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150. The Globalization of the American Psyche w/ Ethan Watters · Radically Genuine

• Roger K. McFillin, Psy.D., ABPP (00:01.058) Welcome to the Radically Genuine Podcast. I am Dr. Roger McFillin. Imagine a world where the way we think about our minds, our very sanity, is as culturally constructed as a Big Mac. A world where the rich tapestry of human experience, woven over millennia by diverse cultures, is flattened into a one -size -fits -all model of mental health. This is happening right now. We're the ones doing it. For decades, America has been exporting more than just movies, music, and fast food. We've been shipping our ideas about the human psyche across the globe, packaged with the certainty of science and the promise of relief. But what if, in our rush to heal the world, we're actually changing the very nature of mental illness itself? Think about it. We categorize disorders define what is normal and what's not and then present these ideas to the world as undeniable truths. We send our therapists, our drugs, our DSM manuals to the far corners of the earth, confident that we're spreading enlightenment and relief. But here's the unsettling question. What if mental illness isn't a universal constant? What if the way we experience psychological distress is as culturally shaped as the food we eat or the clothes we wear? From China to Tanzania, from Sri Lanka to Japan, a disturbing trend has emerged. As our Western ideas about mental health spread, so do our mental illnesses. It's as if we're not just treating these conditions, we're planting them. We're living in an age where a teenager in Hong Kong can develop a quintessential American form of anorexia, where a grieving tsunami survivors in Sri Lanka can be labeled with PTSD before they've had a chance to process their own loss in their own cultural context. Roger K. McFillin, Psy.D., ABPP (02:19.864) where pharmaceutical companies can literally create a market for depression medication in Japan by redefining what it means to be depressed. The implications are staggering. We're not just changing how the world talks about mental illness, we're changing mental illness itself. And in doing so, we may be robbing cultures of their unique ways of understanding and coping with psychological distress. This isn't just about them. It's about us. By examining our impact on other cultures, we're forced to confront our own assumptions. What if our understanding of mental health isn't as objective or universal as we think? What if in our quest to categorize and medicalize every aspect of human suffering, we're missing something crucial about the human experience? Today, we're going to deep dive into this unsettling reality. We'll explore how America became the world's therapist. and what happens when we export our ideas about the mind. We'll challenge our assumptions, question our certainties, and perhaps, just perhaps, learn to see how our cultures approach to mental health may be perceived in a new light. Our guide on this eye -opening expedition is Ethan Waters, an investigative journalist and author. He's most widely known for his book, Crazy Like Us, The Globalization of the American Psyche, which was published in 2010. He's appeared on a number of media outlets such as Good Morning America, Talk of the Nation and CNN. He's written articles published in the New York Times Magazine, Spin, Details, Mother Jones, Clammer, GQ, Esquire, and the San Francisco Chronicle Magazine. Ethan Waters, welcome to the Radically Genuine Podcast. Ethan Watters (04:08.46) Roger, it's so nice to be here and what a nice introduction that was. I couldn't have written it better myself. So thank you for that. Roger K. McFillin, Psy.D., ABPP (04:16.398) Yeah, thanks. Thanks for coming on the show. I mean, I just recently was exposed to your work. I was telling you before we got on, I wish I would have read this in 2010, because it's that enlightening. And right now, I have a training clinic here in Bethlehem, Pennsylvania, where we train psychologists and licensed professional counselors. And just from a cultural perspective, we're going to make your book like mandatory reading, we're going to do some continued education on it. But it's been almost 15 years since you published Crazy Like Us. I'm curious, number one, what inspired you to write this book? And then what was the response at the time of publication? Ethan Watters (04:59.151) So how I got to the idea is a little bit of a long story, but maybe I'll answer the second part first, which is it was a remarkably positive reaction. It was interesting within the profession, you so you make the case that people are tromping into other cultures with little understanding of the local modes of expressing mental illness, local modes of healing and I got a lot of people saying, yes, when I go to another culture, I'm super respectful of those cultures, but the guy down the hall, he's got a real problem. So there was a lot of finger pointing at the other guy, or the other organization that they don't do it right. But our organization, when we do our interventions in other cultures, we're really respectful. there was not a lot of pushback. Some of the people in the book didn't, their portrayals. weren't the most flattering. Those people were unhappy as they often are. How I got to the idea is a little bit longer story. started in the early 90s, early 1990s, writing about recovered memory phenomenon and the sort of controversy surrounding people going into therapy and coming out with memories of being abused as infants and then the ways in which those notions often spread to ideas of multiple personality disorder, ideas of satanic cult abuse. There was a way in which those ideas really spread through the mental health profession. And if you wanted a lesson in how culture can shape a person or shape even things as fundamental to us as memory, that was my introduction to that. So. it was very clear that to me from having written Making Monsters, which was my first book collaboration with Richard Offshe, that culture has a unique impact on our sense of self all the way through. And then, you know, if you think about something like multiple personality disorders, which is now called dissociative identity disorder. Ethan Watters (07:08.487) And you realize it doesn't exist in all times, in all places, in the same form, that it can rise in one moment in culture and sort of go away in the next generation. You begin to look across history, you can see this pattern repeat again and again. There's times when anorexia rises, there's things like hysteria that happen, they go, what comes in these generational waves? You begin to realize that something else is happening besides mental illnesses being the same everywhere and the same in all times. So you can look at it two ways. You can look at it across history and see those waves, or you could look at it across cultures. when I began to look at it across cultures, I ran into these remarkable cross -cultural psychiatrists who were studying the ways in which other cultures express mental illnesses differently. but also the way in which it's changing, the way in which we're impacting how other cultures think about mental illnesses and how that actually relates to how they get expressed, which symptoms become salient in that moment in history. So I began to follow these cross -cultural psychiatrists to their various expertise around the world. One took me to Zanzibar and one to Sri Lanka to Japan and began to document their work, which was just remarkable because as I say in the book, I kind of compare these cross -cultural scholars to botanists in the rainforest who are just trying to document the diversity of human thought, just one step ahead of the bulldozer. And the bulldozer is our American certainties about these things and how they're becoming sort of, how they're homogenizing notions of mental illness around the world. Roger K. McFillin, Psy.D., ABPP (08:59.01) Let's start with the concept of depression. You know, I did mention previously before we jumped on here, you know, asking the question is, you think possibly, you know, maybe the American public is more open to some of these ideas? And the reason why I asked you that was because it seems like there's somewhat of an awakening to how we can be mass conditioned, especially by the medical authority into adopting some ideas and being able to kind of step outside. of our culture a little bit. like when the veil is, the veil is kind of pulled back and we can observe maybe like who's behind the, you know, kind of like the wizard of Oz, who's behind some of these strong messaging and who does it serve. That awakening kind of allows us to question some things that we previously may have accepted as like absolute truth or there's pure strong scientific validity behind it. And so the concept of depression is an interesting one because I think if you, ask most Americans, know, at least 95 % are going to say, yeah, like depression is a real genuine medical illness. It's a condition. It