Sure.
• 35:18
  What did you keep from the psychoanalytic world, that form of thought, all your training?
• 35:24
  You were you were steeped in it.
• 35:26
  What did you end up keeping?
• 35:27
  What did you take away?
• 35:29
  Well, at the beginning, what I maintained was the psychoanalytic stance, which was the lack of personal investment, objectivity, uh, listening, listening to myself as much as the patient, feeling my own reactions and emotions to patients.
• 35:47
  As you know, when a borderline walks in the room, you can feel it immediately.
• 35:50
  That's their biggest sign that the person is borderline or narcissistic, cluster B types of disorders.
• 35:57
  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.
• 36:07
  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 on my part, is I'm just not dealing with personality disorders anymore.
• 36:17
  Uh, I'm not gonna try to work with them or treat them.
• 36:20
  I just don't have the energy or the patience.
• 36:22
  Um, I think that people today who come in with expectations from their therapist that they're going to magically cure them of their what is ultimately a personality disorder, are not worth my time and my energy.
• 36:39
  Uh, and I think you do get ground down working with personality disordered patients because they take something from you every time you see them.
• 36:46
  And I think it my own mental health is is I need to prize that above all else.
• 36:52
  And so um, that's one reason why I don't work with them anymore therapeutically.
• 36:56
  I mean, I might see them in medication management, but I'm not going to work with them as a therapist.
• 37:02
  Um 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.
• 37:09
  And uh, I'm just not willing to do it anymore.
• 37:14
  Makes perfect sense to me.
• 37:16
  So CC, let's get into your book.
• 37:18
  The fog of war.
• 37:20
  What an interesting title.
• 37:21
  Uh subtitle, unmasking narcissism, breaking illusion, and becoming victorious in the face of defeat.
• 37:28
  Tell us about that.
• 37:31
  Okay.
• 37:32
  One thing I have to tell you is since I told you the book is in final editing stages.
• 37:37
  It's the subtitles change.
• 37:39
  It's the fog of war, reclaiming yourself on ground.
• 37:44
  Ah, very good.
• 37:45
  So that's change.
• 37:46
  I don't, that's a that's a pejorative word.
• 37:49
  It's a it's a uh inflammatory word, and I don't want that to be the reason why people pick up the book.
• 37:56
  My hope is that I feel like narcissism was in almost in the bloodstream of my family line.
• 38:05
  And I was as even as a child fighting an invisible war.
• 38:10
  Can you define narcissism?
• 38:13
  Well, the DSM could find define it better than I could.
• 38:17
  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.
• 38:31
  Like Dr.
• 38:31
  Mark says, you can feel them energetically when they walk in the room.
• 38:36
  There's a change, there's this subtle humiliation, there's a subtle, there are digs, and sometimes it's so refined.
• 38:47
  The only someone on the other side of when their comments can feel the blade.
• 38:52
  It is a very, it's a very uh sophisticated way that they move and manipulate you.
• 39:01
  And my hope is that I unpack all the ways that narcissists do manipulate us so they feel like I'm can I give you a story?
• 39:14
  Sure.
• 39:15
  I have five girls, Dr.
• 39:16
  Mark.
• 39:16
  I uh and my oldest was in jujitsu.
• 39:20
  And jujitsu, I don't know if you know the whole philosophy about jujitsu, but it's fascinating.
• 39:26
  It is a really fascinating martial art because instead of combating aggression with aggression, you combat aggression with posture, with position with leverage.
• 39:41
  You learn how to use opponent's strength against them.
• 39:46
  Right.
• 39:47
  And so, and they call it the the human chess, like it's human chess.
• 39:53
  You were you were thinking two to three moves above your opponent.
• 40:00
  And I want to train people to really recognize how they're getting manipulated.
• 40:07
  So they have more standing inside of themselves.
• 40:11
  And they are less likely to be manipulated and bullied by them.
• 40:16
  Is narcissism a personality disorder?
• 40:18
  It is a personality disorder.
• 40:20
  I don't know.
• 40:22
  We all sort of and like Dr.
• 40:24
  Mark said, it is a very grim diagnosis.
• 40:29
  Wouldn't you agree, Dr.
• 40:30
  Mark?
• 40:30
  It's a it's not amenable to change.
• 40:33
  It's pretty much not, in my opinion.
