In simple words, "your problems might not be your fault but they are your responsibility". I think internalizing that statement was one of the milestones of becoming an adult for me.
yeah, it still fucking sucks because it's not my fault so why do i have to pick up the broken pieces? but then if you don't start doing that then you put yourself in a worse position. Accepting that you have the right to be upset at being dealt injustice and misfortune, while also having self love to treat yourself with kindness and encourage yourself to be better than you were yesterday, so that you can have the happiness you *do* deserve. it sounds easy on paper but it really isn't. When I was uber depressed i would rather just die than to continue to be hurt over and over again. Stage one is blaming yourself because it's easy to believe that things could have been different if you had done the right thing, rather than the hopelessness of stage two when you realize sometimes shitty things just happen for no apparent reason, and that to be mortal is to be subjected to the roll of the dice, or the spin of the roulette. That it doesn't matter if you did do everything right or not, that this shitty outcome could have happened anyway. Anyway it took a lot of therapy (mightve been DBT? My therapist wasn't giving me any names on what techniques he was using but this seems to fit the mark) to help me get over stage two (and I still fall back in every once in a while). But the turning point was before i went back into therapy, where i finally got the antidepressants that worked for me (bupropion, an NDRI instead of an SSRI, the latter being more popular for patients to be given first).
A psychiatry resident I work with framed it beautifully and explained that there are three main forms of insight: 1. Insight that there’s is a problem 2. Insight about the person’s diagnosis (AKA underlying cause of the problem) 3. Insight into solutions to the problem or accepting help
Went from watching you to gain insight into my medical career to gaining insight about my own (and others I suppose) mental wellbeing/health. 10/10 plot twist
Simpler yet may still come off as insensitive to some folks, because "it is your problem to deal with" is often used to dismiss people's concerns and just not care. You may not have come across people using it in that way, but prejudice against mental illness is still very prevalent (and also blame game/deflecting). Is it not an injustice for people to be wronged then told that only they can fix the wronged doing, whereas the actual people or society or external thing that contributes to the injustice don't have to amend their actions? There are better ways at phrasing, and a longer explanation may seem unnecessarily drawn out yet provides greater reassurance that yes, people do care about them and want what is best for them, and are not just saying "it is your problem" to shut them up from talking about their issues.
On the subject of insight, I’ve been treated like crap by psychiatrists in the emergency room in my past. Purely because I always seem to be able to articulate myself and have insight into my illness even when I’m at my worst - this is something years of intensive therapy has taught me to do. They would refuse to believe I was having any kind of serious psychotic crisis just on the assumption that people that are that ill completely lack insight
Something that someone said to me once was “you are the common denominator of all your experiences”. She used that as a way to victim blame herself but idk why this stuck with me and I think about this sometimes
Insight is knowing you have depression vs in psychotic disorders when patients are out of touch with reality and don't think there's anything wrong with their thoughts. What you're talking about is self reflection. Although a lot of patients know they have depression, they are unable to take an honest look at their inner world and thus blame others or unrelated things to the core of the issue. The beginning steps towards meaningful psychotherapy is trying to spike the patient's curiosity about their inner world. This is not to say that the person is to blame for the depression, but their inability to look at their own virtues/flaws in an honest way makes it really hard to want to change. Change is very often needed to heal from depression.
Like you said, the key is trying to figure out what the problem is and how to fix it. Cause can be internal or external. Yes, determining that can help us better us to "fix" the problem. Or give us insight on where we should go or who to turn to for help. It's not about blame or responsibility. It's about figuring out the best course of action to help us arrive at a solution. Or in the very least reduce pain/triggers until we can continue to make progress in that direction. Instead of backsliding or stagnating.
I wish I could talk to a psychiatrist like you, my current one just speaks to me over the phone and it makes it really hard to have a conversation about my mood. I am taking meds right now but im afraid their effectiveness is often limited or even sometimes harmful. Thanks for making such good and interesting videos, I am glad you create such meaningful content and interesting conversations
God dam dude.. is this how good therapy is??! Youre an exceptional individual and we are lucky to have you sharing your knowledge and healing with us all!
