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142. Rogue Doctor Turned Poker Pro Overcomes Chronic Depression · Radically Genuine

• Roger K. McFillin, Psy.D., ABPP (00:01.23) Welcome to the Radically Genuine Podcast. I am Dr. Roger McPhillan. The medical industrial complex, much like a high stakes poker game, operates on a grand scale where the players are institutions, corporations, and policymakers, but the chips are human lives and wellbeing. Just as a skilled poker player might exploit less experienced opponents, we're seeing a system that often prioritizes profit over patient care. The house in this case, Dr. Jaclynn Moskow (00:20.15) This is a small one. Roger K. McFillin, Psy.D., ABPP (00:30.638) Big Pharma, insurance companies, certain healthcare conglomerates seem to hold all the cards, making rules that benefit their bottom line rather than public health. We're witnessing an alarming trend of over -prescription, unnecessary procedures, and a focus on treating symptoms rather than root causes. This game is creating mass harm, leaving many patients financially and physically worse off. Dr. Jaclynn Moskow (00:43.318) And then so, that's the question. Roger K. McFillin, Psy.D., ABPP (00:58.446) mirroring the way an unscrupulous poker shark might clean out an unsuspecting table. The difference is in poker, players can walk away. In healthcare, walking away isn't an option for most. It's a rigged game where the house always wins and the average person keeps losing. What we need are more professionals willing to challenge the system, expose its flaws, and help rewrite the rules to favor the true purpose of medicine. Healing. and protecting public health. When I was a young man, I had the fortunate opportunity of learning poker from my father -in -law. He was a true grinder. He wasn't just a player. He approached poker with both psychological acumen and analytical rigor. His style was tight, but aggressive. A strategy that demanded immense patience and discipline. He taught me the art of waiting for the right moment. of recognizing when the odds tipped in your favor. This wasn't just about the cards you were dealt, but also reading the table, understanding position, your opponents, and knowing precisely when to strike. His approach demonstrated that success in poker, much like in life and professional endeavors, often comes not from constant action, but from thoughtful restraint. Dr. Jaclynn Moskow (02:02.542) with business. Roger K. McFillin, Psy.D., ABPP (02:25.39) punctuated by decisive moves when the time is right. This lesson in strategic patience and calculated risk taking has informed my approach to both my personal and professional practice as a psychologist, reminding me that sometimes the most powerful move is knowing when to hold back and when to go all in. The game of poker in many ways serves as a microcosm of life itself. It's a complex interplay of skill, chance, and human psychology that offers profound lessons far beyond the felt table. In poker, as in life, we're constantly making decisions with incomplete information, balancing risk and reward. We face ups and downs, learning to maintain composure and victory and resilience and defeat. The game teaches us to read situations and people to recognize patterns. and to adapt our strategies as circumstances change. It demands patience, the ability to wait for the right opportunity while staying engaged through less eventful periods. Poker also mirrors the financial aspects of life, teaching bankroll management, the importance of long -term thinking over short -term gains. Perhaps most importantly, it reminds us that we can play our cards right and still lose. or play them poorly and still win. But in the long run, it's our decision and how we handle the inherent uncertainties that truly matter. If we want to drive meaningful change, we need to look beyond the usual suspects, the appointed experts whose careers and identities are tethered to existing institutions often have the most to lose from real transformation. Instead, it's the outsiders. Dr. Jaclynn Moskow (03:57.766) Thank you. Roger K. McFillin, Psy.D., ABPP (04:16.43) the rogue physicians, whistleblowers, critical thinkers, those harmed by the system, even professional poker players who can help us break free from conventional boundaries. Which brings us to today's guests. We get to learn more about medical school training, how a physician is trained to think, what happens when the doctor becomes the patient, what does it mean to overcome mental and physical health problems? Dr. Jaclynn Moskow (04:17.398) you Dr. Jaclynn Moskow (04:42.802) you Roger K. McFillin, Psy.D., ABPP (04:45.71) psychedelics, and even we can talk some poker. Her name is Dr. Jacqueline Moscow. She is a trained physician, scientist, writer, healthcare business consultant, and well -known professional poker player. She began her career in molecular biology labs, has served as med school, on a med school faculty, currently operates her own business, Moscow Medical Writing LLC, which helps. Dr. Jaclynn Moskow (04:46.934) you Dr. Jaclynn Moskow (05:00.182) you Roger K. McFillin, Psy.D., ABPP (05:10.19) ethical medical companies and healers through providing strategic guidance and digital marketing writing service services. She notes, and I love this. I can think critically in spite of my training, not because of it. We have so much to learn. Dr. Jacqueline Moscow. Welcome to the radically genuine podcast. Dr. Jaclynn Moskow (05:28.95) Thank you so much for having me. That might have been my favorite introduction I've ever heard to any podcast, not because of the bias of being the guest today, because you're so articulate. You're a great writer and speaking is just writing out loud. Roger K. McFillin, Psy.D., ABPP (05:45.23) Thank you. That's very kind. And this might be one of the more interesting podcasts that I have recorded because of your multifaceted nature. And you are certainly an individual, distinct thinker, critical thinker. And so I got to get start from the beginning here. Before we get into the poker, you decided to be a physician. You went to medical school. I want to learn a little bit more about why you made that decision. What was your hope from going into medical school? How did you envision your career? Dr. Jaclynn Moskow (05:49.91) Ha! Dr. Jaclynn Moskow (05:59.99) Thank you. Dr. Jaclynn Moskow (06:07.542) I did. Alright. Dr. Jaclynn Moskow (06:14.934) Great question. I think it's very hard for me to say, like, what am I, right? I'm bad at this niche thing. I was going to say, I am a scientist. And I'm like, I am a doctor. No, I am a writer. But I am a scientist. And I spent many years working in molecular biology and virology labs. It's absurd. I actually started working in them when I was 11. It's like pretty silly, right? But interesting. That's what I wanted to do. I didn't want to, like, I don't know. What do kids do? Join sports teams? Maybe that would have been a healthier choice in some regards. I wanted to work in labs. And so I went to college with the intent of becoming a mad scientist. That's what I wanted to do. And I spent every day in the lab. Like I'd go to class when I had to. I'd socialize a bit, but I was always in that lab. I was pipetting and altering cell lines and transforming cell lines, studying tumor genesis. It was interesting. And I just started watching, because we go into a lot of things with a very idealistic standpoint. I went into medicine with an idealistic standpoint. I went into, I'm going to become a scientist from an idealistic viewpoint. And so I was watching the laboratory PIs compete for grants and make decisions as a consequence in part of red tape and bureaucracy. And I also started to get this sense that you might you might, as a scientist, study some protein for 20 years and it may or may not ever have a real life consequence. And what is the real life consequence? It's usually development of a drug. And so I started to feel really disconnected from humanity and making a tangible difference, but I still loved science. So the only logical choice at that point was to become a physician so that I could take the scientist within me and kind of play scientist on a daily basis with a human in front of me instead of whatever, a PCR machine. So that's why I went to medical school. Roger K. McFillin, Psy.D., ABPP (08:23.566) What was your experience in medical school? I mean, did it really beat those expectations for you? Were you going to be a trained healer? What was your observations like through that process? And then. Dr. Jaclynn Moskow (08:30.166) It's just... You're gonna notice a pattern in my life storytelling, which is sort of like a pattern of disillusionment and a pattern of, yeah, just having this like pure, naive heart shattered by the forces that be. I was absolutely shocked in medical school by the exams. The exams in medical school, whether it's like what they call a shelf exam, which is just like the exam maybe to pass a class or the board exams, almost every question relates back to a pharmaceutical. So sometimes the question is, what pharmaceutical do you pick? Sometimes the question is, a patient's coming in and they have this side effect, what pharmaceutical caused it? Sometimes the question is, could you describe, you know, pick the mechanism of a pick? It's usually ABCDE, which isn't how humans work. pick the mechanism of action of the drug. So that was one of the first things that kind of like took me back was having come from this standpoint of I'm a scientist, I want to understand everything. I like to think probabilistically to be kind of shown the answer to everything is a pharmaceutical. Well, probabilistically, that can't be the case based on my understanding of life and the body and science. So that was a little bit shocking, I guess. I also was a little shocked by all of the third parties by the fact that physicians are not really in the room with just the patient. They're in the room with the managed care, the health insurance company. Will they approve this or not? Let me see. Like, let me make my decision about patient care based on the likelihood of reimbursement. They're in the room with pharmaceutical companies, sometimes unknowingly. I'm not sure a very large percentage of them really sit and ponder the extent to which their decisions are influenced by pharma marketing, which we can get into because I think it's a really interesting topic. And yeah, there's attorneys that they're concerned with, the electronic health records, the government, the regulations. It's a long list. The American College of XYZ, whatever they're boarded by. What is the standard of care? Well, who Dr. Jaclynn Moskow (10:52.47) decided that and why and what