• 40:35
  To me, I uh would say in the medical world, and you can correct me, you can give me a different one.
• 40:41
  But if someone's diagnosed with narcissism, it's like saying you have stage four pancreatic cancer.
• 40:50
  Like there's there's a chance, there's a chance, of course, there's always a chance, but it's not good.
• 40:58
  And so my passion is never going to be in changing that.
• 41:02
  So there's you know, just Webster dictionary on my phone.
• 41:06
  I know that doesn't really do it justice.
• 41:08
  There isn't really a definition, it's defined as egotism, egocentrism, um, narcissistic personality disorder, they don't really define it, and then there's love of or sexual desire of one's own body.
• 41:23
  So, how how do you define narcissism, Mark?
• 41:28
  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.
• 41:43
  If we don't have any narcissistic tendencies, then we just roll over and die.
• 41:48
  You have to be preoccupied with yourself in order to survive.
• 41:51
  So there's nothing wrong with it, yeah, yeah, to a certain extent.
• 41:55
  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.
• 42:08
  There's, I think, two kind of specific subgroups of narcissists that that I've seen and that I think refreshted back in the psychoanalytic literature, and some are very pathologic.
• 42:17
  One group is a very pathologic, harmful, explosive narcissist that's the the type that we're most familiar with raging, selfish, obnoxious, nobody wants to be around.
• 42:28
  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, um, are these brittle narcissists, the people that have these really hollow cores inside, no sense of identity, very low self-esteem, poor 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.
• 42:51
  Uh, they ghost them, they cut off communication, and then the the injured person says, Well, what what did I do?
• 42:59
  Uh why what's happening here?
• 43:01
  I thought I was just being nice, and this very, very fragile narcissist that gets so easily injured with just a casual critique, um, turns into a um a kind of hurtful, passively sadistic character.
• 43:15
  And I see this very, very often in Los Angeles.
• 43:18
  Um, it's very common, I think, with with women, this subtype.
• 43:23
  Um, the raging narcissists are more commonly, I think, men more aggressive.
• 43:28
  Uh, 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 uh 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 uh 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 act out and they harm people and they destroy relationships and burn bridges.
• 43:59
  So I think we're a magnet in Los Angeles for fragile narcissists uh for women and sort of raging narcissists for men.
• 44:05
  That's my just first hand experience having been uh a resident and a physician here for a number of years.
• 44:13
  I I imagine most people that are narcissists are not self-aware that they are.
• 44:20
  I think that's very fair to say.
• 44:22
  And how and your your book, it's designed to help victims of narcissism or narcissists themselves to overcome this personality disorder.
• 44:33
  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.
• 44:49
  Mark.
• 44:49
  The one thing that I think is really a telling degree of it is that almost structural absence of empathy, they lack 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 the So your book is sort of like the Al-Anon equivalent for alcoholics.
• 45:24
  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 point you make, when at any time you really try to confront them and they're how they injure, you you're dismissed, you're invisible to them.
• 45:51
  It's almost like how if you're coming, if we're going up to see Dr.
• 45:55
  Mark, or he's coming down here and you see litter on the side of the freeway, you can feel that invisible in their presence.
• 46:02
  They do not see you as a whole person.
• 46:05
  So this was a big part of your life growing up, huge, yeah, and you were able to overcome it.
• 46:12
  Yes, I think that there's something really exciting about thinking that everything we've walked through, all the suffering, if none of it's in vain, and we can learn to help someone else through what we've been through.
• 46:32
  To me, that's the biggest gift.
• 46:35
  What role does what role does religion or a uh higher power belief system have in alcoholics anonymous, for example?
• 46:43
  Maybe there's narcissist narcissistic narcissism anonymous, I don't know, but an AA giving giving up your self to a higher power you can't control what's going on, and you need to give it up.
• 46:57
  Is there a is there an equivalent in narcissistic abuse relationships?
• 47:04
  I've not seen an AA model, Dr.
• 47:08
  Mark.
• 47:08
  Do you have you heard of something like that?
• 47:10
  For I have not, I have no because alcoholics anonymous is is based on uh an acknowledgement that you have an addiction.
• 47:20
  Uh I don't see any narcissists showing up acknowledging that they're narcissists.
• 47:25
  Right, but the victims of it show up, and then you're oh sure, sure.
• 47:30
  They are alcoholic.
