Moby (00:00:12):

Hi, and welcome to another episode of Moby Pod. Hi, Lindsay. Hi. Hi,

Lindsay (00:00:18):

Moby.

Moby (00:00:18):

Hi Bagel. Hi, Moby <laugh> <laugh>. And today we'll be talking with Dr. Kirsten Thompson. And I am so fascinated by her and her story. Lindsay, will you tell us a little bit about, well also, ah, okay. We'll give you a little bit of background on Dr. Kirsten Thompson. But then I'd really like for her to tell everyone about herself.

Lindsay (00:00:42):

She will go into great depth about these things, but just to prepare you, the listener, uh, Kirsten Thompson is a wonderful person, but in addition to that, she's a board-certified psychiatrist who works in California. And she also has started, I mean, she's done lots of different things. She worked for JP Morgan Chase, she was a surgeon, but now she's working as a psychiatrist. And she also has a company called Remedy,

Moby (00:01:10):

Remedy Psychiatry, right? Mm-hmm. <affirmative>,

Lindsay (00:01:12):

Which is a kind of more accessible online, uh, psychiatry for the state of California. But she's also working on lots of other ways to make psychiatry and mental health more accessible. And she's a wonderful fun person, lady wife and

Moby (00:01:27):

I have about 500 questions about different therapeutic modalities and her story. I mean, I'm obsessed with the brain and how it works and the fact that so many people are struggling and suffering and many people are underserved or unhelped. So if you're listening and you're struggling with anxiety or depression or other issues, I hope that there's something that we talk about that will be of benefit to you. I'm saying you, well, I'm looking at you, Lindsay, when I say you, cuz I'm hoping it'll be bene of benefit to you, but also to the people who are listening.

Lindsay (00:02:03):

Yes. If you, we'll learn a lot about Kirsten, but we'll also get a lot of information about what to do if you are worried about accessibility to care, and also just the care itself and what it might be like and what it may entail for you. Okay. I'll also ask her about Lobotomies

Moby (00:02:20):

<laugh>,

Lindsay (00:02:21):

Which I will be embarrassed about, but I still will do

Moby (00:02:23):

It. So without further ado, let's bring in Dr. Kirsten Thompson.

Lindsay (00:02:40):

Hi Kirsten. Hi Lindsay. Because we're all very curious about how someone goes into your field. I think it would make a lot of sense for you to kind of tell us where you're from and how you got into this career.

Moby (00:02:55):

Um, start at the beginning if you can.

Lindsay (00:02:57):

<laugh>, I was just gonna say,

Moby (00:02:58):

Do you want the

Dr. Thompson (00:02:58):

Born You Born Answer birthday? Yeah. Or the long, long?

Moby (00:03:01):

Where you were born, when you were born, how you were born, astrological

Dr. Thompson (00:03:05):

Style, going right

Moby (00:03:06):

In there. Childhood, um, rosebud moments, anything

Dr. Thompson (00:03:10):

<laugh>. Okay. Cause I have a short answer, but, so the, the longer answer is, you know, the, the, the phrase that always comes to mind is physician heal thyself. Right. So, I'm a psychiatrist and I don't think everyone I know goes into mental health field for some very personal reason, I would say. And myself included. So I'm originally from upstate York, whereabouts, Rochester. Mm-hmm. <affirmative>. Um, my dad worked for Kodak for 30 years. My, um, my parents got divorced when I was a year and a half old. So I grew up sort of going shuttling back and forth from both homes

Moby (00:03:40):

And both parents were in Rochester,

Dr. Thompson (00:03:42):

Both parents were in Rochester at the time. And for, for all of my growing up years, you know, I'm, you know, I think having divorced parents was, was hard. Not on the grand scale of trauma and lifetime. Hard but hard enough for me. Um, and then my mom remarried when I was like four and had a baby sister who died when I was five years old. Ugh. And that was such a sort of palpable grief moment. I, wow. I mean, I still have visions from when that happened and it really, I really was looking forward to having a sister and that was probably my first sort of like, big trauma and sort of the moment I also realized like my family had no language around death or grief or depression or mental health. And it was just on the record, no one in my family had any mental health issues. So nothing was discussed really in depth. Um, including, you know, I think the depression that my mom went through and had to start medication for, I had no idea at the time. Um, so I kind of proceeded with growing up and, you know, went to high school, went to college, and then, um, always loved math and science was pre-med in college. And Where'd

Moby (00:04:48):

You go to school?

Dr. Thompson (00:04:48):

Cornell. Mm-hmm. <affirmative>. And so really loved math and science, but was from upstate New York, so was sort of wowed by the internet boom in the late nineties. And so took a job on Wall Street at JP Morgan when I was 21. And my first day of work was actually September 11th, 2001. Oh my God. So I'm kidding. The very, like

Moby (00:05:08):

Your first day, like putting on your sneakers, getting on the 6 train going down to Wall Street was on September 11th.

Dr. Thompson (00:05:17):

Yes. Yes.

Moby (00:05:17):

How is that even

Dr. Thompson (00:05:18):

Possible? Except I was wearing like three inch heels and I was in like a power suit, or so I thought when I was 21. Okay.

Moby (00:05:25):

I, I was, I was imaging, I was thinking of like Melanie Griffith and Working Girl with like this sort of like <laugh>, you wear your sneakers on the subway, but you have your fancy shoes and your bag, you're rollup shoes. I've never, never, I've never had a real job. So I don't know how anything works. I, I only know about these things from tv. Yeah,

Dr. Thompson (00:05:38):

Yeah. So that, yeah, I was, I was in my suit and it was um, 8:00 AM and we were on the 30th floor of this one Chase Manhattan Plaza building. Um, chase had just bought JP Morgan, so we were sort of like one block away. There was a block between us and the World Trade Center. Oh my God. That was probably like the second major trauma of my life. And you know, at the moment when it happened, you know, now it sort of falls into this chronology of events where like first plane and then second plane and then we knew it was sort of a terrorist attack, but at the time it was just total chaos. And so we had to walk down 30 flights of stairs and rather than going far away, um, my boss at the time said, let's go to the Wall Street building, which was one block away and we thought we were kind of safe.

Dr. Thompson (00:06:18):

And so we sort of proceeded to try to have the meeting again when the building fell. And we were in this building called 60 Wall Street, which has, it's sort of a glass atrium on the ground level so you can see glass mm-hmm. On both sides. And so as they fell, we just saw people screaming and running on both sides of the building and then this like, sort of huge cloud of debris passing. And so all of us inside the atrium didn't know what was going on and just started running and screaming and running in circles cuz there was literally nowhere to go. And I remember this like very sentinel moment for me, which was looking to this to my right and there was like a man with his briefcase just clutching it. And I just thought to myself, oh my God, I'm gonna die and this is where I'm gonna die with. And if I was him and I was 16, all I had done was to work in finance for my whole life. I'd be really disappointed with my life. Mm-hmm. <affirmative>. And so, like, luckily everything sort of calmed down and we sat down and, you

Moby (00:07:13):

Know, oh, mask where, where you were living at the time.

Dr. Thompson (00:07:15):

So I was living in Hell's Kitchen mm-hmm. <affirmative>, um, 45th and ninth. And it was a long walk back to that apartment, although very unifying for all New Yorkers who were kind of there at the time. Yeah. I was

Moby (00:07:26):

On Mott Street between house and friends.

Dr. Thompson (00:07:28):

Okay. Okay. Yeah. So it was a really intense time and I, I think I, I didn't know anything about P PTSDs then, but,

Moby (00:07:36):

And jumping around that one, one of the things that was especially, and I don't know what your perspective is on this as just an individual who lives through it, but also as a clinician is the P T S D we didn't think we were allowed to have. Mm-hmm. Like after September 11th, like, I mean clearly it was very traumatizing, but I was fine. Mm-hmm. <affirmative> and like everywhere you went you remember those fences that were just covered with pictures of people. Like, have you seen this person? Have you seen this person? And like you felt like you were adjacent to real grief. Mm-hmm. <affirmative>, like I, I felt like I was like all these people had died and I didn't feel entitled to my own trauma. And I was like, sure. I, it was rough but I was like, I, I didn't die. I don't know anyone who died. And also at that point I was drinking and doing tons of drugs. I'm sober now. But like it's just so interesting when you have that like adjacent trauma that you don't feel entitled to mm-hmm. <affirmative>, I don't know if you had any experience like that.

Dr. Thompson (00:08:36):

Yeah. It's almost as though it was normalized in New York at the time. Everyone experienced it, so if you experienced it too, you weren't necessarily allowed to kind of suffer. And to my knowledge, all the people I knew didn't really do anything. It wasn't viewed as trauma cuz it was sort of this collective experience, meaning nobody I knew got therapy at the time or disgusted as though it was a trauma. And I could tell it was just sort of different. So my boss sort of speaking of wanted to have a meeting like the next day and was like, let's just go to a different building. And I was like, no, I am, I am not. Okay. Which for me, who tends to sort of be a people pleasing person in general mm-hmm. <affirmative> was like very hard to do. So I mean eventually I went back to my Wall Street career and I, but I definitely had nightmares about plane crashes and being in planes that crashed, but I didn't necessarily put it together that that was sort of elements of PTSD mm-hmm. <affirmative> until many years later. And so I think that was really hard for me, but it was also good. So it also changed the trajectory of my life because I decided I didn't wanna do finance.

Moby (00:09:32):

You didn't wanna be the 60 year old guy clutching his briefcase on death store.

Dr. Thompson (00:09:36):

No <laugh>, no. And you know, that's kind of where I was headed. I was in this sort of analyst track program, it just didn't feel like what I wanted to do. So I sort of actually kept that program and job for a while because I was supporting myself. But I started volunteering at night in the hospitals of New York doing different programs. So I did a program for women with HIV who are getting their GED I did a program where I volunteered at Mount Sinai Hospital as the lowest person on the totem pole who would sort of clean bed pans and feed patients. Um, which many people think would, you know, probably be gruesome. But I really loved the sort of caretaking aspect mm-hmm. <affirmative> and realized that I really loved medicine, which is something I loved when I was a a kid.

Dr. Thompson (00:10:11):

But kind of came back to that. Prior to that I had sort of said to myself like, it's too hard going to medical school and I'm too old, I'm in my twenties already. And sort of all of that went out the window. So I went back to, well I had to take pre-med classes. So when I was um, three years into my Wall Street career, I went back to Columbia and take, took pre-med classes in order to be able to apply to medical school. And then I went back to medical school when I was old at 26. <laugh> I'm saying old in quotes because it felt old at the time.

Moby (00:10:37):

And where'd you go to medical school?

Dr. Thompson (00:10:39):

I went to medical school at SUNY Downstate, which is in Brooklyn.

