Latest / Radically Genuine / 136. I drank the Kool-Aid for a while w/ Florian Birkmayer, MD

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136. I drank the Kool-Aid for a while w/ Florian Birkmayer, MD · Radically Genuine

• Welcome to the Radically Genuine Podcast, I'm Dr. Roger McFillin. There is a large growing movement globally recognizing the harms of psychiatric care, the limitations of categorical DSM diagnoses that lack scientific validity and resemble more dystopian reflections of humanity than anything we can reliably agree upon as scientific. Yet many psychiatrists communicate them as if they're diseases. I'm sorry to have to reveal to you, but you have borderline personality disorder, generalized anxiety disorder, and major depressive disorder. The unsuspecting patient or family member automatically equates this to a medical condition and not some archaic label from robotic drones limited in providing any critical analysis of such an idea in the first place. This movement, which is certainly driven by a large and vocal global community of hardened Sean (00:58.329) professionals across disciplines. We now know more about the harms of psychiatric drugs, how their effectiveness was fraudulently distorted to the medical professionals and the general public and that the pharmaceutical industry that promotes them is a criminal organization that is fined yearly by regulatory agencies for misrepresenting their science base. The FDA routinely approves drugs that have not developed efficacy nor studied long-term. keenly prescribed toxic pharmaceuticals off-label for our most vulnerable of populations, young children, developing adolescents. This movement highlighting the harms, which I might add is our legal and ethical right to have access to this information, is being deemed an anti-psychiatry movement. I myself and this podcast are often labeled as anti-psychiatry by those in the establishment who wish to maintain their illegitimate authority. What is ironic is that ethical and conscious psychiatrists are abandoning this corrupt specialty in droves. Can it be anti-psychiatry when psychiatrists themselves are branching off to de-prescribing these drugs and adopting alternative perspectives and treatments? I think as a general field, we have to ask ourselves some critical questions. Are human beings void of a soul? Is life nothing more than our brain projecting a consciousness where Our emotions, thoughts, and behavior are driven by genetic determinism? Do we trust that psychiatry has made any meaningful advancement of the human condition? Or has it perpetuated false ideas, misrepresented scientific data, and sold lies that are collectively leading to the downfall of our culture and contributing to drug dependence, confusion, mental anguish, and suffering? It's our responsibility to hear from psychiatrists who have left the profession and understand why. We know we're not going to hear their voices in the mainstream media. They're going to be drowned out by the large scale voices of those who are benefiting from the system, who have taken money from the pharmaceutical industry, support their families in academia and so forth. Are those the legitimate authorities that we want to listen to? Sean (03:24.541) Or has the awakening allowed us to be able to see things more clearly that we were unable to see previously? I want to introduce our guest for today. His name is Dr. Florian Burke-Mayor. After a career in mainstream psychiatry, he became frustrated by what the profession had evolved to and has honorably been open about psychiatry creating professional patients. exactly what I have witnessed. You do not enter into the psychiatric system to restore health. You now become managed on drugs for life by a professional that sold its soul through an alignment with drug companies. I want to welcome Dr. Burke Mayer to the radically genuine podcast. Florian Birkmayer (04:20.843) Thank you for having me. Sean (04:23.213) So doc, let's just start off with a little bit about your story. Why did you originally choose to go into psychiatry? Florian Birkmayer (04:33.299) Well, let me try to answer that with a giant asterisk of, of course, that's, you know, the youthful idealism and, I don't want to use a technical word, but delusion, illusion. I have to apologize for that. Already, I think in high school, I was interested in, you know, before we can understand the world, we have to understand ourselves. So that was the first seed. And then skipping forward, I mean, one of the things where I've already questioned my choices at the time was I kind of decided to go to medical school. And there was a subtle pressure from my father who was a physician and my grandfather who was a physician. And it was like, you know, that phrase, Tina, there is no alternative. I didn't even think about saying, well, what do I really want to do? And I did enjoy medical school, but it was already Florian Birkmayer (05:32.559) indoctrination was starting. In medical school, there was this real focus on symptoms, systems, the individual, the human, was being lost. After all the rotations, when I met psychiatrists, I was like, or when I did the psychiatry rotation, I was like, oh, this is my tribe. Again, in retrospect, extremely naively, I said, well, psychiatry is holistic because you can treat from the molecule to the community. You know, the I was thinking about, well, maybe I'll do family practice. But again, that gap between the ideal of what family practice does and what it's become was more apparent to me than my own path. And then I remember going around to residences, interviewing at residency programs in 99. And it was like the heyday of this biological psychiatry, which is again, or, you know. I don't know if that's even the right word. And it's certainly propaganda, not the truth. And people would say, oh, we just retired or fired all our psychotherapists. It was like the ideology was medication is everything. And admittedly, I drank the Kool-Aid for a while. So I guess to keep my answer relatively short, I thought I could treat holistically that the origin of disease is really in. emotional spiritual imbalance. And that's not the sort of, oh, you chose to get sick. That's a, I think that's a very distorted view of that. I think that, I think imbalances happen in the psyche and beyond the personal psyche long before they manifest. And then if we keep Florian Birkmayer (07:19.267) know, sometimes our life paths then manifest in physical illnesses. But I felt it was, again, rather naively that if I could treat, help people with emotional psychiatric conditions, I could give them a better quality of life for longer. Again, in retrospect, it sounds terribly naive. Sean (07:41.101) Yeah, so it seems like that you are entering into the system at a similar time that I was. In 1999, I accepted my first position working in a children's psychiatric hospital, exposed to this biological psychiatry revolution. And I was 22 years old, and it was my first exposure to what is the mental health system. And I was working with what amounted to very traumatized young children in the children's psychiatric hospital. So I was appalled by the treatment. because they were perpetuating these ideas that their emotional reaction to the events that occurred in their life was somehow related to some biological mechanism that they could correct with a psychiatric drug, which was, you know, I felt unethical, certainly seemed unscientific. Well, how can somebody respond to trauma with the necessary mechanisms in place around fear and- irritability and difficulty sleeping that I think are necessarily they're designed for us to be able to survive. And when you're talking about children, it just seems much more nefarious and see that their quality of life would be would be better from what amounts to a brain experiment. So you go into the system thinking that there's kind of this holistic way of being able to support people who are suffering, and you find out that there's this new movement around psychiatric drugs. So you said that you drank the Kool-Aid, take me back to that younger version of yourself, and how did you drink it? How did it make sense to you? And how did you find it credible at the time? Florian Birkmayer (09:18.803) I mean, this is hindsight is 2020. One thing that I picked up on already in medical school and in residency when, you know, we were required to do rotations in other fields just so, you know, that we had some medical training. So, I spent a couple of months in the ER neurology. And the bias from the other specialties was like, oh, yeah, you went into psychiatry because you're not good Florian Birkmayer (09:48.587) believe that and I wanted to, you know, I wanted to know how the medications worked. I wanted to know the theories, the model. It wasn't just like, oh, I can't be a real doctor. And, you know, the Again, a lot of times medications are prescribed without people really, the prescriber is really knowing how they work. So I wanted to be really good at that. There were a couple seminal experiences. Already in medical school, I remember being part of some sort of, it wasn't exactly a journal club, but I looked at the original SSRI studies and they're not that selective. if you look at them. And so like this whole term calling them SSRI, selective serotonin reuptake inhibitors, I was like, hmm, that's weird. And again, there was this big otherizing like in medical school, I did a rotation in a inpatient, inpatient cycle. And then at the same time, I'd spend days or afternoons in an intensive outpatient program. And I remember this client revealing that they were also using substances. It was like you could hear a pin drop in the room. It's like the psychiatrist was like, well, okay, let's send you off to a treatment program. And then when you're done with that, come back. It wasn't this holistic. It was like almost like someone said, oh, I have this STD. It was bizarre. Like even within the other rising, there was more other rising. And that sort of this proclivity of mine is sort of seeing the shadow side of systems. in my college days was the heyday of postmodernism. Maybe that's sort of one of those gifts. I don't want to just be a psychiatrist because I'm not good enough to be another doctor. I really want to be well-trained, but the cracks started appearing in the system. I remember one client that was – we do these rotations. I'd rotated away from an outpatient clinic. This client I'd seen in this previous rotation was sitting in the waiting room. I'm like, hey, how's it going? He's like, Florian Birkmayer (11:50.335) terrible, I'm still feeling something. He was drooling on himself, horrible medication side effects. But this whole idea he'd been programmed to accept is if you feel something, we got to change our add medications. And another conversation around that time, I was thinking, how can people that are in what's called the continuing care clinic, which again is an ideology, how can they have more meaningful lives? you know, graduate or, you know, so that they're not these professional patients. And this one supervisor once said, well, every place I've ever worked at has had a continuing care clinic. And I was thinking that's exactly the problem. So I'm sort of getting ahead of myself. But I think the other thing sort of cracks appearing was, you know, there