Latest / Radically Genuine / 89. Myths of Mental Illness w/ Chuck Ruby PhD: Part 2

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89. Myths of Mental Illness w/ Chuck Ruby PhD: Part 2 · Radically Genuine

• I'm gonna get into the complexity of human experiences, consciousness and culture. So I'm gonna tell you a personal story. About a month before the pandemic, I'm gonna say the entire month of February, 2020. I'm gonna say it was probably about a total somewhere of four to six weeks. Now I get into my car multiple times a day, drive to work, pick my... son up from wrestling practice, drive here, drive there. Every single time I got into my car and put on the radio, Billy Joel's song came on. Every single time for about four to six weeks. Now, there's a personal story behind this, Chuck. Shawn and I, our father died suddenly of a heart attack on his 50th birthday. All he did was listen to Billy Joel. He was kind of like the soundtrack of our lives. And every time he went into the car, he just listened to Billy Joel. So all I did was hear Billy Joel. OK, now the odd thing about this, it's not like I had the Billy Joel channel on Sirius XM, and that's why it popped on the radio. Right. I would go into my car after I realized the phenomenon that this is statistically almost impossible for this to happen. And I would just switch up the radio stations to make sure. that there's no way Billy Joel is gonna come on this station. Like, he's not played on 90s grunge rock, right? This doesn't happen. And Billy Joel would come on the radio, four to six weeks. So I ended up having the belief that my father was present, was communicating with me. And then I spoke with a professional medium who reinforced that idea without me even telling. Right? So I go and see a medium, I keep my mouth shut. I'm a skeptic, I'm a scientist. I don't say a damn thing. Keep my mouth shut. And this person then tells me that, your father's talking to you through Billy Joe's songs on the radio. Okay? I got no reasonable way to explain this from the manner in which we understand human consciousness right now. Right? Nothing about my training as a psychologist would inform me that what just happened makes any sense. Okay? I go say that to a psychiatrist. My dad father's talking to me, right? How are they going to view that? Chuck Ruby: delusional, hallucination. Yeah, no doubt. I'm sure there's gotta be some psychiatrists out there that wouldn't say that. They would say, oh, tell me more about that. And they would respect it. And they would try to find, if there is, if there was a way to do this, is to find the meaning of that to you. But at the least, just respect it, that that has happened to you. You've experienced that. and you may never find out why or how that occurred. The more important thing I think is how does that affect you and what does it mean to you and what do you do about it? That's the key and all the things we bring to a specialist, a mental health specialist, that's what can be done is tell me more. Let's explore this thing if you want. And let's see what this does to you in your life. And where do we go from here? Where do you go from here? I think that I had a case of a person who was, during COVID, very concerned about some of the questions about the reality of COVID and things like that. And it wouldn't be a matter for me to disagree. Even if I disagreed, I would say, well, what are we going to do about this? What are you going to do about this? How does this affect you? Can you do anything about it? Many situations, including your experience perhaps, you'll never find out. So we're left with this awful uncertainty feeling about, God, how did that happen? And we're always left with that. And that element of uncertainty is always there in our life. There's that, look at a pie chart. There's like, I don't know what, we don't even know how much uncertainty there's there. Is it 90% or is it 10%? We know it's always there. We can't know for sure anything. There's always an element of, I don't know. And it's, but it's impactful. It's meaningful to me, but you're right. If you went to see our conventional psychiatrist, they would be, oh my gosh, let's see, Abilify, Alexa Pro, how about Syracwap? Sean: Yeah, and although they speak to this idea that for it to be a diagnosable, it must have some impairment in functioning. That idea in itself is so arbitrary, right? If I'm distressed about it or it's affecting me in some way, they have this power to be able to arbitrarily decide what is impairment based on the limitations of their own existence. So That's the trouble with all this is when there's no medical science to actually support one's diagnosis. It's left up to the opinion of the individual. And people have many different viewpoints on things. And we are creators of our own reality. So that is what ultimately how I grew from this entire experience is I was able to read things that are outside my... areas of understanding. There's fields of quantum physics and energy and human consciousness that would suggest that there are various planes of experience that people can tap into. And so why would my own limited and restricted way of viewing the world, how do I have the power to then interfere with another person's ability to think about the world in a manner in which they want to? And for me Chuck Ruby: Mm-hmm. Sean: to diagnose that as normal or abnormal. Now the possibility exists that the way in which they do think about the world creates problems for themselves. And then my job is to be able to assist them in to be able to adapt no matter what is happening internally. And so I think when we start exploring the conversation from different perspectives, we're first saying to people is be very wary. of the conceptualization of mental illness in American culture because it can walk you down a path that constructs your reality for you and changes the way that you then interpret all