Moby (00:10:42):

Okay. I went to SUNY Purchase. Oh yes,

Dr. Thompson (00:10:44):

Yes, yes.

Moby (00:10:45):

SUNY alums. Yeah.

Dr. Thompson (00:10:47):

Yeah.

Moby (00:10:48):

Considering there are about 800 Sunni campuses, <laugh>, but mm-hmm <affirmative> nonetheless, uh, you know, anything to bring it back to me, <laugh>.

Dr. Thompson (00:10:57):

Yes. Yeah. Went back to medical school and that was a really good experience. It was um, sort of a program that had a lot of people who are underserved, um, and also an academic hospital. So you'd learn sort of complex things but also be serving people that really needed help and did medical school there and started my mental, this is a very, very long answer to your question. No, it's great. No, this is amazing. Feel free to cut me, me off. This is, this is what I was personally hoping for. Feel free to cut me off at any point. Um, I, you know, probably for a variety of personal reasons, maybe one of which is kind of often I am driven to sort of do the hardest thing and the most accomplished thing. And that kind of probably goes back to fi family dynamics that I grew up in with in my role.

Dr. Thompson (00:11:34):

And it's not always a bad thing, but that is sort of a long way of saying I ended, ended up going into surgery, so did medical school and then came out here to Los Angeles to be a surgeon. So I ranked USC surgery program as my first choice because they had a really incredible program with two female transplant surgeons. And you know, transplant surgery is one of the most intense types of surgery cuz you have to be willing to operate at any moment for 14 hours to replace like an entire organ, sometimes longer. And so I was sort of inspired by the nature of a program that was at the time progressive enough to have two female transplant surgeons. And so you became a surgeon? So I became a, well I was training, yes, as a, a resident and in a general surgery program. So was operating for two years during surgery at LA County Hospital here in Los Angeles.

Dr. Thompson (00:12:22):

I liked the program because it was both a county hospital again, where it was serving the underserved, but also in academic hospital where you'd learn very complex um, cases. And I loved the nature of the people, but I realized pretty soon into surgery that I wasn't the best fit for surgery. And I say that for several reasons. One was that it was all encompassing. So I was working, you know, there was a law that you were only supposed to work 80 hours a week, but we routinely work a hundred hours a week and you know, I wouldn't sleep every three nights cuz I was on call and I thought I could sustain that for training. But I realized sort of shortly into that career that even after training, it's a sort of incredibly intense lifestyle and I wanted a little bit more of a broad-based lifestyle for myself.

Dr. Thompson (00:13:07):

So I'd come in and be like, Hey, did anybody see this movie? And everyone would sort of like scowl at me like, what do you, you know, you're not supposed to see movies. And I wasn't the type one of my colleagues was so into surgery that he would come in, we worked six days a week and he would sort of come in on his seventh day just to observe surgery. Wow. And that's amazing. That's exactly what you want in your surgeon. But that wasn't necessarily the life that I wanted to just be doing kind of surgery all the time. So it wasn't a fit for me in that regard. And the other reason I sort of found surgery to not be a fit was because I was more interested the more I sort of got into patient care. I was much more interested in people's emotional experience of the world and their life.

Dr. Thompson (00:13:48):

Um, so on more than one occasion, you know, we had a lot of trauma victims at the LA County Hospital and a lot of it was due to gang violence. And so, you know, we would have, and this happened, two kids in one night were stabbed in the heart at parties, presumably over over gang violence. And as a surgeon, I was sort of meant to sort of like help operate. And then at the moment someone's sort of no longer alive, there's no point in sort of spending time there anymore. You wanna go save the next person, of course. Which makes sense. But I was sort of really hit with the poignancy of like an 18 year old kid, one of which was wearing like Christmas, um, sort of themed boxers that night. Um, and I, you know, felt the need to kind of stand there and hold this person's hand who was dying completely alone in an operating room.

Dr. Thompson (00:14:35):

And to me that was really meaningful and emotional and I wanted to sort of be with this person as opposed to kind of, you know, running to the next operating room. And so, and I was wondering like, you know, why did this happen? Why is this poor kid in a gang? Why are people joining gangs? Like where is their community? What, you know, sort of all the sort of thoughts behind what, what goes into that decision, I guess? And just the extreme grief that this sort of family would feel. So I was definitely like an odd duck to say the least in surgery. Um, and I started kind of reaching out to friends who had gone into psychiatry. And I also had started my own therapy actually not until I was 30. And that sort of opened up this new planet that was like, wow, feelings. And

Moby (00:15:17):

What, what kind of therapy did you do?

Dr. Thompson (00:15:20):

You know, it was, it was still when I was in New York in medical school and I th it was a social worker. I honestly think she just did sort of a general psychodynamic what I would call psychodynamic. So it wasn't C B T, it wasn't, I didn't even know anything about it. So if she did have a type of therapy at the time, I had no idea what

Moby (00:15:35):

It was. So like dynamic psychoanalysis or

Dr. Thompson (00:15:38):

Yeah, probably mm-hmm. <affirmative>. Yeah, probably. And she wasn't like a, you know, strong analyst. It was very much about like, processing and it probably was mostly like a supportive psychotherapy because I had no exposure to anything mental health in my life. <laugh>. And I was 30. So I think at that point, you know, just kind of processing what was going on and at the time, and this wasn't even going deep into my sort of childhood, it was just kind of like relationships and that sort of thing at the time mm-hmm. <affirmative> mm-hmm. <affirmative> medical school.

Moby (00:16:04):

And with surgeons, I have a few, I have a few friends who are surgeons and I, I can't imagine what that's like as your job cutting people open and working in an environment that's just filled with blood, literally. Wh what's that like the first time you make an incision, the first time you're holding the scalpel and you cut someone open? Do you remember where, what that was like and how you felt?

Dr. Thompson (00:16:30):

Yeah, I mean, I, I don't remember the very first time quite honestly, but I do remember the sort of recurring sensation or feeling that I had. And it, you know, it really did feel powerful. And I, I say that not in a controlling other people kind of powerful way, but sort of a meaningful and poignant and the honor of being able to do that felt really extreme. And it was also scary. So, you know, obviously making, and there were times where people would make an error and you're literally either killing someone or almost killing them. Mm-hmm. <affirmative>. So it's, it's, you know, it entails tremendous responsibility, um, in a very like, immediate term way as well, which I think is very different than Mel Mental health now as a psychiatrist, it's, things progress slower as well, but surgery, you know, has to be so exact all the time, otherwise people you know, really can die. Yeah.

Moby (00:17:22):

An old friend of mine is a brain surgeon and I just can't, no pun intended, I can't wrap my head around that <laugh> like that. His, but, and he's, for him, it's the most normal thing in the world. Like, I wake up, I go in my studio, I work on music, he wakes up, he goes to his hospital and he cuts people's heads open and tinkers with their brains with a knife or a laser. And how I, I can't, again, I can't make sense of that. I'm glad that people do it. I'm glad that he knows how to do do it and he's so good at it. But that's his daily life is like covered in blood and brains. Um, one fascinating thing he told me, and I don't know if you've ever had this experience, is when he's cutting people open, he can immediately tell who the cigarette smokers are. He said because their skin falls open. Oh. Like, it doesn't ha like, it doesn't have the sort of like collagen or like, uh, like a healthy young person, he'll cut them open, you have to like push their skin apart. And he said with the smokers it just kinda like falls apart, like wet, wet newspaper. That's

Lindsay (00:18:20):

So gross. Yeah. Really.

Moby (00:18:22):

If so, if anyone's ever thinking of quitting smoking or not starting smoking, that's a very good reason is that you don't want to have your skin have the consistency of wet newspaper <laugh>.

Lindsay (00:18:32):

Um, so Kirsten, so you're in this, your trauma surgery moment where you're with this guy and you have this realization of, I don't know if this is, if I wanna be doing this exactly. Maybe I wanna deal with more of like the emotional side of healing seems to be this moment that you had, right? Yeah. So then what did you do after that?

Dr. Thompson (00:18:53):

So I did a lot of soul searching. And what I mean by that is I, I talked to my, I dunno if it was my husband then boyfriend husband at the time. And you know, I was like, I'm really not happy in this and this is sort of like a probably a semi negative character trait of myself. But I was like, I can't quit. I just can't, like, I'm not a quitter. And by the way, nobody ever quits surgery. And this is, it's such a privilege to be in this role because a lot of people can't get those residency spots. There's only few and they're limited in the country and blah, blah. Nobody ever quit surgery. And he was kind of like, I'm sure people quit. It's sort of when someone says something and you realize like, oh, why have I been so narrow-minded about this?

Dr. Thompson (00:19:31):

So I ended up just sort of talking to people and lo and behold people quit all the time and go into different types of medicine. And so I started talking to friends from medical school who had gone into psychiatry. And I did that because I had worked in psychiatry, Columbia and research when I was doing the pre-medical program. And I really loved, I felt like my people were there mm-hmm. <affirmative>. And so I had loved that job. So I sort of reached out to people who were training and, and they all were so happy and they really loved kind of the mental health field and were really interested in it. And it seemed like something I could do. And as my own therapy was kind of opening up too, um, in my life, it's, it was just opened this vast world that I felt like there was so much to learn.

Dr. Thompson (00:20:10):

And that was an important thing to me too, is, you know, on some level I wanna be kind of learning my whole life. And I felt like I could be like a crusty 95 year old psychiatrist. Like still learning and still loving talking to people and each new person and hearing their story versus surgery was, was on some level to me a little bit, um, mundane and repetitive. And you know, if you become a super specialist, you're kind of doing a lot of this same surgery but looking for anatomical differences. But your goal is to really be solid and repetitive, whereas mental health is just so vast. Um, it seemed really exciting. So I, I quit the, well, I actually applied to psychiatry residency programs in Los Angeles cause I was al already here and loved it. And then I got a couple of spots and went to UCLA where I finished psychiatry training three years. So two years of surgery in psychiatry. And I really just loved it. Um, just so much to learn. I really knew nothing even though I'd gone medical school, knew nothing about sort of mental health. But, um, really loved working in psychiatry and tried to kind of experience every type of mental healthcare system that we had in the us which is really possible in Los Angeles. Which, which has been really great.

Moby (00:21:18):

So one question I have about 15 years ago, I got really excited. I was going on a date with a psychiatrist and during, cause I was like, you know, granted we only had one date because she was a pretty seriously mentally ill drug addict <laugh>. But, uh, and I say that as someone who used to be as pretty seriously mentally ill drug addict. But on the date, like before the date, I was so excited because I was like, oh, even if the date's terrible, like we can talk about different like modalities and like who are her? Does she like young? Does she like Viktor Frankl? Like who she inspired by, she didn't know anything about therapy. She'd never been in therapy. She knew how to write prescriptions. And I was like, what do you mean? I was like, you're a psychiatrist. She was like, yeah, I'm a doctor and I know how to write prescriptions. And I was so taken aback by that. Cause I assumed that psychiatrists were psychologists who knew how to write prescriptions. Mm-hmm. <affirmative>. And she had no background in talk therapy or any type of non-pharmacological modality. Mm-hmm. <affirmative>. And is that just her or are there a lot of psychiatrists who are just like, they write scripts and that's it?