were the other third parties that were involved in that decision. So that was another thing that I found like, you know, a little heart shattering. Roger K. McFillin, Psy.D., ABPP (11:03.502) Yeah, so your training is kind of what my experience is within the healthcare system is like you're almost training doctors at this point to be legalized drug dealers to fit a symptom, right? And you're working within a system where you're following protocols. Those protocols are often developed by the American college of whatever X, Y, Z, and you're following those medical guidelines. And there's these large interplay of all these various institutions from the pharmaceutical agency to the, to the, Dr. Jaclynn Moskow (11:19.446) Yeah. Yeah. Roger K. McFillin, Psy.D., ABPP (11:30.19) insurance companies and even even these like large hospital networks and it's all this large financial system to try to deliver hair health care in a way that maximizes profit. So even like right now in primary care centers, you're looking at average time for your meeting with your doctor is somewhere around the eight to 10 minute mark. So it's really getting as much information quickly through these standardized checklists and then prescribing a drug. So it kind of fits the system, right? And you are trained to be part of this system. And this is a dramatic shift in how healthcare has been delivered, you know, over the course of human existence for the most part. So that was your experience in training too. You really understood that you were gonna be part of a system. Dr. Jaclynn Moskow (12:15.446) Yeah, it was a lot to take in. When I was speaking earlier about in the room with farm reps, I kind of was in the back of my head like laughing because I recalled, your question triggered this memory, a time that I was a third year medical student doing a rotation in the clinic. And what will happen in a lot of these primary care centers when you're a medical student is they'll tell you, go talk to the patient, like before the doctor does, like you kind of do like the pre visit to get it. a little experience taking a history and coming up with your own list of diagnoses. And I went and saw a patient and when I went into the doctor's office, he had an office in between the patient rooms, and walked in, a pharmaceutical rep was sitting on his lap. This is South Florida. I don't know. I feel like contextually, culturally, I wanna add that in, because there's some really interesting characters here in South Florida. And yeah, I'm like... In my late 20s at this point, I'm a med student. I walk in, I'm not sure if it's relevant for the story, but an attractive pharmaceutical rep is sitting on the lap of this doctor that I'm supposed to be learning from, and neither of them looks at me as if this is anything abnormal. I was just like in a actual state of disbelief. I'm like, this is like something that would happen maybe in some kind of like Hollywood script or something that maybe they would, patients would joke happens, but I like saw it happen. That kind of stuff. That is one story. I have other stories, right? So that kind of stuff, I just saw it. And that would foreshadow what would happen later, which is later I would open this medical writing and marketing business. And I would actually get reached out to at times by pharma. And I've never taken a pharmaceutical company as a client, but I have met with a couple kind of for information gathering purposes. And I then learned that That situation I just described was kind of a metaphor for what's also going on when it comes to marketing pharmaceuticals, not just to patients, but to doctors, because pharmaceuticals are marketed to doctors. And again, it was naive of me not to realize that that has to be the case because it's a product and products are marketed and there's marketing teams and there's marketing teams gathering data and there's marketing teams that are making strategic choices. Dr. Jaclynn Moskow (14:39.542) and that are hiring not just medical writers, but copywriters. I do both, but writers who specifically know how to create content to drive an action, to drive a conversion, content with a call to action, contact with like a hook, the first sentence, how do you get them to come in? All of that sort of stuff, as I later would learn building my own business where I do provide writing and marketing services and consulting services on those topics. I would then realize that all these third parties I referenced earlier are actually doing that. That's what businesses do. Interesting, right? Roger K. McFillin, Psy.D., ABPP (15:16.942) So Jack, so Jacqueline, what did you want to do when you were, where was your residency? I saw I'd be interested in kind of the residency that you chose and where were you going to focus your, your training? Where were you going to focus your expertise and how you wanted to deliver medicine? Dr. Jaclynn Moskow (15:32.342) Great question. Take a guess at what I thought I wanted to do. Roger K. McFillin, Psy.D., ABPP (15:38.862) let me see. Dr. Jaclynn Moskow (15:40.95) Not to put you on the spot there. You don't have to answer this, but I feel like it's a good question. It's a good guess. I mean, I wanted to be a psychiatrist. It's funny, right? Like those posts that I'm putting out on Twitter and stuff come from the place of having really thought... Roger K. McFillin, Psy.D., ABPP (15:44.558) I mean, was it possibly family medicine? Roger K. McFillin, Psy.D., ABPP (15:53.678) Really? All right, so that opens up more discussion for us. Dr. Jaclynn Moskow (16:02.742) yeah, I went on interviews for psychiatry residency, some good programs. I interviewed at Mayo Clinic. I interviewed at some great programs in Florida, whatever. I did an externship at Yale. I did an externship that's like a month in med school at Pitt, Western Psych. Yeah, I ultimately made the decision not to go into residency, in fact. I was walking through my parents' house in my fourth year of medical school. I was visiting over there and I... don't know where this question came from in the universe or God or myself intuition, but I remember walking through their kitchen and all of the sudden saying to myself, are you really going to do this? Like, are you, can you imagine doing that? Like imagine yourself 10, 20 years, like here's your drop, here's your prescription, here's your, and just instantly no. And then just as instantly as the no was. Well, I better finish because it's like a month away from graduation. So I better just put that no aside for a moment. I've spent over $300 ,000 for this degree and many years of my life and it will open other types of doors and not just that I need doors opened in titles, but it gave me, you know, all of the information that I use on a daily basis to make decisions in a sense when it comes to my understanding of health care and life. And I'm glad I have education. I help friends and family a lot. But yeah. I made this radical decision that nobody understood not to enter a residency program. Roger K. McFillin, Psy.D., ABPP (17:36.718) your family take that. Dr. Jaclynn Moskow (17:38.358) well, they... They heard me on the I need to at least take a break. I mean, ultimately, like my decisions are my decisions. My parents have always been amazing about that and my brothers and sisters and everyone like they kind of have an inherent trust that I know what I'm doing in some way, even when they're not quite sure why they trust that. I had said like I need to at least take a year off because I'm miserable. I need to at least take a year off because I'm like I think I was like 130 pounds, 125 pounds overweight. I was on psychiatric medications. I kept, I was buying into it at the same time that I was pulling out from it. I was going to a psychiatrist who kept doing the medication, merry -go -round, try this drug, try this drug, try this dose, add this drug. And yeah, the side effects were worse than, you know, the disease. I'm not sure that I would call depression a disease, but there are. biological aspects and social aspects and spiritual aspects and psychological aspects. I'm preaching to the choir here on that one. So yeah, I had said I need to at least pause and regroup because I'm at risk of ending my own life, which was something I had started telling people because it was thought circling in my brain at that time. So it kind of all came to this head of I have to like, sometimes like intense suffering will put you in these where you have to make really drastic decisions, like decisions that'll change the course of your life. And so the decision was, if I continue medical training, I likely will go down that route one way or another, it'll kill me. So I didn't. And then at that point, my, yeah, go on. No, it's not, I'd rather hear your question than tell you the next thing, it's not that interesting, go on. Roger K. McFillin, Psy.D., ABPP (19:27.502) So you were struggling. Roger K. McFillin, Psy.D., ABPP (19:36.206) So you were struggling with your mental health. Did you by any ways like attribute that to the lifestyle you were living as a medical student? How were you thinking about mental health? What drove you to go see a psychiatrist? Dr. Jaclynn Moskow (19:38.614) Yeah. Dr. Jaclynn Moskow (19:48.278) Great question. Okay. I... The first time that I went to a psychiatrist, I was 19 years old in college. I wasn't really adjusting too well to having gone off to college. And I was in poor physical health, pretty bad shape. And that was really way in the timeline before I started to, what's the term I wanna use here? See things the way that I see them now. and I remember going to the psychiatrist at 19 and listing off things that I was experiencing and feeling. And I remember him like latching onto one of them. Like I was like, he latched onto this, this statement I had made of going back into my childhood about how I would like line cars up and line pennies up. And if the penny wasn't totally centered in the book, I would cry and Nowadays, if I told that to someone, they'd probably just instantly be like autism. But back then, 20 years ago, like, wasn't really the thinking. And so they instantly said, I'm not saying that I am autistic either. I think all these labels, we can... They instantly said, he said obsessive compulsive disorder. And I remember in that moment thinking to myself, if I had just spent more time explaining... depression symptoms, he would have said depression. If I had spent more time explaining the anxiety symptoms, he would have said anxiety. But I had been pulled by him as the interviewer down a track that led me to talk about things associated with OCD. And so that's the diagnosis he gave me and put me on an SSRI. And I even remember him saying a