was this big push for evidence-based medicine, which again is an interesting ideology. It is really the pharmaceutical industry saying, well, we can do these studies and, you know, anything else we have an ideological sledgehammer against. The bizarre thing was, when we'd have these supervisors in training, the clients obviously had been in treatment for a while and they'd gone through a lot of the evidence-based as thin as that is algorithm. First line, second line. And then these wise old people of psychiatry, mostly men, would be like, well, my secret formula is this and this. while it was nice that they had clinical experience, they completely undermined their entire ethos of, oh, we got to be evidence-based, but if that doesn't work, I've got my secret formula. Maybe I'm getting ahead of myself in terms of answering your questions, but the crack started appearing. One thing that I did was having attended, or done residency in psychiatry in Albuquerque, New Mexico, University of New Mexico. There was this program, it might still exist, called the Program in Rural Psychiatry, and I was interested in that. Through that, Met found out about a treatment center in Gallup, New Mexico to help very impoverished, very severe substance abusers, mostly alcohol, mostly in Navajo or the Neh tribe. This center had really... Florian Birkmayer (14:10.471) I just got, you know, the citizens of Gallup marched on foot to Santa Fe, which is like over 200 miles away to say something's got to be done. And the center was set up and really underfunded. And what the treatment really was, was novel tradition, was, you know, reacquainting people with their traditions. And I went there, I helped out in different ways, but I never wrote a single prescription. Once I took a friend of mine from New York there, who was working at a— substance abuse treatment program. And he's like, oh, this is your non-prescribing rotation. And that was again, that's that seed that got planted. Like, there's so much more beyond prescribing. The other thing, again, maybe I'm getting ahead of myself, but you know, I like history. And when we learn about Eugene Bloyler and Egon Kreplin in medical school or a psychiatry or psychology class undergrad, it's like, well, Bloyler called it. Schizophrenia had the four A's and Kreplin called it Dementia Precox and felt it was a biological illness. And so, you know, it's a biological illness. So we honor Kreplin and we honor Bloyler by taking his name for it. But that's actually, again, an ideological oversimplification. What really happened was Bloyler, you know, the four A's are really all symptoms of interpersonal deficiency. He used the term autism, not in the modern diagnostic sense, but difficulty communicating. I admit I can't recall the other. three A's right now, but it was all about difficulties, interacting difficulties being in the world. And Kreplin said, oh, it's a biological illness. So the entire ideology, that debate about war is the locus of illness. What makes these people suffer in a subtle and again, you know, there is no alternative way. We live in an article I read many years ago called, we live in the neo-Kreplian world. If the locus of illness is other people, like you've alluded to, then what? with the children, then giving a medication isn't treating the illness. But if we say, oh, this is a biological illness, which is an ideological choice, then we have a supposed philosophical underpinning for why medications are the answer. So we've sort of swallowed this. Behavioral health has swallowed this ideology without really knowing where it came from or questioning it. And it's not the truth. It's just one guy's idea. Florian Birkmayer (16:32.195) 130 years ago. Sean (16:35.085) Yeah, I mean, it's interesting because I'll just refer to a couple of clients that come to my mind yesterday. So this idea of evidence based medicine is one that can be very manipulated and distorted. So an example would be the Sean, maybe you're having difficulty sleeping. I am. And you drink a 12 pack on a Saturday night of beer. And and then you pass out and you get nine hours of quote unquote sleep. Does that Does that make Miller Lite then an evidence-based treatment for insomnia? I guess who's running the study? Is it Miller Lite? Exactly. And it's the same thing when a client says, well, I've been having trouble with sleep and my doc prescribed me trazodone and sirequil and clonopin. And I was able to sleep. I was like, well, yeah, that knocked you out, didn't it? And that's going to last for maybe a while. It's certainly not going to provide restorative sleep. So how do you feel when you wake up in the morning? Well, a little bit drowsy, you know, but I was able to sleep the night before, right? And so we can communicate that as evidence-based medicine, but it's sedation. And drugs sedate people, alcohol sedates people. And we use the term medicine. That's why I hate using the word psychiatric medicine with the idea that it's somehow medicinal, right? A plant could be medicinal, a certain food can be medicinal. I certainly understand how the idea that we can ingest something that can be corrective, that can be healthy for us, it can be restorative, but drugs are not that. They are synthetic chemicals. They're created in a factory and they induce a biological reaction or response, whether that's hormonal birth control or whether that is trazodontocerequel or selective serotonin reuptake inhibitor. So that's part of the mass manipulation. Two things here, one that the reduction of an emotion is a positive outcome that leads to long-term health. That's the lie. So trying to reduce the intensity of an emotional state can be communicated as, at least in the short term, an evidence-based treatment. So all you have to do is create an outcome measure that reflects those physiological symptoms. So same thing with anxiety. Sean (18:55.265) Sean, let's say you were really, really anxious and then you drank that 12 pack and you were not so anxious anymore. Then is Miller Lite a evidence-based treatment for anxiety because it led to the reduction of anxiety. It is anxiety reducing. And that's somehow despite centuries of knowledge as well as our own experiences being human beings. And then a lot of the evidence-based that I was exposed to in the psychology field was The allowance and experience of emotions is therapeutic, right? It's a learning component. It's a necessary biological response or even a spiritual response that provides us like these distinct messages. There would be exposure-based treatments. I mean, this was always the mind fuck for me. You know, I'd go into my graduate school programs and I'd be working with people who have phobias or obsessive-compulsive disorders. Florian Birkmayer (19:28.642) Mm-hmm. Sean (19:52.289) legitimate fear based conditions that are leading to avoidance. And we are systematically exposing them to that fear to create new learning. And then the reduction of fear is included over time through systematic exposure to what they're afraid of. And the way that you maximize these treatments and exposure based therapy is full exposure, right? Allowing the emotion fully to experience. And you realize that you start targeting the fear of fear, that people have a fear of their emotional states. And once they give up the fear of their emotional states and they allow themselves to embrace the situation that they were afraid of, they learn. It's like an adaptive mechanism. So if I learn that Sean is a scary, violent man somehow, and then I stay away from him, I never correct that learning, but I have enough experience with Sean, then that changes my viewpoint and it changes my emotional experience. So these very adaptive experience. And then you go into psychiatry and they give you the exact opposite. Oh, you feel too much. That's a symptom of a condition. Let me drug you too. You don't feel that again. And so it never made sense to me, doc. When I was a 22-year-old man, it didn't make sense to me. And I was always open to, I could be missing something. Maybe there's these real serious mental health conditions. I didn't really understand what bipolar disorder was at 22. I don't think I So I was open to the idea that there could be some role in medicine improving the quality of life from people who were really disconnected from reality. However, the more you dig, the more you learn, none of that really plays out. And the labels that we were using to identify them as diseases are not accurate. They are kind of crude labels that don't actually reflect the real conditions. Florian Birkmayer (21:45.891) Well, you said so many things, Roger, and please call me Florian. I'm just going to try and remember some of what you triggered in me. First of all, you know, the word pharmacology comes from the Greek word pharmakon, which means the poison. And, you know, Paracelsus said everything's a poison, it's just a matter of the dose. And in fact, the basis of pharmacology is always to interfere with the natural function. You know, the SSRIs, the lock, the reuptake inhibitor, et cetera. Now where I'm going with this is there's the word pharma-kos in ancient Greek, and that's the scapegoat. And, you know, the scapegoat, there's a long tradition, you know, they say, okay, you know, our community, we've had drought, we're no food. You, Joe, you got to go. We're either going to sacrifice you or we're going to exile you. So there's this weird parallel to me at the root of the word pharma-kon and pharma-kos. So that's one thing. The other thing is, again, talking about the hidden ideologies. You know... I listened to a brilliant talk a couple of years ago, and I don't remember the name, it was a behavioral economist. And he said, you know, capitalism is making us sick. And so, and then another talk I listened to recently were when things are wrong in the system, you know, jobs, work, capitalism, whatever you want to call it, lack of meaning in life, lack of connectedness, instead of saying, well, we got to change the system. No, it's your fault because you're not fitting into the system. You know? big, ideological, in order to be a functioning member of society, you have to meet these criteria and that dark night of the soul, feelings, even insomnia, well, they don't fit. I mean, the idea that we need to sleep whatever, eight hours at night continuously is a modern invention based on capitalism. Okay, if I want you working in the factory from sunrise till sunset, you better get your sleep at night. And you know, the human body is perfectly capable of missing sleep. But we've created this. oh, it's my fault, it's something wrong with me. If you just say, oh, I'm having a sleepless night, well, let me just embrace it and look at everything else. But again, it's been this weird upside down. Something is wrong with the way we live our lives. A lot of people are struggling with meaning. Well, there's a pill for that. It's bizarre, and then the pills don't really, I mean, the withdrawal syndrome, and I don't wanna get ahead of myself, it's a feature, not a bug. Florian Birkmayer (24:10.675) And no one teaches you how to get people off medications and medications pile on and then I'm still feeling something. And again, locus of illness. I had clients, several clients over the years with psychosis say, don't take away my voices. They're my only friends. They