Dr. Thompson (00:22:30):

Well, I think, you know, I can't speak to every psychiatrist or program in the nation. No, I'm

Moby (00:22:35):

Not maligning psychiatrist. I'm, I'm glad it exists. I'm And and it sounds like what you're describing is diametrically opposed to how she approached things like Yeah, like I said, she just, she talked to people, she wrote prescriptions. That's it.

Dr. Thompson (00:22:46):

Yeah. Well, and there certainly to this day are psychiatrists who, you know, choose to do a hundred percent medication management, is what we call it. Where they are writing scripts and sometimes do 10 minute visits to check in. And that's sort of the way they practice and their focus. And, and I would say though the, the breadth of psychiatry is, is vast. So some psychiatrists end up doing only talk therapy or a certain type or modality of talk therapy now mm-hmm. <affirmative> because they love it so much or they find it to be so effective. And then there's kind of everything in between. I think the types of therapy have also evolved and improved so much in the last 10 to 20 years. So, you know, before it would be, you would either learn about medication of which there were a few medications or you were an analyst. Right. That was sort of the traditional type of therapy. And then in the last 20, 30 years, so many different types of therapy have evolved and have been shown to be effective like cognitive behavioral therapy and so many others that I think now there's so much more, more to learn and specialize in. Because

Moby (00:23:46):

When I was growing up, my understanding to what you're saying was that like psychologists picked a lane and they stayed in it like they were a youngian or they were a Freudian. And that's kind of it, like the, the, you know, the Woody Allen approach to therapy. It's like you go to analysis five times a week for 40 years. So my assumption growing up was that it was quite siloed in a way that the, you know, the therapists studied one approach and that was it. And I was, when I started going to therapy as an adult, and Lindsay, I don't know if you had this experience or not, but I was really happily surprised to find that the therapists I was seeing were sort of multi disciplinarians. Mm-hmm. <affirmative>, like they were interested in C B T. Mm-hmm. <affirmative>, they were also interested in dynamic psychoanalysis. They were interested in Jungian archetypes. They're interested in all these different things. So my question is, is the standard now to be multidisciplinary in that way as opposed to exclusively siloed in one modality?

Dr. Thompson (00:24:48):

So as a psychiatrist, and I'll speak to sort of the training in residency, which is four years and you know, I just, well, well I didn't just, sorry, years ago, graduated from UCLA <laugh>, I feel very young still. Um, and I'm, I'm still on volunteer clinical faculty there. So I have a bunch of mentees and um, teacher residency class and was teaching med student classes. So I've sort of watched their curriculum evolve and if anything it's been, you know, far more in depth on the therapy front. So, you know, whereas on the medication front, we haven't had a lot of new players in the last 20 years as far as new medications that have come out and been shown to be wildly more effective than the old medication. And therefore a lot of the innovation and the learning has been on the therapy front. So for sure the UCLA program has a really robust training program in things like C B T, um, or cognitive, this

Moby (00:25:38):

Is within psychiatry. So within

Dr. Thompson (00:25:40):

Psychiatry Yeah. And all different types of modalities of therapy specifically. And there's a lot of support around that too. Not only classes and clinics, but having supervision from, you know, sort of therapists who are very experienced in the field. So it's very, very therapy intensive and a lot of psychiatrists do want to specialize and do mostly therapy as opposed to medication. So it's really sort of individualized. Hmm. Um, but the programs themselves are very much trying to, at least UCLA for sure. Trying to expose doctors to much more of the therapy side instead of just doing medication. Great.

Lindsay (00:26:14):

That's amazing.

Moby (00:26:15):

I feel like I'm monopolizing things. Lindsay, what

Lindsay (00:26:17):

Do you have? Well I have a question because I have done this many times and I just wonder what you do when it happens. Not many times. I did it recently where because of the internet <laugh> and because of social media, I would assume that often when people come to you, this may be the case that they already know what they have and they just want you to affirm that they have the thing that they know they have and give them the medicine that they already researched that they want. And please and thank you and that's all. Does that happen a lot or am I the only person that sort of like

Moby (00:26:48):

Self-diagnosis? Oh yeah,

Lindsay (00:26:49):

Self-diagnosis.

Moby (00:26:50):

The WebMD approach to self-awareness. Well, cause

Lindsay (00:26:52):

I feel like Dr. Google, a lot of doctors have this issue, but I wonder how you handle that specifically because I'm one of the annoying people that does that <laugh>. No,

Dr. Thompson (00:27:00):

No, I think everybody does that. So just to validate, I think it's, with the availability of the internet and information, it's perfectly normal. Um, and I do that myself too. And I think it's funny, I'm on all these like doctor groups and they have like things like mugs that say, you know, really mean things like go back and talk to Dr. Google again. Right? Yeah. Yeah. And people get angry because patients do come into that come

Lindsay (00:27:19):

In. Well it must be annoying, especially because people are fallible and wrong and not, I'm not a doctor, there's no way. You know what I mean? Yeah. So you would be the one that would know. I'm

Dr. Thompson (00:27:28):

Just, well I think that, I think the idea of getting angry at a patient though for self diagnosing misses the mark. And so far as like you're suffering, you want some answers and information mm-hmm. <affirmative>. And so of course we all Google and try to come up with what is, so as a, a physician myself, I don't find that annoying in patients. I think they're trying to provide a solution and get information while they're waiting for their doctor's appointment. Yeah. And it feels right. The nature of anxiety is you have worry and you have no problem solving or you have no capability to do anything about it. Mm-hmm. <affirmative>. So on some level, doing research when you're suffering makes sense cuz you're actually solving a problem as opposed to just worrying. But I think the, the only trouble I have is, you know, and I don't actually encounter this a lot, but if someone feels so certain with the medication that they know is gonna be right for them, for example, for, for example, one time I had a patient who probably had seen, I don't know, 20 psychiatrists before me and sent like a four page list of medications that they had been on in the past, which is actually, you know, great.

Dr. Thompson (00:28:27):

And I have a lot of patients who have seen many, many psychiatrists and been on tons of medications. And I actually kind of enjoy the complexity and having hope and trying to figure out a solution for them. But this one patient who I saw once was very certain that they should start a medication at a very, very high dose, which to me was just not safe. And there's sort of an idea of what is right for your body, but there's also the idea of, you know, when you go to medical school and you learn the side effects and that this may not be good for your heart, even though it may help your brain, we don't wanna start you at a really high dose. So I, I don't do anything that I don't feel comfortable with that's not in the best interest of the patient. And that's when patients kind of get angry. And I think that's when there's a sort of mismatch in fit mm-hmm. <affirmative> or you know, in that case I think the patient, I think the patient had a lot of other issues that were kind of going on on a relational level that was kind of coming into play a sense of control, you know, and, and sort of going to doctor but feeling like you have the answer already. Yeah. But that doesn't happen so, so often.

Lindsay (00:29:26):

I bet there's a sense also, I mean when I do it, I'm really cool about it and I'm like, but whatever you think, just to put that out there. But I bet even when somebody comes in like that and they're like super prepared and they're really forceful, you're like, okay. That in and of itself is a lot of information to me about what maybe would be,

Moby (00:29:45):

Cause we all want safety and control, you know, and having access to information and being able to control that. There's a comfort that comes along with it. I mean I even if you're like dilatantishly mis self-diagnosing, it's like still you're like, you're trying to create control in the chaos.

Lindsay (00:30:03):

Yeah. I mean there's extreme versions of it obviously of people taking it to a degree that is scary. Yeah. But I think that it makes a lot of sense to be like, Hmm, I wonder what's wrong with me and who should I be talking to about it? Have

Moby (00:30:14):

You have you guys in a non-professional way, I don't know if you've ever experienced this, where you take one of those like, like whether it's Buzzfeed or whatever or like Psychology Today, it's like, are you a psychopath? Are you, do you have Asperger's? Do you, do you ever take, take those tests and maybe like, like for example, I took an Asperger's test. Like I'm definitely a little, like I'm wiggly on the spectrum <laugh>, but I'm spectrum adjacent. But I was actually a, a little disappointed that I was, that it didn't like confirm my pathology for me. Has that ever happened to you where you take a test and you're a little disappointed that you're not pathological? I see

Lindsay (00:30:52):

What you're saying but there's complexity to it. Which brings me to my next question. Which there's a lot of people that are very pro DSM and there's a lot of people that are very anti dsm. Mm-hmm. <affirmative> because they say,

Moby (00:31:04):

So that's the DSM is just, just for anyone listening, that's the diagnostic statistics. What is it? Something something diagnostic statistic. And we're up here like DSM five now. Yeah, seven, six

Lindsay (00:31:15):

We're

Dr. Thompson (00:31:15):

Five. I think well done.

Lindsay (00:31:16):

Okay. Um, there's people that think that human, the human experience is far more complex than can be boiled down into the dsm. But then there are people that say it's necessary to have these kind of general ideas so that we know where do you fall on that line. That's

Dr. Thompson (00:31:29):

Interesting cuz I just was like skimming a study on the DSM and how there's just so much repetition of symptoms amongst mm-hmm. <affirmative>, multiple different diagnoses mm-hmm. <affirmative>, which I think we all know. And it's sort of like diagnoses in general are kind of like this Venn diagram of over overlapping circles to begin with. I do think some level of organization is necessary mm-hmm. <affirmative> as far as figuring out what someone is dealing with and we have to somehow honor it by giving it a name or giving it a number or something. And so in, in a very simplistic way, like an organization to the idea of our mental health I think is helpful. I'll also say diagnoses are very person specific mm-hmm. <affirmative>. So some people come in, I've sort of seen it go both ways. So some people, you know, they've been suffering their whole life from a set of symptoms and people have, you know, sort of said like, oh it's very normal to be feel depressed and just hate your life.

Dr. Thompson (00:32:23):

Or you know, it's because your job is this or whatever the case may be. They've sort of been told it's normal and they should just kind of suck it up. And so to have a doctor or therapist, psychologist, whomever kind of see them, really see them and say, no, your suffering is an illness. Yeah. And it's called major depression. Mm-hmm. <affirmative>, you know, to some people being identified as having an illness is actually really healing. And that's kind of bears true in certain types of therapy as well where you sort of apply that diagnosis and it can be incredibly healing to have a name for something. On the other hand, having a diagnosis can actually be really negative. So I had a patient once that was diagnosed with borderline personality disorder mm-hmm. <affirmative> at some point during his twenties. And he came in sort of wearing it as though he had been marked for life mm-hmm.