certainly, you know, can impair people and has been observed cross culturally and it's acceptable going back centuries. So this is a disorder and we're making advancements in the way that we understand and treat depression. However, I don't think people realize to the degree it has been culturally constructed and it is not a universally accepted kind of illness, disease or disorder in the way we view it, whatever you want to call it. So I think this opens up the conversation about how other cultures may have may think about something like depression and have experienced previously and what is what has been our role then in shaping their culture's way of thinking about. Ethan Watters (11:01.161) There's a lot of interesting points there. I think Americans and people with a Western mind have a real problem with the notion of psychosomatic symptomology. The idea that some symptoms are given to you by culture because they're literally like the language of suffering for a moment in history. And your subconscious picks that up and understands that when I describe this, you know, this depression and depression is, you know, in a sort of a big general category exists across time, across cultures. You know, for someone, you know, someone in another culture might complain of semen loss or a feeling of a weak heartbeat or, you know, stomach pains. They might literally have a somatic expression of this depression. We tend not to in the West. We tend to think of it as, you know, up here in the mind and as cycling thoughts. it's very clear that it gets expressed differently, but here's the thing. That doesn't mean it's not, like if it's culturally influenced, doesn't mean it's not real. Like that's the problem we have in the West of like trying to understand that it can be absolutely real. The soldiers experience a PTSD if it's expressed in a Western style. Just because those symptoms are fed to them by culture, you're unconscious by culture, doesn't mean they're not also. absolutely real. So understanding this phenomena, understanding that culture shapes our symptomology is not a easy way to a fix. It's not the way to sort of, can't just suddenly say, if culture has fed me these ways of expressing this mental illness, then I can suddenly overcome it just by sheer will. But I think you're also right that there are ways of stepping, you we can step back from the stories that we get told about depression, know, the story in the West is often like this is a serotonin imbalance, which may have some, you know, some medical truth to it. But it's also a story. It's a story you tell yourself about your brain being out of whack, like, so you separate the even even that you can separate the medical truth of something from the story that that truth Ethan Watters (13:21.331) entails. in the book, I talk about schizophrenia in Africa and the way in which that culture is now juggling a notion between spirit possession as the cause for schizophrenia and the sort of Western idea of it's a medical imbalance, something is wrong with the brain. So you have these two stories, right? And I'm not a person that believes in spirit possession. From the West, I tend to sort of believe that the Western notion of the mind. But the next question you have to ask yourself is what is the downstream consequences of that story? And so in Zanzibar, where I went with the anthropologist, the downstream consequences of the spirit possession story is often one, it's a little bit counterintuitive, but it's the one that keeps the person within the group. Because everyone in that culture tends to believe that they're possessed by spirits when they get angry sometimes or they do things that they didn't expect. The idea that this person who has schizophrenia is like us only more so allows them to keep that person within the group. And I think that's the key thing. And the medical notion of schizophrenia in the West tends to be the narrative that really pushes the person outside the group, that they're nothing like us, they're schizophrenic, they really frighten us, so they get pushed outside the group. So it's this. The truth or falseness of the story on a medical level is not the end of it. You have to sort of look at like, what does the story mean next? does it mean for a group inclusion or exclusion? What does it mean for other, how you view this person, it's sort of down the line. Roger K. McFillin, Psy.D., ABPP (15:10.102) Yeah, it's interesting. So one of the things that I've been quite vocal about is that in Western culture, United States in particular, we've kind of lost our language of suffering. In fact, you know, I'm a treating psychologist and I don't even hear the word sad anymore. know, most of the young people will say, well, replace that with I'm depressed, you know, and for me as a clinical psychologist, I've certainly seen people in these pretty severe episodes that are quite enduring and chronic. And so I have this idea in my mind about what, you know, a real episode of depression may be and understanding the complexity of it, when someone might fall into it. But when you have like a young person, teenager, a college student talk about their depression being in terms of like feeling lonely on the weekend because they didn't go out and they were on social media and they saw their friends out, right? So it's like this use of language, clinical psychiatric terms. that are replacing the way we would articulate it in our culture previously. And so there's much less of a tolerance now for the experience, the wide range of human emotions that are part of our existence. And so when you say before that, it doesn't mean, when we look at things cross -culturally, it doesn't mean it doesn't exist. But the language that culture might use to describe the experience, how the group, the family, society thinks about it and responds to it can change the course and outcome of the condition. for example, I to stay with depression because it's the easiest for people to understand right now. If we identify depression, the experience of depression to be transformative, that it is a state of being that we will go through at some point in our lives that is representative of real critical information. Like it's our bodies, our emotions, our minds response to events we have to face in our lives and change, right? So we're unhappy for a reason and that adverse response to it, the uncomfortable, painful emotions are there to support our growth and for us to grow, to face them. That has a distinct and unique Roger K. McFillin, Psy.D., ABPP (17:36.046) response to it, where if you said that there is something wrong in your brain and you have to see the doctor, that's going to have its own response. Now, I believe 1000 % from understanding the literature and working with people for over 20 years, that if you viewed this as something that's temporary, and that can be potentially transformative, it completely alters the outcome. And so when I when I read your chapter on like what we did to the Japanese culture. And I think this is a great opportunity for you to kind of discuss some of your research there. It felt like it's very, very similar is that we're altering the way that a culture over millennial has developed these strategies and these ability to respond to the suffering that exists in life in a way that's protective. And then we come in or Western societies come in, pushed by the pharmaceutical industries, alter that way in a way that kind of creates worse outcomes. Ethan Watters (18:40.585) Yeah, I think the idea that I would put both depression and trauma in the same thing. There's this way in which we're sort of being trained to think of more and more things as traumatic. So and I think there is a backlash to that now. There's this idea of post -traumatic growth. And I think, you know, depression and sadness can be put in the same category of like you could look at these experiences as moments to grow. And you're right, the Japanese culture remarkable cultural embrace of notion of like the experience of sadness and quietness. And so you have it in the movies, you have it in the literature, you have it in the religions, you have it in the, you know, just it's deeply embraced. And when, know, GlaxoSmithKline came in, you know, there was a Japanese notion of clinical depression. was a considered by the culture, it was fairly rare and considered to be like a very severe mental illness, like one that you would really be in the hospital for. Like that was their notion of depression at the time. And GlaxoSmithKline was rolling out Paxil and moving it into Japan and did a very savvy marketing campaign, hiring, doing this sort of thing that looked like a grassroots, patient -oriented publicity, got a lot of major celebrities to endorse it and sort of attempted to change the cultural notion of that depression being this, clinical depression being this very rare severe mental illness and everything else being culturally normative, know, culturally normal, all other experiences of sadness. And they were very successful. in doing it, they really changed this idea that the