are so lonely. They are so isolated in society. And in fact, the medications we give that cause tardive dyskinesia and a lot of the other symptoms that make people, oh, that guy's crazy. Well, that twitching isn't... psychosis, that twitching as a side effect of the medication. So we're actually contributing to the stigmatization, isolation, this othering through the very act we do. And that's, I mean, it was Florian Birkmayer (24:51.671) much more curious about your questions than what I'm gonna say. But after residency, they hired me and I became part of the department of psychiatry for a few years and I was involved in the residency matching process where you select the new crop of medical students. And many people would say, oh, you know, the reason I wanna become a psychiatrist is because in college I got depressed and I took an antidepressant and it was great. And as I'm saying, well, you know, this person obviously had great personal. connections like, well, you know, they got depressed before, are they going to be able to handle the stresses of residency? I'm not sure we want them. I mean, it's like, there's this hidden knowledge that what we're doing isn't working. All it does is people get identified or self-identify as somehow deficient, you know, including inside. And, you know, the other thing I'll say is there's no such thing as a side effect. That's a pure projection. You know, Benadryl, or if you have allergies, the fact that it makes you drowsy is a side effect. if you're using Benadryl for sleep, the fact that it dries you up and dries up your mucus membrane is a side effect. Well, which is it? You know, you mentioned, maybe I heard you or imagined things, but serocol, partyepine, was never approved for sleep, you know, and it's massively being prescribed and sold for sleep. And then there's this whole other thing, oh, there's good medications and bad medications. You know, when I was in residency, even though I never prescribed an opiate, I remember the drug reps. Like there was that TV series with Michael Keaton recently. I can't remember the name, but the drug reps were coming in saying, well, do you know you could get sued if you don't prescribe, if you don't relieve your patient's pain enough? You know, really manipulating us just like in that mini-series. So there's all this manipulation happening. You have to prescribe. This is on all these levels. And again, with the medications, the data is really... Well, and then, you know, there's this effect, the filing cabinet effect. If you say... Oh, I'm evidence-based. I only look at the studies. Yeah, but you're not looking at the 90% of studies that are in the filing cabinet. So even saying I'm evidence-based, you've already drank the ideological Kool-Aid. Sean (26:51.567) Yeah. Sean (26:55.893) Yeah, not only that, I don't even know if they're very good at deconstructing the methodology and the statistics. So I mean, it's very clear that the conclusions of a lot of these studies don't actually meet the data. And that's why it's so nefarious because you're talking about ghostwriters who are funded by these pharmaceutical companies who are pushing the drug out to market. Great example is Lexapro right now that was approved for children as young as seven. It's very clear that it did not outperform a placebo. And when you have a six-fold increase in the likelihood of suicide, when you give that drug to a child or a teen compared to a placebo, how does something like that get approved? And how is that something that is actual part of a clinical guideline? The docs don't know this because they've never read the study. What they'll do is they'll read the conclusions, which are something ridiculous, that they believe it's safe, it's tolerable, and it can be effective. And how is it based, how is it effective? There's five outcome measures. Four out of the five outcome measures, it's not, it doesn't even outperform a placebo, but one outcome measure that they construct themselves, they can find a statistical difference and then use that. If a doctor doesn't know the difference between a statistical difference between a drug and a placebo group versus clinical relevance, if they have no idea what the outcome measures were, if they don't know that it increased suicidality sixfold, then how do you provide informed consent? So it's an illusion of evidence-based medicine that is based on marketing propaganda because most of the doctors today do not have the time to read any research. Their research is what the drug rep tells them or what a guideline tells them. The guideline developed by these major medical organizations funded by the pharmaceutical companies themselves. It's a game that we need to be able to know the rules in order for us to be able to keep ourselves safe. And that's why we need more honorable and conscious clinicians to be able to be, have to understand what this literature is, to communicate it to people, to make informed consent. Now I wanna get an idea about how your colleagues are viewing your profession. So going back to when you were in the system, when it was the revolution of biological psychiatry and that there are medicines to target brain conditions, what was your experience with your colleagues? Sean (29:18.921) My experience in the field is I wasn't seeing people get better. And that's how I needed to wake up and see how I could help people. I don't know how people are doing the work under this delusion that they see improvement from their clients. Florian Birkmayer (29:32.627) Yeah. Well, I think that's where it starts. You know, how do we define improvement? I think you alluded to it. You know, the measures we have are biased towards what we want people to function like or behave like and what the drugs can do that we can measure. And that's really problematic. You know, the years ago, there was this whole debate about self-medication. You know, when people use illicit substances, they're self-medicating. Well, the self-medicating The criteria used was what, let's say, psychiatrists were saying, well, this is what I think you are trying to self-medicate. No, why don't you ask the client, again, even the word, why don't you ask the individual what, how does this work for them? You know, why does someone with psychosis use methamphetamine that, well, that worsens psychosis? Well, what is it, what's their behavioral economy, what are the choices they're making? But I want to go back to your question. I mean, I think there was, again, so many people I met said, well, I'm a biological psychiatrist. And that was like, pretending, you know, it's like putting the blinders on and saying, well, if I pretend that all the interpersonal factors, all the unconscious transference, coun we have all these fancy labels for it, if I decide that doesn't exist because I'm a biological psychiatrist, I don't have to think about it. And one of the greatest Psychiatrists in America was Henry Stike Sullivan 100 years ago and he wrote a book called The Psychiatric Interview where he says it starts the moment you first lay eyes on the patient and I would argue it actually starts long before because the entire system, what makes people say, you know, something is wrong with me, I got to go see someone. I had this experience years ago on an in-patient, I was running an in-patient unit and one of the clients, patients, again both these words don't work for me anymore. was wearing a t-shirt, people like you are the reason I'm on medication. And the entire unit had a meltdown, you know, the other clients, the staff, because it was true on so many levels. So there was this holier than thou, well, I only look at the evidence. I don't take, I don't eat the food that the drug companies bring, which, you know, is a practice that as far as I understand, has disappeared. And I had someone tell me recently, you know what, I love psychiatry. Florian Birkmayer (31:45.907) I thought about it. I don't love psychiatry. Even if you're like, well, I only look at the studies and I don't eat the food that the drug rep used to bring, you are still in the ideology of still drink the Kool-Aid. And I don't want to sound like I'm so much better or more enlightened. For me, I realized in the last few years how, well, it's a longer journey, but how much this identity... has taken up root in me at such a deep level. And on some level, again, I mentioned sort of the subtle pressure to go into medical school, but even with the psychiatry, like, I think it was an identity I was hiding behind. And I'm just sort of discovering like, who am I really? And that, I mean, that's maybe outside the discussion about the ideology, but I think the ideology is very... seductive and maybe that's a better word but we're like, oh, you know, we're the tough guys. We deal with the conditions that no one else wants to deal with, you know, when there's another medical specialty and there's the, you know, the specter of a psychiatric condition. We said, let's turf them off the cut high, even though we're turf. And then we'll roll up our sleeves and we'll do the dirty work that no one else is willing to do. So that's part of the ideology was that, oh, we do what no one else does. Part of the ideology was, oh, I only look at the study so how somehow I'm better or more informed when the entire field, even the way illnesses are constructed. It's like years ago, there was a review. I want to say it was in the Atlantic. It was a book review of the DSM-5 as a dystopian novel. There's no way out. There's no definition of healthy. If I ask you, how do I get to LA from here? And you say, well, don't go this way. Don't go that way. I still don't know how to get there. There's no definition of health and of what it means to make the most of living our life. Instead of, sorry, you're really stimulating me. It's like shut up and take your pills. Sean (33:31.598) Hehehe Florian Birkmayer (33:53.255) and that questioning of what are we actually treating? Yes. Sean (33:53.721) Florian. Sean (33:58.245) Florian, you brought up your time in New Mexico. I believe you said you were working with some of the Navajo traditions and the culture there. And you said that it was very little prescriptions. So I'm curious, what did you witness during your time there? And how did that maybe contribute to your transformation? Florian Birkmayer (34:17.735) I think it, I mean, when I moved here 24 years ago, I had no idea how I was going to change it and I haven't worked in that setting in a long time, but I'm glad you asked me about that because it was, I mean, there's layers. So the first time I went out there and, you know, it's always there is there's this what's called a border town. So it's on the border of the reservation. The reservation itself is dry, meaning no alcohol is for sale. So out of really, you know, when I use the word post-colonial, my friends are like, what post, or let me put it another way, like the Snava friend of mine said, you know, I went to Walmart and applied for a job and they said, do you speak any foreign languages? And I said, yes, English. So there's this population of homeless people who are severely, you know, you use alcohol in an extremely self-destructive way, including non-beverage alcohol. So hairspray, certain brands of hairspray actually get you really wasted. Sean (34:57.63) Hehe Florian Birkmayer (35:16.659) And then I