• 47:31
  There are there are groups for uh the victims of of alcoholics and well, that's called Al Anon.
• 47:36
  Yeah, I don't remember what Alan stands for, but so but equivalently the victims of all personality disorders, not just narcissism.
• 47:44
  I imagine there are recovery programs for them as well.
• 47:48
  Yes, yes, but I so I guess a couple of things.
• 47:51
  I don't know what if you were asking me that personally, like uh is there a theological side to what I'm saying?
• 47:57
  Were you asking me that, or are you saying in general with a they talk about it?
• 48:01
  Well, I'm sure I'm interested in both.
• 48:02
  Um, you know, what role does a higher power play in recovering from uh being in a relationship with a narcissist?
• 48:13
  Well, I can only speak personally for me, but I would say it's huge.
• 48:17
  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.
• 48:30
  So for me, that is very huge.
• 48:32
  And one of the main reasons, and I don't know, Dr.
• 48:34
  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.
• 48:53
  There are it's it's not it, 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.
• 49:09
  I think that the brittle narcissism that you're talking about, that's fascinating because you think about anyone whose dominant narrative is victimhood, right?
• 49:17
  That's what you're talking about, right?
• 49:19
  And what they're everywhere.
• 49:20
  You talked about what was the analogy that you said someone's out of milk, it's not trauma.
• 49:26
  But what about like you get you go through McDonald's and you spill coffee on yourself and you you you you litigate and you win, right?
• 49:34
  There's so much victimization, right?
• 49:38
  And but my hope is that I've changed the conversation about what can happen if you let all that has come at you actually forge you into a weapon.
• 49:52
  And so that is really the hope of the fog of war.
• 49:54
  I hope that I bring a lot of light and a lot of hope, because in my belief.
• 50:00
  God is hope.
• 50:01
  And so write a book without hope.
• 50:04
  Are there uh but it's not, I gotta just be clear.
• 50:07
  I'm sorry.
• 50:08
  I don't mean interrupt, but just let me know.
• 50:09
  No, you're good.
• 50:11
  My hope is not for the narcissist.
• 50:14
  My hope is for the person on the other side of narcissist.
• 50:18
  And you tell a lot of stories in your book about people that have gone through this and recovered.
• 50:22
  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.
• 50:35
  And so in very disguised detail, they're in there.
• 50:38
  Is narcissism more common in men or women?
• 50:42
  I think it shows up differently.
• 50:44
  I I I think I think we have I think we have I think we have plenty of folk on both sides.
• 50:51
  What do you think, Dr.
• 50:53
  I was just thinking about a quote by Tanner Goosey, men's style consultant and also part-time philosopher in a reel that he posted recently, where he said, I think that our valorization of ugly is wrecking our society.
• 51:15
  We should be valorizing and pursuing beauty, not ugliness.
• 51:19
  And one example of that he gave is our obsession with trauma.
• 51:23
  At its core, trauma is ugly.
• 51:25
  Yes.
• 51:26
  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.
• 51:33
  But remaining mired in your trauma is the same thing as marrying the ugly.
• 51:40
  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 elevate our ugly, i.e.
• 52:05
  our trauma, in the same way that we prayed to the altar of fear for two, three, four.
• 52:10
  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.
• 52:19
  And we worshiped fear endlessly for two, three, four now, even five years ongoing.
• 52:24
  And look what it's got us.
• 52:26
  We're a bunch of pussies and crybabies.
• 52:29
  And the same thing with this trauma.
• 52:30
  We're a nation of victims, and that is a expectable, anticipated, necessary consequence of worshiping the ugly, i.e.
• 52:40
  trauma in the psychological mental health community.
• 52:44
  And I think we need to get out of it.
• 52:45
  I think we got to stop doing it.
• 52:47
  We ought to treat the wounds and move on rather than then holding up our arms and being proud of all these weaknesses and injuries, as if somehow that makes us a better person.
• 52:56
  In other words, what is what is more ugly is not more real.
• 53:03
  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 a divine, worshiping piss Christ, worshiping dogs urinating at the museum uh as a as a piece of art, worshipping cacophonous music.
• 53:20
  Um praising people for looking cool and hip because they have four colors of hair, scarifications on their face, tattoos, and rings.
• 53:30
  That is not what we should be doing.
• 53:32
  We should be saying that's ugly.
• 53:33
  Make yourself beautiful, make everything beautiful.
