Latest / The Vietnamese with Kenneth Nguyen / 469 - Why Do Vietnamese People Avoid Therapy? - Dr. Lu Le

Transcript

469 - Why Do Vietnamese People Avoid Therapy? - Dr. Lu Le · The Vietnamese with Kenneth Nguyen

0:00
[SPEAKER_02]: Welcome to the Vietnamese podcast.
0:01
[SPEAKER_02]: Today I have Dr. Lou with me.
0:04
[SPEAKER_02]: He is a psychiatrist in the Navy with the background of the military and welcome to the Vietnamese podcast.
0:14
[SPEAKER_00]: I can't wait for having me.
0:16
[SPEAKER_00]: I did serve in the Navy.
0:17
[SPEAKER_00]: I'm now a veteran, so I'm out of the Navy, but happy to be here and looking forward to our conversation.
0:24
[SPEAKER_02]: Thank you for your service a little bit more background about you is that you recently opened up a YouTube channel and you really dig into psychiatry in the Vietnamese language and you speak perfect Vietnamese perfect English and I think that it's a huge service to the Vietnamese community both.
0:47
[SPEAKER_02]: in the diaspora and in Vietnam, I'm sure there's so many people that are tuning in to your episode.
0:52
[SPEAKER_02]: So thank you for your veteran service and thank you for establishing this new YouTube video series.
0:59
[SPEAKER_00]: Thank you for the plug.
1:00
[SPEAKER_00]: It's a Dr. Lou or the Handos at Baxi.
1:04
[SPEAKER_00]: Lou BACS ILU.
1:07
[SPEAKER_00]: It's caught me by surprise how much responsive response I've had since starting this after I
1:14
[SPEAKER_00]: went to Vietnam for my second round of medical mission there and met a friend who basically taught me the technical side of how to start a YouTube channel.
1:24
[SPEAKER_00]: And I've been wanting to do this for some time, but just the technical steps of how to put a clip together, how to post it and be compliant with YouTube posting rules and regulations.
1:34
[SPEAKER_00]: And my focus was mental health,
1:39
[SPEAKER_00]: uh, in Vietnamese intended for our Vietnamese audience.
1:42
[SPEAKER_00]: Uh, I think there's a huge gap in that realm.
1:44
[SPEAKER_00]: Uh, and uh,
1:47
[SPEAKER_00]: not surprising and but very pleasant to know that I had overwhelming response in people asking questions people being open to like admitting there is a mental health need there is a mental health concern here for us to work with rather than more of like no that doesn't exist or we don't address that we don't talk about it stigma shame and hide kind of deal it's like
2:11
[SPEAKER_00]: It's in the open.
2:12
[SPEAKER_00]: I do have depression.
2:13
[SPEAKER_00]: I do have anxiety.
2:14
[SPEAKER_00]: I am living in Vietnam.
2:16
[SPEAKER_00]: And here's my limited range of resources.
2:19
[SPEAKER_00]: What can I do?
2:20
[SPEAKER_00]: And the thing, actually, question can be applied here.
2:23
[SPEAKER_00]: In America, I don't have access to all these things.
2:26
[SPEAKER_00]: What are my options to improve my mental health?
2:29
[SPEAKER_00]: So I found it to be extremely rewarding.
2:32
[SPEAKER_00]: And I look forward to continue to communicate and connect with the community about these topics
2:40
[SPEAKER_00]: to depression, to anxiety, PTSD, post-traumatic stress disorder, my bread and butter.
2:46
[SPEAKER_00]: And you know, all the ranges of bipolar, schizophrenia, medication, should I take it, should I not?
2:53
[SPEAKER_00]: And, you know, addiction, right?
2:55
[SPEAKER_00]: What are the challenges in treating addiction's relationship?
2:57
[SPEAKER_00]: I love talking about relationship and how all this top culture stuff is going on.
3:05
[SPEAKER_00]: endless topics.
3:06
[SPEAKER_00]: It's just where do I find the time to, you know, concentrate the material in a meaningful, helpful way, so I look forward to sharing more of that with anyone really to listen.
3:17
[SPEAKER_02]: Before we get to all the good stuff from why we're here, I want to compare notes with you.
3:22
[SPEAKER_02]: This is a question I'm beginning to ask everybody in this next five years of my podcast journey, which is.
3:32
[SPEAKER_02]: What is the next evolution of the Vietnamese people globally?
3:36
[SPEAKER_02]: Not only just in Vietnam, but also in America.
3:39
[SPEAKER_02]: And what is our job?
3:41
[SPEAKER_02]: And the reason I bring this up is because you just went back to Vietnam recently to go to a concert, meet them concert.
3:48
[SPEAKER_02]: I just got back from another concert.
3:50
[SPEAKER_02]: It's weird that we're both there for really, for concert.
3:54
[SPEAKER_02]: I was there for the Hein Thun concert in Dalat.
3:57
[SPEAKER_02]: Yeah, you were the foster dumb concert.
3:59
[SPEAKER_02]: Yeah, and when you're sitting in an audience in Vietnam now and you're looking at the performance in the sound stage and the I you probably grew in the era with me with Persevernite and we went to just a rich or you know, yeah, yeah, honey.
4:13
[SPEAKER_02]: This stuff is taking it to a whole another level.
4:17
[SPEAKER_02]: You know, you're sitting.
4:18
[SPEAKER_02]: I don't know how big me thumbs concert was, but mine was 2015-20,000 people in the audience and it was just electrifying to see and I turned over to the person that I went to the concert with and I said, I think I found my next question.
4:32
[SPEAKER_02]: My next question is, oh my god, like this is the evolution of society here in Vietnam and it's
4:39
[SPEAKER_02]: You know, went to the doby theater in LA, where the Oscars, Hanklyn actually did a concert back in October, you know, uh, I mean, at that, the same sort of like vibe.
4:49
[SPEAKER_02]: And I'm like thinking the evolution of Vietnamese people, all over the world is phenomenal.
4:55
[SPEAKER_02]: So I wanted to get your thoughts on that.
4:58
[SPEAKER_00]: Great question.
4:59
[SPEAKER_00]: And people might think I'm crazy, but I've been back to Vietnam six times in the last two years and make the leisure and business.
5:08
[SPEAKER_00]: A lot of it is traveling and a lot of it is in this new excitement of perhaps writing a book or documentary and following the Vietnam history story.
5:20
[SPEAKER_00]: And this most recent trip was purely a leisure with me thumb but sitting there
5:25
[SPEAKER_00]: in Vietnam's biggest stadium of San Vung, that we didn't, right?
5:32
[SPEAKER_00]: And thousands, I forget the exact number, but she broke the record.
5:35
[SPEAKER_00]: In having the most amount of people is just sold out seeds, standing in the front and sitting in the back, the whole stadium is lit up with these light sticks.
5:44
[SPEAKER_00]: You can't help but feel joy for such a war-torned country's history.
5:51
[SPEAKER_00]: to feel like this is where we're at.
5:53
[SPEAKER_00]: You know, I was right.
5:55
[SPEAKER_00]: That's the feeling that it's like they're not worried about dying.
5:59
[SPEAKER_00]: We're worried about like, you know, are we going to get a good seat to watch this show, you know?
6:03
[SPEAKER_00]: And we're enjoying the music that this
6:06
[SPEAKER_00]: you know to me is a remarkable performance artist singer who has maintained such sustainability and viability wholesomeness for over decade.
6:16
[SPEAKER_00]: I mean, yeah, kids growing up and now are adult having kids and still liking this, I barely knew about her in the last five years.
6:24
[SPEAKER_00]: That's how much under a rock I am, but you know, it's a same here.