I only work at a hospital, but I don't do any patient care, and I really appreciate your insights into things like this and willing to explain in detail about things.
This was incredibly helpful. I watched it a second time and stopped it occasionally to really think about how this is applicable to me. More videos like this please.
Good stuff, yet I have a kind of missing feeling of something 'je ne sais quoi'. Reminds me of this scene from The Wire essentially 'What would you do if you can't build/make/get/find a ladder?' What would you do if you had no tools or access to a ladder or didn't know how to make or get one. What if getting a ladder would take your whole life, all of your time, energy, and you'd only get 20 feet of ladder at the end with still a 20 foot drop? Kinda how I look at issues like poverty, the political landscape not exclusive to the US but other countries as well. The wealth gap etc.
Question: As a mental health occupational therapist, I often wonder about deconstructing the « how » of certain cognitive skills and functions. Besides motivational interviewing and baseline pharmacological treatment, I wonder whether there are ways to help build insight. I’m curious to know people’s thoughts.
I’m curious. If your depression/anxiety is situationally induced as a result of abuse, would it still be an internal issue of fulfillment? I understand the taking responsibility to heal part, but at the start you mentioned there’s a deeper meaning. In regards to abuse, would that be the deeper meaning or cause (given that most don’t notice their abusers as abusers)?
“I was traumatized and now I don’t feel whole as a person, I’ve lost my sense of identity. I don’t feel safe in my skin.” AN EXAMPLE: Ultimately you may be depressed because you don’t feel comfortable in your body, and the way you arrived at that feeling was through trauma. But that means the way out is by feeling comfortable with who you are and not by trying to “undo” the trauma. If that makes sense
I have PTSD caused directly by specific people, completely outside my control, and yes it does. In this situation is it understandable, even reasonable, to blame the specific people who created the traumatic events here? Yes. Am I obligated to forgive them? Absolutely not. Going back to the ankle example used here, let's say my ankle got broken by someone hitting it with a hammer. I am now in pain and it is that person's fault. However, it isn't the fault of other people in my life touching the now-broken ankle, or the floor for happening to re-trigger pain when I step on it. I have the option to go "this person broke my ankle, therefore I have no responsibility for any of this and when I refuse to walk, lash out because someone touched my ankle and it hurt, or swear off shoes forever because they make my ankle hurt more, it's that guy's fault for breaking it". Or I can go "that guy broke my ankle, and that sucks really bad, and I'm gonna complain about that. But the floor didn't break my ankle and the shoes didn't and the other people who touched my ankle didn't, and even though it means potentially more (temporary) pain and probably means resting more than I'd like to, I'm going to put a cast on, wear crutches even though that might be embarrassing, and do what I can to repair the ankle so it doesn't hurt in the future - or at least hurts less." The insight in ptsd/trauma-related stuff isn't shifting the narrative to claim that the original situation(s) were not traumatic, it's shifting the focus from the triggers themselves into what we can do to make them easier to deal with. Similar to a broken ankle it probably means removing yourself from the triggering situations for a while (like how you might not put weight on a broken ankle, or ear a shoe on a broken foot for a while), but the ultimate goal is resolving WHY those things are triggering or painful, so that eventually they can be experienced without pain. Unfortunately with Brain Stuff it's usually more complicated and difficult and takes a lot longer than a simple broken bone. But it's still possible, and still something worth working towards.
@@dolphinloser6546 is the underlying thing here then the fact that optimism leads to insight? Rather than blaming things and not directly addressing how or what the triggers are and why they make you feel that way? That’s the general sense I’m getting is that it’s the manner in which you approach the situation using insight (if you have any at all). Maybe optimism isn’t the correct word but something along those lines?
While your version does work for many types of mental illness, I do think it breaks down for people who have lost agency, e.g. abuse, assault, war, etc. It can be potentially reinforcing of traumatized cyclic thinking to say a person does not have insight because they don't "see" how their own behavior affects their mental illness. By their very nature, experiences that rob people of agency mean that no matter their choices, the outcomes are the same or unpredictable.