sensory information. It is that complicated. That's why I think the pharmaceutical industry is brilliant because they're aware of this. The reason they spend more money on marketing than they do in research is they know... that if they can get people to interpret their own internal experiences, their own emotional states as an illness, as something is broken within them, there is a butterfly effect to that in the way the changes that they interpret all sensory information and experience in this level of consciousness. Therefore, their recourse is to have to alter that experience. because there is something wrong with them. That is powerful because that increases their customer base. Chuck Ruby: Absolutely. Sean: I'm going to bring something up here because I'm thinking maybe how can we make that connection towards other things? And I've been thinking, and you brought up sensory, Roger. And the idea of your five senses, you have your taste, your sight, your hearing, those can evolve over time. You can train yourself like a Somali, a can train themselves to taste nuance and flavors and enhance, you can hear, you can lose your sight and your hearing can be more profound. You can, you can build more ability to, to hear things. When my son was born, we met with a nutritionist and that nutritionist said to us, like your son's brain at this age does not know what tastes good. And what tastes bad. So you can train your son to eat vegetables, even those bitter ones. Put it in front of your son, put it in his mouth, get him to eat those, and you'll reap the benefits for years to come. So we did. Like my wife was very, very diligent about, you know, cooking these vegetables, blending them, and then putting it in our son's mouth. And even now, he's still young. So we'll see how this plays out over the next couple of years, but. He's a very good eater. He'll eat avocado, he eats eggs, he eats vegetables. We kept those sweets out for well over a year because all kids are gonna love sweets, but his brain has been trained to enjoy the bitter vegetables. Now, when it comes to other cultures, what you think tastes really well is different from what the American diet is. So you might go to an Asian country and they may love a certain flavor, and for you, you're like, oh, there's no way I can't eat that. Chuck Ruby: Mm-hmm. Sean: Is it possible like other cultures how they view stress and these moments that are kind of anxiety producing In a different way than the way we do that is making us more debilitated instead of it enhancing our lives What are your thoughts on that the both of you i'm curious? Chuck Ruby: Yeah, I agree with you. And I think we tend to say culture, and we think of large groupings of people, like the American culture or the Asian culture. We could even pick smaller groups, Northeastern United States culture versus Southwestern, for example. We look at large when we think culture, but I would argue that individuals have their own culture. So if you take any group of people and take all the individuals and whittle them down to a littler group of people who share some idea or value, you can whittle them down to even more fine tune shared value to you get to one person and one person is an individual and one person is that one person's own culture. So that's why it's important to understand people's problems through their eyes, not our eyes. That cultural thing does have a huge impact on what you just said, everything from food and the taste and what tastes good, what feels good, what's right, what's wrong, is all influenced by that. So I grew up in Western Pennsylvania, Pittsburgh Steelers, deer hunters, steel mills, men were men and women were women, right? And so just even with my extended family culture, there were certain things that were good. including what tastes good and things that were bad. But it wasn't just taste. It was what one does, what a guy does, what a boy does, what a man does. If I were to say I couldn't stand deer hunting, maybe, that may have been looked at kind of oddly. I do remember someone within the family who liked to read a lot was ridiculed. because they read a lot and they wasted time reading. Obviously they may have other obligations in their life, but still the idea was that reading was, there's something wrong with that. So yes, cultural influences set up our implicit assumptions about what's valuable and what we do, what we don't do. Is it okay to hear a voice, for example? Is it okay to hear someone talking to, but you can't see that person? Some cultures would say, there's no problem with that. Others would say, oh my God, get V to a doctor. We talk about these cultural influences within the mental health field. And we say things like, if it's culturally approved, it's not a mental disorder. But what does that mean? If it's, Sean: Hm. Yeah. What does Chuck Ruby: diabetes Sean: that mean? Chuck Ruby: is diabetes, no matter what culture you're in. But... The more important question is which culture has to approve it? Right? So is it, is it American culture? Are they talking about, are they talking about Western Pennsylvania culture? Are they talking about, um, I don't know, this culture within Scientology or the culture within other groupings of people. And if you think about it, if what I said is true, that every individual is a separate culture, that means nothing is a mental disorder. Because it's accepted by the person who's experiencing it. I don't know how else you would argue that. But this cultural exclusion kind of a thing is odd, very odd. Sean: Mm hmm. We have this ADHD boom that exists. And this is, to me, this is criminal that you'll have some maybe precocious young kid who's very active and exploratory and their mind is always like seeking adventure and has a hard time being able to focus in very restricted environments where they don't find it interesting or that novel, right? Even if they just are daydreaming and