6:27
[SPEAKER_00]: Yeah, but her charm, her wholesomeness and her artistry, what's not to like and what to see the positive influence on the country to see how much goodness can come out of one person's artistry.
6:44
[SPEAKER_00]: is remarkable, impressive, and you leave all the other parts aside like, is it us, is it them, and all that stuff, just leave it on the side, just enjoy the person for their performance, and enjoy the atmosphere, as if you're just in a concert anywhere else in part of the world.
7:02
[SPEAKER_00]: Don't don't don't start putting in things of like, oh, I'm here, I'm with this, I'm with that, it will taint to you.
7:08
[SPEAKER_00]: You know, it takes away from, really, the diaspora is we've chat to do this.
7:14
[SPEAKER_00]: We're in, yes, a transition of a different mindset.
7:18
[SPEAKER_00]: We get to experience this mindset compared to the folks who are in whatever mindset they had to do in their survival and development.
7:28
[SPEAKER_00]: And now we're in the same space.
7:29
[SPEAKER_00]: And we're enjoying this.
7:30
[SPEAKER_00]: And I was like, you know, benefiting from their creativity and, you know, like, smartness.
7:36
[SPEAKER_00]: It was like, I got to see
7:38
[SPEAKER_00]: behind the stage, right?
7:40
[SPEAKER_00]: I got to like check hands and give a gift and I was like, dude, that this is from someone's like motivation and willingness to go the extra miles to figure all this out to just like give us an opportunity to be that much more of an experience.
7:53
[SPEAKER_00]: Heck, yeah, you know, more power to this kind of growth and
7:59
[SPEAKER_00]: interest in the arts, interest in, you know, joyful and whole some parts of life, the whole reason why we're working so hard.
8:08
[SPEAKER_00]: Save up for these tickets, go.
8:09
[SPEAKER_00]: I spent four days there.
8:10
[SPEAKER_00]: I think I flew, I spent more time flying there than actually staying there.
8:15
[SPEAKER_02]: I love your answer because it really is showing the shape
8:20
[SPEAKER_02]: of the blending of our new generations.
8:23
[SPEAKER_02]: You know, they don't question it.
8:25
[SPEAKER_02]: They don't have identity issues.
8:27
[SPEAKER_02]: They don't.
8:27
[SPEAKER_02]: They really do not have, we are, you know, every time I talk to somebody in the media and in the entertainment sector now, it's dire asper people who have like this major shake-up with identity.
8:39
[SPEAKER_02]: And the more you go out in international waters, the more you're gonna be like confronted with this identity, but in Vietnam,
8:47
[SPEAKER_02]: kids that are growing up in Vietnam, they leave it on, they are just standing tall, they're just, you know, shredding there, they're walking around like, you know, that they're just complete people, meanwhile, like, you know, guys like me are like, you know, comparing everything, right?
9:02
[SPEAKER_02]: And it's, it's, it's a, it's a deadly place to be sometimes.
9:07
[SPEAKER_00]: Absolutely, it's, um,
9:10
[SPEAKER_00]: It's just reframing and reorienting and remembering who we are, what's our identity, and what we are about what we want in life.
9:20
[SPEAKER_00]: And you know, just keep an open mind to all that is a lesson, all it is to embrace and what we're thankful for.
9:30
[SPEAKER_00]: It's the same stuff I give to my mental health patients in therapy or just motivational talk, you know?
9:36
[SPEAKER_00]: It's like,
9:37
[SPEAKER_00]: you could very easily descend into a world of what's wrong with me and what's not going right and what I don't have and what I don't like about myself, what I don't like about life, and it'll just fester in that energy level, right?
9:52
[SPEAKER_00]: And so it doesn't matter who you are, where you are, you can still have this other mindset of I'm thankful for these things that I do have.
10:00
[SPEAKER_00]: And I'm thankful for the lessons I've learned from the things that have brought me challenges,
10:05
[SPEAKER_00]: and for me to overcome and for me to know the strength that is within me to do that.
10:10
[SPEAKER_00]: So I try my best to encourage for what are you thankful for mindset?
10:17
[SPEAKER_00]: What are you grateful for?
10:18
[SPEAKER_00]: It just elevates your thinking right away from a state of not having to a state of what is possible and doable because of what I am and who I am and what I do have.
10:29
[SPEAKER_00]: So
10:31
[SPEAKER_00]: It doesn't seem to matter boundaries or nationalities at that point, right?
10:35
[SPEAKER_00]: It's just what we're thankful for, what we can do in the context of our capability and gifts and talents, right?
10:43
[SPEAKER_02]: You know, before we get started into the heavy stuff, I need to ask you to define the difference between psychology and psychiatry.
10:54
[SPEAKER_02]: I think because those two terms are very closely related and so for the lay person like me who often, you know, wonder about the responsibilities of each of those roles and professions, psychiatrists do different things.
11:08
[SPEAKER_02]: Psychologists do different things.
11:11
[SPEAKER_02]: And I ask you that because it'll give us some context about psychiatric drug prescriptions that I'd like to really address on this podcast.
11:23
[SPEAKER_00]: Sure, great question.
11:24
[SPEAKER_00]: I love answering this question again and again, any chance anyone asks because it helps to give the whole complete picture of what mental health care is on the psychiatry side, my background.
11:39
[SPEAKER_00]: you go through medical school.
11:41
[SPEAKER_00]: You get an MD or a deal degree.
11:44
[SPEAKER_00]: You go through psychiatry residency to learn about, you know, the core of it is medication management.
11:53
[SPEAKER_00]: What psychiatric meds to prescribe?
11:55
[SPEAKER_00]: I feel like it's a loss because psychiatry continues to be more defined in just the
12:05
[SPEAKER_00]: when we first learned about this field is so broad.
12:08
[SPEAKER_00]: I mean like you're talking about psychology and therapy and all kinds of modalities and you had to learn so many things beyond just like what he's prosaxial off will be you turn and all that, right?
12:20
[SPEAKER_00]: So to me, it was great that I had to die-dactic in the foundation of psychiatry to know what to do in the case of psychotic episode, in the case of a
12:32
[SPEAKER_00]: by polar manic episode in the case of a severe depression episode.
12:36
[SPEAKER_00]: You need to know your meds to care of these kind of like extreme ends of mental health.
12:42
[SPEAKER_00]: But after you get the meds in, and then the person now is within the realm of reception ready to understand about themselves and do the therapy, you kind of got to synergize with the psychology side.
12:59
[SPEAKER_00]: My count of parts in psychology is a PhD, right?
13:03
[SPEAKER_00]: That's the highest level of the therapy side.
13:06
[SPEAKER_00]: There's many other ones.
13:07
[SPEAKER_00]: There's like licensed clinical social worker.
13:09
[SPEAKER_00]: There's like a licensed psychiatric, yeah, MFT's marriage family therapist or LPMHC, right?
13:17
[SPEAKER_00]: And nurse practitioners that go into mental health as well could do the med side or could try
13:23
[SPEAKER_00]: You know, the other aspects of mental health.
13:27
[SPEAKER_00]: But psychology PhD is the highest train the most amount of time involving research and clinical where you're learning different modalities.
13:37
[SPEAKER_00]: If you're going to be providing care for couples, what kind of couples therapy modality you need to know.
13:42
[SPEAKER_00]: If you're providing care for family therapy, what
13:45
[SPEAKER_00]: What clinical expertise do you need to have to have everyone in the room to talk to right and if you're a child psychologist are you a child psychiatrist that's also a subspecialty under psychiatry right and have the time child psychiatry psychologist who do you treat you actually treating parents more than you treat the child because
14:03
[SPEAKER_00]: there also contributing to the well-being of the child or the lack of it and you got to coach the whole circle of people to get the individual better, right?