very severe case of obsessive -compulsive disorder. Very severe. That diagnosis would be changed and flipped around and added on Dr. Jaclynn Moskow (21:43.766) throughout the course of the next 13 years, I, from various different practitioners, heard OCD, generalized anxiety, panic disorder, major depressive disorder, type 2 bipolar disorder, because that was really trendy at one point. Everyone had type 2 bipolar, and maybe that still is the case. I kind of willfully don't know, but it does seem like right now ADHD and autism are the trends. And so, those titles were eventually added on too. So there you go, like the gambit, like... I was never told I had schizophrenia, but that's the only one I can think of that I didn't get thrown the label at. To get back to your question, I had gone on and off all these different types of psych meds and every time that I would experience a side effect, it was always attributed, as it often is, to the disease. And so it wasn't that you're having more panic attacks because of the meds, it was you're having more panic attacks because you have panic disorder. And towards the end of medical school, the psychiatrist I had chosen to see got into this panic one day and he was like, you're not gonna make it through residency if we don't get these medications right. And this is really serious and you're not taking it seriously enough. And I just, and And I was listening and hearing getting through residency is the most important thing on this planet and it's more important than the way you feel or the way you experience life or your own happiness. You must get through, because he had to, right? It's like, you know, abused, individual abuses, I know why. You have to get through residency. And at this point, he was like, I know you've been so opposed to taking lithium, but that's the only way. I'm like, I'm hearing this. That's the only way. OK. the only way." And he's like, and if we put you on lithium, we have to put you on this other medication to protect your kidneys. I'm like, He's like, and you have to possibly use this other medication if you get lithium tremors, which a lot of my patients do. And then he starts rattling off all the medication, the polypharmacy. Like the most textbook -like ridiculous, again, looks, sounds like it's out of a sitcom or something. Example of polypharmacy that like I had ever seen, only it was to me. Dr. Jaclynn Moskow (24:07.51) and yeah, that was probably a month before I made that decision that I wasn't gonna go into residency. And so it all just like happened. It all just happened in the short period of time where I just was just like, F all of this. Like this can't be it. This can't be why I'm on this planet. This can't be how life is supposed to feel. And these clinicians are wrong. Roger K. McFillin, Psy.D., ABPP (24:30.126) Yeah, I mean, you're exposed to the pseudo scientific nature of this. I think you probably come in with some general mood presentations and concerns and it turns into a pretty serious mental illness where you're going to have to be on lithium. And it's because of all the other drugs didn't work. It's almost like the way the psychiatrist thinks is if this drug doesn't work or it creates a side effect for this condition, that's the underlying mental illness. And they so often get to bipolar disorder. So if they're, if they're recommending lithium, Somehow he's starting to conceptualize your life as if you have bipolar disorder, a pretty serious condition. Dr. Jaclynn Moskow (25:04.694) Yeah, yeah. Because at that point, a lot of psychiatrists, especially like I like kind of looked into it, the year he was trained, the place he went, like the school of thought, the fellowships he did, a lot of those types of psychiatrists believed, slash believed possibly still, that suicidality in and of itself is often just blanket indicative of this bipolar disorder, even if, even without, even without like cycling, even without mania, even without hypomania. I hate these terms. Like he, I remember, and I would push back. I would, well, what about, what about this? What about, you know, why would you? I even called a friend who was in a nephrology residency, a kidney doctor. And I said, do you? think I should take lithium. He's like, what? He panicked. He's like, why? That's the worst thing I could hear you say. And essentially, I then started to really think about, well, all these, a lot of these clinicians are practicing medicine independent of each other. Like they're practicing a organ system. Like that doctor, a friend of mine, I asked the opinion of in a sense as a joke almost because I wasn't going to take that drug, was thinking only about my kidneys. And that psychiatrist was thinking only about my brain slash getting through residency. And there's a lot of that in healthcare, sub, sub, sub specialized. It's like almost as if they forgot that all parts talk to each other and influence each other. And it's, well, this drug only treats this one organ, so you're on that drug, it's for that organ. other organs go to another specialist like worry about your heart you go to a cardiologist. Dr. Jaclynn Moskow (26:59.798) And on the lithium, they want you or he wanted me to get blood work every month to monitor my kidneys, to see if the lithium was just showing my kidneys. Yeah, fascinating. Roger K. McFillin, Psy.D., ABPP (27:12.43) So you didn't follow those recommendations. Dr. Jaclynn Moskow (27:14.102) I tried a lot of medications, but no, I think I actually would be inaccurate to say I never took lithium. I think I took it for a few days before I was like, F this. But I didn't get to the point of taking more drugs to account for it. And I didn't get to the point of blood work. Might have done an initial baseline blood work. And yeah. Roger K. McFillin, Psy.D., ABPP (27:34.286) So what was your health like? What did you feel like under the psychiatrist care? Dr. Jaclynn Moskow (27:42.998) What? Health -wise? Life -wise? I'm the experience of I can vision myself sitting on his couch I felt... What is this word? Pathologized? I felt like I had this disease in his mind, although I was questioning it, and my brain wasn't doing what it should and what other people's brains do. And there was this problem that perhaps was genetic. I didn't really know that much about epigenetics at that point because it was not... widely studied or talked about like it is now. But I think nowadays, I'd be sitting there going, it's the epigenetics, I must have done something as a kid. I was trying to take my scientific background and wrap it into what he was saying and make sense of myself as a diseased person while also having this gut feeling that it was all a bunch of BS and that psychiatry is actually the worst offender if we're going to talk about... specialties of medicine and harmful medications and harmful practices, harmful standards of care. yeah, it's like they took this notion that, that organs and cells, and disease are, are all things that we can. Dr. Jaclynn Moskow (29:16.79) easily manipulate with pharmaceuticals and that there is like this perfect pharmaceutical for every situation and then they tried to jam it into the mind and soul. Like they were like, well, this is how we get things done when we're trying to, you know, address blood pressure. You take a certain kind of medication, we play with the dose and it works. And when we're trying to account for whatever, XYZ disease, there's often, you know, you have a bacterial infection, take an antibiotic, pick the antibiotic that's going to kill that type of bacteria, do you need it to hit a cell wall or do you need it to do something else? And then they were like, let's take the human mind and soul and try to jam that model into it. And so let's try to find these drugs that we can just find this magic bullet for each, you know, type of feeling a human being could have or, you know, challenging life chapter, manifestation of other things of life. And then we'll try to find like the perfect drug for that and market it to doctors and patients and hurt people. Basically, that's what I think. Roger K. McFillin, Psy.D., ABPP (30:25.678) So how did you eventually, how did you survive psychiatry? I mean, how did you break free from it? And I am interested in the next step of your life after residency, especially getting into poker. Dr. Jaclynn Moskow (30:37.558) Yeah. So it's a very holistic story. There's a lot of pieces that were talking to each other and occurring simultaneously. So during this, I'm going to take at least a year off to try to make sense of everything. At that point, let's see, my med school made me adjunct faculty because they didn't want me to just totally disappear from the medical world and training, but the real reason was because I had unpublished research and they wanted their name on it. So I had like this foot in the door of medicine and I was showing up in these poker rooms in part as a distraction, in part because I really wanted to understand how to beat this game because I knew it was beatable. During that first year, I got off of any remnants of psych drugs and I had tried a lot of them. I had tried like off -label anti -epileptics. I tried SSRIs, SNRIs, ATIsCA. The only thing I had, could not get off in that first year was a Benzo and I'll get to that because that took a really long time. And so as I was getting off of these psych meds and I also took myself off birth control at that point because I was like that might be causing some of this and I started getting sleep for the first time in like 20 years like I could just I didn't have to stay up late cramming a textbook I didn't Have to wake up to an alarm at some hour that my biological rhythm wasn't like feeling So I'm starting getting sleep for the first time. I started going outside. I started getting sunlight like I started living a healthier -ish lifestyle while playing poker, which sounds like those things shouldn't work well together, but they did. And I did better, and then there were periods where I felt worse, better and worse, better and worse, but I was still taking that benzo because it was so hard to get off. And eventually, fast forward, because I don't want to make this... Dr. Jaclynn Moskow (32:50.39) story eight hours, I ended up in an office of a psychiatrist that had ketamine, that could perform ketamine infusions. That was the final piece. Roger K. McFillin, Psy.D., ABPP (33:03.406) interested in kind of the conceptualization of when someone is struggling. So, you know, you can go into one psychiatrist and they'll throw DSM labels at you and they'll try drug after drug after drug, and then you can go into another office of someone else and they start thinking about it differently. You can go to a