maybe they're creative. And for another person then to designate that as an illness because they actually could be a gift, right? If you're saying you don't fit into this norm, in this norm you are supposed to sit in this classroom, you're supposed to sit in this chair, you're not supposed to move, you're supposed to listen, you're supposed to focus, you're supposed to be able to read and if you don't, you're disordered. So now that conceptualization of that individual becomes part of their reality. That affects then how they interpret themselves and their actions amongst others. So it's my belief that the, that the conceptualization creates mental health problems. It's ironic, right? But the exact idea of it is harmful, in my opinion, that you could change for the better if you altered the way that a person viewed their own experience. And we did this on the last podcast. If I created a book, and I might create this book, depression is a gift, right? We just altered our understanding of what depression is. That our emotions are valid and adaptive and they're used to enhance our lives. Once we experience them, we can make the appropriate changes to drive our own growth. And if you had gratitude for that struggle because that struggle is necessary for success, that changes everything. Just Chuck Ruby: Mm-hmm. Sean: like the idea of thinking about it as an illness changes everything. Chuck Ruby: Yeah, I mean, you know, in my book, in the second part of the book, I try to give my ideas of where this is the alternative view as I see it. And I see it mostly as an that mental disorder, at least the problems. Again, it's hard talking about this without using the industry's language. But the problems that get labeled mental disorder, in my view, are because we're trying to escape those painful emotions in life. And So the emotion's not the problem, which as you're saying, that intends to spare about life or fear about something or shame about myself, those are not the problems. Those are actually pointing toward the solution. And traditional treatment tries to rid us of those emotions. So traditional treatment itself could ironically be called a mental disorder because it's trying to help us escape these. painful emotions that are so important to listen to and are laden with value. So I teach a real simple model, ABC model, to help people understand what these problems are that we are calling mental illness. A is just the context. It's like everything in your world up to this very point in time, everything about you, everything you know, all your values, everything, what's going on in politics, everything. B is how you feel about that. B is the emotion. So you might feel disturbed or you might feel frightened or whatever it is. So far we have no problem. We have pain, but we have no problem. We have an emotional reaction to a context and that emotion has meaning in it. And if we try to ignore it, we're gonna not know what's going on fully. But that emotion is what the industry tries to dampen. And then we also try to dampen it either with C, which becomes drinking or staying in bed or in extreme cases, considering an alternative reality that makes better sense or is more valuable sounding than my current reality I see. That's where the problem can rest is in C, is what we do about what we feel given the context. And we can't change the context right away. We can work toward that over time, but we're always gonna be stuck with distress about the context in our life. I can't get rid of baby birds nesting in my bushes and this is going to happen. It's what I do about the emotional reaction I have to difficulties with that. That's the key. And that's what we can help people with. What do you do? Sean: Absolutely. That's so brilliantly stated. And let's go back to my Billy Joel situation. Right? I can now, meaning making, right? That is, that's part of this. Well, maybe I didn't really hear Billy Joel. Maybe I made that all up. Maybe it was some, you know, hallucination, delusion idea that I'm hearing this. Like, maybe I was getting sick. Maybe it's the beginnings of schizophrenia. Or, hmm, a lot of people believe in God. There's something about human beings who have a spiritual connection to a creator. Various Chuck Ruby: Mm-hmm. Sean: religions, but a lot of people on this earth believe in spiritual connections. What if I just viewed it differently? That our life is time limited? We... We live, we die, but our soul continues to evolve. Maybe there's reincarnation, maybe there's heaven, maybe there's other dimensions, who knows? But there's an eternal soul. And we are connected to guides and spirits and those who've come around us. And I'm just a little bit more connected to the universe now and spirituality, and I just felt closer to my own father and that there's a purpose to my life. And this allowed me to explore other perspectives and I'm better for it. Imagine the same event happens, how you make meaning of it takes you in two different trajectories in your own life. And then the thing that concerns me is who you say it to, that matters. Chuck Ruby: Exactly. Sean: If I talk about it to a psychologist or a medium or clergy member, then there's one viewpoint of it. If I talk to a psychiatrist, an atheist, another medical professional, maybe it's another perspective. So I just... Say it on the podcast, I say it to everybody, right? So you spoke about fear before, and fear prevents a lot. It prevents us from stepping outside of that narrative because we're afraid of retribution. We're afraid of being called crazy, we're afraid of losing our license, we're afraid of losing clients, everything that we cling to safety wise, money, everything, the way we view the world. Fear prevents us from living our life as ethically and honestly possible. Right? So we have to somehow find a way to overcome fear, not just us, not me on the podcast, not just you, Chuck, but every client that comes