14:14
[SPEAKER_00]: It's like, hey, my kid's not acting right.
14:16
[SPEAKER_00]: I was like, well, let's take a look at where the origin of this is and you know, you
14:21
[SPEAKER_00]: break it down and you're like, he sure could use some positive role modeling, right?
14:27
[SPEAKER_00]: We're we're we're we're we're not going to call it out outright, but there is a lot of influence and imprinting and we we've got to work at that if we're asking for these things and changes in people.
14:39
[SPEAKER_00]: What changes are we willing to work within ourselves and that goes for everything same with couples, right?
14:43
[SPEAKER_00]: They go and like fix my husband.
14:45
[SPEAKER_00]: You fix them, our marriage is good, right?
14:47
[SPEAKER_00]: And when we, you know, it's think about how the dynamics is evolved for us to feel like we need to fix and change the other person for the sake of our own happiness, right?
14:58
[SPEAKER_00]: And so all that needs to be unpacked and then the same goes for therapy.
15:03
[SPEAKER_00]: It's like having the sensitivity to synergize with the doctor that prescribed so that the patient can tolerate
15:11
[SPEAKER_00]: the distress when they're going through therapy.
15:14
[SPEAKER_00]: So a good example is what I do PTSD, post-traumatic stress disorder.
15:18
[SPEAKER_00]: Guys have extreme amount of anxiety.
15:21
[SPEAKER_00]: Very fearful, very hesitant to go into stress provoking kind of environment, crowded places, or noisy places, or just places where they feel like their amygdala is lighting up in scanning for danger.
15:39
[SPEAKER_00]: And if they're always scanning for danger, they're likely not in the mindset of taking in therapeutic suggestions.
15:48
[SPEAKER_00]: I'm always watching out like, what are you gonna do to me?
15:51
[SPEAKER_00]: What are you gonna do to me?
15:52
[SPEAKER_00]: What I was gonna happen to me, right?
15:54
[SPEAKER_00]: So with our hardware, I call it, but it's like, okay, let's get some medicine.
15:59
[SPEAKER_00]: Let's help with the anxiety.
16:00
[SPEAKER_00]: So your heart is not beating at 120 all the time.
16:04
[SPEAKER_00]: Let's help with the depressive side.
16:06
[SPEAKER_00]: Let's help with things that make you crave alcohol less.
16:11
[SPEAKER_00]: So if I put a combo, a starter package to help with your PTSD symptoms, and we kind of start seeing the positive response to the medication, what we arrive at is a person that's more in the doable range of emotions, rather than the extremes.
16:28
[SPEAKER_00]: And we're in the more cognitive right and ready kind of mind to receive the therapeutic interventions.
16:36
[SPEAKER_00]: Then we have this therapist, the psychologist, trauma therapist, do the work.
16:42
[SPEAKER_00]: Tell me about the most traumatic incident that you had.
16:45
[SPEAKER_00]: Tell me how it makes you feel what comes up in your body.
16:49
[SPEAKER_00]: Where does this sit in you?
16:51
[SPEAKER_00]: Where do you feel the pain?
16:52
[SPEAKER_00]: What emotions come up?
16:53
[SPEAKER_00]: What thoughts come to mind?
16:55
[SPEAKER_00]: And let's go with that, right?
16:56
[SPEAKER_00]: So these ways of extracting the information out comes easier when the person feels
17:05
[SPEAKER_00]: biologically safe and medically stable to do the work without having to feel like oh my god every time I feel anxious I'm going to go get a drink I'm going to go take a benzo I'm going to go do everything that is maladaptive but it's what I know and what I have access to and I do but now I'm okay with sitting with the discomfort I don't feel as uncomfortable and I can stay within this space so that my therapist can really challenge me and put in some
17:32
[SPEAKER_00]: difficult concepts with a clear and sober mind to take the information in.
17:37
[SPEAKER_00]: So I think that's a good example of the synergy in the best of both world of having the care of the psychiatrists and the psychologists.
17:47
[SPEAKER_00]: How feasible it is in today's insurance age and how cash, you know, finally it is and how cost effective it is.
17:55
[SPEAKER_00]: That's a whole different matter, you know.
17:58
[SPEAKER_00]: Yeah, so that's my long-winded answer for psychiatry psychology.
18:04
[SPEAKER_02]: In terms of actually, you know, we hear so much now and I know you're, you know, we talked about this earlier before we started the podcast is that, you know, you come from a very military world in your treatment and the patients that you've dealt with as a relates to veterans.
18:23
[SPEAKER_02]: But,
18:25
[SPEAKER_02]: Big Pharma is getting a bad rap for like, just putting a lot of pills out there and people are getting addicted to it and, you know, we're really living to kind of consume all these big Pharma products and yeah, I'm assuming a lot of it, you know, works obviously because otherwise they wouldn't be a business.
18:45
[SPEAKER_02]: But how much
18:48
[SPEAKER_02]: meds do we need for our body for our minds to get better?
18:52
[SPEAKER_02]: Can we not go to church?
18:53
[SPEAKER_02]: Can we not go to temple?
18:55
[SPEAKER_02]: Buddhist?
18:56
[SPEAKER_02]: Can we not talk more to therapists and use our words to get better?
18:59
[SPEAKER_02]: How much medication helps?
19:03
[SPEAKER_02]: How much does medication help the body to help the mind function?
19:10
[SPEAKER_00]: Good question.
19:13
[SPEAKER_00]: I think the the boring answer.
19:17
[SPEAKER_00]: is it depends.
19:19
[SPEAKER_00]: And in mental health, most of our answer is it depends because we like it to be on an individual basis, not everyone.
19:29
[SPEAKER_00]: I mean, there's an extent of a stereotypical thing that we can say it's similar enough, but then also everyone is different enough that we would like to approach it on a very individualized model.
19:42
[SPEAKER_00]: I love the individualized model because
19:47
[SPEAKER_00]: you, you have to really hear and know and take the time to encourage the person to really understand themselves before we even choose what treatment it is, right?
20:00
[SPEAKER_00]: I don't say like take this med and that's it, right?
20:04
[SPEAKER_00]: I actually offer a risk benefits alternative discussion of like here's what it looks like if you do decide to take this anti-depressant and here's what you can
20:16
[SPEAKER_00]: Um, if it doesn't work, here's what you can expect for us to do next and then here's the benefits of it and here's the alternative to it and here's the risk to it.
20:25
[SPEAKER_00]: If you don't take it, uh, what would that look like?
20:29
[SPEAKER_00]: And if, if, uh, you have all the other options of, uh, let's say most people say like give me the natural stuff.
20:37
[SPEAKER_00]: Give me the mindfulness, breathing yoga exercise diet and just go out and do all these fun stuff and I'm good, right?
20:46
[SPEAKER_00]: And if that was all that was needed, I think we wouldn't need any of this, right?
20:53
[SPEAKER_00]: Right.
20:53
[SPEAKER_00]: But the point remains that there is an individual journey of each person.
21:01
[SPEAKER_00]: And if you ask the person who has come back from the brink of, I want to kill myself, and I'm so thankful that this medication has helped me to stay in a more doable range.
21:16
[SPEAKER_00]: to be in a more like life is hopeful mindset rather than life is not worth living mindset.
21:23
[SPEAKER_00]: You know, we've done our job, right?
21:25
[SPEAKER_00]: So it depends because there's four components.
21:29
[SPEAKER_00]: I feel like there's the doctor, there's the patient, there's the, you know, the pharma.