therapist, they'll conceptualize it differently. You can talk to me, I'll think about it differently. But how did you make sense of what you were going through? And then why ketamine? Like what was the goal of going to ketamine? Dr. Jaclynn Moskow (33:07.798) Yeah. Dr. Jaclynn Moskow (33:22.166) Yeah. Dr. Jaclynn Moskow (33:29.046) yeah. Okay, that's a good question. How did I make sense of it? Well, there were phases. So like I said, in the very beginning, I thought this was just some sort of like genetic curse. Like I started just like looking back several generations. I was like, yeah, you know, this parent, this grandparent, this great -grand, you know, it was just this curse of like suffering and struggling in this life. And I had... you know, moments during that where I would think, like, yeah, it's probably, you know, related to your diet, or it's probably related to not getting sleep, like, could be related to maybe the pills they're putting you on. And let's see, man, what is such a beautiful thing about this life is that it's been so long since I was, like, deeply suffering that I almost have to think. And there were periods in my life where I could never have imagined sitting here not remembering what it's like to want to like, you know, play because it was such a gigantic part of my reality. It was my reality. My reality when I was suffering was that I suffered, that I was better at suffering than anything else in this entire world. It was self -fulfilling and that that was just sort of like my destiny and that I was just a person that suffered and other people were happy and I wasn't happy and Other people didn't have maybe whatever brain chemistry situation I had going on. And there were some people that did and a lot of them didn't make it. And so maybe I wasn't gonna make it either. And so yeah, it was just like when you're in a pit of depression and suicidal ideation, it's like to me, mental pain is worse than physical pain. I think a lot of the same like, Dr. Jaclynn Moskow (35:23.318) maybe, or neurotransmitters are involved in a sense, but I would take physical pain any day over like the mental pain I experienced at certain points. And another really interesting thing is throughout my life as a child, as a teen, and in my twenties, when I got depressed, when I had these like episodes of like feeling utterly awful, the world would actually look grayer. Like it would actually somehow in some pathway and I don't know, the world would actually lose color in a sense. To my perception of what the world looked like, it looked grayer. Wild. Once in a while I think about that. I'll be outside, man, the grass is so beautiful and green. I'm so glad that I see it that way now. Literally and metaphorically. Roger K. McFillin, Psy.D., ABPP (36:10.382) Yeah, so it's interesting when you start talking about your suffering, it's almost like it's something that's happening to you, almost like it's outside of your control. Not only you, but there's these other people that exist to walk the earth and they're just, you're genetically biologically vulnerable to suffering. And then you adopt a mindset around it, almost a personality or an identity around this suffering and it can really consume you. Dr. Jaclynn Moskow (36:15.638) Yeah. Dr. Jaclynn Moskow (36:33.846) Yeah. Roger K. McFillin, Psy.D., ABPP (36:39.598) And it seems like what you were trying to do was try to get rid of the suffering through some external means. Like if you can take the right pill, you'll suffer less. And then if you go see this psychiatrist, this doctor, they might have the right potion to eliminate yourself from this. Dr. Jaclynn Moskow (36:45.814) Yeah. Yeah. Dr. Jaclynn Moskow (36:53.622) Right. Right? Like, I wasn't playing a role in it, in a sense. At certain points, I don't think I saw that I was playing most of the role in it. Most of it. That is what it is like. I try not to forget. I try not to forget what it's like, although I do at times. But, you know, when people are suffering, because I did go through it and I did have those experiences, and it's easy for me to sit here having a wonderful life, happy, choosing joy every day and go, wow, these people should just make a better decision. But that's obnoxious because there's a lot to it. And it's a process. A lot of the process was more of a spiritual process of identifying the ways in which I was contributing to the situation, identifying alternative perspectives regarding the psychedelics. I read, I had read that there were people, and this actually dates back decades, but they were starting to talk about it again. They were talking, they'd been talking about psychedelics like it's this new phenomenon. That felt better having gone through these psychedelic. treatments and ironically running to go get a psychedelic was the same mindset of running to go get an SSRI or any other psych med. It's this idea that something external is going to be the solution and that there is a potion. But the manner in which I utilize psychedelics was in a sense from my perspective the key. I went and got ketamine infusions. Dr. Jaclynn Moskow (38:46.038) And prior to every infusion, almost like it was homework, I would think, what are the things that I'm going to work on during this infusion? Like, what pathways in my brain are detrimental to my well -being that I would like to override in a sense? While my brain is neuroplastic on this chemical, I still like made it a little too nerdy, geeky molecular bioperspective. It was like, while this substance is rushing through my veins, what is it that I would like to augment? And while it's not, it's absolutely not necessary that somebody take a psychedelic to feel better, it can be a really great hack, like turning a computer on and off. And I approached it from that perspective of taking a really active role in the medicine. Like I was going to sit there during the infusion and think about all of the pathways and things and that I would like to, you know, rewire. And then there were other psychedelics. There were psilocybin mushrooms and LSD and DMT and things that maybe I wasn't accessing through an MD, but they were all a really important part of this story. And it was over the course of several years of using them and doing the work and such and playing poker, totally away from healthcare that I kind of feel as if I was in a sense reborn. I don't necessarily recognize very many things about who I was before those years. Roger K. McFillin, Psy.D., ABPP (40:19.854) So before we get into that process, because I'm really interested in diving into that, I do want to kind of segue into your poker life. So I'm getting a sense of where we are and kind of the trajectory of your life and your lifespan is there's this concurrent like survival from psychiatry. You choose not to go into your residency program. You end up at the poker table because you know it's a game you can beat. And so I want to start there. How were you introduced? Dr. Jaclynn Moskow (40:40.118) Yeah. Dr. Jaclynn Moskow (40:44.63) Yeah. Yeah. Roger K. McFillin, Psy.D., ABPP (40:47.854) poker and how do you know that it was a game that you could be? Dr. Jaclynn Moskow (40:52.182) Good question. When I was in medical school, I went to med school in South Florida where I grew up. So I left South Florida to go to undergrad. I went to Pitt and then I worked for University of Pittsburgh for a while and then I came back to South Florida. So there were people in my life that I knew in South Florida that had nothing to do with med school. They weren't med students. They were people I knew from high school or middle school or whatever. One of them was hosting a weekly poker game on Sundays at his house for fun. And I had no life outside of medical school, no medical students do. Like you don't do anything but study and maybe hang out with other med students, which can be kind of toxic. And I guess the ones that go into training from a maybe healthier place than I did might like make it to the gym. But I decided that like my thing that I was going to do was I was going to go to this home game every Sunday. And I always brought a textbook because at my school are tests for usually on Mondays. So I had to like study. I couldn't possibly not study the night before an exam, but there was poker going on. And a lot of times I was so absorbed in the book that I couldn't really like play that many hands, which actually ended up being the key to why I was doing well, which I didn't understand at the time because 99 % of people play too many hands in poker. And top players usually don't, there are exceptions. But I, at that point, really just became really interested in this game. I hadn't yet to read a poker book, I had yet to watch poker training, I had yet to talk to poker pros. I didn't know really how to beat that game. I didn't know that there was so much that went into it. I thought it was mostly just card selection. I didn't know anything about poker. I didn't know anything about stack sizes and bet sizes and all this other stuff. But once I like made this decision that I needed to know what it was that these players that were so much better than other people were doing and I started learning about all those things I just rattled off, I was just like, like this is a totally beatable game. You're not playing against the house. So when you walk into a casino, if you go, you know, spin a slot machine. Dr. Jaclynn Moskow (43:09.11) or go play blackjack or roulette, you're playing against the house. The house isn't gonna let you win in the long run, right? Yes, whenever I say that, somebody always is like, but blackjack, but MIT? Like, yeah, a couple of those guys were poker players too, and I know them, but they, that's not really the case now, that's an old story. So nowadays, you're not really going to be able to beat the house without finding some weird exploit, don't do that, except in a poker room. except in a poker room, because in poker, you're not playing against the house, you're playing against other players and the house, when I say house, I mean the owners of the casino, the casino, they make money because they take a tiny cut. So they take a tiny, a little bit of chips out of every pot to cover them. It's like the least profitable part of the casino for a casino is poker. But gamblers tend to want it there and like it and it's kind of like more relaxed, sit there, talk to each other. Sometimes the TVs are playing and I don't know, people like poker, because it is really a great model for life. It's a great model for entrepreneurship. It taught me so much. Taught me a lot more than medical training did. So that was kind of the mindset of I know this could be done. I like to challenge myself. I don't know if I want