slogan was the cold of the soul, you can, and what do you do for a cold? You take a pill, right? So this is the pill you take when you have a cold for the soul, when you get sad. So, really fundamentally changing how people thought about the experience of depression. And it's important to say a couple of things because Japan does have a fairly high suicide rate. Ethan Watters (20:59.625) And over the course of the introduction of Paxil, that suicide rate did come down a little bit. It's not exactly clear whether there was a connection there. However, it should be said that our interventions are problematic, but they should be taken in for their good and bad. So I imagine there were some people that might have been suffering from depression who were in that. relatively small group of people that have a good reaction to antidepressants. So I don't want to paint this with one brush, but I do think with KlaxoSmithKline and the introduction of Paxil, it was fairly clear that this was a way to change a narrative about a culture in order to profit from the change of that narrative without a full understanding of the value of their way of thinking about depression. and sort of a general disrespect for the cultural notions of sadness and those other states of being that they had a long tradition in working with. Roger K. McFillin, Psy.D., ABPP (22:12.962) Yeah, I mean, it's interesting because I looked into some of those statistics too around suicide. And I think that in the West, we tie suicide together with depression. And that's not always the case. To be honest with you, most of my experiences as a clinical psychologist too with people who are suicidal, it's not always tied to the idea of depression. People can die by suicide. in response to life events that in that moment, they deemed them to have lasting effects not only on them, but on their families. The role of shame, impulsivity, substance abuse, things like that, you know, tend to be more related to ending one's life. And so looking at the culture of Japan, how that was tied to like honor culture and a number of things, like, especially when it came to where they were economically. Ethan Watters (22:51.754) Yeah, I Roger K. McFillin, Psy.D., ABPP (23:08.224) And you described, I think you described a story of a Japanese man who was working in the financial markets. And, you know, what happened after the crash, the crash of their economy after they had such a boom and the amount of hours that like that gentleman was working like to the degree of exhaustion, you know, and what that does. And to like to deem that as like some medical disease that can be easily fixed with a pill is just So quintessential, know, United States like go get your food real quickly get everything quickly like this this fast food approach to health care Ethan Watters (23:47.529) Yeah, we definitely have the, know, we're a hopeful people, you know, we really are. And the ideas of, you know, sadness and depression and we really want to fix things, you know, and especially when it comes to things like schizophrenia, you know, when someone suffers from that, the desire to fix it is completely understandable. And but it's often the very thing that, you know, makes the outcomes worse because, know, for people with schizophrenia, if they're feeling constantly monitored for their cognition and their behavior, it tends to have the, you know, unwanted effect of making the person, you know, more worried about their behavior and cognition. And it has this effect that you don't see in other cultures where people can be more accepting of alternative states from unhappiness to depression to even things as dramatic as schizophrenia, the ability to accept it at some level and to allow people around you to live with it without being constantly encouraged or monitored or come out of it or we can fix this turns out to be something that can be helpful if you or you are more accepting of these alternative states of cognition. Roger K. McFillin, Psy.D., ABPP (25:22.412) Yeah, I have a hypothesis. I think it's backed by some pretty good research that the way we respond to our eternal states is much more important than the existence of them in itself. So in my work, I've come across a number of people who have experienced altered states of consciousness. We can call it a hallucination or a delusion. And the varying way in which they think about it seems to be implicated in whether this is something that turns into like a chronic condition under the care of medical and mental health professionals, or if it's something that's viewed as maybe episodic and there's meaning attached to it. And so I'm concerned about the way we think about hallucinations or delusions in the United States. There's a fear base around it. Many of the psychotic Ethan Watters (26:19.197) yeah. Roger K. McFillin, Psy.D., ABPP (26:21.93) episodes that do exist in the United States are actually due to substance abuse, one, substance abuse or an adverse reaction to like a pharmaceutical, they often get misrepresented as like a mental illness or a mental health condition. But in my line of work, I'll see people who are post trauma, or have kind of like a severe depressive episode, and they experience something. along the lines of hallucinations that tend to have great meaning around them, especially if they're more spiritually inclined or religiously inclined, that those hallucinations, if viewed from another perspective and different meaning attached to them, provide some protective factors and even some relief and might help them get out of that kind of dark state that they're in for a period of time. But yet if we say you have major depressive disorder with psychotic features, let me give you this SSRI and this, we'll combine it with polypharm drugging of all these different kinds. It's almost like we're creating an illness and it's very hard for us to move away from that because we're so dominated by our allopathic medical system. Ethan Watters (27:36.511) Yeah. So I think that's very true. And when you say like the way you think about it, you know, becomes paramount. I'm curious where like, where do those narratives come from about the way to think about it? Like, what would you say? Does it come from like personal introspection? Roger K. McFillin, Psy.D., ABPP (27:57.87) I think it's a combination of like a number of factors, probably most influenced by family and culture. yeah, so I mean, like if, if someone is deeply religious, and they're visited by, you know, the Virgin Mary, for example, which I recently did a podcast with a woman who, you know, gave birth to still, stillborn child. And she also is a trauma survivor. She had Ethan Watters (28:04.713) Yeah, so, yeah. Roger K. McFillin, Psy.D., ABPP (28:26.294) raped when she was teenager. During the experience of given birth, she had this vision of Mary. So, know, born with Christian and Catholic upbringing, this experience with Mary was one that created a sense of peace and hope. And along with her husband, who was from Ireland and had similar beliefs, this She wrote a book about this and this was part of her recovery, you know, from PTSD. And so you say that story to the wrong person and that person's going to say you're mentally ill and they're going to drug you and they're going to tell you you're required to be under this treatment. And so what happens is you learn this in our society, like who can I say this to and who can't I say this to? And there's some aspects that are culturally acceptable, like some people, like for example, seeing a medium. know, we kind of have this acceptability that a medium might be able to tap into this energy and communicate to others from people who have passed on. And then we don't talk, we don't necessarily call that delusions, and we don't view them as, as mentally ill. And so when it comes to like the meaning attached to the event, that is going to also influence your, your reaction to it and how other people react to it. Ethan Watters (29:54.111) Yeah, and I think those stories always come from culture. I have a theory, and this is a little off the topic of my book, but I've written about it a little bit, this idea that our ability to see into our own thoughts is very limited. I can see or chat with you, and words come out of my mouth. have no idea sort of where they're coming from. just at the top most of my consciousness. deeper down, they've done remarkable sort of psychological studies about this where they, you know, basically they will trick people into a behavior or an answer and they can influence, clearly influence their behavior. But if it's done in the right way, you ask the people, why did you do that behavior? They will never be able to see the influence that was given them. We don't go back into our brains and interrogate. We think we do, but I believe what we're doing instead is we are basically going through a quiver of culturally acceptable narratives for that behavior, whatever the behavior was. Doesn't necessarily mean that it's absolutely wrong, but we only have the cultural narratives for why we behave in a