21:34
[SPEAKER_00]: And I guess like if you wanna call it the world of how the world is going to be.
21:41
[SPEAKER_00]: do, what it does to you, how do you interface with the world, right?
21:45
[SPEAKER_00]: And then how do you interface with me as the provider who kind of like tracks your progress to adjust?
21:53
[SPEAKER_00]: And then, you know, how does that play into with the culture and then also the business side of things with medicine, right?
22:04
[SPEAKER_00]: Thank goodness we're in this era of more meds than not.
22:08
[SPEAKER_00]: Thank goodness that we're in less of an experimental time frame versus like lobotomy or some other very old style kind of way of approaching mental health.
22:21
[SPEAKER_00]: But we just got to stumble and learn through it all because
22:24
[SPEAKER_00]: There was, it was maybe the best of intention of everybody, but it didn't have as much of an evidence-based approach as what we have now.
22:34
[SPEAKER_00]: So thankfulness for that.
22:37
[SPEAKER_00]: I do think there is a big
22:41
[SPEAKER_00]: business influence like anything else.
22:43
[SPEAKER_00]: Farmer has has has its ways of wanting to make the money to make up for its research and all the regulation it has to go through and whatever else it does and saying like I got the special drug no one else has.
22:54
[SPEAKER_00]: I should be able to have the right to pay to make people pay for when it wants but then you know I don't know much about
23:09
[SPEAKER_00]: If you're in a system where you're just prescribing what is in your formulae and that's for the most part, you know, a large percentage of your prescription, your opportunity to get the different prescriptions will be less and then wanting those prescriptions will take a lot more steps before you can get it.
23:30
[SPEAKER_00]: So to be fair to the folks that can prescribe the new stuff and to experiment with the new stuff, you know, well, it's it's it's
23:38
[SPEAKER_00]: If you don't do, you wouldn't know, and then you've got to try to know, like, is this that much better?
23:42
[SPEAKER_00]: Is this new version of Prozac 2.0 or Zoloth 3.0, the better of what it is before?
23:49
[SPEAKER_00]: And are they really effective or is just a marketing thing where you change a little molecule?
23:56
[SPEAKER_00]: And you call it something else, just to maintain license, like uniqueness, to continue to charge people a premium price for.
24:04
[SPEAKER_00]: It's really just the same stuff as before.
24:08
[SPEAKER_00]: Um, to to to simplify, it is an individual journey of a person that is having a difficult time of, I'd like narratives of like timeline of like who were you before, who are you now and what has happened for you to be where you are for me to better understand, um,
24:34
[SPEAKER_00]: Is it a medication question?
24:36
[SPEAKER_00]: Is it a personality question?
24:38
[SPEAKER_00]: Is it a therapy only kind of thing?
24:40
[SPEAKER_00]: Say, yeah, I'd love to have just a therapy only.
24:42
[SPEAKER_00]: You wouldn't have to need the meds, but sometimes you got to need some of this stuff to lower the sympathetic system to enhance the safety factor inside you, to go to a psychologist for the therapeutic work.
24:58
[SPEAKER_00]: excuse me, one thing I did during residency was I actually did a whole course in psychoanalytic therapy.
25:07
[SPEAKER_00]: So that I would know if I psychologist was going to do a therapy what would it look like and so I basically tried to
25:15
[SPEAKER_00]: Uh, get into their world and learn from theirs and not just stayed on my side of like I prescribed the med you do talking.
25:21
[SPEAKER_00]: I, so most of my patients, I basically offer both.
25:27
[SPEAKER_00]: If I'm seeing them in a treatment context, whether they know it or not, I'm applying psychodynamics, psychotherapy principles along with my psychiatry, med management balance and I love that because I just don't feel like I would feel like I have enough to isolate and
25:45
[SPEAKER_00]: compartmentalizing do just the meds, but that's personal, you know, thing for me.
25:52
[SPEAKER_02]: How much of Vietnam and Vietnamese people in America is beginning to tune into the idea of
26:07
[SPEAKER_02]: getting to be better.
26:09
[SPEAKER_02]: And I'm not looking for any quantifiable sort of like percentages or ratios here.
26:14
[SPEAKER_02]: I'm just curious, you know, it seems like you have your ear to the ground in Vietnamese communities.
26:20
[SPEAKER_02]: Just wondering, how much of our previous generation is now understanding mental health is a real deal, a real issue.
26:36
[SPEAKER_00]: I went to a medical organization to ask if I could volunteer my mental health services to Vietnam to be years ago.
26:46
[SPEAKER_00]: They said we got to ask permission so they asked the Vietnam government and the summary was they're not ready for it and they don't think they need it at the same time.
27:00
[SPEAKER_00]: So that organization basically told me you can go as a primary care doctor, but you can't go as a mental health doctor.
27:08
[SPEAKER_00]: So I was like, whoa, that's unfortunate to hear.
27:14
[SPEAKER_00]: Two years ago, I went with another organization and there was also internal debate of like, we're not sure, but the bottom line
27:28
[SPEAKER_00]: And I was very excited because at least it's better than I know, right?
27:34
[SPEAKER_00]: So we went as a formal designation as a mental health.
27:38
[SPEAKER_00]: Actually, I'm done.
27:39
[SPEAKER_00]: and that was great.
27:40
[SPEAKER_00]: We had tremendous reception and we did a good job in being the ambassador of mental health for the population in need in the underserved and you know doing this medical mission.
27:54
[SPEAKER_00]: And last year we repeated it and I got even more.
27:57
[SPEAKER_00]: I saw 75 patients in three days in a matter of like maybe six hours a day and this is like a
28:06
[SPEAKER_00]: rapid fire one case after the next of like you know I'm not sleeping well my husband is beating me I'm stressed about life.
28:13
[SPEAKER_00]: I think I want to kill myself or I don't think I'm on the right mad so the whole gamut of what psychiatry would see here I saw there and you can see a need you can see a need and you can see a willingness to ask for help within that context of that
28:35
[SPEAKER_00]: It could be extrapolated to the general community of saying like those are the same types of life problems people would have, right?
28:44
[SPEAKER_00]: I'm not sleeping well, I'm worried about my finances, I'm worried about my kids, I'm worried about my relationship, I'm worried about myself, a lot of the worry and the road along, a lot of the anxiety, right?
28:59
[SPEAKER_00]: A lot of jump game, right?
29:00
[SPEAKER_00]: All these technical words, I didn't know before I started YouTube
29:04
[SPEAKER_00]: And yet, it's already heavily aware in the Vietnamese community and it was kind of refreshing to see that we're not having to describe at the basic level anymore and they are aware and it's just more of like, what can you do to help me, right?
29:24
[SPEAKER_00]: Contrast that with over here.
29:28
[SPEAKER_00]: I do see so much during my day job of non-venomies and military types, so the residual left over time that I do seevenomies is a lot less, so it's hard to say the representation of it, but of the few that I see.
29:47
[SPEAKER_00]: I don't see.
29:48
[SPEAKER_00]: I do see a willingness to ask for help again.
29:52
[SPEAKER_00]: It is a makes some are less willing to try this and that and some are more open to.
29:58
[SPEAKER_00]: So, in the grand scheme of things, I would say, Vietnamese are
30:03
[SPEAKER_00]: more open to it are more receptive to the idea of asking for help and getting the help.
30:13
[SPEAKER_00]: I do face a lot of dismissive people like thinking like, you know, it's not necessary.
30:18
[SPEAKER_00]: It's just whatever not real medicine and you know, we we have so much business from the ones who need it that I don't have time to.
30:27
[SPEAKER_00]: It's just down and saying, yeah, you know, there's this is encounter and it's just, we'll work on the ones that are willing to get the help.