to grow. I want to do a lot of things on this planet. I have done a lot of things. And all these different experiences taught me different things. So I wanted to do that. And at that point, having decided I wasn't going to go, into training, further in training, there's really no like guidebook on what to do if you go through med school and then decide you don't necessarily want to do that. It's not a position that, I don't know, it's not an easy position to navigate. I actually have a lot of people reach out to me these days asking for assistance navigating it because in certain little corners and groups of the world like People are like, Jocelyn managed, let's, you know, she knows how to maybe find a way out of this mess. But I even ran an online group about this topic once. I wanted to be a business owner, but I was not in the mental shape of someone that would have succeeded at that point. Like now I am, but it took a while. So I feel like poker was this great bridge. Dr. Jaclynn Moskow (45:32.342) It was like this bridge between the academic world and entrepreneurship. It was actually like the perfect training grounds for entrepreneurship. It really worked out. Roger K. McFillin, Psy.D., ABPP (45:45.441) When I first learned poker, it was during kind of that online poker boom in the 2000s, early 2000s to 2006, 2007. And I was in my, my PsyD program, my doctoral program at the time had young kids and my father -in -law who was a just, I just call him a grinder because he would sit there for long, long periods at a time at a casino and just kind of grind out an hourly wage, just kind of Dr. Jaclynn Moskow (45:49.526) Yeah. Dr. Jaclynn Moskow (46:09.206) Yeah. Roger K. McFillin, Psy.D., ABPP (46:14.382) playing a tight aggressive style. And he taught me on doing these sit and goes on the online poker. So I just started learning by playing sit and goes. And really I just mimic that style was I would play position. I really limited the hands that I would play. I would play them aggressively and I would just consistently beat the game. And then on Sundays they would have these larger, tournaments like the Sunday millions and stuff like that on some of the larger poker sites. And I started Dr. Jaclynn Moskow (46:19.094) Yeah. Yeah. Roger K. McFillin, Psy.D., ABPP (46:43.054) had some big wins and some places in those and built up a bankroll, which was great for me at the time because I was in school and had young kids. But then my ego got in the way, which it was, I'd started to deviate from my tight aggressive style. And I wanted to step up my game against some of the stronger professional players even sat down on Dr. Jaclynn Moskow (46:47.286) Awesome. Dr. Jaclynn Moskow (46:53.59) Dr. Jaclynn Moskow (46:59.254) This is Roger K. McFillin, Psy.D., ABPP (47:07.726) on some cash games with some some bigger names because I had a larger bankroll and I just wanted to test myself and I wanted to see how well I could do against the better competition. And that's where I lost most of my bankroll because what I began to notice is that it became very predictable as a player, even playing a tight aggressive style. It was very predictable to those to those type of professionals who can really understand patterns and who could really push you around aggressively at a table with a larger range of hands. And that's how my ego kind of got involved by was going up levels that I wasn't supposed to be at, which was another life lesson, right? Is that you, you, you kind of respect the levels of expertise that other people are at. You learn from them. You also learn from your mistakes, but you, but one of the strongest thing I've worked, learned from poker is how important it is to maintain. this emotional focus and state regardless of what happens at that poker table, right? Because you can go on tilt, you know, for those who are listening and don't understand what that means in poker is that if you have a, you know, a cold hand or, you know, the probability is in your favor, you still lose a number of hands or you start, you know, really struggling, it's really, you're really vulnerable to letting that emotion affect your decision -making. Dr. Jaclynn Moskow (48:13.322) Yeah. Roger K. McFillin, Psy.D., ABPP (48:33.422) And if that emotion affects your decision -making, like you're trying to get the money back that you lost, then you are really deviating from, you know, a style of play that is going to lead you to be successful in the long run. Because really when it comes down to poker is you can only play in the now. What happened previously doesn't matter. Statistically, what's happened in the past doesn't matter. You can just make the best decisions you can in the moment you have. I think there's even a book called the Zen of Poker. Dr. Jaclynn Moskow (48:46.646) Yeah. Roger K. McFillin, Psy.D., ABPP (49:02.318) I don't know if you've read it, you know, but I'm interested to. I am interested to learning more about, you know what the game taught you and also some of who your influences were, because it's when you started learning the game and that you knew you could beat the game. I'm sure you just opened up your repertoire of like what you were going to read or who you were going to. You maybe follow in the sport that really helped, you know, assist you in your style. Dr. Jaclynn Moskow (49:03.862) I know of it and I don't really. Dr. Jaclynn Moskow (49:28.022) Yeah, so I think the best poker author is Ed Miller and David Sklansky. They did write one book together. Sklansky kind of came before Ed Miller. They're like in a league of their own. And there may be some more modern authors now that can compete. I haven't read a poker book in probably seven years. Those books really like reframed the game for me and helped me understand stack to pot ratios and developing ranges and all these fancy things. I made friends in the local South Florida poker scene who let me know pretty fast how you're pretty bad in the beginning. And they were like, everyone's bad in the beginning. They're like, well, you're bad. You're playing way too many hands. And what are you doing? You're pot committed there. And then you just fold it. What are you doing? So talking to other players was a huge benefit. And putting in a lot of hands, I would play like. baby microstakes online, like, you know, 12, 16, 18 tables open just to put in the hand volume. In the beginning when I was playing live, the thing is that a live poker is very, very, very soft compared to online poker. There's some geniuses playing online and there's nowadays like, it's complicated. There's like solvers and programs and you have to worry about maybe the game's not always being clean online. worry about cheating, worried about that sort of stuff. But in live poker, almost everybody's bad. People don't really go to card rooms, casinos, private games to make a living. Some do, but most people are there for entertainment. Maybe they're break -even players or maybe they're losing a lot of money. Maybe to them, it's entertaining to lose the money in some sense, maybe. There was a lot of like... Dr. Jaclynn Moskow (51:28.118) energy in the casino of like this, how do I put it? It's not particularly energy I want in my life, it's part of why I don't go over there anymore. Like the addicts, you know, not to say that in a disparaging way, it's just like, I feel everything, like, you know, I'm in a room with someone and they're stressed, like now my heart rates up, like it's just how I am, which was interesting working in hospitals. But there was just a lot of... characters in these casinos that were struggling in their lives and bringing it to the poker table in a sense. And I also would at times feel as if, I don't know, like maybe I was supposed to in some other iteration of this lifetime be helping them as opposed to sitting there taking their money and just messed with my head a little bit. although they were gonna lose it anyway and they were gonna lose it somewhere. And that's kind of like one of the rationalizations that your poker players make is that like they're gonna lose the money anyway. And it's kind of just like go do something good with the money, like be a good person, donate a little bit and like make good decisions and it's fine. But which tangent did I just come off of? Basically, the, yeah, my brain is going a million places. They're talking over a million topics. Re -direct me for a second. Roger K. McFillin, Psy.D., ABPP (52:49.87) So yeah, I'm really interested in kind of what you've learned through that sport. You know, kind of some of those lessons that you learned, but I'm also interested to know how well you did in it. I think right now you're not playing as often as you did, but like, how did it support you? Dr. Jaclynn Moskow (53:03.222) No, I don't play. Yeah, so, I know that was the tangent I was going off of, actually. I was a cash game player. So when most people hear professional poker player, they think about like World Series of Poker, poker tournaments, poker tournaments. Poker tournaments are a variation of poker. Poker cash games are something a little bit different. And so the tournament kind of gets like the glory and the coverage and the TV and the name and the title and it's like first place, second place. But a lot of people that make a living playing poker, they might enter tournaments sometimes. And if you're online, you can play a ton of hands, you could do it. But most people that make a living playing live poker are doing it through cash games. It's something different that is not like the thing that's sensationalized in media. So I was playing cash games. cash game players tend to be pretty loose and pretty bad. And, yeah, I wasn't like making millions and millions of dollars. I was making enough money to pay the bills. I was taking enough money to keep a roof over my head, to eat, to get ketamine infusions. Those were kind of expensive. and to kind of float myself through this period between, medical training and putting up a writing business and there's a few other things I've done. I've done a few other things, but it was in some sense like a godsend that I was able to do that. I don't know what else I would have done. I was pretty devoted to this idea that I would never have an employer. I hadn't had an employer since I was in my 20s working in a lab and I felt like doing like going from med school to a job would like be putting myself in a position to just experience different versions of the things that were disillusioning to me. I'm not saying this very articulately, but about medicine, like those third parties, they would just like be showing up in a different form. Basically, I kind of knew that I needed to carve out my own path in a way that I didn't