Dr. Thompson (00:33:10):

<affirmative> with this terrible diagnosis that someone along the lines had given him. And so part of our work together in, in doing medication, but a little bit of therapy was sort of realizing that to him this diagnosis was a really negative thing, but it was just the word that was negative. And he was very aware of sort of his coping skills. And we talked to him about why that happened. And one of my mentors once said something that I love, which is that all the things we become in childhood allow us to survive to become an adult mm-hmm. <affirmative>. And so sometimes we acquire these skills in childhood that really allow us to survive bad parenting, for example. And so with borderline personality disorder, I like to give the example that, you know, if your parent is neglectful and abusive, when they are sort of smiling, you kind of run to them and it's a day where it's like, oh mom is feeling good today. I'm gonna get a hug, I'm gonna get cereal. Then, you know, you know, okay, I'm connected, she's happy. Okay, I'm happy the next day, you know, you see mom kind of slam the door when she comes home and children immediately pick up on that energy, right? Mm-hmm. <affirmative> and they realize, oh mom's really bad, I might get hit, she's gonna ignore me. Today's a bad day. I need to go take care of myself in my bedroom. So the world becomes very black or white.

Moby (00:34:20):

Thank you for just describing my childhood <laugh>.

Dr. Thompson (00:34:24):

Um, yeah. So I think it allows those kids to survive, right? Because if you didn't, you might stay in the room and get hit. Right? Or or worse get killed. Right? So if you just lived in the gray, it wouldn't be good. It allows people to, to live and get through their childhood. So we talked about this with this patient and I said, all those skills, we'll call them skills or just the way you adapted, the way your brain and your behaviors formed, allowed you to survive this childhood. And that is actually truly amazing. The problem is that now when you're an adult, those ways of adapting are now maladaptive or bad. Mm-hmm. And so now when you, you know, when your friend forgets to text you back and you end the relationship in a very black or white way, you know, they treated me wrong. I'm done with that person. It's maladaptive and you're losing relationships and you don't want that. Your goal is to have relationships. So yes, those symptoms might have been borderline personality disorder as a kid and now they're hurting you. And now we need to kind of work in therapy to change those coping skills. It

Moby (00:35:21):

Always reminds me of the Japanese soldier in the Philippines. Do you know this story? I

Dr. Thompson (00:35:26):

Don't know if I

Moby (00:35:27):

Do. So the war had end World War II ended and there was one Japanese soldier in the Philippines and no one told him the war had ended. And I think in the mid fifties they finally brought him back to Japan and in, and, and he sat down with the emperor and the emperor was like, the war's over cuz he, no one told him. So from 1945, whenever the war ended until 19, whenever he was still fighting the war, you know, in his, in the jungle in the Philippines mm-hmm. <affirmative> this one man army. Oh. Because no one had told them the war had ended. Yeah. Um, so it's sort of like this patient co completely like, yes, the war's over. Yes. You can let go of the armor, you can let Yes. But it's so hard when like it's all you've ever known. Right. I do wonder, and I don't want to in any way malign or dismiss DSM diagnoses, but it does seem sometimes like some diagnoses become real trendy for a minute.

Moby (00:36:20):

Mm. Like borderline personality disorder seemed like it had its moment where it was like the dalmatians of diagnoses where suddenly everyone was like, I'm BPD and I was like, oh, it's like the same people who go out and buy Labradoodles, <laugh>. Like again, I, I know people who have very serious borderline personality disorder mm-hmm. <affirmative>. But it does seem like some, some people are like, well I don't know what's wrong with me. I bet you I have, I have BPD. Mm-hmm <affirmative>, do you ever see that? Where people come in and they've read an article and Red Book or whatever, or Red <laugh> <laugh>, I don't, uh,

Dr. Thompson (00:36:52):

Parade

Moby (00:36:52):

His parade still

Dr. Thompson (00:36:53):

Out. I

Speaker 4 (00:36:53):

Don't know Woman's Day.

Moby (00:36:55):

Yeah. But they've read an article in Parade Magazine, um, about, okay, I'm gonna throw myself under the bus. I do this. Like I'll read about some type of diagnosis and I'll be like, oh, I bet you I have that. Like, do you remember the good old days of riding the subway in New York? And you'd see an like an ad in the subway. Like, are you tired? Yes. Are you irritable? Oh, all the time. <laugh>, are you prone to depression? Yes. Do you have lupus? I guess I have lupus. Yeah. Like you'd read these general symptoms, you'd be like, well clearly now I have lupus mm-hmm <affirmative>. And you're like, no, you don't have lupus. But the same thing with like borderline personality disorder. I know people who had self-diagnosed after reading their article in parade or Red Book or Highlights magazine

Dr. Thompson (00:37:38):

<laugh>. Yeah. Well, and I think that's happened very much so in the last three years with the pa during the pandemic mm-hmm. <affirmative> with ADHD specifically.

Moby (00:37:47):

Hey, don't you think you have that?

Speaker 4 (00:37:49):

Yes, I think I have that.

Moby (00:37:50):

You don't

Dr. Thompson (00:37:51):

<laugh> I did test for last week. We

Speaker 4 (00:37:53):

Don't know yet. <laugh>.

Dr. Thompson (00:37:55):

Yeah. And I think

Moby (00:37:56):

As your clinician, you don't have your PhD

Dr. Thompson (00:37:58):

<laugh>. Well yeah, maybe you do, maybe you don't. I'm not sure. But I, I think the way information is disseminated has a lot of impact on how people relate to it. So during the pandemic, you know, this was sort of put out in the Wall Street Journal in a series of articles. So I, I'm just sort of quoting the Wall Street Journal, but the, there was a big startup called Cerebral that was doing tons and tons of business and at one point there was a report that someone on their sort of executive team said, get everyone on stimulants because then they'll be sort of patients for life. And so what happened purportedly by the, the Wall Street Journal is that they sort of started doing tons of ADHD diagnoses and prescribing medications, um, from a top-down approach and doing a lot of kind of what I would call false advertising, which was later called out and then had to be removed. For example, there was a big TikTok push and a lot of the articles had one symptom, or sorry, not articles. TikTok videos had a, like are you a binge eater? If so you probably have adhd, which is first of all not even a symptom of adhd. Whoa. You know, maybe some people with ADHD have binge eating and then some ADHD medications. I think, I think think

Moby (00:39:08):

Binge eating is generally a symptom of binge eating. Yes,

Dr. Thompson (00:39:10):

Exacty. Exactly. So what that did though, it was, it was false information. Um, and there was a study that also showed with regard to mental health that TikTok about 50% of the information is actually false on TikTok. So it's really important to know kind of the source of the,

Moby (00:39:24):

Hold on just a second. Back up. You're saying social media isn't 100% true. True.

Dr. Thompson (00:39:29):

I know. It's crazy. It's crazy.

Moby (00:39:31):

You rocked me to the foundations of my

Dr. Thompson (00:39:33):

Yeah. Can I just say often when I'm like, I read an article that said it was a TikTok Yeah, <laugh>. Which actually, which is actually fine right? If you're getting it from like, from like physicians. Right. But I think that that that sort of statistic is because a lot of people suffering or you know, who just kind of know something about something are kind of putting out information that may not be accurate, but that ended up starting in this cascade of people getting diagnosed with A D H D that, you know, now there's this nationwide stimulant shortage. Yeah. And maybe in part because of that. Yeah. And it can be dangerous.

Moby (00:40:05):

A a good friend of ours has A D H D and he's having a very hard time getting Adderall and he needs it. I mean, one thing I would just want to say is we're having a lovely time and we're laughing and it might sound like I or any of us are making light of some of these diagnoses. To be clear, I'm not, I'm not making light of lupus, I'm not making light of A D H D, I'm not making light of borderline personality disorder. I think these things are incredibly serious and if someone's suffering through them, I'm not, not making light of them. I'm just trying to make light of people like me who miss self-diagnose sometimes cuz they're bored <laugh>.

Dr. Thompson (00:40:42):

Well, and I mean that's like another tangent we could go on. But you know, I'm, I'm also not saying I, these disorders are very debilitating and that's, for most patients that I see, it's really life impairing. Yeah. And that's when you wanna consider potentially treatment and or medication. Um, and,

Moby (00:40:57):

And I was just feeling preemptively guilting about like someone listening and feeling like we are making fun of their diagnosis. And I just wanna be super clear, like absolutely not. If someone's suffering, by all means I hope they get the care that they need and we're not making light of their suffering.

Dr. Thompson (00:41:11):

Yeah, no. If anything, my message sort of to everyone is, if if someone is suffering, they should seek help. Yeah. And it, regardless of whether it has a label or not, or is a ADHD or it's not. And that's what, I don't blame any of these patients that were diagnosed, you know, potentially inappropriately or on medication cuz they needed something and they were seeking help. It's the medical system in my opinion, and the prescribers and you know, the doctors that sort of failed the patient. So I don't think any patient is at fault. If someone needs help and they're getting help, that's the hardest

Moby (00:41:39):

Step. Can I, can I tell one pharmacological story? So I went to a psychiatrist to potentially get prescribed and at the end of our session he was like, so what do you want? And I was like, what do you mean? He's like, dude, what, just name something? What do you want? And I was like, wow. I was like, shouldn't you prescribe me? He was like, and he said verbatim. He's like, they're all kind of the same <laugh>. Well I think

Dr. Thompson (00:42:00):

There's, there's some truth to that. Like, you know, some, we have classes of medications like the SSRIs that we use for anxiety and depression and they are very similar with subtle differences similar to you were mentioning Klonopin or Xanax. Yeah. And those are the benzodiazepine. So, you know, as a group or a class, they're very comparable with sort of subtle variations in in each. So it's an interesting approach.

Moby (00:42:22):

I remember being very excited with myself when I finally learned what the S S R I acronym stood for. Cause it's the weird, you know, selective serotonin reuptake inhibitor. Oh, I

Dr. Thompson (00:42:33):

Thought it was like so sad. Right. <laugh>.

Moby (00:42:37):

I just love that idea of like selectively inhibits re uptake. Like this seems the most complicated way of saying Oh, it keeps the serotonin in your synapsis. Yeah. Like it, it selectively inhibits the reuptake.

Dr. Thompson (00:42:52):

There's a lot of like poor nomenclature going on in psychiatry,

Moby (00:42:56):

But what acronym but what Yeah, I don't have much experience with the actual drug. I hope it helps people, but it's, I'm, I just get real pleased with myself when I figure out an acronym.

Dr. Thompson (00:43:05):

<laugh>. That's a good one. Yeah,

Moby (00:43:06):

I don't, I don't have a lot going on so if like I can figure out acronyms. You

Dr. Thompson (00:43:09):

Got it.