30:33
[SPEAKER_00]: So, yes, the need is there, the willingness to get the help is there and the openness to understand the degree of help and, you know,
30:54
[SPEAKER_02]: Yeah, and it looks like that as a society as a whole.
30:57
[SPEAKER_02]: It looks like it's everybody's sort of tuning into this mental health deal.
31:03
[SPEAKER_00]: Oh, yes, yes, yes, yes, psychiatry residency training used to be seen as not as popular.
31:13
[SPEAKER_00]: It's more like, you know, it's, it's just not a field that people want to go into for, for whatever reason, thinking like it's just, you know, not, not, not the fun exciting residency, but now it is one of the most sought after.
31:26
[SPEAKER_00]: when they realize how much in demand the job is and how rewarding the job is and how what an amazing lifestyle of work-life balance it brings, you know, you work this many hours, you have this many hours to go play, you know, it's like it's not like you're just tied into it and you're sucked into it and you just don't ever see the end of the day and then, you know, doing other stuff you enjoy doing.
31:49
[SPEAKER_00]: So the
31:54
[SPEAKER_00]: and the world is a whole nose.
31:56
[SPEAKER_00]: We need to train more mental health doctors to chase this need.
32:00
[SPEAKER_00]: So, which is spells out good for our business for now, I guess.
32:05
[SPEAKER_00]: We're thankful that we're in demand.
32:08
[SPEAKER_02]: So as it relates to the improving mental health, general mental health of the Vietnamese community, I feel like it's getting better every day, but we're not quite out of the bushes yet.
32:22
[SPEAKER_02]: We're not in the clear just yet because I feel like there's these patterns that we have within our culture and our tradition.
32:29
[SPEAKER_02]: There's these things that prevent
32:32
[SPEAKER_02]: And I mean, intimacy from men and women to parent and child, intimacy in its real form is being real, right?
32:42
[SPEAKER_02]: I feel like that is such a big thing that causes a lot of mental health problems.
32:47
[SPEAKER_02]: And it causes like this inability for families to be really real with each other.
32:55
[SPEAKER_02]: And it's a clash between being able to kind of like be real about things, but yet it affects us on a very deep mental health level.
33:06
[SPEAKER_02]: Do you encounter that?
33:07
[SPEAKER_02]: And you're just at your everyday dealings with people in the Vietnamese community?
33:14
[SPEAKER_00]: Yes.
33:19
[SPEAKER_00]: You know, the whole politeness and the cultural
33:25
[SPEAKER_00]: trying to say things without saying things and being in direct, right?
33:30
[SPEAKER_00]: It can be exhausting to try and read.
33:33
[SPEAKER_00]: What are you really saying?
33:34
[SPEAKER_00]: How can I really hear what you're saying underneath what you're not saying?
33:39
[SPEAKER_00]: To be fair.
33:41
[SPEAKER_00]: I'm learning within my own day job working in the VA corporate structure or the Navy side of things before.
33:52
[SPEAKER_00]: We do a fair amount of saying without saying, right?
33:56
[SPEAKER_00]: And you got to be a poker player to go into a board meeting to know, like, okay, when to speak up, when not to.
34:05
[SPEAKER_00]: And how to listen to the message when they're not saying it all the same.
34:09
[SPEAKER_00]: Right, so do I say this is a Vietnamese thing or do I say this is a human thing, a personal thing that we just got to learn to have more emotional intelligence and awareness to be sensitive to how humans communicate and I did not think it was a big deal in growing up and staying in the cocoon of like Orange County and among the Vietnamese community, but when I
34:36
[SPEAKER_00]: had to transplant myself to out-of-state schools for medical school, for masters, and then all that other Navy stuff, and the different organizations, I keep running into different organizations, and the multi-fripeted itself of how communication happens, the non-verbals versus what is said, right?
34:57
[SPEAKER_00]: The body language, the type of culture that this
35:01
[SPEAKER_00]: organization is in and how do you read the information, how do you read the people in the room, how do you know who you are to best match the needs of the service that you're as a participant of.
35:13
[SPEAKER_00]: I feel like the stereotype went away and it more was like, what do I need to do to improve my skills of understanding and reading people?
35:25
[SPEAKER_00]: that was more important like no matter who I got to still know is my boss really saying that or is my wife really saying that do I really understand so um but the cultural nuance I'll I'll I'll I'll I'll I'll try to stay on the point the cultural nuance of us being Vietnamese and how we just can't really
35:49
[SPEAKER_00]: say it because we would either be judged as too harsh, too honest, too brutal, too blunt or you know, they're not ready to listen or you don't want to offend.
36:02
[SPEAKER_00]: The range is there, right?
36:05
[SPEAKER_00]: And at what cost is that to the authenticity of the relationship versus in what environment can you
36:18
[SPEAKER_00]: I just don't feel this about you, or I'm, you know, I really am frustrated with you doing this, right?
36:25
[SPEAKER_00]: Can we have an honest talk?
36:27
[SPEAKER_00]: I think it could be there, and if you're talking about generational, we are better off now in having that dialogue than we were before.
36:38
[SPEAKER_00]: I don't think our parents could have that dialogue compared to the current
36:44
[SPEAKER_00]: folks.
36:44
[SPEAKER_00]: If we're bringing it up, I think the folks would agree that they have a much better time communicating with their spouse counterparts than the parents did.
36:53
[SPEAKER_00]: So as a whole, I would think we are more for the sake of the cultural shift, the increase awareness, the openness, the desire to remain authentic and genuine.
37:08
[SPEAKER_00]: It has certainly helped, but the nuance is of the
37:13
[SPEAKER_00]: I think you get it more when you're actually in the room with the couple or when you with the person and you ask them, I wonder why you didn't tell them that you were so irritated.
37:25
[SPEAKER_00]: I wonder what held you back from really saying what was on your mind, but you're here, you're just, you know, you're causing them out right here in this room, but yeah, there you were like, I don't know, I couldn't say or I didn't want to say and I'm just frustrated and it's like,
37:43
[SPEAKER_00]: why you dismissed your own emotions and had to put on this face, but then now you're here trying you're letting and saying like rescue me from this emotion that I'm having, right?
37:55
[SPEAKER_00]: So, um,
37:57
[SPEAKER_02]: It's that this is a big problem in in Vietnamese culture and I think a lot of Asian cultures that use honorifics like back to go gone right because we just start to throw the honorifics down when you start to throw titles in you don't want to disrespect your grandmother you know yeah to buy you know y'all mongenai it's just a great
38:25
[SPEAKER_02]: you actually embody the physical side of the difference and you know, it comes a thing and it really is I think an impediment to our
38:39
[SPEAKER_02]: You know, I wish we had a live show, you and I, uh, just to take in incoming rounds, right?
38:44
[SPEAKER_02]: Uh, okay.
38:45
[SPEAKER_00]: Yeah.
38:46
[SPEAKER_02]: Uh, yeah.
38:47
[SPEAKER_02]: Like the love line, like back in the 90s, you know, yeah, as a girl, uh, I love line and they would just, you know, take all these questions about relationships and sex and, you know, okay.
38:57
[SPEAKER_02]: Dr. Drew was a medical doctor and, you know, I think it was a psychiatrist too.
39:02
[SPEAKER_02]: Uh, I think so.
39:03
[SPEAKER_02]: I think so.
39:04
[SPEAKER_02]: Yeah, I'll play.
39:05
[SPEAKER_02]: Yeah, Corolla, you play Dr. Drew.
39:08
[SPEAKER_03]: Yeah.
39:09
[SPEAKER_02]: Yeah, yeah, yeah.