in and sees us, that role of fear so profoundly powerful in how it influences our lives. And if we are going to live fully in freedom, we have to transcend that we have to transcend fear to live in according to our values to experience what we want to experience. And my problem in the mental health field is fear controls too much because we got restricted. There's a lot of people like us, Chuck, I believe. There's a Chuck Ruby: All Sean: lot Chuck Ruby: right. Sean: of people who think like us, they're afraid to say it out loud, they're afraid to talk about it. They just don't want to get out of their lane. They're too fear driven. So the therapist, they just make their referral to the psychiatrist because that's what they were told to do. And they're afraid to do something that the rule didn't tell them to do. Chuck Ruby: Yeah, by the way, I would tweak, I agree with you. I would tweak what you said about fear. I don't think fear or sadness or shame or any emotion prevents anything or dictates anything. I try to spend some time in the book about this idea about individual choice, about mental disability, so-called mental disability, insanity and things like that. My view is that B. That's where the fear lies when the ABC model B. Yes, it's fear, it's painful, but it's not dictating. What it's doing is providing rationale for taking some action. So I am very much against, and I don't know if you saw my Mad in America essays, the two essays I wrote a year or so ago, got some very strong negative reaction when I was talking about mental disability as also a myth. It's not a disability, nothing's preventing or dictating. Now, I wanna have compassion for people who are struggling and in that sense, try to help them, but by calling it a disability, meaning, My fear prevents me from doing something. We're creating a dependency system where we're also, I think, being dishonest about what's actually going on here. Because if it prevents you, then how are we ever going to change? How are you ever going to, if it's dictating something, just like if depression dictates you to stay in bed, how are you ever going to, I can't change the fact, if that were true, that it does prevent. You know, I can't talk you out of diabetes. You have to do things. to get out of that problem. So again, to me, B, the emotions in life, even the very, very, very painful ones. And I recognize, by the way, sometimes some emotions are so intense and startling that it does prevent at least immediate action, but follow-on action is possible. It's just damn difficult. I mean, it's frightening as hell. It requires a lot of digging down deep within. it might actually cause a lot of disruptions in your life too. So for instance, if an alcoholic stops drinking, as difficult as that is to do, they have the ability to stop. It's just really, really difficult. And they very often get negative reaction from their family when they stop, because now they're sober. Now they have to be interacted with as a sober person. So on their part, it's hard to interact sober. And on the family's part, it's hard to see dad now sober and to take them seriously. So there's negative consequences to these positive changes that over time can be enhancing for people's lives. So again, that part of my critique, I just like to accentuate it. I don't see the empiricism behind saying anything is forcing us to do something unless it's something like a physical thing. So if I can't see, I can't see. I'm not choosing not to see, for example. Sean: Right. Yeah. Chuck Ruby: But if I'm staying in bed because I am just so fed up with life, I have the ability to get out. It's just, we understand why they stay in bed. It's good rationale for staying in bed when you think your life is a waste. Sean: I want to go up to your point about this idea of what we can or cannot do. So, you know, disability, you know, if you are blind, you cannot see, right? That is truth. But in our system, we will have psychiatrists who will identify a young person as disabled with an anxiety disorder. Therefore, the school legally through either an IEP or some form of an a presentation in public. They can't do a presentation in their class because their anxiety prevents them from doing it. That is creating a reality in the person that tells them what they're incapable of doing that will do harm. And unless those ideas get challenged from mainstream psychology, and this is what's disappointing in my profession, is too many or so forth are so aligned with these other institutions around the greater mental health field that they'll support this idea of disability, either by not doing anything about it, even though we have these therapies, I'm board certified in behavioral and cognitive psychology, so I do exposure-based treatments, right? So fear is something that we lean into that we expose ourselves to. in order to be able to learn that it's a safe situation, that we can handle it. The best thing we can do for that young kid or teenager who's unwilling to do a presentation is to help them overcome that fear. It only becomes a disability. If you create it for them, you tell them they can't do something, they will not be able to do it. Chuck Ruby: And that's with every mental disorder category, ADHD, learning disability, you name it. Any one of those, unless you can demonstrate some kind of defect that's putting up a wall to do something, none of those things are truly disabling. The unfortunate part is there's no system in our culture. other than that one, other than the mental disability system to offer assistance to people. There is no other, there's no compassion system, which is kind of odd that we wouldn't have a, just a compassion system with, if you're having a struggle with something, a serious struggle that we have resources to, to provide to help you with that struggle, to help you through that struggle. We have to now even children in school, label you with some