Moby (00:43:10):

You got it right. If I can win it, click word. Like <laugh> <laugh>. So I have a whole list of like very general questions. Mm. One is, do you have, who are your psych psychiatric or psychological or even just philosophical heroes?

Dr. Thompson (00:43:24):

Well you mentioned Viktor Frankl, um, and Search For Meaning. That's a book I read probably 20 years ago. But

Moby (00:43:29):

Maybe it's funny, we actually talked to a friend of ours who is a therapist the other day and Viktor Frankl was her hero as well.

Dr. Thompson (00:43:36):

Yeah. So I think that book in general, not specifically for medicine but just for life, is really meaningful to me.

Moby (00:43:43):

Can I just contextualize him for people? Oh yes, please. Who might not be familiar please. So Viktor Frankl invented this type of therapy called logo therapy and he developed his philosophy, his psychology in Auschwitz. Mm-hmm. <affirmative>, he was an Auschwitz survivor. For me, the most remarkable, memorable quote of his between stimulus and response is a space. And within that space resides all of our freedom.

Dr. Thompson (00:44:06):

Wow. That's more detail than I remember. So thank you. But <laugh>,

Moby (00:44:09):

Yes. That's my favorite. Agreed. Viktor Frankl Agreed. Beautiful. And the fact that he went through Auschwitz. Yes. And he lost his entire family, I believe. And he still believed that we could choose our responses. We didn't have to identify as victims. Mm-hmm. <affirmative> like we had the ability to transcend adversity. And when you've gone through Auschwitz and lost your family, clearly he knew of what he spoke

Dr. Thompson (00:44:29):

Mm-hmm. <affirmative>. Yeah. Yeah. And I think that sort of speaks to the depth of loss that a person can experience and, and still come out sort of surviving or even thriving in some cases. So as far as other sources of mentorship, meaning, um, in general, I, I like sort of consuming the research as it comes out and learning about new sort of treatment modalities, um, and ways to kind of help people including different types of therapy, you know, or medications. Right now, you know, psychedelics and ketamine are sort of the newest mm-hmm. <affirmative>, um, form of treatment that we're kind of exploring on more of a hopefully prescribing controlled mm-hmm. <affirmative>, uh, approved way in the coming years. And I have a really great community within UCLA where I still kind of learn aggressively by working with an old mentor and kind of paying for supervision so that we can discuss the latest research and that sort of thing.

Dr. Thompson (00:45:21):

And I think far as, I was trained in a bunch of different types of therapy as well. So cognitive behavioral therapy that you mentioned. Another type of therapy is called I P t or Interpersonal Therapy, which is a very sort of focused 16 to 20 week sessions, um, or weeks, um, where you kind of start and end, um, with a very kind of formulaic path to, uh, treating things like grief or depression. So I really sort of like using those and kind of pull from those when working with patients. And as far as other, I sort of like to, you know, kind of consume pop culture books on, you know, I'm starting one called Mother Hunger right now, which is the relationship between daughters and mothers and, you know, what's that loss there,

Moby (00:46:04):

Lindsay? Write that down.

Dr. Thompson (00:46:06):

<laugh>.

Lindsay (00:46:06):

I already have it. <laugh>.

Moby (00:46:07):

You do <laugh>.

Dr. Thompson (00:46:10):

Okay. Yeah. So I think there's a lot to, uh, you know, I like sort of enjoy reading a lot of nonfiction in my area of expertise. Mm-hmm. <affirmative>,

Lindsay (00:46:18):

I know that modalities are always evolving and there's always new, like I know, um, psilocybin is kind of making its way up through and there's always this evolution happening, but I wonder if anyone comes in and you're just like, man, I wish I could lobotomize this guy <laugh>.

Dr. Thompson (00:46:35):

No, I've actually never, never really had the thought before.

Moby (00:46:38):

You don't keep little ice picking drawers, you know, I've got the answer to all your problems. I just go in through your nose, take your prefrontal cortex, everything's gonna be fine.

Dr. Thompson (00:46:47):

Totally. I think that's the only treatment we've decided. Like there really is no utility in a lobotomy anymore. I mean, you know, things like e c t actually electroconvulsive therapy, which is an induced seizure. Right.

Moby (00:46:58):

The Sylvia Plath approach.

Dr. Thompson (00:46:59):

Yeah. And it's actually one of the most effective means of treating severe depression and a couple of other things. So it's still very much used, very much effective. But some people, sometimes when I suggest kind of that as one of many options for treatment and just sort of laying the groundwork, you have a lot of options. You know, look at me like I've suggested a, a lobotomy, but it's very different.

Moby (00:47:20):

It's kinda like different saying like, have you considered leeches? Yeah, yeah,

Dr. Thompson (00:47:22):

Yeah, yeah. Yeah. So, and some people are sort of horrified at the suggestion, but I think that's mostly because of how e c t has been described in movies. I

Moby (00:47:30):

Mean, Sylvia Plath would definitely not be the ideal poster child for electroconvulsive therapy. Yes.

Lindsay (00:47:35):

How does that, why does that work so well for depression?

Dr. Thompson (00:47:39):

So, and I don't practice ECT, so I'm, you know, as far as the details, you know, I'm not an expert in that. But essentially the, what an induced seizure does is it sort of floods the brain with the sort of the neurochemicals, um, the all, which include all the feel good ones, um, like dopamine and norepinephrine and serotonin. And so it, it sort of just changes the brain's chemistry through the treatment itself. And I've seen, when I was training, I, I, I literally saw a man who was so depressed, he could not speak in, spoken in weeks, and he also could not walk anymore. The depression was so severe, which some people don't understand that either, that depression can just rob you of absolutely everything. Mm-hmm. <affirmative> and after one treatment, he was speaking and talking again. It was truly Wow. Truly amazing. And so there is a role for it, but I also understand why many people are fearful, given how it's been sort of depicted in the media, which I think is kind of true for a lot of aspects of mental health as well.

Lindsay (00:48:32):

It's gotten some bad press. Yeah.

Moby (00:48:34):

Also, there's the, there's over time things become fine tuned. You know, I imagine like electroconvulsive therapy in the forties and fifties was a blunt object. Right.

Dr. Thompson (00:48:44):

<laugh>,

Lindsay (00:48:45):

You know,

Moby (00:48:45):

And now they kind of understand it better, so, you know, they're not hitting someone on the head with a hammer. Mm-hmm. <affirmative>, it's like giving gentle little electrical love taps, <laugh>.

Dr. Thompson (00:48:53):

Yeah. Yeah. Minimum effective dose. Yes.

Moby (00:48:56):

So, Lindsay, I have a bunch of questions, but do you have, I also feel like generally speaking, monopolize things what with the patriarchy and whatnot, <laugh>? So

Lindsay (00:49:05):

Speaking of the patriarchy, I do have an out question. Oh. So my question, it's not ne necessarily a patriarchal question. It's more of like a capitalism issue, which is a part of patriarchy, in my opinion,

Moby (00:49:15):

Who invited the hippie.

Lindsay (00:49:17):

Um, um, so I think people sometimes view what you and people in your field do as not always the most accessible thing to people of a certain income bracket. Mm-hmm. <affirmative>, is there a way that your services are more, uh, accessible? Is there a way to get them, like are there services or how does that work from an accessibility standpoint?

Dr. Thompson (00:49:39):

Yeah, it's a great question because it's about, less than 50% of our country has a psychiatrist in every county, which is crazy. That's just a psychiatrist. So not even, we're not talking about children, which the problem is far worse. Mm-hmm. <affirmative>. So mental health care in general is, is minimal compared to the number of people who need, need help in our mm-hmm. <affirmative> in our country. And it's a, it got worse essentially during the pandemic when many people got depressed. So luckily, you know, hopefully our things are changing. So that's, you know, that's a big purpose in my life is to increase access to care. So I, I started out after training and, and still do see patients myself in a private practice, sort of one-on-one. Um, but you know, as an individual I can only see one person at a time. So in 2020 I created a company called Remedy Psychiatry with the premise that everyone really deserves to have a mental healthcare provider who knows their name and knows who they are and can be more affordable and accessible.

Dr. Thompson (00:50:37):

And so the goal was to have it over telehealth to sort of pass on, and this is pre pandemic, um, but to pass on the cost savings of offices to the patients so it could be more affordable to patients. And so we could also reach people in geographic areas who have no access to care mm-hmm. <affirmative>. Um, and so it's been great since we've seen thousands of patients and we see kids and it's been really, really amazing to see kind of what can happen. So yeah, one of my goals is to kind of increase access to care. Um, and I think it's access on multiple levels. So it is really hard, even, you know, here in Los Angeles, a big city to find a psychiatrist, even when that takes cash and is wildly expensive. 600 to a thousand dollars an hour, it can be still weeks to months to get an appointment.

Dr. Thompson (00:51:17):

And most people don't have that. Yeah. So having broader access where people can use their insurance or at Remedy, we have sort of a cash budget friendly monthly option mm-hmm. <affirmative> so people don't have to drop $300 for an appointment, it's very low fixed rate per month. Mm-hmm. <affirmative> has been really helpful and kind of transformative. And now we've seen kids in the middle of California who had no access to care, including within their county system. Yeah. Where there's just literally nobody to treat them. And it's, it's really horrible. I just, last week was in the mammoth area and I met with the hospital there, and they don't have a psychiatrist in all of Mammoth. They have somebody comes two days a month, and this is Mammoth, which is like a fairly affluent, you know, people bringing a lot of money in there, but they don't have any psychiatrists in the entire town.

Dr. Thompson (00:52:01):

So we talked, I talked about bringing kind of remedy and telehealth because the, the hospital and some of the pa the therapists said, well, people don't always have cars and they don't have wifi even, so is telehealth even accessible? No, it's actually not. Yeah. So we talked about having them bring sort of like a van or office with Remedy where our team could see people who don't have cars or don't have wifi and kind of come in, which is really exciting to be reaching those people. Um, so the, the problem is just multifaceted. It's, it's about finances, it's about geography. Mm-hmm. <affirmative>, it's about lack of providers and just, you know, even having enough people in the workforce,

Moby (00:52:37):

Not to mention the ongoing stigma around mental health. Yes. You know, especially in certain communities, it's like you're not allowed, like you were talking about growing up, where like in your family, it just wasn't addressed in my family. It certainly was not addressed.

Lindsay (00:52:49):

And even mine wasn't, and wasn't. Yeah. But also g geographically, culturally, culturally, there's just so much people are afraid of it. But I wish looking back and, you know, I had the internet, but I was even afraid to look it up and there was nothing in my school that told me where to get it. And I just, I think people just don't know what to do when they're suffering for the most part.