I think your not quite right here. Even for those with PTSD from war or a similarly lack of agency related experience it is important to understand your injury and insight is how much you understand it. If a veteran is having nightmares from their experiences but just ignores what might be causing it, they are doing themselves further harm by not taking actions to mentally heal: like you would be doing harm if you are thinking your broken leg is nothing. I understand that you are saying these individuals struggle to move past trauma and blaming them is not the best move, but he isn’t ever blaming them. That is exactly why he made this new video
@@mattmaco9065 ah, I'm talking about ongoing events, not past events. A person actively being abused may have perfect insight to say that the harm is out of their control, and for many reasons may not be able to alter that situation. That's what the end of the video is about - when the model breaks down. Not everyone /can/ build themselves a ladder because they systematically have had that agency taken from them.
I don't think this advice is meant for those situations, it's for people outside of those situations Think of the ankle analogy: advising someone with an ankle that was broken, by falling over or by someone hitting it with a hammer, to wear a cast and use crutches is different than the advice you'd give someone whose ankle is currently being hit by hammers, or someone who has JUST fallen over and is lying on the floor in front of you
Or in the real medical world of today “Doctor look at my MRI, I am clearly injured and in pain” “Yes I can see that but medicine is dangerous, try meditating and an ice pack”
Oh wow this is wholesome and empathic but not in a way that would enable helplessnes, more like supportive and building up your own agency. This gives me hope for humanity 🥹
In simple words, "your problems might not be your fault but they are your responsibility". I think internalizing that statement was one of the milestones of becoming an adult for me.
Amazingly put
yeah, it still fucking sucks because it's not my fault so why do i have to pick up the broken pieces? but then if you don't start doing that then you put yourself in a worse position. Accepting that you have the right to be upset at being dealt injustice and misfortune, while also having self love to treat yourself with kindness and encourage yourself to be better than you were yesterday, so that you can have the happiness you *do* deserve.
it sounds easy on paper but it really isn't. When I was uber depressed i would rather just die than to continue to be hurt over and over again. Stage one is blaming yourself because it's easy to believe that things could have been different if you had done the right thing, rather than the hopelessness of stage two when you realize sometimes shitty things just happen for no apparent reason, and that to be mortal is to be subjected to the roll of the dice, or the spin of the roulette. That it doesn't matter if you did do everything right or not, that this shitty outcome could have happened anyway. Anyway it took a lot of therapy (mightve been DBT? My therapist wasn't giving me any names on what techniques he was using but this seems to fit the mark) to help me get over stage two (and I still fall back in every once in a while). But the turning point was before i went back into therapy, where i finally got the antidepressants that worked for me (bupropion, an NDRI instead of an SSRI, the latter being more popular for patients to be given first).
@@cameronschyuder9034Maybe hanging is the solution, you sound too far gone.
A psychiatry resident I work with framed it beautifully and explained that there are three main forms of insight:
1. Insight that there’s is a problem
2. Insight about the person’s diagnosis (AKA underlying cause of the problem)
3. Insight into solutions to the problem or accepting help
Went from watching you to gain insight into my medical career to gaining insight about my own (and others I suppose) mental wellbeing/health. 10/10 plot twist
Maybe that's why you went into medicine in the first place
quite sophisticated explanation. I had a simpler framework in my mind: it might not be your fault but now it is your problem to deal with it.
Simpler yet may still come off as insensitive to some folks, because "it is your problem to deal with" is often used to dismiss people's concerns and just not care. You may not have come across people using it in that way, but prejudice against mental illness is still very prevalent (and also blame game/deflecting). Is it not an injustice for people to be wronged then told that only they can fix the wronged doing, whereas the actual people or society or external thing that contributes to the injustice don't have to amend their actions? There are better ways at phrasing, and a longer explanation may seem unnecessarily drawn out yet provides greater reassurance that yes, people do care about them and want what is best for them, and are not just saying "it is your problem" to shut them up from talking about their issues.