certain way and we pick among them. And the end of the day, I think that the truth or falseness of that narrative. is not as important as the downstream consequences. Like as I mentioned, it's not as important as whether it's healing, whether it keeps you within the group, whether you value in the story. Those are the consequences that I'm interested in. And going back just briefly to the notion of spirit possession in Africa, it's important to note that in other places in Africa, that spirit possession notion is the excuse for the rankest form of cruelty you can imagine. someone gets labeled with being spirit possessed, you were just able to treat them like a non -human. And so here's the same narrative in different cultures. It's this one that keeps you within the group and in another place, it's the reason for torture and abuse. So it really matters what happens with that narrative within the culture. And I think... Ethan Watters (32:17.919) You know, to access those narratives though really does require culture. And I tell the story in the book of the anthropologist I followed to Zanzibar who studies schizophrenia, comes back home and her husband has a psychotic break up in Tacoma, Washington. And here's this anthropologist that knows all these ways of like how, you know, people have better outcomes in Zanzibar oftentimes in these situations when they embrace religions, when they embrace. It's a spirit possession notion and she gives it a shot. You know, she sort of tried they try to go to a church they try to you know, it just doesn't quite work because the You know the the way in which that thing happens in Zanzibar and ways just wrapped into culture That doesn't exist in Tacoma, Washington. There's not the same way. There's not the same You know, they live in they're more isolated from other people They don't have the family structures the kinship groups that the belief that everyone shares And the outcome was worse. was, you know, it was not a good outcome. So it's hard, even as we know that these cultural influences can happen, asking an individual to adopt one or another on their own to find meaning is problematic because it has to really exist around you. So again, this notion that culture affects mental illness and symptomology is not necessarily an easy path towards a cure. You know, it's not a way of saying, now that we know this, we'll do x. It's not as simple as that, unfortunately. Roger K. McFillin, Psy.D., ABPP (33:54.892) No, it's not. And in the United States, you know, we use the diagnostic statistical manual and it's communicated to the general public. Like a lot of these are discrete, identifiable medical illnesses. Although it's very clearly stated in the book itself that they're descriptive, they're not explanatory, that they're just ways of categorizing what professionals see it by no means does it reflect that we have science that supports their underlying pathology. That's purely medical, that's Western society and culture, but we still talk about it that way, like their brain chemical imbalances, although that's been disputed scientifically. 85 % of the American public still believes that depression is related to low serotonin, although that's clearly disputed scientifically. So we are creating this narrative around it. And when it comes to schizophrenia, There's this belief that the Western world has medical treatments with success, like positive outcomes, and your research really demonstrated otherwise. Ethan Watters (35:02.185) No, it's pretty clear that the World Health studies on schizophrenic outcomes, we're among the worst in terms of, and partly that has to do with like to exist in a busy capitalist culture. The tight rope of behavior is pretty thin. Ethan Watters (35:26.379) One second. One thing I forgot to turn off is the automatic cat food thing. Apologies for that. But we really have a very, very narrow way of being able to act in this culture and to get by. we immediately see when people are outside of it. But when you look at what they studied in terms of those outcomes is, Does the person who has gotten the diagnosis of schizophrenia, do they get married? Do they keep a job? Do they stay within a family unit? Do they have children? And all those outcomes, these are the life outcomes. Like, are you living a good life after you've had this diagnosis? We tend to do much worse than other cultures. And so there's something clearly wrong there. Ethan Watters (36:25.117) You can hear that, right? Let me just unplug this thing. Ethan Watters (36:35.305) Ethan Watters (36:39.871) So yeah, as I was saying that. Ethan Watters (36:45.759) Where was I? yeah, so if you look at the World Health Organization studies on schizophrenia, we definitely do worse than other cultures. And I think that really fundamentally has to do with the way in which schizophrenia just scares us to death. If you have this idea of the high locus of control of the human mind, that our selves exist just within here, which is really a Western notion. that we are just up here, we're not a part of the larger group, we're right up here. The people that have lost the ability to sort of control their behavior or control their cognition in this very narrow way we expect in the West, terrify us. That is something that, and I think other cultures have a better sense that the self is a little more fluid. It's connected to... know, people around us and the cultural narratives and your place in the culture and the health of the culture and your, yourself exists a little more outside yourself than we like to think of it here. And so those, you know, behaviors like, you know, that dream states or hallucinations are a little more accepted and a little less scary in other cultures because everyone has some experience with them in some way, some altered more. comfortable with altered states of being and that ends up being applied to the people that have sort of ongoing problems with with schizophrenia like disorders and it tends to keep them closer in the group and that tends to have better outcomes including everything from you know whether they have children whether they stay within the family group whether they stay within the kinship group whether they have jobs have marriages and you know are able to live a good life even with this you know severe condition. Roger K. McFillin, Psy.D., ABPP (38:40.76) Yeah. And therefore like when you do experience those challenges of living, the way one would view healing is quite different. You know, you're now connected to the greater group, you're supported by the group and probably also like there's more aspects related to connection to nature and you know, the greater universe and spirituality and so forth. So this goes beyond just our medicalization, the Western medicalization of this condition, also the Western view of psychotherapy. You have a great section when you're talking about PTSD, which was after the tsunamis that occurred in Sri Lanka. This is a great opportunity to kind of discuss these points about how others heal in response to the aftermath of a widespread crisis or traumatic event. Ethan Watters (39:32.575) Yeah, so after the tsunami, single day, single moment in time, tens of thousands of people killed, hundreds of thousands of people losing their homes, horrible, horrible event across this huge swath of the world. you know, to our credit, we want to help in those situations. know, Americans tend to be really helpful, but in addition to, you know, rushing in with, you medical aid and other forms of, you know, food and support, we, you know, had a huge number of trauma counselors got on planes and went, and their idea was like, we need to teach these Sri Lankans, you know, that there's another tsunami of PTSD coming and we have to, you know, we have to. warn them and we have to begin to treat them and teach them how to, you know, how to heal from it. And, you know, that level of hubris is kind of remarkable because you're oftentimes rushing into a culture, you don't know the language, you don't know the religions, you're not deeply immersed in the history of the culture. And this is Sri Lanka. I mean, this is the place that has, you know, history of natural disasters and civil wars, you know, if there's one place in the world that knows a good deal about trauma, it's Sri Lanka. And you've got these suburban American traumatologists going in there and saying, we need to teach you what the reaction to trauma is. And that assumes this sort of medicalized version of PTSD is the same all over the world. Your reaction is the same all over the world. And the ways of healing is something that we know. that we know we need to teach you. When I talked to one scholar on this topic, he asked me to sort of imagine this other scenario. He said, imagine after 9 -11 that some priests from Mozambique came and started knocking on the doors of the people that had lost loved ones in the Twin Towers. they said that, Ethan Watters (41:50.111) We need to lead you through these certain rituals to separate the soul of your departed loved one from the earth. How would that