remember working there, the police would bring in these inebriated people on domiciled and they'd say, you know what, we found all these bottles of fabric softener. We don't know why. Well, I looked into it. It turns out fabric softener is 20 proof. So if you don't mind the taste and all the other chemicals. So that's one layer is this just incredible human suffering that really is result of colonialism. When the Walmart opened in Gallup, it was the top-earning Walmart that weekend in the entire country. And it's not like, oh, these people have pent up demand. No, it's like this invasion. And I think so one thing we have to recognize is that out of the damage of colonialism, there's a profound lack of meaning and value for many of these people. And so then And alcohol was a weapon and, well, I guess you could say continues to be a weapon of colonization. So, there is this population, there is this very marginalized setting, you know, border town, homeless people. And so, thank God that there was people saying, we got to help them. And again, as much out of… Florian Birkmayer (36:36.799) awareness of this colonial battle or ongoing war, plus really lack of resources. The idea was Navajo traditions are like the cultures like an immune system. And when the immune system collapses through this colonial attack, that's when people become prone to all sorts of things, you know, substance abuse, domestic violence, you know, I'm sure you've heard about all the missing and Florian Birkmayer (37:06.967) The idea was forget medications. We have to help people to learn their culture as an immune system. And that was already an epiphany. And having these conversations and even the way illness was conceptualized. And I mean, the other thing, that profound ideological thing, everybody's called a relative. And that's not just some hippie dippy term. That's based on the clanship system. And there's... you know, room for all of us, even non-Navajos in the clanship system. So when you say, well, this person is my relative, that's not just, oh, hey, bro. It's really based on Navajo philosophy and really let us know, saying, well, I'm the psychiatrist and you're the client, we're relatives. All these things left more than a mark on me. I think they changed me in ways I couldn't imagine. And so I think already at that point, the seed was planted that one day I want to have written my last prescription. And then… Fast forward a couple of things. I remember going to an APA meeting in New York many years ago, the American Psychiatric Association, and I'd heard about the Radical Psychiatric Caucus. They met in some sub-basement of some hotel in New York. It was like this clandestine thing, but then they were so coward. It was really, I'm realizing there's two ways to spell coward, but they were both cowering and they were also cowards. I said, you know, my... at the time, this was many years ago, my life dream is to become an ex-psychiatrist and they were appalled because they were still playing by the rules. And the other thing is when I opened my private side, I left university, worked at the VA for a year and that was again, it was great not to have to deal with insurance, but the VA is really good at turning people into professional patients, lifelong patients. And then I... somehow found it within me to say I want to open a private practice. And it was more for genetic field. I mean, I told a few friends about it and these people found me to help come off medications. And I remember what, I mean, it was more than one, but one lady in particular had permanent tardive dyskinesia from a neuroleptic and anti-psychotic given for maybe bipolar, maybe borderline. I think it was really all trauma. And she just, she was long off the medication. I was just, she saw me for a while cause she just needed to vent her anger at me. And I realized Florian Birkmayer (39:25.955) coming off medications isn't just, oh yeah, here's how you'd safely tape it. It's really about all of us allowing for the anger that I think Roger, you've alluded to. I mean, there's like… What are we doing? You know, there needs to be room for that. Sean (39:44.901) One of the challenges I think that psychiatrists who are in the field and are recognizing that they may be doing more harm than good are struggling with is one that's economic in nature. So I'm not usually that vocal about this, but I do get these, the best way I can describe it is these whistleblower emails from somebody who is like a current resident in psychiatry and they believe they've been misled. in the effectiveness of their interventions. And they're now involved in a hospital-based setting and they're seeing the quality of the care. They're seeing what they're told to do. That is against their ethics, against their morals. And they want to do something about it, but they realize right now that they cannot because they would be at risk of not completing their residency. They've devoted a lot of financial resources to their medical education. They're in a large amount of debt. And the only way that they can function in the system in the way it is right now is to be legalized drug dealers. There's really no other path for them to be completely independent, or at least not now, because they're going to have to repay their student loans and get out of debt first. And this is what we heard when we had that conversation with Dr. Joseph Witt during, you know, it is the economic aspect of this. How do you function in a system? with how much money you're devoting to your education, with just reversing course and doing something different. How challenging it really is to leave the system when you're in it. Same thing with the conversations with the pediatricians. What do I do when my guidelines tell me that I need to prescribe an SSRI whenever a adolescent is in any way revealing suicidal thoughts, regardless of context? even though the science-based will tell us it's gonna probably increase the likelihood that they become suicidal, the fact that they don't follow the guidelines puts their profession at risk. This is the depth of the problem that exists. So Florian, I do wanna know how you were able to escape it really. How did you choose to make your decision to leave and what do you do to support yourself? Florian Birkmayer (41:53.383) Yeah. Florian Birkmayer (41:59.203) Well, those are questions I'm really wrestling with right now. I mean, where to start? So one blessing in disguise, which was also, again, sort of the hidden manipulation, is my father, who is a physician in Austria, paid for my medical school. So I never had those loans, even though I said, well, you know, I want to take out loans. I mean, that's maybe hindsight is 20-20. And I think one way he made me drink the Kool-Aid was say, don't worry, I'll pay for it. But that is, and then in residency again, there is this incredible, it's more than a cohort effect, it's an effect of the entire system. Already in medical school, I remember people saying, you know, I don't really wanna become a doctor, but I don't know how to do anything else and the same in residency. And you know, I had a colleague who had done, I don't know, some sort of research, maybe a survey, or the data is out there that... Physicians have some of the highest suicide rate, like there's this profound dissatisfaction, there's a lot of burnout, people are talking about compassion or fatigue, but there really aren't alternatives. It's again, it's like, oh, you know, the system's inhumane, so you're the one with the problem because you're not able to survive in this inhumane system. And that's... I think that my private practice, you know, I met colleagues who would go into, who went into private practice after residency and then sort of found their way back to group practice or to the academy because they were lonely. But I really liked my private practice because I was in charge and I got to do what I wanted to do. But then I've written about this in the past as, and I wanted to be really good, you know, be the quote, best psychiatrist. And then I read this book by Edward Whitman, The Alchemy of Healing. When in a nutshell, he says, you know, when we want to be there for our clients, no matter what, it's really like we have this part of ourselves, this really wounded part that we almost feel unconsciously isn't even worthy that we ask the client to carry. And that book, I literally flung it across the room. It was like holding a mirror up to me saying maybe I'm unconsciously or not maybe it's like I'm unconsciously doing this. And I closed my private practice in 2015 because I really felt Florian Birkmayer (44:17.869) I was perpetuating the system in a way that I didn't know how to stop other than stopping my private practice. You know, I was keeping, even though I was really good at what I was doing, and you know, maybe I was using the medications in a better way, quote unquote, but I was still perpetuating the entire ideology. And that was really revolting. And then it's been, I mean... Yeah, there are other factors that went into that, but it's been a journey. And then I met my current wife and we decided, you know, I was already very interested in Jung's view about sort of, again, healing the opportunity of life being individuation of really taking all these challenges and stepping stones on evolving, which, you know, back then, almost 10 years ago now, I had less understanding. I still don't think I have much understanding, but life. all these challenges in life are really grist for the mill, are really opportunities to evolve. And I had already been interested for a long time in using aromas transformatively because I could see it. You know, in residency and medical, and even after I was kind of told I wouldn't say that too, I mean, I said I'm interested in holistic healing and people said I wouldn't say that too loud around here. But then in my private practice, I was sort of, as a friend of mine said, I jumped out the allopathic window and I remember having a few essential oils nearby because I like them and these patients, I guess, very, these clients, and neither word is right, dissociating in the moment. I start fluttering, some traumatic memories flooding them and that have them smelling oil and they'd come right back and it wasn't here's some lorazepam or here's some SSRI and I'm the one who's prescribing it. It was sort of like giving them a tool to self-regulate and it's much deeper than that. My wife and I have been working and teaching together. And then I admit that in 2000, when COVID hit, we were supposed to teach all over and it all got canceled. And a friend of mine had been, you know, not invoking another ideology, but the devil never sleeps. This friend of mine who's a great guy, he started right out of residency, started a psychiatric group practice and he wanted someone to... Florian Birkmayer (46:35.875) established a ketamine program. I hadn't worked for five years at that point. I mean, at first, I thought I'm just going to take a few months off, but I just couldn't go back to the way I was doing things. But then with COVID, I was like, well, this steady paycheck sure sounds nice. And I was very flattering. He's saying, I want you to build up my ketamine program. So I went back to it. And then two years later, I decided to surrender my license for a number of factors. And so since 2022, so in