On the subject of insight, I’ve been treated like crap by psychiatrists in the emergency room in my past. Purely because I always seem to be able to articulate myself and have insight into my illness even when I’m at my worst - this is something years of intensive therapy has taught me to do. They would refuse to believe I was having any kind of serious psychotic crisis just on the assumption that people that are that ill completely lack insight
Damn man well said. You're killing it in psych. Would be so excited to refer mental health issues to you because I know you'd do a great job.
Something that someone said to me once was “you are the common denominator of all your experiences”. She used that as a way to victim blame herself but idk why this stuck with me and I think about this sometimes
Insight is knowing you have depression vs in psychotic disorders when patients are out of touch with reality and don't think there's anything wrong with their thoughts. What you're talking about is self reflection. Although a lot of patients know they have depression, they are unable to take an honest look at their inner world and thus blame others or unrelated things to the core of the issue. The beginning steps towards meaningful psychotherapy is trying to spike the patient's curiosity about their inner world. This is not to say that the person is to blame for the depression, but their inability to look at their own virtues/flaws in an honest way makes it really hard to want to change. Change is very often needed to heal from depression.
Like you said, the key is trying to figure out what the problem is and how to fix it. Cause can be internal or external. Yes, determining that can help us better us to "fix" the problem. Or give us insight on where we should go or who to turn to for help. It's not about blame or responsibility. It's about figuring out the best course of action to help us arrive at a solution. Or in the very least reduce pain/triggers until we can continue to make progress in that direction. Instead of backsliding or stagnating.
I wish I could talk to a psychiatrist like you, my current one just speaks to me over the phone and it makes it really hard to have a conversation about my mood. I am taking meds right now but im afraid their effectiveness is often limited or even sometimes harmful. Thanks for making such good and interesting videos, I am glad you create such meaningful content and interesting conversations
God dam dude.. is this how good therapy is??! Youre an exceptional individual and we are lucky to have you sharing your knowledge and healing with us all!
Incredible explanation/clarification! Thank you for this!
You're too good bro, save some greatness for the rest of us
I only work at a hospital, but I don't do any patient care, and I really appreciate your insights into things like this and willing to explain in detail about things.
This was incredibly helpful. I watched it a second time and stopped it occasionally to really think about how this is applicable to me. More videos like this please.
Good stuff, yet I have a kind of missing feeling of something 'je ne sais quoi'. Reminds me of this scene from The Wire essentially 'What would you do if you can't build/make/get/find a ladder?' What would you do if you had no tools or access to a ladder or didn't know how to make or get one. What if getting a ladder would take your whole life, all of your time, energy, and you'd only get 20 feet of ladder at the end with still a 20 foot drop?
Kinda how I look at issues like poverty, the political landscape not exclusive to the US but other countries as well. The wealth gap etc.
Question: As a mental health occupational therapist, I often wonder about deconstructing the « how » of certain cognitive skills and functions. Besides motivational interviewing and baseline pharmacological treatment, I wonder whether there are ways to help build insight. I’m curious to know people’s thoughts.
Gaining insight is when you can see the lovecraftian horrors around ever corner.
Love your videos 🥰
I’m curious. If your depression/anxiety is situationally induced as a result of abuse, would it still be an internal issue of fulfillment? I understand the taking responsibility to heal part, but at the start you mentioned there’s a deeper meaning. In regards to abuse, would that be the deeper meaning or cause (given that most don’t notice their abusers as abusers)?
Can you apply this to depression that’s caused secondary to trauma or rather a traumatic experience?
Absolutely
“I was traumatized and now I don’t feel whole as a person, I’ve lost my sense of identity. I don’t feel safe in my skin.”
AN EXAMPLE: Ultimately you may be depressed because you don’t feel comfortable in your body, and the way you arrived at that feeling was through trauma. But that means the way out is by feeling comfortable with who you are and not by trying to “undo” the trauma. If that makes sense
@@itspresro it absolutely does.
I have PTSD caused directly by specific people, completely outside my control, and yes it does.