39:12
[SPEAKER_02]: do didn't mean version of that.
39:14
[SPEAKER_02]: That would be cool.
39:15
[SPEAKER_02]: But I think it's changing in Vietnam.
39:18
[SPEAKER_02]: I think that there are therapists and psychiatrists.
39:21
[SPEAKER_02]: I don't know about psychiatrists, but I know therapists are coming on to the scene.
39:26
[SPEAKER_02]: But there's no governing body.
39:27
[SPEAKER_02]: There's not 3,000 hours as an MFT, but I know that a lot of, you know, I mean the more money you have, the more problems you're going to have.
39:35
[SPEAKER_02]: And I think
39:35
[SPEAKER_02]: more money-ball problems, right, as they say, and as a developing country that is becoming more and more rich as the days progress, I think the therapy business is going to be a booming market.
39:51
[SPEAKER_00]: My wish as an educator, Dreamer, kind of thing, is to enhance it.
39:57
[SPEAKER_00]: If you're going to be treating people, you should do it responsibly.
40:06
[SPEAKER_00]: and bring some of the safety factors, especially if you're talking about in the Vietnamese context of difference and like do what the doctor says or do what back says and do what on says.
40:15
[SPEAKER_00]: And if they are not with the most informed academically or scientifically to make these decisions and we've got to defer to them, we're not doing ourselves a favor.
40:27
[SPEAKER_00]: So to form a, you know,
40:35
[SPEAKER_00]: gosh, an education system that allows for residency training in equivalent and, you know, the safety rules that goes into like protect the patient's face interest like, I wonder, what is the restraint laws look like when you have to tie someone up in Vietnam?
40:55
[SPEAKER_00]: I wonder if there is even a law or because over here, if I had to put any patient under any kind of
41:04
[SPEAKER_00]: You know, scratching themselves or they're flinging poo at the doctors, you tie them down, right?
41:10
[SPEAKER_00]: But then even then, you have to write out like clinically, uh, why and how long you're going to do it for.
41:16
[SPEAKER_00]: How are you going to reassess and how are you going to like make sure that you can, uh, not try to restrain them again, you know, what measures you would take.
41:24
[SPEAKER_00]: So it goes through a long list of things before you can put a person in restrain.
41:31
[SPEAKER_00]: What's the standards there, right?
41:33
[SPEAKER_00]: So I would love to see some kind of patient protection, standardize educational format to that.
41:40
[SPEAKER_00]: And if I can be in any way, shape or form to participate in that, it would be a synergy of using what I enjoy doing to enhance the quality of life for all involved.
41:56
[SPEAKER_02]: So yeah.
41:59
[SPEAKER_02]: Yeah, that's just one little aspect, one sliver.
42:03
[SPEAKER_00]: Yeah, what they call it 50, 50 ones or 51, 50s is the 50, 51, 50 is the first 72 hours, 52, 50 is the next 14 hours.
42:13
[SPEAKER_00]: So if you believe a person's medically and mentally unstable, when you first see them in the ER, and you think there will be a danger to themselves, a danger to others, or their gravely disabled, and they can't take care of themselves.
42:27
[SPEAKER_00]: you as a psychiatrist have the ability to put them on a 51 50 involuntarily admit them against their will.
42:37
[SPEAKER_00]: They will say, I want to go home.
42:39
[SPEAKER_00]: I don't want to stay here, but they still have thoughts of wanting to hurt themselves.
42:43
[SPEAKER_00]: They still have thoughts of hurting other people.
42:45
[SPEAKER_00]: They do not have that privilege to be discharged, right?
42:50
[SPEAKER_00]: You would hold them.
42:56
[SPEAKER_00]: ready.
42:57
[SPEAKER_00]: They need another 14 days in here.
42:59
[SPEAKER_00]: That's the 5250.
43:02
[SPEAKER_00]: On the 5250 you actually have to prove to the court that the patient needs to stay.
43:08
[SPEAKER_00]: So the court assigns a judge that comes to the psych ward and you on the doctor side and the patient on the other side and the patient with state their case of why they think they're ready to go home and you the doctor would say like I don't think this patient is clinically ready to go home.
43:22
[SPEAKER_00]: The judge hears both side and decides
43:27
[SPEAKER_00]: If the patient is further impaired and, you know, after the 52-50 and you still think they need to stay in, you do what's called a temporary conservatorship, that's 30 days.
43:40
[SPEAKER_00]: And then a permanent conservatorship is for life.
43:42
[SPEAKER_00]: You find a family member or state designated and you just keep this person, you know,
43:49
[SPEAKER_00]: basically under a mental health care institution.
43:51
[SPEAKER_00]: But that's on the rare end of things.
43:54
[SPEAKER_00]: More the percentages is they are cleared within the 72 hours, they're cleared within the 14 days and they go home.
44:00
[SPEAKER_00]: So, but yeah, those those kind of rules, it would be nice to see what we have standardized in, you know, a system that is going to integrate more of mental health care on, you know,
44:11
[SPEAKER_00]: system wide bases kind of that.
44:13
[SPEAKER_00]: I don't know what it's like in Vietnam, but I would love to see in here and learn about it too.
44:18
[SPEAKER_02]: Yeah, I'm going to make a completely left turn here for you.
44:23
[SPEAKER_02]: I'm going to like, you know, as I'm hearing you talk about all this stuff, it's very mechanical and I'm thinking about human beings as spiritual beings and for somebody like you who's been practicing psychiatry and giving therapy, verbal therapy to patients all these years and you've probably seen people become not themselves.
44:51
[SPEAKER_02]: Do you ever think about like, what's in the body and the mind that, you know, is it a spiritual thing?
44:58
[SPEAKER_02]: Is it just a mechanical thing that we are, you know, there's chemicals running around in our brains.
45:04
[SPEAKER_00]: What's your spiritual stance on on human sort of thinking and behavior?
45:21
[SPEAKER_00]: you know on the extreme side first the easier side on the extreme side of clinically assessing someone there is a tendency of we say like this person's hyper-religious this person is you know just like is on the extreme of hearing Jesus talk to them directly or like they are the Messiah and they're going to do these things right and then
45:45
[SPEAKER_00]: I don't think we go into a debate of saying, like, are they really Jesus?
45:48
[SPEAKER_00]: And we don't know it, but we just say, like, you know, okay, this person is of this mindset and there's not a peer to have the within the normal range of the mental status for us to function on the society level and is it impairing their day-to-day functioning?
46:08
[SPEAKER_00]: Is it impairing with their job, their family relationship and their own health?
46:13
[SPEAKER_00]: if it does hit those realms in a very impactful way, you would then call it a disorder, right?
46:20
[SPEAKER_00]: A mood disorder, a schizoaffective disorder, or, you know, a schizoid or a schizophrenia, right?
46:28
[SPEAKER_00]: It depends on not schizoids, schizophrenia.
46:31
[SPEAKER_00]: So, um,
46:32
[SPEAKER_00]: you make a western diagnosis to it of like these are the the core symptoms the auditory hallucinations the visual hallucinations and you just label it and you just flap on the label and the treatment that's the mechanical side, but it is what it is and you you and you go for that as what you know to to address the issue.
47:02
[SPEAKER_00]: You know, the fervor of the spirituality, the feeling like they are so close to God.
47:08
[SPEAKER_00]: They are such a connection and, you know, they, if they are functioning and they're integrated and they are not negatively impacting their own health or the relationship of those around them.
47:28
[SPEAKER_00]: who are we to say?
47:30
[SPEAKER_00]: We leave it be, right?
47:32
[SPEAKER_00]: More power to you.