think Dr. Jaclynn Moskow (55:24.438) would be possible if I like went and worked in a lab again or whatever other kind of job you could come up with that maybe you would use a medical degree to have. It felt like it was still too much in that system that I was trying to escape from. And so I knew that I was going to need to find a way to pay bills and support myself making money where I'm the one calling the shots. That's what I'm trying to get at as in starting a business. But Again, I wasn't at the point where I could have done that successfully right when I graduated med school because I was such a miserable person. And so, like, yeah, poker helped me with all that. And the psychedelics. Roger K. McFillin, Psy.D., ABPP (56:08.11) So you mentioned earlier that your lifestyle began to change when you started playing poker. So I am interested in like how you went about making money. What were your hours? What hours did you play? What other things did you do for your health at that time to improve your lifestyle? Dr. Jaclynn Moskow (56:13.91) Yeah. Yeah. Dr. Jaclynn Moskow (56:24.854) Yeah, my hours are actually kind of, I'm almost embarrassed to say it because I'm talking about how I felt so healthy and then I'm going to tell you I stayed up all night long. But while that is the case, the fact of the matter is I was getting a larger quantity of hours of sleep than I ever had before. So like once I went to bed, I could actually sleep enough and I had never done that. I was always like, you know, in a textbook until 2, 3 a and then the alarm clock goes like I was just chronically sleep deprived for years and years and years and years. So that was no longer the case. I was a night grinder. I grinded at night. The characters that come out at 11 p 12 a 1 a to play poker as you You guys could probably imagine they're wild in comparison to somebody that might show up to play poker at 10 a Like, totally different game. Totally different game. I remember sometimes I would play overnight and on my way out, I'd see the people coming in to play for the day and I'd be like, wow, that game's not gonna be worth any money. Like, you guys don't have fun at the table. Yeah, people showing up in the middle of the night are ready to throw money around. And so it was just more profitable to play weird hours. I also eventually got really good at this, they call it poker. It's really kind of like a poker chess hybrid. It's called like open face Chinese poker, pineapple, silly name. It's a game. It's a game that people in the poker community were playing a lot of that, was a strategy game. And I got very good at it before anyone really knew what it was. Now there's a lot of people that are good. That's part of like the theme in the, in the gaming world is you got to get in early before a lot of people figure it out. And I was able to play that from my iPhone. And so then there were like chunks, like six months here, four months there where I wouldn't go into the poker room because everyone wanted to play me or some people did on this app. And so I was just like sitting at home playing this app. Wild, right? Even saying these things, I haven't thought about this in a while. Although it is like an important chapter, maybe longer than a chapter of my life, on a daily basis, it's just not something that I think about too much. Dr. Jaclynn Moskow (58:43.478) But it sounds wild as I'm saying it out loud. I'm like, what did I do? What was I doing? That's crazy. Roger K. McFillin, Psy.D., ABPP (58:52.974) So at the same time, you were also getting ketamine infusions. And so you're in this, you're in this struggle with your own mental health. You're changing some things about lifestyle. You got out of medical training and in residency, and now you're, you're focusing on kind of surviving through, through a game, through strategy games. And, but you're also at concurrently, you're kind of working on your mental health and you chose to see a psychiatrist who Dr. Jaclynn Moskow (58:57.462) Yeah. Roger K. McFillin, Psy.D., ABPP (59:22.702) provided ketamine infusions. So I wanna slowly walk through this and I wanna know like the process, like even working with that psychiatrist, what was the belief about what ketamine was going to do? Like what was its mechanism of action? What did you experience in it? And when we can just kind of take that conversation, walk it through to where you are right now, maybe some of... Dr. Jaclynn Moskow (59:28.182) Yeah. Roger K. McFillin, Psy.D., ABPP (59:45.998) some of the understandings that you've kind of learned about yourself, your place in this world, the universe, spirituality, and so forth. Anything that has really contributed to you feeling well and living well is like fair game for discussion. Dr. Jaclynn Moskow (01:00:00.022) I would absolutely love to answer all that. Is it okay to take a one minute break? Now I'm like putting you in a situation where you're gonna have to edit this out, I'm sorry. Is that okay? I'm so sorry, I'm like, I can't focus because I drank too much coffee. I'll do it, I'm so sorry. Roger K. McFillin, Psy.D., ABPP (01:00:09.518) That's fine. Go ahead. Yeah. Yeah. Roger K. McFillin, Psy.D., ABPP (01:01:51.278) Are you there? Can't hear you. Roger K. McFillin, Psy.D., ABPP (01:01:57.55) Can't hear you. Can you put up your hand if you can hear me? Roger K. McFillin, Psy.D., ABPP (01:02:19.502) Jacqueline, can you hear me? Roger K. McFillin, Psy.D., ABPP (01:02:29.646) Can you put up your hand if you can hear me? okay, you're back. Roger K. McFillin, Psy.D., ABPP (01:02:50.19) Yeah, well, what's interesting is I can actually hear you much better now and see you actually. Did you have a, you were very grainy and there was a delay. So the first hour of this podcast has been a little bit of a challenge. It's going to be fine because you're recording on your end and I'm recording on my end, but now I can see you and we're all synced up. Roger K. McFillin, Psy.D., ABPP (01:03:16.558) Okay. Roger K. McFillin, Psy.D., ABPP (01:03:29.934) Yeah, I think so. And do you want to try hooking your mic up right now? Roger K. McFillin, Psy.D., ABPP (01:03:36.654) And if did you see on the bottom where it says mic and speaker and those things? Did you click on that and then make sure? All right, let's just give that a shot because you might even sound better with your mic. Roger K. McFillin, Psy.D., ABPP (01:03:53.678) not a Roger K. McFillin, Psy.D., ABPP (01:04:20.942) Okay, we won't do that then. Not a problem. Roger K. McFillin, Psy.D., ABPP (01:04:30.158) All right, we were going to get in. Roger K. McFillin, Psy.D., ABPP (01:04:39.63) Yeah, so everything looks better and sounds better. So what I want us to and we're going to edit this part out, but I want to get into the ketamine journey and everything you experience. So I'll just start us off with a question so we can start into the second half of the podcast. Okay. So I'm fascinated to understand more about your ketamine journey, but I also want to get into your kind of mentality when you first started, like what you were expecting was going to happen. I want to know about your experience with the psychiatrist and what they were communicating to you about what maybe the mechanism of action was. And then we can jump into your entire experience throughout the process. Roger K. McFillin, Psy.D., ABPP (01:08:03.886) were you basing getting better quote unquote was that about just like your emotional state is that what you're referring to when you say getting better Roger K. McFillin, Psy.D., ABPP (01:12:37.966) So I tend to think about mental well -being, emotional well -being a little bit different than maybe a problem that has to be solved. Okay. So let me share my thoughts on this. I want to get how you think about it now. So I see our emotional states, the various emotions we have, anything that's kind of going on in our eternal experience is there to serve us. And I see it as like a very necessary way that our body and our, and our, and our soul, they communicate with each other. Right. So. Like there's challenges that we're going to face in life and life is an adventure. And I see life as something that's transformative. Like we're going to go through dark moments. We're going to go through pain in our life and our emotions, they communicate to us like very necessary messages that, all right, you need to face this or you need to make a change here. And that change may be physical. I'm not denying the, you know, the physical and emotional, the mind body experience of someone who might be physically unwell, for example. or who is sedentary, not exercising, not sleeping well, all those really important physical aspects that make you feel like shit, right? It's still there to inform you and to say, you need to make changes, just like you did. Like you eventually said, I have to make changes. And there might be some problems that you have to solve in your life externally, but internally, those emotions are really there to serve us, they're partners. And what's happening now in our modern culture, is that our emotions as symptoms of an illness or a disease, it creates almost this adversarial relationship to our internal experience. Like now you get bad thoughts or negative emotions and it's viewed as if they are outside of us, like they're happening to us, like we caught a disease and therefore we seek external solutions in order to solve it, which I think compounds everything, makes it worse. There's like this paradoxical effect with our emotional or internal states, like the more we don't want to feel something or the more we don't want to think something, the more we're going to think about and the worse we're going to feel. And then you eventually take steps to break those patterns in the way that you cope with it. And when I'm talking to people who've gone, who've used psychedelics, they tend to see things closer to the way that I'm talking about it, that it opens up Roger K. McFillin, Psy.D., ABPP (01:15:02.446) a new avenue of thinking about your life. It's not something you turn to to necessarily escape from the emotions that you feel. But in fact, it changes your perspective in a way that alters how you live your life that then has the secondary effect of feeling better. So with me saying that, what are your thoughts? Roger K. McFillin, Psy.D., ABPP (01:20:16.238) Well, it makes total sense because I've had, there's two different experiences for me. There's the learning about it through the experience of another, which has happened quite frequently for me and just working with as many people as I've worked with over the course of my career. And then it's my own personal experience where I've experienced this through meditation. And it took a long time