the last year and a half, That's really when I realized how deeply my identity was tied up in this and this going back. Even though I got to do... what I Thought I wanted to do it even that you know, it's very tempting and how do you make a living? It's it's very hard. I think that Florian Birkmayer (47:23.871) I'm blessed I get to do what I want to do, but it's not the same safety as that steady paycheck that I get for. And I mean, that's the other thing is I realized, oh, I thought people liked me. No, they liked my role. They liked me being the legalized drug dealer, as you said. And that's flattering until you start looking at it closely and saying, hmm, what's really going on? Sean (47:45.589) Florian I heard you Maybe was in a video you spoke about this default mode Network that we all go under and I think that's very relatable for anybody who works and might be even doing things that they Don't truly believe and you use the word unconscious. So how does one how does one disrupt that? How do you break out of it? Okay, so the default mode network and that's the full name, you know, it's not just, well, there is a neuro anatomical correlate. There are networks in the brain that are the default mode network. And I think a little bit of history is really helpful. So when people develop the technology of functional MRI scanning, where you can measure brain activity, they ask people, well, don't do anything in particular, just sort of relax. Don't think about anything. And the theory was, well, the brain would just sort of go into like screen saver mode, like our laptops or phone, but instead certain areas of the brain got more active. And at first it was like, well, that's cute. And then they realized that network is there all the time. So if you're driving to work or a place you've been a hundred times the store, most of the time you don't remember. And I have these experiences all the time I'm driving. It's like, oh my God, how did I get here? And that's because the default mode takes over. You know, there's some evolutionary theories and I find a lot of those again, very sort of. ideologically suspect. What was fascinating is we're discovering that the default mode network is involved in a lot of, for lack of a better word, psychiatric diagnosis. There are changes in it in depression, in PTSD, in anxiety, in OCD, and substance abuse and many other conditions. If you really delve into it, what is the function of the default mode network? Let me start with a silly analogy. In the old days, when you went to see movies that were film strips, you know, there's lots of little still pictures and then the flicker in the movie theater creates the illusion of continuity. And that's basically in a way what the default mode network does on one level is it creates this continuity. I'm me, I'm the guy that I woke up this morning, I'm the same guy I was yesterday. And so really besides, and I mean, the other thing I'll say as a side note is one thing the default mode network is involved in is very rapid social judgments. You know, like, oh, I don't trust that guy or that these people are of a different ethnicity. And so I actually think that whoever developed a Facebook like button and the similar things were hacking the default mode network knowingly or not, but they were going into that very quick judgment that. Florian Birkmayer (02:15.692) happens all the time, we're not conscious of it and it reinforces our sense of self. And so I think the real one of the fundamental functions of the default mode network, it's really the ego, you know, the sense of this is who I am, my story of myself. And the more I think about that, the more that's actually what's got the blinders on. We often, depending if you're into psychology, depth psychology, you think, oh, there's the ego and the unconscious. Well, but the ego is actually quite unconscious. I mean, one trick the ego places saying, I'm all there is the unconscious is doesn't matter, or you're not even aware of it. But that program is actually, it's putting blinders on us, it's putting rails on us and move makes us move through the world in a very predetermined and extremely limiting way. And we're completely unaware of it. There's this beautiful talk by David Foster Wallace, who again, tragically ended his life by suicide, that's now on YouTube and it's called This is Water. And he's like, you know, the fish swimming in the water and they don't realize they're surrounded by water all the time. But that's the default mode network, that sort of going through our life saying, this is important, it's important to go to good night's sleep, it's important, I'm a keeper of the faith in psychiatry, it's important I perform my economic function. The default mode network is really haunting. It's like, oh, this is my choice. This is my free will. No, it's not. It's this very all -encompassing program that convinces you that you're making a choice. Well, that's... Sean (03:48.005) Is it a, is that a survival mechanism that evolutionally has just been ingrained in us? Florian Birkmayer (03:54.188) This is interesting because I would say, you know, one thing it does is it cuts us off. It cuts us off from each other. Instead of saying, well, what am I unconsciously asking you to carry or this other person? Oh, I don't like them projection. And it cuts us off from the environment. You know, instead of saying nature's alive and I'm dependent on the plants to breathe the oxygen that they make, oh, I'm going to cut down these trees and sell them from firewood and I'm going to dig in the ground and dig up the fossil fuels. So, and it's interesting because it is also related to... psychedelics, I was just listening to this talk by a psychedelic researcher who's English but now in Japan. His theory, and I'm sorry, I'm terrible with names, but his theory is that this sort of default mode network structure, this sort of very rigid way of interpreting data that we constantly receive from our senses, one thing that happens is there's sort of a... a filter, okay, this fits my prediction, this fits, you know, the sun's rising, if I put one leg in front of the other, and anything that doesn't fit the prediction often doesn't even reach the threshold of conscious awareness. There's this massive filtering going on. And his theory is that, and you could say that's sort of this top down processing that depending on how you look at the brain, whether you look at the networks or the larger structures of the cells, it's this top down. There's something on top that decides this is the story and this is relevant to the story and this isn't relevant to the story and psychedelics. He postulates, it sort of turns out upside down that the ability to filter out the quote unquote errors is less. And so then the, this network has to come up with a new version or the, this habitual unconscious default version is questioned. Sean (05:48.677) Um, I'm glad you brought up the psychedelic treatments. Uh, this is something that we've had many discussions in this room, also some other psychiatrists. And I follow a lot of financial news and, uh, psychedelic treatments is actually potentially big business. So there's actually a company right now it's trading on the NASDAQ and just in the last four months, they published some clinical trials for, uh, LSD use to treat anxiety and ADHD. So I think your perspective as a. practicing psychiatrist, um, who had worked in that field. Are you concerned? Florian Birkmayer (06:26.028) I mean, I'm not practicing anymore. I just want to be clear. I'm an ex -psychiatrist, but I always say it's like being an ex -con. There's nothing ex -about it. I am very concerned. You know, on the one hand, there's this great promise, which I've, you know, I started offering Ketamine or private practice in 2011 when there wasn't this Ketamine industry now. I mean, there was a couple of studies by Crystal and Zaratha and, and again, because I had clients that were really survivors of the system or burnt out of the system. Sean (06:28.997) Yes. Hahaha. Florian Birkmayer (06:56.076) It was like, well, let's try this. You know, many reasons. And I saw some shifts, but what's happening is exactly what you said. Now it's this big business. And one of the fundamental questions no one has been able to answer is, you know, if I give someone Prozac and they take it for months and years, business model is clear. You know, every month they're there at insurance company or paying. If you have this pivotal experience with Silo Sivan, let's say, or MDMA, you might only need one or two treatments or, you know, a short course of treatment. How do you make money on that? That hasn't really been answered. I mean, there's, there's weird, you know, trying to graft old thinking onto the new thing. But the other thing is, there's already an entire ideology that comes with that. One is, you know, these potentially radical transformative treatments have to fit some sort of capitalist commercial model. That's already weird. And the other thing is I think that as we've talked about, you know, I think a lot of my colleagues, similar to myself, there's sort of a maybe conscious, maybe semi -conscious, mostly unconscious anxiety about what we're doing. The efficacy is low, side effects are terrible, both for medications and a lot of behavioral treatments. So I think there's this what I call a messianic projection. This is the answer. I mean, this is exactly what happened with Prozac in the early 80s. You know, all these books came out about how... Prozac is changing culture, you know, listening to Prozac and Prozac Nation. And I think the same sort of messianic projection is happening now that in a very unexamined way, the industry, my colleagues are sort of saying, well, this is the answer. And while there are certainly opportunities for that, it's like we bring the same old ideology. One of the ideologies is in seeking FDA approval for these psychedelic molecules is well, you need to have a diagnosis. You know, these people are saying, well, I'm getting trained in this, I'd love to have an experience, but the training cannot include me having an experience with psilocybin or MDMA because I don't have a diagnosis. So there's this, the ideology is unconsciously being carried forward. This is the Masonic projection. One thing that's happening now is this mandatory optimism. Like you can't really stay what I just said. There are people who are trying to be more questioning and there is, you know, Florian Birkmayer (09:24.044) Obviously, their questioning voice is coming, but sometimes the response to those is, well, no, don't talk about that. That means that the cause of psychedelic therapy might be undermined in some way. You know, go ahead, Roger. Sean (09:42.021) I want to bring back our conversation and we had with Susan Hannon. Part of this is the conceptualization. So, right. If you, if you create a disease, well, then you can create a treatment in order to try to treat that disease and then you can benefit financially from it. So the idea that ADHD is a disease, a discrete illness or some anxiety disorder is a disease. If we accept that to be true, then we're entering into the ideology where we're working within that system. But when there's no such thing as ADHD, then how do you create a treatment for it? Right? It's an idea. It's a conceptualization of a certain way