47:34
[SPEAKER_00]: Um, I only, you know,
47:38
[SPEAKER_00]: enter the conversation when either the patient him or herself or the family member says or the cop that brings them in and says this person is negatively impacting their family and their community and they believe they are Jesus and they're going to do all these things to these people and they're just not within
47:59
[SPEAKER_00]: the realm of a redirection and redirectable and to kind of like come back to how we socially normalize and believe a person should be in believing Jesus but not believing that they are Jesus.
48:14
[SPEAKER_00]: So I've learned to what I really like about psychiatry that has taught me is
48:29
[SPEAKER_00]: um, and just more patient and open to meeting the patient where they're at.
48:39
[SPEAKER_00]: It sounds easy, but it's difficult when you have so much of stereotypes and biases of who you are.
48:44
[SPEAKER_00]: The lens is that you bring into the world of seeing people and you try to have on neutral lens, but then you know, it's just like if you have certain
48:54
[SPEAKER_00]: values and principles that doesn't agree with this person, and you're the treatment provider for them, how will you not contaminate the treatment relationship in a fair way, right?
49:07
[SPEAKER_00]: Sometimes it's okay to excuse yourself.
49:09
[SPEAKER_00]: It's okay to say like, I do not believe I have the best of consistency in not having such a strong counter-transference to this person.
49:19
[SPEAKER_00]: And I would like to recommend this person to find another provider that they would feel like it's more, you know, attuned and agreeable to their values and beliefs.
49:30
[SPEAKER_00]: But I don't think I would be a fair person in providing care for this person.
49:35
[SPEAKER_00]: So, you know, have I done that?
49:37
[SPEAKER_00]: It's more of by the time the patients realize that they are not a good fit for me and they excuse themselves.
49:44
[SPEAKER_00]: I haven't had to say like,
49:47
[SPEAKER_00]: you got to go away.
49:49
[SPEAKER_00]: I can't treat you.
49:49
[SPEAKER_00]: I rather allow for it.
49:50
[SPEAKER_00]: And then they, they, they find it for themselves.
49:53
[SPEAKER_00]: So there's that.
49:55
[SPEAKER_02]: Yeah.
49:55
[SPEAKER_02]: I ask you about that.
49:57
[SPEAKER_02]: Yeah.
49:57
[SPEAKER_02]: You know, because I think the next evolution sometimes for me is to really be in Vietnam to, to, to, yes, to be a part of the therapy community.
50:07
[SPEAKER_02]: I, I, I gravity towards that a lot.
50:09
[SPEAKER_02]: And you know, there's a lot of religion
50:17
[SPEAKER_02]: your thoughts on, you know, psychedelics and mushrooms and all of these other, I mean, their ancient forms of medicine, but they're new, they're new, they're new, um, untested,
50:34
[SPEAKER_02]: not a whole lot of empirical data on these new modalities of treatment, but it's being introduced into PTSD in the military, right?
50:44
[SPEAKER_02]: So the cyber and all of these other, you know, mother earth kind of treatments.
50:51
[SPEAKER_02]: What you're taking on all that?
50:53
[SPEAKER_02]: And I asked that again because in context to one day Vietnam adopting all of these treatments, I'm curious to hear your thoughts.
51:05
[SPEAKER_00]: I am on the conservative side of it.
51:08
[SPEAKER_00]: I'm more of like, let's wait until all my smarter friends can figure it out and do all the research and show me a compelling treatment algorithm that is really evidence-based and compelling because it's still in the experimental phase.
51:24
[SPEAKER_00]: I hold my opinion on its effectiveness, it's whether it's a yay or a nay.
51:31
[SPEAKER_00]: way more smarter friends that are doing that.
51:35
[SPEAKER_00]: I stay in the like, I'll stick with what I know.
51:37
[SPEAKER_00]: I have plenty of work to do in just the realm of the what's already approved.
51:45
[SPEAKER_00]: And when that is like all done and proven time and time again is effective, then bring me in and teach me and I'll
52:00
[SPEAKER_00]: cannabis is so generally accepted and now you can get a medical license for it and you can do all these things and then no one questions you anymore using it.
52:10
[SPEAKER_00]: Have I seen enough improvement from people taking it medical marijuana that they no longer need anything else and they're doing fine.
52:29
[SPEAKER_00]: And it needs a whole complete picture, like how I said before, you need a psychiatrist, you need psychologists, the self medication, the word self medication worries me.
52:39
[SPEAKER_00]: Right.
52:41
[SPEAKER_00]: You're not formally trained.
52:42
[SPEAKER_00]: You don't know enough, but then you just want to go with the belief that you have that you want the natural stuff and you don't want the doctors to tell you what to do.
52:49
[SPEAKER_00]: Nor do you believe in the psych meds and nor do you believe that the the the talk therapy would do anything.
52:56
[SPEAKER_00]: So what's successful.
52:57
[SPEAKER_00]: What's easy.
52:58
[SPEAKER_00]: Let me just go out and buy this thing and use it.
53:02
[SPEAKER_00]: So.
53:04
[SPEAKER_00]: I.
53:05
[SPEAKER_00]: find that the guys who haven't had success with all that, doc, I tried it.
53:09
[SPEAKER_00]: Right?
53:11
[SPEAKER_00]: I'm still an angry guy.
53:13
[SPEAKER_00]: I'm still an anxious guy.
53:15
[SPEAKER_00]: I'm still this not happy guy.
53:17
[SPEAKER_00]: I'm like, yes, I'm so glad you recognize, I'm having awareness of that because that's half the battle.
53:25
[SPEAKER_00]: Let's work on it.
53:26
[SPEAKER_00]: Let's understand the root of it from a therapy angle from, you know, the hardware side of that didn't work.
53:31
[SPEAKER_00]: That means like there's other things to try.
53:33
[SPEAKER_00]: I'm not saying everyone needs to try
53:35
[SPEAKER_00]: antidepressants.
53:37
[SPEAKER_00]: I'm more often than not, start with like, what can I do without needing the meds, and only when the conversation arises to, I think there's an opportunity here to do more with this than we will introduce that.
53:50
[SPEAKER_00]: And I get a lot of buy-in from my patience because I don't push it.
53:55
[SPEAKER_00]: I let the
53:57
[SPEAKER_00]: and I always do my best to describe all the stuff before I do like here's here's here's prosak what I can do for you here's what most people think it will do and here's what it actually does um sometimes people think like taking a med and then having it as well is them being addicted to it right I don't want to be addicted to anti-depressants I'm like mmm
54:23
[SPEAKER_00]: Can I help explain that addiction is on a different algorithm and a different mechanism?
54:29
[SPEAKER_00]: This is just what we designed it to do.
54:31
[SPEAKER_00]: It's to go into your brain, saves you the amount of serotonin you have so that you feel less depressed.
54:38
[SPEAKER_00]: That's not addiction.
54:39
[SPEAKER_00]: That's just science, okay?
54:40
[SPEAKER_00]: Addiction is when you feel like,
54:44
[SPEAKER_00]: You can't control it and your body is like adjusted to the dose and you need a higher dose to feel some kind of a rewarding effect.
54:52
[SPEAKER_00]: For example, a benzodiazepine, Xanx, and a van, right?
54:56
[SPEAKER_00]: or a stimulant like cocaine or math or, you know, the legalized form, adder all and they get it and misuse it from somebody or, you know, alcohol, right?
55:08
[SPEAKER_00]: I was like, I drink to sleep.
55:09
[SPEAKER_00]: I don't wanna drink because I'm an addictive person, but then it slowly becomes over time.
55:15
[SPEAKER_00]: I drink it because I can't sleep and then I can't be not angry without it, right?