to be able to get to that point to develop the skills, to be able to get deep enough into a meditation where you experienced the oneness. So it's like there's a, there is the illusion of separation that exists for all of us as we go through our day -to -day experience in this human body. So for me, I like I'm going through this human experience as Roger, but the truth of the matter is there's a deep soul that's connected to all things. And the purpose that I have on this, on this earth is really for mine to define, but I, in some ways it feels like my, my soul has to carry out something for its learning. And then when I go into meditation and I take these experiences and try to bring them into my day to day life, I experienced this much more frequently. So if like, for example, like each the synchronicities, each client that comes to see me was like this purposeful, meaningful relationship that the universe or God has created for just you and that person, which then enhances everything. As I think, so as I walk through from my office out to the waiting room, I'm about to come in contact with God, right? So it's like that type of experience that I never experienced in my life previously to that, which is kind of depressing, right? Like life doesn't have the same degree of meaning, but now when I'm going to sit on a podcast with Dr. Jack, Yeah, yeah. And now like that I'm going to sit with Dr. Jacqueline Moscow. It's like, this is a holy relationship. Like this conversation that we're about to have has greater meaning. And so it does enhance your, it enhances my experience. Like it's changed my life. And so I hear this from other people who have, who have used psilocybin mushrooms, you know, for the most part. And you know, they've microdosed and they've done this different work and Roger K. McFillin, Psy.D., ABPP (01:22:34.766) They've overcome chronic depression and anxiety, not because it's eliminated their symptoms, like not that it has changed their experience by this emotional blunting or numbing effect. No, it's completely like opened up a portal that they experienced the world in such a new way that it has different meaning. And that new meaning changes thought and it changes action. And within the action creates new experiences. So when you lose that fear and you're allowed to distance yourself from the ego and what your mind wants you to do in that egoic state, which is like connected to the body and you're not connected to the oneness that exists. Well, then it's all about you, right? It's all about you. It's about life and your death here. It's about what you're going to achieve. It's about money. It's about your... your own feelings and all those things that we humans get really caught up on, right? And we're sensitive and our mind creates these horrible scenarios that we predict into the future. We go back into the past and we focus on these shameful moments. And now we're creating this existence. We're creating this reality and this reality can become miserable, right? It really is. But when you transcend that and you see everything a little bit differently, you know, Life is just, it only exists in the now. It's got great meaning. I can create that meaning. There's great purpose to it. And I can see God in everyone and everything is happening for me, not against me. That's such a shift that I don't think you can be depressed when you're in that mindset. Roger K. McFillin, Psy.D., ABPP (01:27:49.806) Yeah, I mean, we're talking about altered states of consciousness and the different ways that one can achieve an altered state of consciousness, even a higher consciousness. And you just mentioned gratitude practice and I'm in the middle of a gratitude practice where I wake up every morning. So I created a list of all these things I'm grateful for. And then I go through that list in the morning with, you know, a thank you to each one and why I'm grateful for it. And then at night I have these two little stones by my nightstand where before I go to bed, I just reflect on my day and try to identify what I'm most grateful for that happened in that day. And I'm telling you it's altering my state of being. And if I, cause I think it's transferring throughout the day. So if I'm starting at morning and I'm starting at night, but I find myself just becoming more grateful for little things that I'm observing, which has completely shifted my perspective of where my attention is. Because, you know, you go through your day, you have these little challenges, you know, these minor pains and struggles and, you know, your struggle with your own thoughts and your own doubts and these things. But your ability to kind of observe it from a distance and then like move away from it. I truly believe we are creators of our own reality. And so would you say you learned that too through your experience like that we are? creators, essentially. Roger K. McFillin, Psy.D., ABPP (01:31:57.646) Yeah, I mean, there's so many different trippy aspects of this, like the law of attraction and so forth. But like when you do read historical texts and like biblical texts and so forth across cultures and religions, they do speak to this aspect of being truly rich when you have gratitude, like the ability to influence your reality in this way, as if we're emitting an energy or a frequency and... that you know, that has a powerful impact on others. Like you were mentioning earlier in the podcast, when you're talking about your, you know, your experience in the poker room, about taking on the energy of somebody else, like even feeling their emotions. And as a psychologist, I know exactly what that's like, because that's, that's what I experienced with my with my clients. And I think, and I try to look at it as a like a superpower and try to regulate that in myself. But, you know, a lot of other people can feel it too, like some of my clients who are really like interpersonal sensitive and emotional and in tune to the energy around others, they can pick up on things within me as I'm walking back to my office. Like they, without me saying a word with me doing the best job I can to put on a smile and say, great to see you. And like walking back to my office, we'll sit down and they'll say, what's wrong, right? Like not, I never said a thing. They just can feel it in me because something happened earlier, or maybe it took on the energy from a previous patient that I was working with. So I really do. believe that exists and we haven't been able to even touch into our understanding and maybe it's quantum physics or, you know, how we are all, you know, energy and part of that interconnectedness, that oneness is that we do take on that energy from those around us and we have to find a way also to deal with what the influence of others around us like. I think that's an important piece. Roger K. McFillin, Psy.D., ABPP (01:37:07.598) Yeah, and it also makes me think about the current mental health system, which I, you know, I'd like us to kind of evaluate in context of what we just spoke about. So you now enter into the medical system and you start talking about your emotional wellbeing in very limited context, right? I feel this, I complete a, you know, you complete some form of a screener and automatically the response is a prescription drug. And so now we take a step back and what we just talked about, you know, things that, you know, I've obtained maybe in meditation and my experience working with, you know, countless people, your own lived experience, what eventually you had to do in order to overcome your own struggles. And can we actually begin to examine like how harmful the system is right now in viewing it from that limited lens? Like if you had to identify what are some of the worst things that we could do for somebody's mental health? Well, we would take everything out of context, we'd put a label on it, we'd look at our internal experience as some symptom we have to get rid of. And we would give a fuck we provide a pharmaceutical that the long term consequences haven't been evaluated, they have significant side effects, they harm more people than they help. And In fact, they're probably more likely to induce, you know, suicidal thinking and mood related problems than even helping a person in a moment. So we actually do exactly what would probably lead somebody into developing a chronic mental health condition. It's insane when you think about it. Roger K. McFillin, Psy.D., ABPP (01:43:15.054) Yeah, I mean, and I've done my deep dive into that, you know, just looking at how these drugs came to market and, you know, do they actually help anyone? I mean, I've certainly come to the, I've come to the conclusion that any meaningful benefit that comes from the drug is placebo oriented. You know, it's around the belief that it can change something because we see that there's a high response, placebo response, even in the drug trials. But the person who are the people who are going to maybe have a little bit of a short -term benefit compared to the placebo drug would be those who really attach to the idea that there's something broken within them. That they do believe that there's a chemical imbalance in their brain and it's correcting that and they're really attached to the system and the authority bias that exists when going to see your doctor. Because when they write that prescription, that's something that's powerful. And that's why I think it's so important that we you know, harness the understanding of what placebo is and the relationships between doctors and patients, because you can really use that for positive benefits without, you know, mood and mind altering pharmaceuticals that were, you know, created in a factory. We can, just a simple aspect of validating an experience, understanding that it's short term, it's limited, that there's nothing broken within you, but rather these are your emotions response to the events that exist in your life. And there's probably opportunities for meaningful change. both in your health and in your emotional life. And I hope that you can take the time to kind of figure out what those are and start taking those proper steps to doing so. And that's where I also want to get into maybe the iatrotenic harm of like a therapy. Like I just don't want to say it's about drugs. I think it's about the system in itself. And, you know, I am a psychologist who provides therapy, but I don't think there's a whole lot of people like me right now who are talking about the harms of therapy or even thinking about it like I am. because we're almost brainwashed or conditioned to believe in any circumstances, what's wrong with talking to somebody, right? What's wrong with some emotional support? And there's not a lot of depth to that. So like when