Dr. Thompson (00:53:11):

Yeah. We don't know what we don't know. So if we don't know we're suffering from depression or anxiety, I was actually just talking about this with the patient today, which is, you know, if you're having your first episode of depression, for example, you may not know that it's depression. Mm-hmm. <affirmative>. And if you're going to someone and saying like, oh, I feel sad today. And they say like, oh, you know, did, didn't your boyfriend break up with you? That's why you're sad. It's normal. And then you're gonna someone else and saying like, I don't have any appetite. And that person's like, well, you know, that's kind of normal. You just, you're, you're getting sort of piecemeal misinformation versus sort of going to a professional. And this is why I would mm-hmm. <affirmative> say that anyone who's suffering should go to a professional. Cuz once you combine all those details, someone may say to you, you're suffering. And this is called depression. Yeah. It's not just normal, it's a very different response, but a lot of people don't have access or they grew up in a family where it's, or a culture or a location where it's, yeah. It's, it's looked down upon even to even speak about mental health care, let alone get treatment therapy or medication or to

Lindsay (00:54:06):

Acknowledge to yourself that you're even suffering. Yeah. I think back to myself and also everyone that I knew, I think a lot of people were having a really hard time and afraid to even admit to themselves what they were experiencing was suffering, you know?

Dr. Thompson (00:54:19):

Yeah. Yeah. I think there's reticence to Yeah. To also be ill. Mm-hmm. So I think or have a diagnosis or, or yes. Be suffering. And so avoiding that Yeah. You know, can often make us feel as though it's not happening. Mm-hmm. It's a little bit, you know, fantastical as far as thinking. Mm-hmm. But yeah, a lot of people don't wanna name it because

Moby (00:54:38):

The people who are listening and hi to everyone who's listening, hi, I want to be, to try and be of service to them mm-hmm. <affirmative> in so far as we can. So like, granted everybody listening is a different individual. Mm. And I assume everyone's listening on their own, like at home in traffic commuting. Is it feasible to offer advice to people based on your experience professionally, personally, with research as a doctor, as a clinician? I mean, maybe that's the most ridiculous question I can think of because everybody's so different and everyone's dealing with different things. But generally speaking, are there suggestions you might have to someone who's struggling or any advice you might be able to be give to people?

Dr. Thompson (00:55:21):

Absolutely. I would say that to, to anyone. So anyone listening that what you are feeling or thinking has been felt or thought before. So no one is alone. And that's the sort of beauty of being human is that even though we're all very different, every thought and feeling has been experienced before,

Moby (00:55:39):

Even if someone is a solipsist <laugh>. Yes.

Dr. Thompson (00:55:42):

Yes, exactly. And that includes things like feeling hopeless or suicidal. So a lot of times people feel shameful that they shouldn't want to die or they shouldn't feel like ending their lives. And I, I just want people to know that that is a very felt experience for many, many people. And so I think the first thing I would recommend for anyone is to seek help from a medical professional and to be valuing themselves enough to know that it's worth it and that they can feel better and that they're suffering is likely only temporary, but they just need to go to find a professional. And if they have, you know, some, that being said, sometimes people have a bad experience and sort of see a psychiatrist that wasn't, you know, very warm or a therapist that wasn't a good fit. And it's very much like dating. So I tell my patients like, you know, therapy is like dating, you need to find a good fit. And sometimes it takes a few people, but you are worth it. Mm-hmm. <affirmative>, right? So everyone who is feeling something negative, whether it's anxiety or depression or I'm so alone or I'm ashamed and I don't wanna see Pel, it's all been felt before and it's okay. And they deserve to get help from a medical professional and maybe another, if the first one isn't a good fit.

Moby (00:56:48):

Great. So many people are struggl, I was gonna say, everyone's struggling, but not everyone's struggling. The majority of people are struggling, you know? Mm-hmm. <affirmative> pandemic

Dr. Thompson (00:56:55):

One way or another. Yeah. We're all struggling. Yeah.

Moby (00:56:58):

Yeah. Everything is exacerbated. Whether it's traffic, the pandemic, the way people eat social media. Mm-hmm <affirmative> looking at bright lights before you go to bed, <laugh>, et cetera, et cetera, et cetera. Everything is exacerbating already fragile, psyches. Mm-hmm. <affirmative>. And so to just sort of reiterate what you're saying, like if you're struggling, you're not alone. If you're dealing with addiction, there are a lot of people out there who are in the exact same place and a lot of people who've gotten better. And one thing that I find incredibly encouraging, and I'm gonna make a yoga analogy when I first started, do have you ever, do you do yoga? Oh yeah. Okay.

Dr. Thompson (00:57:34):

So mean I'm not a religious yogi, but yeah. Definitely done

Moby (00:57:37):

It a lot. So when all of us, when we started doing yoga, I assume we were bad at it, same way. Like

Dr. Thompson (00:57:42):

Unless you come into it as a dancer or a, or some, or yeah. Something

Moby (00:57:46):

Like that. Same thing with guitar. First time I tried playing guitar, I was terrible at it, but I remember with yoga, like all of a sudden, like after a month or so, I was like, oh, I can touch my toes now. Mm-hmm. <affirmative>, oh, I'm learning that. Like, I, like I figured it out. And the thing, and this is so self-evident, but I don't think we really acknowledge the power of this, is if you consistently apply yourself to something mm-hmm. <affirmative>, it'll get better. Yeah. You know, like if you, if if you, if you pick up a guitar every day, within six months you'll be a good guitar player. And so with self-care, it's the same thing. Like reaching out to therapists, talking about it with healthcare professionals. Like by, just by doing this, by going to therapy, it will get better. Cause I think a lot of people are hopeless. Mm-hmm. <affirmative>, you know, and feel like, oh, I don't know what to do. And even if I did, it's not gonna get better. But concerted effort makes things get better. Yeah.

Dr. Thompson (00:58:38):

You know, I like to normalize this as well, you know, and we all need help so we can't do it from within. So we, you know, we use teachers and we go to school to learn academics. We get coaches and personal trainers to, you know, improve our body. We get nutritionists when we need to change our diet. We go to spiritual things to sort of grow our spiritual side, but we don't do a lot consciously in our culture to improve our emotional health or our behavioral health. And that's what is getting help, you know, from a therapist or a medical professional in the mental health field, is sort of just giving attention to your emotions in your mind and your behavior. Which would be wonderful if we all had access to do that. And if we looked at it like getting a personal trainer almost as something mm-hmm. <affirmative>, that's, you know, fancy and wonderful and if everyone could do it, we would. As opposed to how we kind of view mental health as though there's something wrong.

Lindsay (00:59:25):

I think a lot of it has to do with, and this is something I've seen and experienced, is that notion of believing that you have value and that you are worth putting in the time and effort. Mm. I think one of the saddest things is that people just don't think that self-care is, is worth it because they don't see their worth. They don't think that they're a person of value in the world and they think all they have to do is get through the days, support the people immediately around them, be able to pay the rent and that's it. They don't see their value. And I, you mentioned that and I was like, that is the biggest part of it. Mm-hmm. <affirmative>, that's part of the struggle that I think people don't consider is just that feeling of, I deserve to be free and live a life mm-hmm. <affirmative> that is

Moby (01:00:12):

Full and, and also exacerbated by compare and despair. Mm-hmm. <affirmative> mm-hmm. <affirmative>, you know, cuz you look at social media and everybody's dancing better and getting more,

Lindsay (01:00:22):

Everybody's giving better misinformation, getting and hot mental health and getting care better.

Dr. Thompson (01:00:27):

Filter Yeah.

Moby (01:00:29):

Likes and looking younger and going to more exotic places. It's like comparing and despairing just sort of like takes that low self-esteem, that lack of self-worth and just keeps spiraling it down. Yeah.

Lindsay (01:00:40):

It's something that's been there, that's always been there and it's not getting any better. Mm-hmm. And that was, I think, what, in my personal journey, what changed my experience was having that first sense of, oh, my actions matter <laugh> mm-hmm.

Dr. Thompson (01:00:54):

<affirmative>.

Lindsay (01:00:54):

Yeah. I am a person that matters and I should probably put some effort into being better at being a person since I do actually matter. And figuring that out changed my entire life. But I don't think I would've figured it out if I hadn't been in New York and LA and been around people who had had access to mental healthcare before and could be like, Hey, <laugh>.

Dr. Thompson (01:01:12):

Yeah.

Lindsay (01:01:13):

Think about this in a different way, if you might. Yeah. So that I think is a huge part of it.

Dr. Thompson (01:01:17):

Yeah. And I, I would just say, yeah, every, I think every single person on, on earth is of value just for the being themselves. Mm-hmm. <affirmative> and I, I would also add to that by saying I have never met someone who's been affected by another person's suicide who felt like it was a good thing. Mm-hmm. <affirmative>. So I, I say that because sometimes people feel so bad in the depths of the depression that the pain is horrible and they feel like they're no use to anyone. And there's a common thought of the, the world would be better off without me or my friends and family would be better off without me. And I would just say I've never heard another human say that to be true. So, you know, suicide and loss of life leads to sort of devastation and it's just a distortion.

Moby (01:02:18):

So for the longest time when I was growing up, I, as, even when I started going to therapy, you know, I did dynamic psychoanalysis, did CBT did psychodrama, did you know, somatic therapy, the focus was always on the individual. You know, the focus was on my experience, my childhood, my trauma, my coping skills, my, it was very individualistic. So much so that it almost seems self-evident to say that, but a few years, um, okay. Not a few years ago, I'm old, so everything seems, a few years ago, like maybe 12 years ago, I was doing a type of therapy that had an, what I think of as an existential component Mm. Where it of course looked at the individual's experience, but it also looked at who we were as a species. It looked at the hereditary aspects of it. Um, not just as an individual but collectively, like who we are as humans.

Moby (01:03:14):

And I found that to be so interesting, very helpful as well. Sort of like realizing like, cuz we keep coming back to this saying like, everybody's struggling mm-hmm. <affirmative> and like, oh, maybe this is just a part of our species. Mm-hmm. <affirmative>. Yeah. This is a part of like, and Lindsay, I dunno if I've told this story before, but I was watching a nature documentary a few years ago, and in the nature documentary they, there was a watering hole somewhere in Africa, and it was the middle of the summer and it was a drought. And so every creature for like 20 miles around mm-hmm. <affirmative> had gone to this watering hole. So it was the, the lions and the leopards and the hippos and the crocodiles and like the vicious, all these vicious creatures. And there in the middle of it were a few monkeys, these tiny little bitty monkeys hiding behind a bush, occasionally working up the courage to run to the watering hole, scoop up some water and imagine what the water's like after hippos.