55:21
[SPEAKER_00]: So,
55:23
[SPEAKER_00]: It just drives my decision making day after day.
55:27
[SPEAKER_00]: If I'm angry, I need to drink if I'm not sleeping, I need to drink and it slowly becomes a dependent pattern where you can't function without it.
55:45
[SPEAKER_00]: Those are the realms we look for in addiction that's like, hey, all these things are not going your way because of this one pattern of behavior.
55:54
[SPEAKER_00]: So, I try my best to explain the difference between taking a medication that is effective versus mistaking it as being addicted to a medication, which has its own realm and, you know, explanation for those things.
56:11
[SPEAKER_02]: great answer.
56:11
[SPEAKER_02]: You know, I want to experiment this next question, final question in Vietnamese, and the reason I want to play with this right now is because perhaps there are some of our listeners
56:32
[SPEAKER_02]: Our Vietnamese, but don't speak to their parents as much and perhaps this next question could be shown to their parents to show that both of us are speaking Vietnamese, they could show the parents so they can go to your channel.
56:48
[SPEAKER_02]: So I kind of want to do a plug, but I also have a little fun with the question.
56:53
[SPEAKER_02]: So if you don't mind, maybe we do a few minutes in Vietnamese, and I think that's always a fun thing.
57:00
[SPEAKER_02]: So here we go.
57:01
[SPEAKER_02]: And we could do one or two questions, but I've shared with one, that is on my mind.
57:08
[SPEAKER_02]: To Bakshi, a Kenneth Munghoid, like Ninky Feng Ma'am, Ben Pornography, AI, Ninky Mangsahoid.
57:30
[SPEAKER_02]: Thank you so much for coming to Vietnam.
57:34
[SPEAKER_02]: I'm a big fan of Vietnam.
57:39
[SPEAKER_02]: Thank you very much.
57:44
[SPEAKER_02]: I think that when I was a kid, I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot of fun and I had a lot
58:13
[SPEAKER_00]: How did you feel when you were a student at the time of the year when you were a student at the time of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the year of the
58:39
[SPEAKER_00]: Kimukui, Bomea, Damdoukong, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, Døi, D
59:07
[SPEAKER_00]: If you want to know how to do it, you can do it with your own hands, and then you can do it with your own hands, and then you can do it with your own hands, and then you can do it with your own hands, and then you can do it with your own hands, and then you can do it with your own hands, and then you can do it with your own hands, and then you can do it with your own hands, and then you can do it with your own hands, and then you can do it with your own hands, and then you can do it with your own hands, and then you can do it with your own hands, and then you can do it with your own hands, and then you can do it with your own hands, and then you can do it with your own hands, and then you can do it with your own hands, and then you can do it with your own hands, and then you can do it with your own hands, and then you can do it with your own hands, and then you can do it
59:35
[SPEAKER_00]: And this is the first time I've ever had a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a chance to have a
1:00:13
[SPEAKER_00]: And I'm going to use KKReward Center.
1:00:17
[SPEAKER_00]: I'm going to teach you how to make a ramen noodle dish.
1:00:22
[SPEAKER_00]: I'm going to make a noodle dish.
1:00:24
[SPEAKER_00]: I'm going to make a noodle dish with this dish.
1:00:27
[SPEAKER_00]: I'm going to teach you how to make a noodle dish.
1:00:30
[SPEAKER_00]: I'm going to use a ramen noodle dish.
1:00:33
[SPEAKER_00]: I'm going to teach you how to make a noodle dish.
1:00:36
[SPEAKER_00]: I'm going to teach you how to make a noodle dish.
1:00:39
[SPEAKER_00]: And if you want to make sure that you have a reward, then you have to make sure that you have a reward.
1:00:47
[SPEAKER_00]: If you have a reward, then you have to make sure that you have a reward.
1:00:51
[SPEAKER_00]: Then you have to make sure that you have a reward.
1:00:58
[SPEAKER_00]: Then you have to make sure that you have a reward.
1:01:01
[SPEAKER_00]: Then you have to make sure that you have a reward.
1:01:03
[SPEAKER_00]: I think it's more like a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a consumer, a
1:01:30
[SPEAKER_00]: K-O-Gridham, a.k.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a.a
1:01:52
[SPEAKER_00]: I don't know what to do.
1:01:53
[SPEAKER_00]: I don't know what to do.
1:01:55
[SPEAKER_00]: I don't know what to do.
1:01:56
[SPEAKER_00]: I don't know what to do.
1:01:59
[SPEAKER_00]: I don't know what to do.
1:02:02
[SPEAKER_00]: I don't know what to do.
1:02:04
[SPEAKER_00]: I don't know what to do.
1:02:05
[SPEAKER_00]: I don't know what to do.
1:02:24
[SPEAKER_00]: He was a member of the United States and he was a member of the United States and he was a member of the United States and he was a member of the United States and he was a member of the United States and he was a member of the United States and he was a member of the United States and he was a member of the United States and he was a member of the United States and he was a member of the United States and he was a member of the United States and he was a member of the United States and he was a member of the United States and he was a member of the United States and he was a member of the United States and he was a member of the United States and he was a member of the United States and he was a member of the United States and he was a member of the United States and he was a member of the United States and he was a member of the United States and he was a member of the United States and he was a member of the United States and he was a member of the United States and he was a member of the United
1:02:52
[SPEAKER_00]: I'm not sure if there's a reason for this, but I'm not sure if there's a reason for this, or if there's a reason for this, or if there's a reason for this, or if there's a reason for this, or if there's a reason for this, or if there's a reason for this, or if there's a reason for this, or if there's a reason for this, or if there's a reason for this, or if there's a reason for this, or if there's a reason for this, or if there's a reason for this, or if there's a reason for this, or if there's a reason for this, or if there's a reason for this, or if there's a reason for this, or if there's a reason for this, or if there's a reason for this, or if there's a reason for this, or if there's a reason for this, or if there's a reason for this, or if there's a reason for this, or if there's a reason for this,
1:03:17
[SPEAKER_00]: I'm not sure if there's any other way around, but I'm not sure if there's any other way around.
1:03:22
[SPEAKER_00]: I'm not sure if there's any other way around, or if there's any other way around, I'm not sure if there's any other way around, or if there's any other way around, I'm not sure if there's any other way around, or if there's any other way around, or if there's any other way around, or if there's any other way around, or if there's any other way around, or if there's any other way around.
1:03:36
[SPEAKER_00]: I'm not sure if I can do it, but I'm not sure if I can do it, but I'm not sure if I can do it, but I'm not sure if I can do it, but I'm not sure if I can do it, but I'm not sure if I can do it, but I'm not sure if I can do it, but I'm not sure if I can do it, but I'm not sure if I can do it.
1:03:49
[SPEAKER_00]: So, what do you think about the future and the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of the future of
1:04:16
[SPEAKER_00]: But I can't identify the common language now.
1:04:21
[SPEAKER_00]: Now, I want to talk about the common language.
1:04:25
[SPEAKER_00]: I want to talk about the common language and the common language.
1:04:30
[SPEAKER_00]: I want to talk about the common language.
1:04:32
[SPEAKER_00]: I want to talk about the common language.
1:04:34
[SPEAKER_00]: I want to talk about the common language.
1:04:36
[SPEAKER_00]: I want to talk about the common language.
1:04:38
[SPEAKER_00]: I want to talk about the common language.
1:04:41
[SPEAKER_00]: I want to talk about the common language.
1:04:46
[SPEAKER_00]: Thank you very much for your support.
1:04:50
[SPEAKER_00]: Thank you.
1:04:51
[SPEAKER_01]: May, uh, you know, do me scrolling there, you know, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no,