In this situation is it understandable, even reasonable, to blame the specific people who created the traumatic events here? Yes. Am I obligated to forgive them? Absolutely not.
Going back to the ankle example used here, let's say my ankle got broken by someone hitting it with a hammer. I am now in pain and it is that person's fault. However, it isn't the fault of other people in my life touching the now-broken ankle, or the floor for happening to re-trigger pain when I step on it. I have the option to go "this person broke my ankle, therefore I have no responsibility for any of this and when I refuse to walk, lash out because someone touched my ankle and it hurt, or swear off shoes forever because they make my ankle hurt more, it's that guy's fault for breaking it".
Or I can go "that guy broke my ankle, and that sucks really bad, and I'm gonna complain about that. But the floor didn't break my ankle and the shoes didn't and the other people who touched my ankle didn't, and even though it means potentially more (temporary) pain and probably means resting more than I'd like to, I'm going to put a cast on, wear crutches even though that might be embarrassing, and do what I can to repair the ankle so it doesn't hurt in the future - or at least hurts less."
The insight in ptsd/trauma-related stuff isn't shifting the narrative to claim that the original situation(s) were not traumatic, it's shifting the focus from the triggers themselves into what we can do to make them easier to deal with. Similar to a broken ankle it probably means removing yourself from the triggering situations for a while (like how you might not put weight on a broken ankle, or ear a shoe on a broken foot for a while), but the ultimate goal is resolving WHY those things are triggering or painful, so that eventually they can be experienced without pain.
Unfortunately with Brain Stuff it's usually more complicated and difficult and takes a lot longer than a simple broken bone. But it's still possible, and still something worth working towards.
@@dolphinloser6546 is the underlying thing here then the fact that optimism leads to insight? Rather than blaming things and not directly addressing how or what the triggers are and why they make you feel that way? That’s the general sense I’m getting is that it’s the manner in which you approach the situation using insight (if you have any at all). Maybe optimism isn’t the correct word but something along those lines?
While your version does work for many types of mental illness, I do think it breaks down for people who have lost agency, e.g. abuse, assault, war, etc. It can be potentially reinforcing of traumatized cyclic thinking to say a person does not have insight because they don't "see" how their own behavior affects their mental illness. By their very nature, experiences that rob people of agency mean that no matter their choices, the outcomes are the same or unpredictable.
I think your not quite right here. Even for those with PTSD from war or a similarly lack of agency related experience it is important to understand your injury and insight is how much you understand it. If a veteran is having nightmares from their experiences but just ignores what might be causing it, they are doing themselves further harm by not taking actions to mentally heal: like you would be doing harm if you are thinking your broken leg is nothing. I understand that you are saying these individuals struggle to move past trauma and blaming them is not the best move, but he isn’t ever blaming them. That is exactly why he made this new video
@@mattmaco9065 ah, I'm talking about ongoing events, not past events. A person actively being abused may have perfect insight to say that the harm is out of their control, and for many reasons may not be able to alter that situation. That's what the end of the video is about - when the model breaks down. Not everyone /can/ build themselves a ladder because they systematically have had that agency taken from them.
I don't think this advice is meant for those situations, it's for people outside of those situations
Think of the ankle analogy: advising someone with an ankle that was broken, by falling over or by someone hitting it with a hammer, to wear a cast and use crutches
is different than the advice you'd give someone whose ankle is currently being hit by hammers, or someone who has JUST fallen over and is lying on the floor in front of you
but isnt it my feet hurts because they're thorns! the thorns are hurting my feet? fix the thorns, not the feet!
Or in the real medical world of today “Doctor look at my MRI, I am clearly injured and in pain” “Yes I can see that but medicine is dangerous, try meditating and an ice pack”
American individualist capitalist mindset. Yikes
"my depression may be aggravated by the world around me but there are still things I can do to help" -> ?????? -> individualist capitalism
Oh wow this is wholesome and empathic but not in a way that would enable helplessnes, more like supportive and building up your own agency. This gives me hope for humanity 🥹