land with us? Would that make any sense at all? And the point is, think that we've done roughly the same thing. And I think the reason is that we think that what we have to offer is science. It's proven. in the journals. We've studied it and we have very little understanding that trauma does get expressed differently. In Sri Lanka in particular, it expressed less again in the notion of like traumas in your head and you're focused and you're really worried about the flashbacks and the lack of sleep and the depression. It's more exists and those symptoms are there for sure, but they're down on the list of how people respond to trauma. The things at the top of the list are people losing their role in the group. They've lost, and their society and their close -knit culture is now disturbed. And that's really where the trauma is. It's not up here, it's in that idea of like my place in the group, my group has been broken. And that's really important when you come to... when you think about the Western notion of healing is that like, let's go with another individual and talk just about your internal experiences. That's the therapy model, right? And that's what we went into Sri Lanka with. need to talk about it with an individual and talk about your feelings inside your head. And that was not where the problem existed. The primary problem existed for Sri Lankans. They needed to rebuild the churches and to rebuild their social groups and to retake their... role in the community and that's what they wanted. And that's why it's, you know, so it's not just about teaching other cultures symptoms. It's about disconnecting them from their modes of healing that they have already in their culture. And that's the real problematic part of this. Roger K. McFillin, Psy.D., ABPP (44:06.154) It's very ethnocentric, the belief that the way that we speak about it in the United States, then is the, the ideal, the beacon of scientific supremacy. And we need to be able to spread that information to people all around the world. And that kind of narcissistic ideas created great harm. And I think one of the things we're learning right now in our culture, and we're in the midst of a mental health crisis. One of the reasons I think we're in a mental health crisis is the way that we approach. human struggle and the emotional pain of living and the challenges that we're going to face inevitably when you have 25 % of the population on some form of a psychiatric drug. mean, that certainly represents how we view emotional distress in Western societies and American culture. I mean, we're pushing people to see it as a medical condition and we're losing that collectivism that exists and how we can support each other. And I think You have these notions of like looking at things through, through symptoms. You don't think about it in terms of a recovery model, right? So like if I cut my arm, for example, it's going to bleed and it's going to scab over. If I face a traumatic event to the nature of like losing a loved one in a tsunami, I mean, there's going to be a period of adaptation there of loss that we all have to face and to not medicalize that and see that that there's something wrong with that. The idea of thinking about it as there's something wrong with it and you have to do something immediately is the problem itself. mean, critical stress debriefing is a great example of this, right? I mean, I think you refer to this in your book. The idea that getting somebody just to talk about something, like forcing them to do that so early on in the aftermath of a trauma actually increases the likelihood they're going to develop PTSD. Ethan Watters (45:41.685) Yeah, yeah, yeah. Ethan Watters (45:57.449) Yeah, no, absolutely. You bring people that I think that's been really well debunked. This idea that like after a trauma, you get together with all the people that are traumatized and you retell your story. And you know, the more emotion you tell it with the better, you know, the outcomes of people that go through that sort of process are much worse than the people who go through other, you know, other processes. You know, the idea of being stoic is just an idea that's not really of interest to people in the West anymore. It seems that, and in Sri Lanka it's really interesting because there is this idea of not expressing your emotional feelings of being traumatized. And one of the reasons that existed there is they had such a terrible civil war that you go through these periods of Radical violence within communities, you where neighbors, know go, you know, you know horrible things happen between neighbors and the idea You know and Western Trump, you know trauma counselors come in and say well, we got all talk about this You know and and Sri Lankans are like, you know in our culture We really have this you know We really don't talk about this because the fear of talking about this of reliving the traumatic moment between neighbors or neighborhoods that that had some sort of know, flare up of violence is to potentially reignite that flame. So like the idea of like not talking about it not only has, you know, individual relevance, but it has, you know, this cultural relevance that you don't want to talk about the things that happen in this little war because you don't want them to spark and happen again. So, you know, we go into these places and give our advice and, know, really at the peril of you doing some real damage, potentially. Roger K. McFillin, Psy.D., ABPP (47:50.102) Yeah, absolutely. Yeah. I mean, I'm also interested in like modern day therapy culture. You know, I'm a psychologist and I do provide cognitive behavioral therapy, but I'm also pretty outspoken about how it also can create harm. mean, just imagine what we're kind of doing in our system. The idea that just some random Tuesday at four o 'clock, the person's going to be absolutely willing and ready to face whatever just happened to them, you know, with a, with a professional is kind of a, odd idea that doesn't always have the best outcomes. And we push a lot of kids and young people into therapy as if it's like universally helpful. And you can see that there's even gender differences in the way that people cope. Like women, for example, are more likely to cope by emotionally processing it with a trusted friend or someone in their group. There's social bonding that can occur. through the articulation of your internal emotional experience with another woman. While men don't necessarily cope in the same way, maybe they'll talk while they're golfing or doing another activity in the way that they're willing to share, but it's the actual activity itself that's probably most likely the part that's healing. so then we'll force men who've been in combat, we'll force them into a system where we push them to talk with a therapist and to talk about what happened in combat with someone who may not fully even understand like military culture, or what it's like to be in a war torn area, or the the multitude of like moral dilemmas that might exist when you're in a situation that is life and death. and so you question and you look at our outcomes and they're notoriously poor. The fact that we're not questioning our system to the way that we need to question our system, which is, you know, for the most part, it's therapy and a pill. The way that we just kind of accept it despite the poor outcomes, to me, it's a definition of insanity. Ethan Watters (49:59.497) Yeah, I'm particularly interested in the outcomes of kids in therapy and teens in therapy. And you really just roll in the dice when you put a kid into therapy. You're ceding an incredible amount of influence as a parent to someone that maybe you've talked to once that has a credential. And whether they lead the kid down a path towards resilience and strength, or lead them down the path of victimhood and seeing themselves as sick, or finding villains in their life to blame for their outcomes, you just don't know. And unfortunately, Ethan Watters (50:50.869) you know, the therapist is slightly disincentivized to be the therapist that says, you're doing all right. I don't think we can end here. You know, like, I think you're pretty resilient. There is an economic disincentive to do that, to keep a kid coming back and to develop a narrative of illness or victimization. And... I think there's beginning to be a backlash, you know, in our culture around that idea of this is the thing every kid needs to do. Every kid of a certain economic status needs to, you know, have a therapist on the team along with their SAT coach, know, their soccer coach, you know, private school. I think maybe that's not the thing. you know, maybe that's not the best thing for the next generation to go through. Roger K. McFillin, Psy.D., ABPP (51:53.73) Have you read Abigail Schreier's book, Bad Therapy? Ethan Watters (51:56.777) Yes, well, I've read some of Abigail's work. know her quite well. I think I'm referenced in that book. Yeah, that's the argument that this is problematic. And yeah, her podcast is quite interesting as well. Roger K. McFillin, Psy.D., ABPP (52:14.894) Yeah, I think what's great about your book is that it allows us to take a hard look at our cultural assumptions by examining, you know, what happens when we try to apply them to other cultures. And so now we can really take a hard look at the way we cope about the way we think about this. And so taking a step back, you know, reflection now, 15 years after the publication of this and your own kind of growth in life experience. And I know you're not a, you're not a mental health professional. You're a writer, you're an investigative journalist. So, with what you know, and you had to kind of create a system and, know, culturally these things become systems. how would you begin to talk about, you know, mental health and the way to approach it, in a way that youth believe would enhance our, enhance our outcomes and, know, improve the next generations. resilience and way of dealing with the inevitable struggles that we'll all face throughout the course of our lives. Ethan Watters (53:19.957) Yeah, that is a really good question. It's one that's been asked of me at the time I wrote the book. I was married to a psychiatrist and she dealt with women who had anorexia and she's like, okay, so it's different in other cultures and it's culturally influenced and now what? Like what do I do here? And I think there are small lessons that are pretty clear. One of them is that I think that what you could say about critical incident debriefing. that put people in a room together to relive their traumas is not a great idea. That might also be true for households of having all the anorexic girls all share the same group. So there's little lessons to learn. I mean, the fundamental point of the book is that culture, we swim in culture. It's around us all the time. It's influencing our unconscious in terms of how we pick our symptoms. when we have distress. speak the language of suffering only, it's only understood in our time and place. And that is a hard thing to... Ethan Watters (54:31.317) Hang on one second. Roger K. McFillin, Psy.D., ABPP (54:33.558) Yeah, don't worry about it. We'll edit all this out. Ethan Watters (54:42.761) Never, you know, it's funny you just have devices all around you that you just don't even realize until you're on a podcast. And it's like how noisy you've made your own life. Yeah, so the lesson of the book is hard to apply because the fundamental case it makes is that culture influences us. So the question is, how do you change culture, which is not an easy question. I mean, It is certainly not the case that once we understand it, things are culturally influences that they can magically go away or they can magically disappear. I think one lesson that really needs to be learned is it seems like every generation of mental health professionals buy into some certainty. you can look back and see. you know, in terms of a cure, like there was the recover memory fad, was, you know, there was lobotomies, and there tends to be like one salient diagnosis, you know, per generation too. And I think for current psychiatrists and psychologists, it's the idea of trauma is that it was really in the ascendant. Maybe it's being replaced now by going back to notions of depression. But the certainties that the mental health profession has and the way it reacts to those and what it offers in terms of a treatment, it seems to me that generationally the profession has no memory. Like I asked people about the recovered memory movement. I just wrote a piece for the New York Times idea page about six months ago, I guess, about re -looking at that. from the middle 90s and like, what did we learn? And you ask therapists today and they're like, what happened? Like they don't have an institutional memory of being swept away by a certainty and then doing damage and then they go on. mean, again, I think because Americans were very hopeful people, we tend to believe that we have arrived at the end of history and we're the first people to understand that X, Y, and Z happens. We're the first people to understand. Ethan Watters (56:59.851) that trauma can be from, infancy can be repressed and then remembered in crystalline form at 35. Like we're the first people to discover that. So I think a little humility on the part of the mental health profession to understand the mistakes of the past and to understand how influential people like you are in cultural thinking about this stuff. So. I'm not saying you're doing anything wrong. think you seem to approach this with a great deal of humility and a broad understanding that you're not promoting one way out or one medical device. You're thinking about this broadly. So I think that you're a good influence in this culture, but I don't see that across the profession. There tends to be these certainties that come up, and they tend to pull patients along. Patients are uniquely susceptible to the narratives offered when they go into therapy because they're in therapy for a reason, they're looking for meaning in their life. The therapist says, maybe it's this diagnosis, maybe we should look at your memories, maybe it's, know, like patients can really be swept away. And I think if the profession understood that, both on a patient level and on a cultural level, when you go out and create podcasts or, you know, when a journalist calls and wants to talk about the new disorder, You have to be careful about how you're presenting it because you can be part of creating a wave that sweeps people away. Roger K. McFillin, Psy.D., ABPP (58:35.072) Yeah, so well said and so important. mean, I'm certainly exposed to the degree of arrogance that exists in my general field and the allure of trying to present yourself with expertise, right? We have this expert culture and I think we've all been raised on expert culture in the United States. You're exposed to it on popular television and media. They're always throwing an expert at us about how to live our lives. And so we're kind of mass conditioned in the way to do that. One of the important takeaways, I think, Ethan Watters (58:46.697) Yeah. Roger K. McFillin, Psy.D., ABPP (59:04.428) from your book and I try to approach my life and my career with kind of communicating some of these concepts. One is that the expression of stress and suffering varies greatly. It varies greatly amongst cultures, amongst families, amongst individuals. The way that we categorize that, we try to neatly put it into certain boxes that fit our cultural narrative and our understanding of it. And so I'm really against that. categorical diagnostic way of thinking about the variability in which we respond to stress. And then the second one is how important it is to recognize that we are creators of our reality, that a consciousness is created, and how we think about something becomes our own unique reality. But the one thing I love about being a psychologist is I never get to meet anybody twice, you know, every situation is new. And it's what I love about human beings is each experience in which they have had in their life is unique. can't be compared to anywhere else. Yes, there's a certain culture in which we all, you know, we all live in, but your experiences in this world differ and they differ greatly and there's no one like you. And so to be able to help anybody is to hear their story and to see what they need. With a lot of humility. And being careful not to intervene in a way that creates harm. And that's the problem. I mean, that's the problem that exists in Western medicine. It exists in the mental health industry is that we're often intervening in ways that we don't have to intervene. We're intervening in ways that actually do create harm under the kind of the disguise that there's scientific support that it's universally helpful. Nothing is universally helpful really. When you think about it, you step back as you know, what might create a state of health in one person can, you know, create sickness in the other. We even see that with our dietary guidelines and the different responses people have to various foods and so forth. You know, but for us in a way that we should start to think about what it means to be a human being is that one of the skills you have to cultivate Roger K. McFillin, Psy.D., ABPP (01:01:25.994) if you're going to either be a medical professional or a psychologist like me is you have to have the ability to be able to observe your own experience, observe what your mind is doing, how your mind is categorizing it and have a little space between your reaction to it. notice knowing that just like your mind creates a reality, so does theirs and You made a great point that when someone is vulnerable and someone is in a stressful condition, they are susceptible. They're susceptible to brainwashing. They're susceptible to creating a reality. And a therapist, a doctor, and a patient, you put those two people in a room, they can create a reality around what is happening. Now the question is, does that new reality serve them in a way that allows them to live more fully and heal? and create a life of purpose and value? Or are you creating a reality