• 53:36
  And we're not doing it.
• 53:37
  We're debasing ourselves and we're pulling ourselves downward.
• 53:40
  We're pulling our humans into the gutter as uh as an act of worship rather than looking down at the gutter and saying, I want to get higher up.
• 53:47
  I want to, I want to go above and beyond my circumstances.
• 53:50
  I think this is actually anti-religious.
• 53:54
  I think it's it's actually uh if you want to call it a conflict that's more spiritual.
• 53:59
  I think it is actually.
• 54:00
  I think we're in a spiritual conflict, and I think we're being pulled into dirt and filth, and and we're we're calling it beauty, and it's not.
• 54:07
  You know, beauty is is is up there.
• 54:10
  And I I think this is a problem everywhere, and I don't think that the uh you know mental health community is escaping it.
• 54:17
  What is your hope inside of mental health?
• 54:20
  What do you see?
• 54:21
  What what do you see is the trajectory?
• 54:23
  What are your thoughts?
• 54:24
  What do you see?
• 54:25
  I think it's I honestly, I think it's over.
• 54:28
  I I think therapy is done.
• 54:29
  I think it's cooked.
• 54:31
  I think therapists are gonna be rapidly out of work, and most of them are women now.
• 54:35
  So we're gonna have a huge contingent of unemployed women because everyone's gonna go to coaching, which is two or three dollars a month with a very, very rapid processor AI tool and agent that knows everything about you and that 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.
• 55:00
  So I think most therapists are gonna be out of work because right now people don't have the money to pay for it.
• 55:05
  It's a very rarefied group of people that can afford to pay for therapy.
• 55:09
  Most people can't.
• 55:11
  Uh, the ones that need it are unable to.
• 55:13
  So I think we're gonna see a calling of the herd.
• 55:15
  We're gonna have a very uh select group of elite therapists who work with uh wealthy people on a cash-based basis, and um everyone else is is just gonna be left for AI.
• 55:26
  I I'm I'm not like trying to be pessimistic.
• 55:29
  I just see that's what's going already happening.
• 55:32
  I think most women are gonna 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 gonna 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.
• 55:52
  That's where women do great.
• 55:53
  But working in offices, doing admin work, uh doing work that requires computers, they're all gone.
• 55:59
  And obviously, the men are gonna be gone too, but we still need men to you know to dig holes to build power lines to manage nuclear reactors.
• 56:09
  We need men for police and military.
• 56:11
  Uh, no women perform those those labors.
• 56:13
  Uh, and if they do, they they end up becoming problematic because they end up shooting people uh unnecessarily and getting kidnapped and raped.
• 56:20
  But we don't have single woman managing power lines in Alaska, not one.
• 56:26
  So men are still gonna be needed for those jobs, but the other jobs, they're gonna be fired too.
• 56:31
  So I think we're gonna have a huge, huge problem of unemployment, and I think therapy is gonna be one of the first professions that's gonna blow up, and very few people are gonna be left.
• 56:38
  That's what we're CCM Mark.
• 56:40
  We are just at about out of time.
• 56:42
  CeC, 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.
• 56:54
  Uh, how do they get a hold of you?
• 56:56
  Okay, thank you for asking Instagram, Facebook, my website, everything's under CC Evans Poglisi, just my whole name.
• 57:05
  C C Evans, E V A N Sh Puglisi, P-U-G-L-I-S-E.
• 57:11
  Yes.
• 57:13
  Perfect.
• 57:13
  Yes, we we ran we ran a bit over.
• 57:16
  I apologize for cutting everybody off, but we gotta run.
• 57:19
  Uh CC, it's been a pleasure.
• 57:21
  Time went by so fast.
• 57:22
  When your book comes out, we're gonna have to have you back on, and I look forward to reading that book myself.
• 57:27
  Thank you.
• 57:28
  Thank you both very much for the time today.
• 57:30
  Of course.
• 57:31
  Thanks for joining us on Informed Descent.
• 57:33
  Goodbye.
• 57:34
  Have a great night.
• 57:36
  You've been listening to informed dissent with Dr.
• 57:39
  Jeff Barkey, board certified primary care physician, and Dr.
• 57:44
  Mark McDonald, board certified child, adolescent, and adult psychiatrist.
• 57:50
  Informed dissent, the intersection of health care and politics.