mental disorder in order to get accommodations. We can't just say you're having trouble, here's the accommodations, because the schools need some rationale for getting more funding for those accommodations. Sean: You know, I think there's an opportunity here, Dr. Ruby, you've been a psychologist for, you know, over 25 years, almost 30 years now. How Chuck Ruby: Yeah. Sean: has your Chuck Ruby: Thanks Sean: experience? Chuck Ruby: for making this possible. Sean: No, no, it's there's value here. And wisdom. So I'm curious, how has how have you observed that response to human emotions and experience evolve over this time? in the clinical setting with maybe with clients. Chuck Ruby: I'm not sure it has. Sean: Okay. Chuck Ruby: I'm not sure the mainstream has, in fact, it may have gotten worse. Well, maybe it has, Sean: I think Chuck Ruby: yeah, Sean: it's worse. Chuck Ruby: because Sean: I think Chuck Ruby: yeah, Sean: it's Chuck Ruby: with Sean: worse. Chuck Ruby: the DSM-5, well, with 3, so I came in right after DSM-3, about 10 years after 3 was first written, and I trained on DSM-3R. So 4 and 4TR and 5 and 5TR have come out since then, and I think it's pretty clear. the trend has been toward increasing the fishing net, bringing more and more human suffering under the domain of the medical profession and seeing human suffering as illness to a greater degree than it was back then. I wonder sometimes what it would have been like before DSM-3, so before the sort of the biologically oriented defect symptom checklist model of DSM was created. It was back more in one and two with a more of a psychodynamic approach to things. I don't know what that would look like because I wasn't there. But yeah, I think it's gotten worse. It's just increased its power over people's lives. It's hard to say, to arrive at that conclusion though, because during that same time, I became increasingly involved in the critical. hydromania movement. So to me it sounds like we're gaining steam but maybe we're not. It's just a Sean: Yeah, Chuck Ruby: relative Sean: let me let me try rephrasing that question. So with the expansion of that diagnostic criteria, and we're using the words of illness, and the labels that we put on things and how it may influence our perceptions of ourselves and what we're capable or not capable of doing. With the broadening of that of those terms and that criteria, are we are you witnessing more people coming in, seeing those normal human experiences and emotions as debilitating instead of just something that has just been dealt with in the past. And you had the ability to go through that experience, maybe independently or without working with a psychiatrist or a psychologist to solve your problem, you just learned how and gain that skill. Are you witnessing like this turning towards psychiatry or psychology to solve your problem? More so. Chuck Ruby: Yeah, I mean, I think the big thing that that I notice is among younger groups of people buying into this almost like a badge of honor. So on TikTok, there are a lot of a lot of people who are, you know, I'm multiple personality, watch me switch. You know, this is my ADHD, this is my bipolar disorder, and there, I think The intention is good there. It's to, I think the message is take me seriously. Even though I have this problem, I want you to take me seriously. And this is consistent with the neurodiversity movement. I have some problems with how that's done, but the intention is great. It's to say, we aren't any different than you. We have our individuality and our individuality causes some problems for us. but don't ostracize us, don't hide us away in hospitals and drug us to death, take us seriously. What the problem I see is if you are gonna say that you have this thing that you have no control over, that's part of the stigma problem, that's part of the reason why others look upon that as something to control, especially the mainstream psychiatry people. So yeah, I think there's more of an acceptance of that idea. Sean: And I think you speak to the problem of the DSM and how it has morphed into something it was never intended to be. So the DSM is an absolute scientific nightmare, a fool's errand, wasted human capital and industry funds. This is from Steve Hyman, the former director of NIMH. physicians at the highest level of this government agencies in charge of NIMH can clearly identify that this is a scientific nightmare. We continue to have doctors communicating that these are discrete and legitimate medical illnesses. So how from a Diagnostic perspective, what do you suggest in the manner in which we begin to communicate these conditions? Because the DSM actually did start with kind of positive intention, kind of a shorthand to discuss some constructs and then be able to be involved in a system to get insurance reimbursement. But it's morphed away outside of that. What's our solution to being able to kind of communicate this to the greater public? Chuck Ruby: I think it relies on finding a different language. It's hard if we keep the same language. So for instance, if we keep using the term depression, if we keep using the term bipolar and anxiety, especially depression and anxiety, those are the two most commonly used kind of lay terms. They're really diagnostic terms. They're not terms that describe feelings. They're terms that describe a diagnostic idea. So what alternative to the DSM? Let's not diagnose. How's that? Let's just ignore that whole concept of diagnosing. I realize if we do this, by the way, we're gonna lose insurance coverage. If we get what we're asking for, Roger, we are going to get thrown out of the proper medical professional field, and we're not gonna be reimbursed for work we do with people. I just think that's a risk I'm willing to take. So let's not diagnose, let's talk to people about what's the problem. Cause they know what the problem is, we don't. They know what the problem is, they