Moby (01:04:09):

And everybody else has been in it. They scoop up a handful of water and run back to the bush and hope they don't get eaten. And I was watching this documentary and I was like, oh, those are our ancestors, but also that's what I would've done <laugh>. Yeah. But like, they're these terrified monkeys. We, we are descended from vicious, terrified monkeys. Mm-hmm. <affirmative>, it helped me personally when I expanded my awareness and realized like, yes, I have my issues, I have my experience, my childhood trauma. But there's also on a very broad, almost youngian level, the idea of like human inherited predispositions towards anxiety, towards depression. Like the old expression that we're sort of like we are Velcro for negative emotions mm-hmm. <affirmative> and Teflon for positive emotions. And I was just wondering if either of you have any thoughts about the looking at human emotions, looking at our experiences less as individuals and more as who we are as these descendants of terrified monkeys. Yeah,

Dr. Thompson (01:05:15):

I agree completely with the idea that we're sort of more conditioned to, we're we're, it's more reinforcing to have negative thoughts about survival. So yeah, this idea of if I don't get water, I'll die, so therefore I need to have water with me all the time. Right. That's a variation of what we might now deem to be anxiety because we have water everywhere, but that allowed our generations before us to sort of survive with water and food and that sort of thing. So yeah, I think that that sort of speaks to the genetic component of, you know, all mental health issues, which is very strong for, for many, um, mental health disorders. And you can kind of see it too in families. And I think that can be helpful for people to kind of realize like, oh, now I see my mom is really, really anxious and this wasn't something that even in some cases happened to me or that I did wrong, but this is just my genetic lineage as a human being. And yeah, I think it on some level it can be kind of adaptive if people are in helpful, if people worry and then they find a solution. But it's the sort of obsessional worries that kind of lead to suffering where we don't have a solution.

Lindsay (01:06:18):

Yeah. I mean I think that our anxiety saved us for such a long time and now we have all of this technology and our lives are kind of, for the most part we have access to things that will help us be okay <laugh>, but our brains still haven't quite cut up to that.

Moby (01:06:38):

That what you're saying is so fascinating. Like, imagine 200 years ago going to someone like who's hungry and filthy with their teeth rotting out of their head somewhere in northern Europe and saying to them, okay, imagine a world where within your house you have perfectly clean water coming out of multiple outlets. You have access to more calories than any human could ever imagine. <laugh> you are safe from, for the most part you're safe from everything. You have this thing called dentistry, which keeps your teeth from rotting out of your head. And you have diagnostics that enable you to understand your human health down to a cellular level. Oh, and by the way, you have this little box that you carry with you that enables you to communicate with everyone you care about and have access to every piece of information ever recorded. That person would be like, I'd be the happiest person in the world. Lo and behold, we're probably just as anxious and depressed, if not more so than they were then. It is fascinating. Like, we fixed everything. Well

Lindsay (01:07:44):

For the most part there are still many, many people

Moby (01:07:46):

Do not have access to these things. And I'm sorry, I don't mean to be glib and say like, I mean I don't want to, it's such a thing of privilege that we fixed everything, but for a lot. Okay. What I will say is for quite a lot of people on the planet, their material circumstances are a lot better now than they were 200 years ago mm-hmm. <affirmative>. Um, and I'm, I'm not in any way making <laugh> light of people suffering or where they exist on the socioeconomic scale, but for a lot of people, the problem now is they have access to too many calories. They have access mm-hmm. <affirmative> to too much stimulation. They, it's, uh, it really is fascinating. There's some, so what it says about our species that when, when people are given tons of calories and clean water, their response is to watch Fox News and storm the Capitol on January 6th, like to be outraged at something. And it is just this fascinating aspect I think of the human condition where like, no matter how perfect or wonderful our circumstances, we're still gonna find ways to be angry and anxious. Well I

Lindsay (01:08:48):

Think we always, we are still, and I we've said this before, but in many ways we are still a, a caveman in a cave. And a bear could come in at any moment and we're always trying to identify what is the bear. Yeah,

Dr. Thompson (01:09:00):

Yeah. And what, what, and also I would say one of the, so I agree with you Moby, all those things that we have now were things we were fighting for, for survival. But one of the things we have less of now, which is one of the most protective factors for mental health is a sense of community. Yeah. So that is a huge sort of factor in correlation with depression. Um, and even, you know, postpartum depression for example, not having a support network and community really is a risk factor for, for postpartum depression. Yeah, absolutely. Right. We don't, even though we have social media, that's not a replacement for like the village. And I think that's a lot of people are suffering kind of alone. Mm-hmm. <affirmative> and that was probably a huge protective factor thousands of years ago. Yes. People living together in a community I don't

Moby (01:09:43):

Have. Yeah. And the stress reduction, I sometimes think about this, like what? Cause I've never lived in a community really, you know, I've always lived, I lived in a house with a person when I was growing up and then I moved to an apartment with a person and then for since then I've always lived by myself. Mm. But that idea of community, suddenly it takes the stress out of child rearing. Mm. It takes the stress out of relationships, it takes the stress out of almost everything because everything's sort of outsourced. Mm-hmm. <affirmative>, you know, you imagine a community with like kids running around with a bunch of other kids and so you're not looking after your child, you're sort of looking after the group of children and you're absolutely right. Like it is that almost reductive Occam's Razor of why are we struggling? It's like, well, all of our ancestors for hundreds and hundreds of thousands of years thrived in community. Mm. Mm-hmm. <affirmative>. And it al i I was talking about this with some friends a long time ago about how it's so much easier to understand with penguins, take a penguin and put it in a box in New York City and give it a lot of empty calories, but no real access to other penguins. And it's pretty easy to understand. It's gonna be a very unhappy penguin now do the same with a human being and we're like, oh, but they should thrive.

Dr. Thompson (01:10:56):

Yeah. And they have their own apartment. They're lucky. It's like, but

Moby (01:10:58):

Without the penguins. Yeah.

Dr. Thompson (01:10:59):

They're wealthy.

Moby (01:11:00):

Yeah. Like the penguin is depressed without other penguins. Humans are depressed without actual vital community. Yeah. You're absolutely right.

Dr. Thompson (01:11:06):

Yeah. And with this sort of, this idea that social media is a, is a replacement for that, I think is what's really kind of hurting younger generations as far as feeling even less connected. Yeah. Even though they may be connected through social media or texting or phones and that sort of thing. So

Moby (01:11:22):

I have two sort of wrapping up type questions. Go with it. Um, one of mine is, again, going back to the people who are listening something to, to try and be of service to them is what, in so far as you can generalize, what impediments do you find are there are, are there sort of generalized recurring impediments that you find with your clients?

Dr. Thompson (01:11:42):

Like impediments as far in, in their functioning in their own life? Is that what you mean? Or impediments even

Moby (01:11:47):

In, in, I mean, cuz we discussed one is the unwillingness to reach out to people. Mm. Um, the unwillingness to value yourself. Mm. But are there more specific ones? Uh, like for example, when I first started therapy, one of my impediments was catastrophizing. Mm. And, and like almost this seduction of like the negativity. Okay. When I'd go to therapy, I'd be like, oh, I've gotta think of all the trauma from my childhood and it became addictive. Mm-hmm. And I realized, I was like, oh, I'm harm, like, I'm, I'm actually depressing myself dredging stuff up just to impress my therapist. Mm-hmm. <affirmative>. And I'm just wondering if, if there are any impediments like that, that you've encountered with clients?

Dr. Thompson (01:12:29):

Yeah. So I think it's, so cata uh, catastrophizing is a, is a cognitive error, like a brain error when we sort of assess some data and we think of the catastrophic outcome. And that's a really common experience for people with anxiety. So it's not just, okay, I'm gonna get on the freeway or the expressway, it's, oh my God, I'm gonna die if I get on there. And so that one of the tenets of cognitive behavioral therapy is not to just stay with what you think or feel in that moment, but is to sort of think about all the data out there. Like, okay, if you really are gonna get in a car, what is the true likelihood of getting a car accident? And you don't really have to even know. But if you think actually it's probably 1% that allows you to reframe your own thought mm-hmm.

Dr. Thompson (01:13:09):

<affirmative> to be more accurate mm-hmm. <affirmative> and therefore you're less kind of fearful. So I would say that actually that catastrophic thinking is a, is a really common, common sort of impediment so to speak, or creator I would say, of anxiety. For a lot of people, I think a lot of people feel just a, as I sort of alluded to earlier, very alone in their emotions. So when people feel depressed, they can feel sad or angry or nothing. Sometimes people feel just absolutely nothing and they feel almost shame about having these negative emotions. And I think that leads to people not getting help. So on some level, one impediment for a lot of people is feeling as though they're the only person and as though their feelings are bad. So just sort of saying it's okay to feel sad, it's okay to feel angry or it's okay to feel nothing. It just might mean that you, you need help and that you could feel

Moby (01:14:02):

Better. You reminded me of when I first got sober and Lindsay, I don't know if you've had this experience in your group stuff, but in, when I first got sober, one of the things that amazed me is I would go to this room full of strangers, some of whom were gangsters, some of whom were politicians, some of whom were rock stars, some like the most diverse group of people. And everyone was sharing about things that I was hiding, their fears, their depression, their anxiety, their shame around certain things. And it was so remarkably liberating to what you're saying is to realize like, oh, the things I'm ashamed of, the things I'm hiding are common to almost every person on the planet. And it's really, I, and I hope for the people who are listening, if you haven't had that experience of recognizing that what you are going through is shared with a lot of people, I hope you get to, whether it's in group therapy or a 12 step program or what have you, like recognizing that you're not alone and there's nothing thankfully unique about what we're struggling with. Mm-hmm.

Dr. Thompson (01:15:08):

<affirmative>. Yeah. And I would, I would go so far as to say too, once people realize someone else is suffering in the same way that vulnerability breeds connection and absolutely. That other people are drawn when, when someone shares. So I think even when I was listening to, to your podcast, the first couple of podcasts in the series, just hearing, oh, you're anxious too, because I was driving here is feeling so unx anxious myself. Yeah. And it, it just sort of brought the level down. Oh right. We're all human. Mm-hmm. <affirmative>, we all get anxious about certain things. So yeah, that lack of aloneness, no matter what you're feeling is I think really important. Um, because none of it is novel and none of it is even worthy of feeling shame. It's just an emotion or it's a thought and that's it.

Moby (01:15:48):

So the one last one I have is tangentially related, but sort of not related to anything professional. What non therapeutic practices do you value and do you recommend for other people?