of being that is observable, but not really scientific in the way that we can measure it with any degree of reliability. So the entire thing is an idea. But Dr. Hannan said something that I thought was very interesting. If you take a psychedelic and then an insight occurs within that experience, like for example, We are not separate. We're not separate from nature. We're not separate from each other. We're not separate from God. That insight can create a profound shift in experience. Then those symptoms that we label as a disorder are altered, right? But it's not necessarily a treatment for a disease. It just changed the way that we view our existence that had meaningful benefits. That is what I'm concerned about when you start applying a business model to an experience like this. The business environment has a way to distill something down into one mechanism that they say is what's contributing to the positive outcome. And Florian, I saw you wrote about the three unconscious presence in the clinical space. Can you share with our listeners what that means? Florian Birkmayer (11:36.844) Yeah, so I mean, I think it applies to any healing encounter, but that particular one came in the context of psychedelic therapy. I mean, you know, because again, the idea that these are just molecules that randomly, you know, why did magic mushrooms or psilocybe species evolve these molecules millions of years ago? Oh, it's random and it's totally random that they work on the brain. And one other thing is, you know, I always wondered why do we have dopamine as a neurotransmitter? It's actually a terrible molecule. And I was just listening to another podcast with... Dave Nichols, you know, the great psychedelic chemist, and he said the same thing. I mean, I've had this thought for years, but dopamine is a terrible molecule. Why do we have it in our brains? Well, because it was a plant molecule for millions of years before humans and other species incorporated it. To me, there's nothing random about these molecules. As Roger hinted at, they hint at this much deeper connection. I hinted at it with how do you nature? know, the tree is a living thing that's perceiving me just as well. It's not just a bunch of wood I can cut down. So there's a fundamental, we have to accept the reality that the unconscious realms exist independent of our ego, independent of our brain. Again, the whole idea that consciousness is in the brain has never been fully proven. So when you are in any encounter, there are unconscious factors. And again, James Hollis has a diagram about this. There's me in the therapist role, healer role, but there's my own inner woundedness that of course, many times, ideologically and for other reasons I'm cut off from, there's the client and often by the time the client comes to see you, their own inner healer, which again is a word that's sometimes being. Florian Birkmayer (13:35.852) buzzworded about without any really depths. But by the time you're ready to see someone, it means your own connection to your inner healer, that inner healers and the unconscious. And then the third presence, if you're working with psychedelics, but really anything is really the spirit of the molecule, let's say. And I think that applies definitely for psychedelics, definitely for Romas. I would say it even applies for these novel molecules that pharmaceuticals. But we have to pay attention to all of these presences. It's just not me wearing the white coat saying, oh, here's what I know. It's all, what am I bringing to the clinical encounter? Like I said earlier, my own unworthy part, the part of me that is so wounded and not worthy of attention. And the implicit message to the client is, well, your own inner healer, you're cut off from that. That's why you have to come see me. And that's why you need these molecules. And I think the, you know, It's interesting because Rick Strassman wrote that book, The Empty Spirit Molecule, which I think was really interesting. And then he's been very anti -spiritual. He wrote a book review of Charlie Grob's book, Sacred Knowledge. Charles Grob is a psychedelic researcher in Maryland. And he wrote a book, Sacred Knowledge or Sacred Wisdom, a few years ago. And in the book review, there was a lot of critique of spirituality. And I think that's Again, we have to accept that these molecules, even the word molecule, they're not just random. I think that is, again, a way of packaging it. So there's this random molecule, prozac, there's this random molecule, psilocybin. Let's figure out how to use it. With, I think, the natural molecules, again, like we even have dopamine inside of us and all the other neurotransmitters and neurohormones, to me, they show that we're part of this much deeper network. And it's not just on the molecular level. It's... You know, the imperative we have, I mean, we've used the word psychedelic, but the word actually, like even more is ecodelegic, and Roger alluded to that. If we become aware we're all one, we're all connected, that is really an imperative right now. We're well on our way to... Florian Birkmayer (15:50.412) being a historical footnote in the history of Earth unless we reconnect. And so I think awareness of the spiritual transpersonal dimensions of all of these beings, whether they take this form as a human or a plant or a molecule, we need to, that's really... The invitation is to be aware of that. That's the fundamental thing of reconnection. I'll just throw it out, but that, you know, there's this term that's been bandied about recently. I don't know if I'm pronouncing it right, Wetico or Wetico, which is a term borrowed from certain native traditions. And it's really this cutoff -ness. And one of the symptoms is there's nothing wrong with me. I think being cut off is something fundamentally wrong, but the spell has been cast. The default mode network does nothing wrong with you. Sean (16:45.093) Yeah, I think that brings up some interesting conversations on how we view mental health treatment. So we do view it within the context of a medical system where there is a healer or a doctor or a professional that I go to for help. And that in itself can be, I think, problematic and concerning. Abigail Schreier has a new book out called Bad Therapy, where she's talking about some of the negative outcomes of therapy. Well, what is therapy? Well, then it's going to be highly dependent on the person that you are with, right? We can try to say that there is cognitive behavioral therapy, psychodynamic therapy, but how each individual would practice that can be distinctly different because you can't separate the human being from the therapy that's being provided. And so one of the things you've been talking about Florian is kind of that power differential that exists. from healer and patient and how problematic that can be. And I'm the more the older I get, the wiser I get, the more spiritual I get. There's a shift in perspective. I'm trying to move away from that power dynamic, but it exists when you provide a diagnosis, when you develop a quote unquote treatment plan, when you are creating, you are working within the industry, not that dissimilar from our medical system. When in essence, You know, what actually might happen in that room that is curative or therapeutic is just the sense that you're able to be with another human being who cares about you and then views you as no different than you. You are a human, you are a soul. We have a history. In our history, we've made mistakes. We have hurts, we have memories, but life is a journey. It is. an adventure, so to speak. And, you know, I care about you and I'll be with you in your pain. And I will help you with everything I know to try to move you in a direction that you live your life according to your own personal values. And you can only do that, I think, when you have value yourself. And I am concerned about the therapy industry. I myself believe that there can be valuable aspects of therapy when we can agree on what they are. Sean (19:05.509) But the therapy industry in itself is working within the ideology. It's creating the idea that someone is sick or someone is disordered in need of my healing or my help when ultimately I believe that each person internally can heal themselves. Florian Birkmayer (19:08.78) Thanks for watching! Florian Birkmayer (19:23.148) I totally agree. And I think that only can but must. I think until I said, you know, I'm a wounded healer, I need to look at these unconscious patterns in me until I accept that. And it's like a re -acceptance, recommitment every day. I'm asking someone else to carry that. That's what's so nefarious about the healing industry is that I'm not willing to do my work. I'm going to be in the provider role and I'm going to make you unconsciously the client carry. that part of me while at the same time sending the message is that you need me. It's a real, it's wrong on so many levels. I remember years ago, we had these, thankfully at the residency program, at the time I went there, there was still an emphasis on psychotherapy and I had this one psychotherapy client and after we wrapped up, I said, well, what was the most meaningful experience you had in our time together? And I thought he'd give me some, oh doc, would you give me that brilliant interpretation? He said, one day you were running late and your shirt wasn't tucked in when I met you in the waiting room. And I thought, he is so in his element. He's so loving what he's doing. He doesn't even notice his shirt's not tucked in. And he's okay with that. And that means I can be okay. I mean, it brings tears to my eyes even now. That completely unconscious humanizing, I didn't plan it, but he healed me in that moment as much as I... that he healed himself. And that's really, we need to reel that in. I need to say, you know, my shirt's not tucked in. What is it that, that very subtle attitude that... Florian Birkmayer (21:07.532) call it a worry attitude, but it's really a worry to yourself making a choice again and again and again to say, well, this is coming up, am I unconscious with this in this way? And not asking anybody else to carry that. I think that's, you know, It's a tangent or maybe not, but you know, there's this whole division as you're familiar with, you know, the serious mental illness or biological mental illness and then quote, not society, there's not even a word for it. But I think the only, not even illness, the only challenge in life is really trauma. If you really talk to people who get labeled schizophrenic or bipolar, there's massive traumas in their lives. And so a lot of what we label as biological illnesses is often very much due to sometimes the craziest traumas and what's fascinating, and I learned this from my wife really, if you meet the rare person that don't have any personal trauma in their life, you go back one or two generations, and often there's incredible traumas in the previous generations. I remember one client early on some years ago had been hospitalized twice for psychosis, and in that person's family, for all these very pivotal events, there were always two versions of what happened that were mutually exclusive. And it wasn't like this one's the right one, this one's the wrong one. It was like, no, these are the two stories. Well, which one's right? Well, both neither. And this poor person carried that into their