tell us. We just take what they tell us and we stick, plug it into the DSM and out pops a diagnostic label that tells us nothing about how to help them. It just tells us, makes a medical sounding word that we then can talk shorthand with people about. Instead of describing a person's problem, we can say they have bipolar disorder. instead of describing the meaningful nature of what's going on with that person. That takes a lot more time. It's not as quick. It's not efficient. And again, it won't get you insurance reimbursement. But I think that's the ultimate solution is that I know there are many attempts to come up with alternative diagnostic schemes. Those are a very bright, young. social worker, doctorate student at I think Colorado State University. His name is Arnaldo Cantu. And he just published in our journal in the Ethical Human Psychiatry and Psychology Journal, an article about this idea of diagnostic alternatives. And he has another one too that he published recently. I'm not sure where that came out in. He's looking for a way to categorize these problems. I'm not sure we need to categorize them other than for insurance reimbursement. And I think the act of categorizing is the problem. Sean: want to speak to some questions that I know people will have, because I've seen it on my Twitter account. Are you saying that there's no biological abnormality that could exist? Well, what if somebody has like a thyroid problem and they're really depressed? Are you denying the fact that there's biological bases to some of these psychiatric disorders? And the answer is no, absolutely not. That would be a medical condition that's observable, identifiable and treatable. And you would go see an endocrinologist. If you have mood related difficulties due to hormone changes or if there's changes in behavior due to an infection or even a brain tumor, then we already have established medical specialties to be able to identify that and to be able to intervene. That's not what psychiatry is. Psychiatry actually can interfere with that process because you actually misunderstand a presentation. And so that's very important for the people out there who might delegitimize kind of these conversations that we're having as if we're denying or minimizing something that is actually more serious and identifiable. Chuck Ruby: Yeah, and I want to repeat what I said at the outset. We're not saying these problems don't exist. They exist and they're big time problems. But you're right. We have medical professional specialties that handle endocrine problems. We have nutritionists. We have gastroenterologists. We have these other specialties that are hopefully, I'm wondering if this is changing within their field too, but hopefully mostly based in science and based on internal functioning of the body and when the body malfunctions, like in hypothyroidism or hyperthyroidism or illicit drug use, the body is malfunctioning. By the way, you prescribe a psychiatric drug, you're actually creating the chemical imbalance. It's not the drug is prescribed to correct the chemical imbalance, but drug use, illicit, prescribed, recreational, whatever. causes a malfunction in brain functioning, right? It causes a defect. We already have medical specialties to handle those things, neurology and so forth. When you take all that away and you properly identify those problems as true medical problems to be addressed by true medical specialists, what you have left is psychiatry sort of, it's what psychiatry is supposed to be dealing with, but it's... There's no body system involved in that stuff. If there were, it would, like you said, you don't go see a psychiatrist for hyperthyroidism. They can't do anything for you. Right? Sean: You brought up neurologists. And I have this image in my head of two brain scans. One being a healthy human brain scan, and one being that of someone who's suffering from what I would say is maybe the colors aren't as bright in one area and the neurologist is trying to show you or say this is what's wrong. Everything's not firing over here. Are you speaking about a functional? Yeah, explain that to me because do they make that connection to mental illness saying like there's something wrong with your brain? Chuck Ruby: Yes, that's the going thing. There's a lot of problems with functional magnetic resonance imaging scans to start with. The sensitivity of them have to be adjusted. So you could see activity that's not really there because you have it too sensitive. And you can miss activity that is there because it's less sensitive. The scans you see in journal articles. in the media many times are not scans of one person. They're average scans. So there are many people like overlaid, aggregated. It's showing true difference among these people. There's no doubt about that though. There is, there seems to be a signature difference in one's brain based on what you're doing at the time. But all that is showing is brain differences. And we already know that brains differ when you're doing different things. And if you live a life, if you have a chronic life of passivity, like we see in what's called depression, or a chronic life of hyperactivity, hyperthought, like we see in anxiety issues, it stands to reason that those brains are going to not only look different, but function differently than people who aren't in that kind of a chronic lifestyle. So what those studies show is something we already knew, that brains differ when you use them differently. But it's not just the case between so-called healthy brain and ADHD or healthy brain and PTSD, it's the case between liberally minded person and conservatively minded person. It's the same between a braille reader and a sighted reader. It's the same with if I'm watching a movie or listening to music. my brain's going to look different. That's, that is not a reasonable or logical way to argue that it's an illness or Sean: Yeah, Chuck Ruby: abnormal. Sean: I'll go back to that taste example of I love cilantro, but my mother thinks it tastes like soap. So you know, your perception or what you like or dislike, I would imagine the whole human experience, you could break everything down and look at how everything else responds differently based on, you know, what you dislike or how you respond to it. Yeah, we've so we've broken this up into two episodes. And so we're well into the second episode in we realize we're taking a lot of your time, but there's just a couple more topics that I'd like to get to if you're okay with time. Chuck Ruby: Sure. Sean: I thought, and you've kind of, you mentioned this earlier in the podcast, probably the first episode, and I'm interested in it because I thought you made an observation that I thought was fascinating. All too often, many industry professionals leave the role of helper. They cross the line and become coercive crusaders for optimal living, despite the person's best wishes. These are your quotes from your book, by the way. They think it's their business to correct unhealthy ways of being, but the observation that you made was kind of driven by their own discomfort of distress and deviations. Can you expand on that? Chuck Ruby: Sure. I think we all have felt discomfort around people. Just like I don't like Brussels sprouts and my wife loves Brussels sprouts. We all are individualized from that small level all the way up to I don't like a lot of crowds. I don't like being in a crowded place and somebody might like to be in a crowded place. I don't like being patient. Somebody else might like being patient. We are all different. So we have our own individual personal, not professional, but personal desires and preferences. And we've all, I think, encountered people that make us uncomfortable. I know I have, and I don't mean just in my work, but in my personal life. There are some people I feel uncomfortable around. And so I look into that and wonder what's going on there. And if... If it seems appropriate to me, I just avoid the person, right? I think that the mental health industry is set up that way. And it was set up that way at the very beginning. Somebody in authority said, that's uncomfortable. I don't like that over there. I don't like the way that person's doing that. It makes me uncomfortable. Something must be wrong with it. It's always based on that. This is that moral crusade part. I make a moral judgment that that's wrong. Why is, why do I say it's wrong? Cause I don't like it. What's morality based on? It's all based on someone's preference about something, right? It's not really based on some moral code, like a religious code or some other moral code, like the APA code, because ultimately even we have a code like this of morality. We choose what parts to take, what parts resonate with us. We don't just take it all. We choose. So we choose as professionals in the mental health industry what things are uncomfortable and what things aren't. And we designate them wrong with a diagnosis. That's what I was getting at, that I think most of it is driven by the personal preference of the practitioner and how uncomfortable they are with something. Just as an example, recently I was talking with one of my supervisees about cultural differences regarding family cohesion. So in an Asian culture, for example, family is important and it's commonplace and expected to include family in one's life, to include what they want you to do, what you want to respect them, you want to take advantage of their wisdom. and it has a huge impact on individual choice. In a Western culture, that's not as much. There's more individuality in a Western culture. So this leads to the question about enmeshment. As a professional, what do we consider when a parent is enmeshed with a child and the boundary issues? Culturally, in some cases, it's, I hate saying this, because I don't know how to define it, but normal. It's not considered a bad thing. It's not considered an off-putting thing. It's not something I'm uncomfortable with. In other places, I'm uncomfortable as a professional with it. It seems yucky. Your mother's always making decisions for you. That drives professionals' decision about, is this, and it comes down to it, right or wrong. It's a moral choice. Is it right or wrong? Therefore, will I diagnose it? Will I at least intervene there and say, well, I think that your enmeshment with your mother is part of the problem. So that's an example of what I'm talking about. The discomfort that we have, and it's a personal discomfort, it is not a professional discomfort. Sean: Well said. Final question. I want to learn more about the International Society for Ethical Psychology and Psychiatry. Just kind of the the mission behind it, some of the work that you're doing and how can we promote this organization? Chuck Ruby: website is www.psychintegrity.org. If you forget that, you can also get there by www.isepp.com. Long standing organization created in the 1970s by Peter Bregan. Those of you, are you familiar with the name? Peter is a psychiatrist. At that time he was in Bethesda, Maryland and he did the same thing. He came to understand some of the things he was doing as harmful to people, potentially harmful, if he complied with the mainstream, still called, standard of care. So he gathered up a group of professionals and people with lived experience. I think just to demonstrate that the convention isn't the only way to do this and that an alternative way has reason, has scientific validity to it. is serious. It's not just some grumblings of, you know, a marginalized few. So he started this group back then. It was called, I think at the time, the Center for the Study of Psychiatry. The name has morphed over the years to the International Society for Ethical Psychology and Psychiatry. It's always remained a small group of professionals and so-called survivors of psychiatric, the psychiatric