Dr. Thompson (01:16:03):

Yeah, so I I, you know, with all my patients and all of the patients on my team sees, we really believe in sort of holistic health. And what I would say, and this is supported by all the research, is that it's critically important to eat healthy whole foods. There are 60% less associated with depression than processed foods. Mm-hmm. It's really important to get exercise. The research shows that reduces symptoms of anxiety, depression, A D H D among other things, sleep is critically important. So reading the book sleep right now and everyone should be getting seven to nine hours of sleep per night. Anything less than seven is associated with chronic disease and weight gain and is considered chronic sleep deprivation. You're

Moby (01:16:41):

Talking in a week,

Dr. Thompson (01:16:43):

So, so <laugh> if you wish, if you don't get it and you tickle nap, does that count towards it? Naps are okay. I mean, yeah. Count hours, getting the seven to nine hours in 24 hours. Okay, great. Great. Um, I think love that. That's helpful. Helpful. Circadian rhythms probably best to get most of it at night, <laugh>, but yes, sleep is like the number I, I call it sort of the number one medicine and there's so many people who don't get good sleep. So I'm worried about Moby right

Moby (01:17:06):

Now. It's not, my sleep is not my strong suit

Dr. Thompson (01:17:08):

<laugh>. And there's also a lot of people who have undiagnosed sleep apnea, which is not getting oxygen to your brain, which causes a host of other problems and is really undiagnosed. Even kids as young as two can have sleep apnea. So sleep is really important, I believe wholeheartedly. Anybody who's curious about themselves should do therapy if they can access it at an affordable rate. So, and if they feel connected to the therapist and though it's productive and helpful, some people have reservations and don't want to and don't wanna open up a trauma box for example. But that should all be monitored and, and sort of titrated by the therapist. And if it doesn't feel right, you know, another therapist is, is the answer not to quit therapy altogether, I would say. Mm-hmm. <affirmative> mm-hmm. <affirmative>. And as far as, you know, I do believe medication can be really helpful to some people when it's kind of appropriate and then we could talk at length about that. But I, I do believe it's helpful to some people and especially when they've tried everything else, it can be really invalidating to say just exercise more when someone's doing that. Yeah. Um, or they can't

Moby (01:18:08):

Get off. Or when someone's anxious and you're like, oh, smell lavender. Yeah.

Dr. Thompson (01:18:11):

Yeah. Right.

Moby (01:18:12):

It's like, it's like your house is on fire. Have you considered spraying it with a hose?

Dr. Thompson (01:18:15):

Exactly. Exactly. It's really invalidating when someone Yeah. For example is so depressed they can't literally get out of bed and take a shower and someone's like, you should run. It's like, are you kidding me? Yeah.

Moby (01:18:25):

Yeah. If we tried St. John's Wort. Yeah.

Dr. Thompson (01:18:26):

Yeah. No, that's not helpful. So I think, you know, at some point, sort of considering medication and the other forms of treatment for mental health out there now, which include tms, which is transcranial magnetic stimulation and you know, there are a bunch of other things kind of coming out potentially psilocybin and psychedelics in the, in the coming years. But ketamine right now FDA approved. So I think in a general sense I kind of espouse all those things and kind of also stress reduction. So I see a lot of people that come in and they have a terrible boss or they have a terrible toxic relationship and that alone get caused. Yeah. Depress depression, <laugh>. Oh yeah. Yeah. I mean it's, it's, and it's good to have community too. I guess that that's a good way of ending with, you know, this idea that it really is protective to against depression to have a community. And so for people who don't have anything and plenty of people are alone, so there's nothing wrong with that if some people have no friends, no family, no community, but it's now possible to get community. So you can go to a meetup and meet people for Scrabble or you can go to your local church even if you don't really believe they're

Moby (01:19:27):

Religion and, and 12 step programs, 12

Dr. Thompson (01:19:29):

Step al-Anon a million well, which is a 12 step. But yeah, there's something for everyone there actually and it's free and you just need to kind of find it. But even if that's, if someone's in an area that doesn't have something geographically accessible Sure. Going to find an online community is an option as well. And that community and vulnerability mm-hmm. Does breed connection and it also is protective against men mental health issues.

Moby (01:19:51):

Mm-hmm. And, and one thing I learned again in 12 step programs that didn't make sense to me at first, but then I believe it wholeheartedly now, which is self-care and showing up and being honest are forms of service. So one of the things that can, can be incredibly helpful is like, even if like, if we don't value ourselves, even if we don't want to necessarily practice self-care, it's a way to help other people like being honest about what we're going through. It's one of the greatest forms of service to someone else. I'm sure you've experienced this countless times where like expressing yourself, honestly talking about what you're going through can be so empowering for other people. Cuz then they're like, oh, I guess now I'm allowed to express myself mm-hmm. <affirmative> and I personally find like when in doubt, try and help someone else when in like nothing for me is as powerful as just reminding myself to try and be of service. Obviously if someone's in the depths of depression or anxiety service might not be the first thing that comes to mind, but in terms of sustaining wellbeing, I personally find service to be that just the ethos of service to be so incredibly important. Yeah.

Dr. Thompson (01:20:57):

And it's sort of like the, the oxygen mask on an airplane, right? Yeah. You have to take care of yourself and to make sure you're okay and then once you do that, you're capable of sort of putting the mask on someone next to you or helping other people too.

Moby (01:21:08):

Yeah. So that's, I mean I, I obviously could talk for next 17 hours, but

Lindsay (01:21:13):

I know I could too.

Moby (01:21:14):

Linds, what do you, what else do you got?

Lindsay (01:21:16):

No, I think this feels like a really good spot unless there's anything else or if you have like a social media or anything like that.

Dr. Thompson (01:21:23):

Yeah, so sure. So I'm, so my company Remedy Psychiatry sees patients in California soon to move to Washington, but that's remedy psychiatry.com where we can see patients locally for medication. Um, but we have, one of our goals is democratization of education that's accurate through social media. So we have a Facebook page, we have an Instagram page and we have a TikTok page for Remedy. Yes. For Remedy. And I think,

Moby (01:21:48):

So it's all called Remedy.

Dr. Thompson (01:21:50):

Remedy Psychiatry is our full name. Okay. And I think the handle is like Remedy Psychiatry. Actually my TikTok is Dr. Kirsten Thompson. And that's been great because I give all sort of research based information and it's been really fun. I, you know, did video, like a video on pmdd, which is premenstrual dysphoric disorder and which is severe depression each month with a woman's menstrual cycle. And somebody saw the video and came back and said like, I realized I had this and I got help and I'm so much better. And so for that one person who had like a free more of information and then felt better, I think getting accurate information through TikTok from doctors Yeah. Mm-hmm. <affirmative> or people are trained can be amazing and priceless. Yeah. And so that's one of our goals as well, in addition to reducing the stigma around mental health in general, which means kind of talking about it and which is why I'm really grateful to, to be talking about it with you today.

Lindsay (01:22:37):

That's amazing. Okay. I'm gonna give those a follow <laugh>. I can't wait. I'm excited.

Moby (01:22:41):

Great. Thank you so much. I think both Lindsay and I are incredibly grateful. I am wrestling with my guilt because we've kept you here for such a long time. It's

Dr. Thompson (01:22:49):

My pleasure. I could talk about this stuff for hours, very passionate

Moby (01:22:52):

About it, but like, boy oh boy, this has been wonderful and I'm just over the moon and so excited that you were able to come over and talk with us for such a long time. Thank you. Me

Dr. Thompson (01:23:01):

Too. Thank you. Thank you for having me. I love talking about this and really just making, hopefully anybody listening feel like they're worthy of getting help and they should. So, um, one of my goals in life, so thank you for the invitation.

Moby (01:23:22):

So I don't know about you Lindsay, but I thought that was amazing.

Lindsay (01:23:26):

It's weird how talking about the struggles that we all share makes me feel so much better. <laugh>. Mm-hmm. <affirmative>. Like, it just makes me feel like, okay, not only are we the three of us, not alone in our struggles, but it's so common and it's such a shared experience to have these issues. It just, there's so much, like I get such a calming feeling out of that, of the not aloneness, you know?

Moby (01:23:49):

I mean I had this experience and some of my epiphanies are very basic and self-evident, but it was about, I guess 10 years ago I was, I was DJing at Coachella. Mm-hmm. <affirmative>, and I don't even know how to pronounce Coachella. I've played there twice and I should know how to pronounce it, but Coachella, Coachella, Coachella. So I was DJing at Coachella and I was driving to Coachella on the 10, which is one of the ugliest roads that humans have ever invented. Like it was a hot day and I was driving through some ugly part of Southern California and the traffic was terrible. And I had this moment, I was so unhappy. I was like, oh, I hate this traffic, I hate this. This is so terrible. It's gonna be four or five hours to get there. And I suddenly realized, I looked around and I was like, oh, I'm not alone.

Moby (01:24:35):

Mm-hmm. <affirmative>, everybody hates this traffic. Mm-hmm. <affirmative>, in fact, there's a good chance people hate it way more than I do cuz there's a good chance people are like coming from a job that they hate going to a home that they don't feel safe in. And all of a sudden I felt this sense of solidarity to your point of we're all dealing with the same things. We're all, we're all struggling, we're, I mean, look at like, if, if, I mean some people based on like their socioeconomic status, struggle more, struggle less. But still it's the human condition to struggle. And you're right, it's so comforting and empowering in a way to not feel alone in our struggle. So I hope for the people who are listening, I hope that somehow you've been helped by what we've talked about and that you feel less alone if you're struggling and maybe even more empowered to go out and try and, you know, to reach out and get help because

Lindsay (01:25:27):

You're valuable and worth it and cool. And then maybe you smell nice.

Moby (01:25:32):

I don't Well you're not talking to me, you're talking to someone listening. Yeah,

Lindsay (01:25:36):

I'm talking to someone listening.

Moby (01:25:36):

Cause I, I do not <laugh> smell very nice. There's a, there's a good reason I don't date.

Lindsay (01:25:41):

I'm just saying that you have value and that is a big deal.

Moby (01:25:45):

Yeah. Yeah. Okay. So thank you for listening. Yeah. I

Lindsay (01:25:48):

Wanna say goodbye, but I also wanna say thank you to Jonathan Nesvadba who edits this podcast like a beast. I also wanna say thanks to human content who helps us to get this podcast out into the world at large. And I also wanna say thanks to Bagel who was a really good dog during that. Yeah.

Moby (01:26:08):

<laugh>. Um, and at the end of the episode, Bagel played one of her favorite games, which is the Pirate Crawl game or the Pirate Crawl, I

Lindsay (01:26:15):

Dunno, it's like an army crawl kind of thing.

Moby (01:26:17):

Yeah. She does this crawl with the, her little breath bone, her vegan breath bone in her mouth. Then she crawls across the floor and it's the most adorable thing I've ever seen. Yeah.

Lindsay (01:26:25):

So thank you Bagel for that. And thank you for listening. If you're still here, you're one of the real ones. <laugh> and boy do I love ya. All right, see you in

Moby (01:26:34):

Two weeks. Bye.