life and ended up with psychosis. And again, we have the opportunity. All of this is grist for the mill. If A, we don't say, oh, there's something fundamentally biologically wrong with me. And we just... I think healing is beholding. That's something I realized. Everything we do, every prescription we write, every CBT or other three -letter acronym technique is really just to get our ego distracted enough so the rest of us can behold the person. The old joke is what's therapy when there's two people in a room and both get better. That's really what we have to get towards. And it's possible in all these ways in which we stigmatize and... Sean (23:12.357) Hehehehehe. Florian Birkmayer (23:20.812) alienate people from society and from themselves, I feel we may have to question that and reconnect ourselves and invite people to reconnect. And it's hard because it's so easy to hide in this identity, in this role. Sean (23:38.981) Florian, I love the story of the untucked shirt. Cause I just think those moments are really what allow people to connect on some level. And I'm going to take it back to just, you know, some final thoughts from me on the psychedelic treatments of where I believe it's going to go wrong is that when you start applying a business model to something that is like so sacred and there's a connection there, maybe when you do your psychedelic treatment therapy, I can't remember if it's just ketamine. If you were practicing that and you use those essential oils, I believe there's like some type of intention. That you're setting, like you're really trying to help that person through that transition. But when you apply a business model and you're, you're doing it at a clinic, what's going to end up happening is they're going to use the psychedelic treatment, the LSD, but then you're going to have somebody sitting there in a room with them. And it's probably going to be a low level entry level nurse. And they're going to be on their cell phones, swiping through social media and not really paying attention for that hour or that 90 minutes, however long it takes for the treatment to work. It's it's course and. And it's missing out on that one element of that connection that's happening that even when you're sitting there with somebody and they may be under your intentions are set to really help them heal, to progress them through that. And that's not going to happen when there's a business model, cause it's going to be someone who just doesn't care. Florian Birkmayer (24:52.236) Yeah, I want to comment. You know, already, the first time I offered ketamine in my practice from 2011 to 2015, there was no guidelines. Someone else was doing it. And then when I went back to it briefly a few years ago, the idea of maintenance treatment had taken a hold. Instead of saying, well, here's one treatment and let's integrate, let's learn from this experience for as long as we can. It's like, well, you're going to come in for six treatments, maybe three times a week, twice a week, and then after that. So, Again, the idea that you have to be a continuing patient maintenance has been applied to this treatment. I don't offer any clinical treatments. I offer coaching. I guide people on aromas. And again, I think the aromas are ideally don't take people's autonomy away, but it is the ideologies everywhere. There's some, well, The origins of psychedelic therapy, just a shout out, I just read this book Tripping on Utopia by Benjamin Breen, I think his name is a historian at a university in California. And the origins of using psychedelics for therapy actually were established in the 40s and 50s with a lot of influence of the CIA. Margaret Mead played a big role, Gregory Bateson played a big role. But a lot of the things that we sort of take for granted now, that's when they were decided. And it doesn't mean that's the way we have to do it. That's just the way that, again, with the ideological drive of the CIA and other forces, that's why a lot of these things were put in place. They're not, there are many other ways of doing this that we're not even paying attention to. And it was really interesting to read this book and see where this came from. And we're already, people were, questioning it, but again, didn't have the courage of their questions fell on deaf ears, you could say. Sean (26:47.525) I can't help but wonder if the idea of sickness and mental illness, brokenness, being disordered is a consciousness that influences our physical reality in a way that kind of makes it so. So the idea in itself is harmful. And that's part of my direction right now in my work with clients. There can be so much shame that is brought into the room by the idea they have constructed about who they are based on a previous behavior and action. I always have to protect the privacy of clients when I talk on the, on this podcast. So I'm just going to change the details a little bit here of a recent interview that I did. And it was just a second opinion of a gentleman who's had multiple suicide attempts. His entrance into the mental health system started at like age seven. Now he was in an abusive family. So it's a, how does a seven year old react? when they're in a home where their parents hurt them. Well, they present as if they have a psychiatric disorder in the manner in which we conceptualize it. And so unfortunately he was put on fluoxetine, which is Prozac, at age seven. And you learn something about that, right? When you have to take a drug at age seven, You've learned that what you are experiencing in the way you are behaving, there is something wrong with it. You are broken in some way, you are sick. So it's this conditioned idea that you have to turn to a medicine, a substance, a pill to change the way you feel because how you feel is inaccurate. It's wrong. It's just, it's not how you can be in order to be okay in this world. And he was wise enough to articulate that message because by the time that I sat down and I met with him, he had been on every psychiatric drug you can imagine and multiple hospitalizations and he's overweight and he's struggling and he doesn't know where to turn next because everything that psychiatry has to offer has literally created illness and sickness. And he himself said, I have to relearn that what I feel is not wrong. Sean (29:10.917) because every time I go to a doctor, they ask me what I'm feeling. And if I report anything that's negative, anxiety, sadness, another pill is prescribed or a dose is increased. To me, that idea in itself creates sickness. And so how do we eliminate the idea of this? It's a shift in consciousness because consciousness influences reality. And that's why I think it's so damaging. Florian Birkmayer (29:34.636) Thank you. Florian Birkmayer (29:40.3) I agree with everything you said. It is really damaging. It's like we voluntarily have this spell cast on us even though voluntary is, it's a subtle spell that we don't even know we're under. Again, it's a program in the default mode network. It's like what you said reminds me of that t -shirt from that client so many years ago. People like you are the reason I'm on medication. I need to take medication to put up with people like you. You're literally the person giving me the medication. I mean, I'm not talking about you, but the system. Sean (30:04.037) Ha ha ha. Florian Birkmayer (30:10.412) And again, that sense of, no, something's wrong with the system. My feelings are valid. No, let's turn that upside down. You're the one with the problem. That's where I believe it starts as a society. And that's until we talk about that and allow, you know, what if nothing's wrong with me? People need to be allowed to own that, you know. Sean (30:37.701) Yeah, what if something is not wrong with me? Right. And listen, like I understand people, the people I work with engage in behaviors that create long -term health problems and pain, right? There's no doubt that overeating and vomiting afterwards is a problem way of living. Turning to drugs and alcohol, same thing. Blowing up relationships, same, right? So there's no doubt that. Florian Birkmayer (30:41.42) Right. What? Sean (31:07.077) they require some help if they're unable to break free of those patterns. And that's where I want to dedicate my life. I want to understand that and I want to know how to best help people through it. But I often find it has nothing to do with the emotions that they're experiencing. It's how they relate to them and how they think about them. So if they experience an anxiety, an unwanted thought, a distressing memory, it's how they relate to it, which then leads to that behavior. It's intolerable. I can't have it. There's something wrong with me. And they enter into behaviors to escape the experience. And there's lots of ways we can escape experience. We can work too much. That the whole default mode network of automatic processing and behaviors can be certainly a way of escaping the unwanted experiences of our lives. You know, the suffering that exists. Florian Birkmayer (32:08.268) Oh, I agree with you, it's... Florian Birkmayer (32:13.996) It's this whole idea of I should be like, I should be a functioning member of society. I mean, what you said has just touched me so deeply. I'm at a loss for words, but the whole ideology behind treatment is, I need to be a functioning member of society. These things that I'm experiencing are somehow invalid. Over the years, I would have clients tell me, you know, when I was a When I was a child, I was molested by the neighbor or uncle and I told my parents and they said, shut up, that didn't happen. And what I realized, all of culture is really a way of dealing with trauma. The Epic of Gilgamesh lists modern PTSD symptoms. The Book of Job is really how do you deal with overwhelming trauma? But it's in that cognitive dissonance when you're saying, shut up, that didn't happen. Your way of thinking about this, your way of being in the world is wrong. That's where people then... Sean (32:45.157) Yeah. Florian Birkmayer (33:05.9) develop PTSD or other things. That cognitive dissonance is really dangerous. And part of it is like, well, if we know inside what's right, why do we allow usually people of authority figures, parents of a younger or other authority figures, why do we let them overrule that? That's part of the sick society. I know what's true for me, what happened to me. And then I'm being told, shut up, that didn't happen, or shut up and take your medication. It happens at a very basic level, and it is very pernicious. Sean (33:43.493) Yeah, I have this I have this friend who's annoying me right now because he's always sending me these this reels from social media. And to me, it's like a constant indoctrination of certain ideas. And I hear him just repeating the ideas over and over again. And he doesn't realize how he's influenced by the constant frame of reels, right? The algorithm. So I keep sharing with him, like, well, first of all, this isn't real. This is fake. Or, you know, this is like, Florian Birkmayer (34:05.388) Right. Sean (34:11.845) flipped to influence you, it's all purposeful. And your reality is being shaped by your experience around this. And if you don't realize it, then you're in it. And it's all you know. And that's kind of what I think about, like DSM diagnoses or mental illness, that people will come into our office now, and this is