system. Initially, it was focused on professionals, though. It was to gather up people like you and I that are in this business. And we want to band together just for support, if nothing else. But again, to show that these critiques we have are serious, well-thought-out, valid critiques. And to try to get a discussion going, internationally now about these questions. And this is one example of how we're trying to spread this discussion. And why I appreciate you have me on your podcast is to get people to hear this, to hear this alternative view, especially professionals, so they can come join us. And if we get professionals within the system, to agree and to understand this, we can change the system better that way, change from within, like I said, from bottom up, than to try to change it from the top down. So we've always, again, been a relatively small organization for understandable reasons. We've had members who had been fired from their jobs because they are public about their concerns, unfortunately. We have a peer-reviewed journal that we currently publish twice a year. And if there are any professionals who are listening to this, I encourage you to try to submit articles. We just published the spring edition, and we'll be working on the fall edition soon here. You can submit articles through our website at the top. link bar, it gives you a, you can click on it, it tells you how to submit articles. So that's what we are. And we have struggled for since that time, what, 50 years here, in trying to keep this conversation going. One of the problems with it, by the way, Bregan was one of Thomas Sase's protegees. And so Sase's ideas had a big influence on the development of this group. And Saez has always been an ally of ours up until his death in 2012. He, you know, he supported us, we supported him. And it, his book, The Myth of Mental Illness is kind of like a starting point, I think, for this whole movement, the biggest starting point. I know there were other professionals and academics before that. But the popular view of it was really started by Thomas Saez, I think. And so I would encourage people to join. I appreciate you joining. I sent you a thank you this morning when I saw that. And I would encourage you to be active within our group, you know, to give us your ideas and just to be active. It's hard because we are such a small group. Sean: It's encouraging because I think the science is actually, you know, reflecting a lot of these ideas. I mean, you know, in time, the totality of science becomes more and more public. And that's the great thing about going on this podcast is I'm able to clearly discuss peer-reviewed science from major journals who question a lot of the ideas and narratives that are promoted in mainstream American society that we do believe are. creating harm. These are not just theories or ideas that we're considering. We do believe in the empirical method and do believe the scientific process is designed to protect human welfare. And we think that open debate and analysis of research is very critical to that evolving process. And I think that allows for humility. Humility is absolutely necessary. You know, if you just think about what at one point in time human beings believed to be true and turns out not to be true, then we have humility about right now where we are, what we think to be true turns out not to be true. And we have to protect people that they don't receive harmful interventions or adhere to ideas that ultimately are going to impair their own quality of life because those ideas are promoted as truth when they are not. And that is an ethical imperative. And That was the spirit, I think, of today's discussion. I think it's the spirit of Dr. Ruby's book in a lot of ways. It's a reasonable argument against a lot of the ideas that are promoted. And it's well, well written, well researched, and it's an easy read. And what I mean by that, it is not a, it is not a book that's designed to be absorbed by just the scholar or the academic who's in the field. The lay person can read that and draw. some conclusions. And we have to get people to critically think and evaluate. That is freedom. That is the responsibility in a free society is to challenge authority. If we are going to be able to evolve as a culture, and it's the one thing about United States, United States is an experiment. It's an idea under government. And so there we have constitutional freedoms and rights. If we give up those freedoms, and we fail to participate in the system and challenge the ideas. then it is those with the most power that are going to assume more and more control of our lives. And make no mistake about it, the medical professional can assume that power and they do. And they do. Dr. Ruby, how can people get in touch with you if they want to learn more about you by your book or check out some of the things you're involved in? Chuck Ruby: I already mentioned the International Society for Ethical Psychology and Psychiatry. I would encourage everyone to join. The more people we have, the more power we have. You can also go to my website. It's www.chuckruby.com. And you can read a little bit about me. And you can also, there's a link to my book there too. But you can also find the book on Amazon and Barnes & Nobles and all the other online outlets. And I would encourage you to. buy a copy and it's really not that expensive. Now I wrote this not for the money. Believe me, that's not how you make money is writing books, especially when you don't have a literary agent. But I wrote it to get this word out to the public. And so people can at least hear it and then make their own minds up about what they want to do about it. Sean: The book is titled Smoke and Mirrors, How You Are Being Fooled About Mental Illness and Insider's Warning to Consumers. Dr. Ruby, thank you for a radically genuine conversation. Chuck Ruby: You're welcome and I appreciate you having me on.