that ultimately holds them back? The mind itself is limiting, very self -limiting. And so are you creating an idea, a notion that like would restrict or limit your ability to kind of express yourself and recover and grow? That's the questions we have to ask ourselves. And when we reduce the human experience to a symptom checklist, for example, then what we're doing is we're measuring our outcomes by the reduction of certain experiences, not on how one creates a life, one that is fully connected to everyone around them, where they're functional and they can be independent when need be and so forth. Like the way we even measure the outcomes is ineffective and wrong. And it just serves an industry. It just serves that idea. Like people don't understand how self -serving it is. If I want to create research study to support exactly what I want to have happen. I can easily do that, you know, and the general public doesn't necessarily see it that way. We see things that are published in a journal, we look at the abstract and the conclusions of the author, and we assume that scientific validity around it. We don't understand at all really that we can that how easy it is to construct a research trial in any way to give us the exact results that we're looking for. That's the degree of bias that that exists. Ethan Watters (01:03:45.897) Right, right. Yeah, I think, you know. you know, a lot of patient outcomes are, you know, the creation of an identity as a patient and as, you know, mentally ill individual. And that can't, you know, that can't be the right outcome. I don't know, and it's not just the mental health profession that sort of motivates this. It's, know, it's the journalists that write about the new condition, you know, kids are cutting these days. Let's, you know, put it on, you know, all the, you know, papers, kids are, there's this, you the new one is, you know, the Tourette's like symptoms that teenagers are expressing. Are you watching this trend at all? Like, which seems, yeah, it's a social division, but for the kids experiencing it, you know, and this is the really tricky thing. You know, even if a kid began by mimicking it, it's very clear to me that some kids get to the point where this is a... Roger K. McFillin, Psy.D., ABPP (01:04:28.312) like a social contagion effect that can be. Ethan Watters (01:04:44.703) this is unwanted and uncontrollable behavior. So it begins as a social contagion and it takes over and suddenly you have a, you know, the generational thing happening largely through TikTok, I think, where kids are going on there and displaying their behaviors. And that's true with, you know, the multiple personality disorder, dissociative identity disorders, making a comeback, you know, by people, you know, mimicking people. you know, on TikTok. And again, it is, it's really hard for the Western mind to understand that something can rise from a cultural expectation and a mirroring and become uncontrollable and become something that's really, you know, impossible for the person themselves to turn off, even though it came from culture, even though it came from imitating behavior. But these, you know, it's very, you culture is very powerful and you know, the mental health profession drives it in terms of what symptoms are in a given period of time are accepted as real. The journalists who write about mental health, you know, the portrayals in movies, you know, of like the multiple personality thing really got going when, you know, after what was the movie, Sybil, you know, came on. So very, you know, engaging idea of a mental health display. goes from popular culture and through the medical system. And suddenly you have dissociative disorder units popping up across the nation. And then 15 years later, they're gone. And the diagnosis goes back to being this exceedingly rare condition. And then social media is coming back. So there's an ebb and flow of these things. And again, knowing that, you know, for a patient knowing that, for someone experiencing something, one of these symptoms or one of these behaviors, knowing that to be true is, it's really hard to get from there to like, and now I can employ that idea. But I think we can all... Ethan Watters (01:06:55.647) sort of take on the notion that, know, stories we tell ourselves about our behavior and our mind are various, you know, and people are gonna come along and tell you and offer you a story about why you are the way you are. And maybe they're, they have your best, maybe they have the best intentions, but we have some choice in the matter as to whether we take on that story or whether we pick another story or whether we just. try to fill our lives with a lot of different possible stories about behavior and therefore having this larger quiver of ideas we can draw from when we go through something like an illness or a sadness or even a darker mental health crisis. So think there's some within the idea that culture is really kind of paramount in this area. There's still some element of choice that we have of of whether we take on the story or we look for another one. Roger K. McFillin, Psy.D., ABPP (01:07:58.094) You remind me of an article I wrote on Substack. I think I titled it, Are You Talking to a Therapist? And it was inspired by working with a client who lost their baby, went through a miscarriage later in pregnancy. And instead of, you know, those close friends, that close community, family kind of rallying around or supporting her, the statement that was made, are you talking to a therapist? Right? So what that communicates to her is that somehow maybe her reactions are unacceptable to others. They can't tolerate her grief. The only way to deal with the grief is to go see a professional and then once you see the professional, then you're entering into those ideas that those labels that are created, you're experiencing this disorder, whatever it may be. I think even the medical establishment is trying to medicalize grief. Ethan Watters (01:08:35.658) Yeah. Roger K. McFillin, Psy.D., ABPP (01:08:54.188) because you really can't develop a drug for, you know, problems of living, you develop a drug for a medical condition. And that's, you know, kind of what, what we do in American culture. And it's, I think it's, it's, it's harmed us. It's harmed us to like, to prop up that industry and say that's the only way to heal. Ethan Watters (01:09:18.571) I think you asked me how like in the last 15 years, what's come of it. I mean, one of the things that's come of it is I've sort of broadened out a little bit and done some magazine stories and pieces and thinking about, you know, if it's true that. that culture really influences mental health symptomology, that the question becomes like, okay, well, what else does culture influence? And there's some fascinating research, cross -cultural psychological studies about, what types of cognition are influenced by culture? And so these cross -cultural research have gone around the world taking things like our economic. tests about fairness, for instance, like what's fair, you know, or, you know, and they've taken them to other cultures to see if people react, you know, the way, you know, people in the West do because like something like 97 % of the psychological tests have been done on like sophomore undergraduates in the West. I mean, like, if you're gonna do a psychological test and you have this assumption that the brain is the same around the world, therefore that sort of the... the hardware must be the same. we don't really need to go around the world to make these tests because we have these sophomores in the class right now where we could test them. But it turns out with almost everything, so notions of fairness, the ways we categorize nature, even visual perception, it's vastly different from culture to culture. So and there's one culture that's kind of the weirdest culture. In fact, the guys that were doing the main focus of the research did this big survey paper on the behavior of brain sciences, which I highly recommend. They entitled the paper the weirdest people in the world. And you can guess weird is an acronym here for Western educated, industrialized, rich and democratic. Ethan Watters (01:11:25.717) the weirdest people in the world when it comes to looking at these outcomes and seeing who's at the edge of the bell curve in terms of all these psychological experiments we've done. It's people in the West. We're the outliers. We're the penguin among birds. so I think the takeaway here is not that culture affects only the mentally ill. It affects them particularly dramatically because when you're mentally ill or when you're going through a trauma, you're really susceptible. You're like a radio antenna for cultural messages about how to behave and what to think and what the story is. But we all are. And in the West, because we have this particularly Western notion of the mind, it's really separate from culture. Like we think of it as just in here. We tend to think of that that's impossible. We don't think like culture, we think like just ourselves. So I think there's a lot