you start taking, like going underneath the layers of what psychotherapy actually could become in a negative way, people don't always think about, you know, where our attention goes, our energy flows and the idea of around creating our own reality. Roger K. McFillin, Psy.D., ABPP (01:45:37.774) So you can walk into a office and sit down with a therapist and that therapist can have a powerful influence in how you experience your own reality. They can change relationships. They can put blame on your childhood. They can, and this has happened, you know, people. Absolutely. And then what you choose to focus on. You know, you mentioned it earlier with the psychiatric interview on what that person wanted to focus that attention on. And then that kind of drives your response and now your attention is focused on those areas. Well, what does a therapist choose to focus on? You know, maybe what's of interest to them, maybe what their areas of expertise are, their specialties, what's most entertaining to them. Think about all the challenges that can exist. Right. And then what you identify as trauma. And if you identify something as traumatic, is that, is there a belief that says talking about that more than it heals that trauma? you know, there's so many things about this does, is like a random Tuesday, Tuesday at 4 30 PM is like that the right time for someone to focus on certain areas of their life? You know, I'm, I'm, I'm just, at this point, I'm, I'm ready to blow up my entire profession and go in a different perspective, different position myself, because I'm just realizing of all the inherent challenges that exist. And basically where I'm at now in growing in my career is, okay, what you're going through, there's a reason for it. Let's figure out what that may be and how can you shift your attention in a meaningful way in your life. And you can understand what's getting in the way of that and trying to prevent someone from creating dependence on me or creating dependence on the therapy. And so ultimately, I think most effective therapies are going to work on people who are truly stuck. There's a great respect for what can negatively occur in the process. There's a plan to get out of it, you know, kind of like drugs to, you know, there's no plan to get out of drugs anymore. Is there a plan to get out of therapy? You know, is it, is it, what are you, what are you working on? Why have you agreed upon together on what the potential harms are? And are you, do you realize this has to be action oriented? Roger K. McFillin, Psy.D., ABPP (01:47:48.75) Right? Like unless it transfers into some meaningful action in your life, well, then all you're doing is you're just talking and creating realities with your, with your therapist. There's just so much, I could go on, you know, for hours on this. What are your thoughts? Roger K. McFillin, Psy.D., ABPP (01:54:37.55) Well, there's a lot you said there that I want to comment on. Some of it was, I think, very, very beautiful, very meaningful, especially when you talk about the duality that exists in our lives, like dark and light, you know, I think is a is just a kind of a great contrast that really to experience the light. It is enhanced by, you know, the understanding of or the experience of darkness and That's part of this transformation that exists in our lives is that we go through cycles. I think there's just a lot of cycles and seasons in our own life. And once you go through a dark period and then you come out and see the light again, there's a lot of growth in that that came from the challenges and the struggle that exists. And I think that's, I think one of the harmful aspects about where we are in our own society is that we've lost our language of suffering that we no longer have this collective way of kind of communicating that going through these challenges is much more normal and necessary. And a new perspective is to see it as, as something that is actually a blessing that is provided to us to enhance our growth. And that's the dark, the dark nature of like these categories, these diagnoses, that people are adhering to and they're building their own personality, their own brand around it is that there's this desire to see themselves as broken or disabled in order to achieve a sense of community or even connection to others. When our collective humanity is where we want to connect with and where these emotional pains or the struggles that exist, you know, that we can feel them together and then we can understand them from a different perspective. And by understanding them, we can use them for our benefit. I have this sign in my office that was given to me from a former client where, you know, it really speaks to your, it says, you know, your emotions are, are, are gifts. And when you begin to think about your emotions as a gift, that changes and alters your entire experience to them. Roger K. McFillin, Psy.D., ABPP (01:56:53.166) When you see them as something to get rid of, when you see them as something that are symptoms or a painful experience for no reason, like that there is suffering without purpose. I think that's a recipe for depression and despair. But when there can be a purpose to even a negative emotion or a difficult period in your life, like you're going through a loss or a breakup, or you're struggling to know what the next steps are in your career, or you're going through a health crisis. There's nothing, there's no meaning attached to that. You know, that is a recipe for an episode where you're struggling. And this is my problem with psychiatry is someone will go into a psychiatrist and they will never even understand it from that perspective. They will see it only as a potential illness. That is an imbalance of a brain as if all consciousness is emitted from the brain. And in that brain, there could be something that's broken and They have these drugs that can fix it. Not that they can measure it, not that they can observe it, right? Not that it follows the empirical method or the scientific method in any way. It's just an idea that was created and that idea is real to them. And I think that idea is harmful in itself. And until we are able to change those ideas, take it out of our collective consciousness. And that's where I think institutions are going to be shattered over this next decade or we're in this that we're in this period right now where the light now is is being shown on the corruption that exists on how systems were developed to benefit few and to harm many. And we've been mass conditioned. And that has happened from social media, from podcasts, through the internet, through connections, through sharing of stories. You know, more people are willing to investigate and learn because the medical authority or the government authority that in itself, you when you realize that you've been lied to, when you realize that you've been conditioned, maybe it's the mainstream media, whatever it may be, that everything is filtered to serve a purpose for someone else. Well, then the good people who do understand that we're all connected, who are connected to their soul's purpose, who are now lifting to a higher level of consciousness, they're more willing to make change through their action to serve others. And there's a lot more of us that exists than those who are in those positions of power. Roger K. McFillin, Psy.D., ABPP (01:59:17.902) And so I think we can see that we may be coming out of a dark period that has existed for quite some time. Post World War II, you know, there's so much that's gone on that has affected the health and well -being of everyone who lives in this country generationally. You know, we are a sick country right now from the food that we eat, the toxins that we're exposed to, to the idea of what mental illness is and to the way that our medical system is now treating everybody. They are not healers. We are not restoring health. We are just masking symptoms and that is coming to light right now. And I think that's powerful for us to be able to make change. And even something like X or Twitter, you know, these few tweets that you can send out can have a powerful impact on the way that someone thinks about something. And then you follow them. And then you start learning about how they think, that's somebody who's a professional, that someone is in the system and they see a different, or this person was harmed and now they've been able to overcome that. What is learned there is so meaningful. And I think it's part of this mass consciousness, increasing of mass consciousness and awareness that is so necessary for transformation. So I do want to kind of conclude with today's episode by maybe some take -home tips here. You know, I've been following your... You're back on the Twitter. I'm great to see that. but you've been sharing a lot too about your personal journey and the things that are like really meaningful. What is your takeaways from your mental health journey? You're what you've had to go through and essentially the transformation that you're in. I mean, you said it well today. It's hard to even remember that former self, right? Because there has been a rebirth and within that rebirth, there's a new consciousness, a new way of living. But what are some takeaways for the for my audience on just what you have learned and maybe they can take some nuggets from that. Roger K. McFillin, Psy.D., ABPP (02:01:27.278) All of those things. So they are all of those things. Roger K. McFillin, Psy.D., ABPP (02:05:37.966) Well said. And I think it's actually the ideal if we can look back in our life and we can cringe at some of the things we've said or done because then we're growing, right? No, we want to be able to look back five years ago and say, no, I've, I've continued to transform. I've continued to grow. I'm better off. I'm better now than I was five years ago. I'm better now than I was 10 years ago. And just think about that mindset. Roger K. McFillin, Psy.D., ABPP (02:06:11.758) Fascinating. Well, what an interesting conversation. I'm so grateful to have met you. Yeah. Where? Roger K. McFillin, Psy.D., ABPP (02:06:26.99) Yeah, so where can people find you if they're interested in learning more about you, maybe some social media that you're posting on or anything about your work? Roger K. McFillin, Psy.D., ABPP (02:09:04.43) It's been a lot. Roger K. McFillin, Psy.D., ABPP (02:09:37.07) Yeah, so true. I, you know, that's, I've found out the same thing. It's a lot easier to, to, to write than have to get on a podcast and start talking. But over time you start to improve it. It's a skill like anything else. And so I'm so grateful for having you on the podcast today. So Dr. Jacqueline Moscow, thank you for a radically genuine conversation. Right.