new. I feel like this is really new in the past 10 years. People used to come into the office and I could spend the time and get to know who they are. Now they say, well, I have ADHD and I have bipolar disorder and I have this and they describe themselves in terms of DSM diagnosis. And it's so frustrating for me because I'm like, that tells me nothing. I mean, who are you? Where are you from? Like, what are you feeling? When? When do you experience it? It's like this level of indoctrination right now of shifting and framing a reality for the person that's... It's brainwashing in so many respects. And then you start having conversations like this, or you have a podcast like this, and you're offering alternative conceptualization, then you're branded. You're a conspiracy theorist, you're anti -psychiatry. They give you these names, like because you are outside of the algorithm, or you are outside of the illusion, then somehow there is something wrong with you. You are now mentally ill, you are dangerous, you are disordered. Check, check, check, check, check. Florian Birkmayer (35:32.14) Yes. Well, which is funny because that's the plot of so many dystopian sci -fi movies. You know, the outlaw hero, the person who's saying something's wrong with his picture. You know, there's a book by Philip K. Dick where, a short story, where a guy is really into drugs and one day he takes this drug and it's this benevolent society. Everything's taken care of. You know, all your pleasures are tended to and there's these benevolent leaders and one day he takes this drug and... everything's horrible, he's a slave, the benevolent leaders are really like these aliens that are exploiting humanity. And he's like, what was this crazy psychedelic? And it turns out it was a truth drug, you know, in a way that, and there are people who are like us having these conversations, you know, who are sort of questioning the narrative and some of them receive death threats. It's really... Sean (36:12.453) Oh yeah. Florian Birkmayer (36:28.556) Yeah, it's really disturbing. And it's not like... This wouldn't make it okay, but it's not like the outcomes are so amazing. Again, it's a little bit like Brave New World. Aldous Huxley actually visited New Mexico many years ago and of course has done other things, but Brave New World is all about, oh yeah, I'm gonna take a pill, so I'm so happy to be a member of this society. He wrote that book, what, in the 20s or 30s, and now we have the technology to make that a reality. And again, what you alluded to with your friend is how our default mode is being manipulated. And we think, oh, this is choice. I like going on social media and liking this and I'm somehow expressing my individuality. And I'm completely, you know, between social media and then all the data collected in the AI, what I'm going to do for the next few years is already completely programmed. It's already part of an algorithm. It's haunting. It's, it's, um, How do we? There's a museum in LA, I don't want to name names because again, it's easy to get labeled and bandied. But in this museum, there's a room about mind control projects, you know, MK Ultra and stuff. And then there was, this was years ago, one of the mind control projects is Project Tower. It could be total conspiracy theory. Project Tower and the medium of mind control is cell phones. And you know, whether it's a conspiracy theory or not, we are being mind controlled by our cell phones. Sean (38:03.557) No doubt. Florian Birkmayer (38:03.82) And it's not like a hammer, like, oh, I'm going to pick it up. It's like, you know, we're addicted to it. It's shaping our reality. People experience withdrawal. It's uncanny. And again, it's, oh, there was this... philosopher of substance abuse, John Powers, I think, or John Booth Powers, he passed away, he wrote a book called The Myth of Addiction. And in the introduction, he said, you know, it's just a question of time until we find the neurotransmitter that is free will. It's just another nerd. And again, I'm not a material reductionist. But the way we've been conned into thinking I have free will is there's something very different going on. Sean (38:35.749) Hmph. Sean (38:49.989) Well, I'm actually reading a book on a subject called science set free and I actually do believe there's free will. I also certainly are concerned about, you know, materialism and reductionism in science because I believe in a soul. I believe in outside of the material and there's a lot that we just have not evolved to fully understand as a uh, where we are as a inhumanity and we will at some point, right? But I know the, the, the person, like the, the, the, the, the priest or the, uh, or the rabbi or, or the minister has a worldview, has a belief system, has a faith. And that experience shapes their reality. The person who is a medium or has these abilities to be able to tap into like energy and experience a different set of consciousness has a different reality. The person who's on television all the time or is consuming social media to such an extent, they have a reality that shaped, right? And then when I step back and realize, well, everyone's living in their own separate reality. Now, is that reality serving their growth? Is it serving their quality of life or is it harming them? Is it getting in the way of them being able to experience love and joy and connection? And that's something that is like really important if you're going to be a mental health professional. Are you really truly interested in understanding that person's view of their reality? Or are you just projecting your own reality onto that person and then consuming everything they say through the limitations of your own experience? And my experiences is that's probably most people because our realities are shaped for us through our education, through our learning. Are you a a kind of true philosopher can a person who's really interested in understanding the internal constructed reality of a person do it without thinking about it from what they were told that person is experienced or presenting to you. Now I know that's this found this sounds very like philosophically and it's kind of like difficult to digest. But if you can sit there with your mind, your mind completely neutral. Sean (41:12.517) just observing the world through their eyes. That's much different than the psychiatric model of symptom checklists, for example. And you're questioning, being very directed to try to limit how that person, their reality is constructed because of what they were taught. So you experience irritable mood? Oh, you felt a higher energy? You had less sleep this day? Now you're constructing a reality with your client. And so then I'm just very concerned about the reality that is constructed by a mental health professional and why I would be quite guarded in that. Florian Birkmayer (41:44.364) Hmm? Florian Birkmayer (41:49.612) Yes. Again, you said so many things that I agree with and resonate so deeply. Our language, I mean, I think free will exists. Let's go there. And I want to say somewhere in Jung, you know, when the unconscious is an integral part of us that shapes us both in everyday life and everything, then I think confronting our own unconscious is really the only free will we have, which in a very reductionist way is saying no to these unconscious impulses that are now being hijacked by social media in all these ways. Oh, I want a soft drink. I want to post, you know, so it's no, no, no. And some years ago now, I think these people with researchers with brain scanners showed that, you know, again, there's this all this spontaneous activity in the brain, and I don't think it's spontaneous. A lot of it is the programming. And then, before we're even conscious of it, it gets edited out. So again, free will is really only the ability to say no to all these impulses. And again, I think we all have to do that ourselves. Sean (42:55.397) Yeah, true. And I Yeah, I think I understand what what you mean. I mean, there certainly can be this automatic conditioning where we're less free than what we think we are like it's a conditioned response, a conditioned reaction. But I also believe we have the ability to observe that and step back and become more conscious in our lives, more aware, more connected to the present moment. And I think we've spoken a lot here about so many different subjects that you know, open it up for future topics when we talk about the limitations of our current model and how mental health treatments can actually be harmful. And I did mention Abigail Shrier's bad therapy, you know, book, because I think that's like a first opening to the idea, wait, wait a second, a reality can be constructed. And an idea can be constructed. And we see this within the trans transgender ideology that has created so much harm for young people who adopt this idea that they're of another gender, they'd be happier if they if they did a complete surgical reconstruction of their anatomy. And now we're seeing some of the real harmful consequences of that. And if that reality can be formed through the illegitimate authority of a professional, well, then you can see that's a path where harm can be made, but you can extend it to anything, any idea. Like all of your pain in life is blamed on a parent or something that experienced another point in your life. Whatever that idea is, it can get constructed in that room. And that's the important takeaway, I think, from some of my points here. Dr. Florian Berkmeyer, we really appreciate your time here on the Radically Genuine Podcast. Before we do conclude, is there anything that you want to, final words here for the audience and how can people get a hold of you or any of your work? Florian Birkmayer (44:44.716) No real final words. I guess the final word is reconnect. If there was one word that I had to boil my intentions of this lifetime to is I'm going to reconnect and I invite you all to reconnect. Go in nature and don't do it because there's something wrong with you, just because it's reconnect to who you really are. And people getting a hold of me, the website is arom .com. A G N O S I S dot com. There's a way to sign up for our email list. Um, we have a YouTube channel that's, I wish it was more active working on that. We're doing online classes. We're doing coaching. Um, yeah, I think if you go to the website, then, um, you, there's a blog and then, so you, people can delve in from there. I'm, I'm so caught up in our conversation. I'm not really. able to point people more specifically, but just come to aromagnosis .com, sign up for our email list. That'd be great. Sean (45:45.029) And you have a sub stack too. Florian Birkmayer (45:47.02) Yes, thanks for reminding me. So I think it's just my name. If you put in Substack in my name, you'll find it in there. There's a long piece about why I'm no longer a psychiatrist. There's a few pieces about the forgotten sense, scent, and really how the shadow shapes, the shadow being the unknown, the unconscious, how that shapes who we're becoming. That's what I think. If I haven't yet, I need to write a longer piece about the default mode network. That's in my intentions. Sean (46:17.925) Great, great. We really do appreciate your time. Dr. Florian Burke -Mayor, thank you for a radically genuine conversation. Florian Birkmayer (46:25.484) Thank you for having me.