of interesting stuff coming out about how culture affects us all. And I'm trying to remember the name of the book that I would recommend on this topic. And maybe I will by the end of this. Or maybe if I don't know if you have show notes in the podcast, I can recommend the research that I'm referring to. Because I think it's fascinating. It's really changed the way I think about how my mind works. Ethan Watters (01:12:53.661) and how adaptable the human brain is. The human brain is the same around the world, but I think its value is not that it's super smart. Like that's not the key thing about our brain. The key thing about the human brain, I think, is its ability to like let culture do the dance. We learn from culture, we're mimicking culture all the time. And so we behave in these sort of... functional group ways, we're not individually thinking about things. If you dropped any human in any environment without culture, they wouldn't survive for very long. You need all these ways of sort of integrating yourself into culture. And that is the thing that the human mind is good at, not necessarily being the most, thinking things through on our own, the way we think of it in the West. Roger K. McFillin, Psy.D., ABPP (01:13:44.398) Yeah, culture creates rules and you follow those rules and it's kind of like a roadmap of living. if you accept those rules without any critical thought or analysis or challenge, you certainly could be walking yourself down a road where you're creating harm for yourself or others. When you were talking, I was kind of thinking about our cultural viewpoint of health. mean, in the United States, 66 % of the country now, I think is obese. know, dealing with a large degree of our population with chronic illness. I mean, we've normalized sickness in our culture. mean, even when you think about, you know, like men will carry body fat in their waist and their gut. you know, there just becomes this normalization of that as you get to middle age. Like that's the way it's supposed to be. But people don't understand how that's just culturally conditioned. there are industries that benefit from your sickness. If you like to drink beer, you're gonna develop a beer gut. Certainly the alcohol industry wants you to continue to be able to drink as often as you want and create enough situations that allow you to drink. And so you think about the whole year, I mean, you can certainly find a weekend or days throughout every week to celebrate something, from football season to... Cinco de Mayo to July 4th and you know, I've realized that for myself like if you're gonna be a social being in this culture And how alcohol is normalized in so many aspects of it You can find yourself drinking quite often because that's how normalized it is and then we've normalized taking pills We've normalized going to the doctors. We've normalized sickness to such an extent that it just dominates our cultural consciousness in so many different ways so we We poison ourselves with ideas, we poison ourselves with food, we poison ourselves with alcohol, we poison ourselves in all these different ways. And we normally go into the doctor to try to somehow restore our health, which they don't. They just manage that sickness. And it's just a large scale industry that's been propped up. Ethan Watters (01:15:52.393) Yeah, no, I think you're right. And the normalization is made more problematic by the fact that in American culture, we're not great at understanding. Our understanding of the rest of the world is often, we often tend to be focused inward. I don't want to be too dismissive of American culture, but we're not great about understanding the ebb and flow of history. We're a new country still. Ethan Watters (01:16:23.46) We tend to be very hopeful. There's so many good, great things about us, but we, I don't think we have that perspective, that global perspective on, you know, other ways of living, other ways of thinking, other ways of worshiping and understanding, you know, both across history and across the planet that there are so many different ways of being. think. might be one of the ways to shake yourself out of that normalization of the cultural behavior that can make you sick. And that could be that could be drinking or eating or, or, you know, living a life of isolation, you know, you know, you know, not having, you know, falling away from kinship groups, there's all sorts of ways that in which we can make choices and we can learn from other cultures. It's not the easiest thing to just adopt another culture, to suddenly become a Buddhist because you want to be better at experiencing sadness that often doesn't really take, but we can have some understanding of it and appreciation of it. And I think in doing that, we can gain some measure of choice in terms of what we decide to normalize in our own life. Roger K. McFillin, Psy.D., ABPP (01:17:41.838) Yeah, that's a really good point. Well, I kept you long enough. Since it has been 15 years since the book has been out, about 14 years, can you let us know about the book title again, where it can be purchased, and if there's any other work you're doing, how can they be exposed to what you are doing? Ethan Watters (01:18:02.404) So it's, the book is crazy like us, The Globalization of the American Psyche. It is had a really nice half -life. You've mentioned you're going to potentially put it into your syllabus when you teach. I'd love to, if there's a chance to talk to your students, I'd love to do that. So it has this, it's on, it's I think 19th printing now. So it's become a little bit of a standard in certain anthropology classes and cross -cultural psychiatry world. So it is still available in the new print form on your various ways you can get the new order books on the web. Thank you, Amazon. And yeah, now I'm currently working on a project that's going to take a while, but. which is a little bit unrelated, it's, you know, this, it's sort of pondering the ways in which the artificial intelligence is going to advance scientific research. So I'm a little bit onto a different topic, but I do hope to get back. I think the things going on with this generation of young people, I have three teenagers and, the world that they're living in in terms of social media, in terms of these conceptions we talked about, about therapy and therapy culture, it's really salient. I'm here in San Francisco and the world that they're living in is... It's really interesting and it really crosses paths with these notions of like how the mental health field can impact a generation. And it's a difficult thing to write about that as a dad in real time because it's important that you maintain your status as a father first, but at some point maybe I'll get back to writing about that from a personal perspective because I know a lot of parents are struggling with these ideas and... Ethan Watters (01:20:11.611) It is a it's an interesting and somewhat terrifying time to be a parent. My kids are doing great, by the way. They're awesome. Yeah. Roger K. McFillin, Psy.D., ABPP (01:20:16.878) Sure is. Yeah, sure is. Good. I want to give credit for how I actually came across your work. It was from Brooke Seam, who is the author of May Cause Side Effects. And she was on my podcast and she has a sub stack as well. And she created a list of like 10 must read books on mental health. And that's how I was exposed to your book. And I was like, wow. This is interesting. This is, we need to be talking about these concepts more. I, you know, as soon as I saw that and got your book, I tried to find you and see where I can get you on. Ethan Watters (01:20:57.451) thank you. Yeah, I've you know, I've gotten to talk about this book for 15 years now and travel, travel the world. There's been it's been printed in eight other languages and I've got to go to Australia and Germany and the UK to talk about it. And it always engenders a conversation like we've had, which is just an enjoyable exploration of these ideas. And, you know, all credit also to the to the various academics and researchers who allowed me to follow them around the world and trusted me enough to let me into their, each of them had 10 to 20 years of work in the area of expertise in which I profiled them in. So what a great journey it was. And it's been a nice intellectual journey subsequently just to follow the ideas and to keep track of it and to have conversations with people like you. So I really appreciate it. I wish you the best with all of it. And again, if you'd like me to talk to your students as you read the book, that would be fun for me. always enjoy it. Roger K. McFillin, Psy.D., ABPP (01:22:02.854) That would be great. If the goal was to provoke and allow us to critically analyze and think and start really important conversations, well, your book certainly accomplished that goal. Ethan Watters (01:22:17.951) Yeah, was the goal. So thank you so much for that. Roger K. McFillin, Psy.D., ABPP (01:22:22.85) Yeah, so Ethan Waters, I want to thank you again for a radically genuine conversation. Ethan Watters (01:22:30.325) Thank you, Roger.