Dr. Drew Pinsky and Ben Shapiro dissect the opioid epidemic, attributing it to insurance-driven overprescription and a spiritual vacuum that fuels tribalism. They critique political polarization, advocating for Aristotle's eudaimonia over hedonism while warning against elite hubris. Pinsky praises the Founding Fathers' genius yet fears California's direct democracy will cause the state to implode into three nations. Ultimately, they argue true meaning stems from service and rigorous honesty rather than ideological purity or isolation. [Automatically generated summary]
- If you're empty and you can't find meaning in other people, in being service to other people, or contributing to society, I don't know what we're doing.
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Okay, so now, Dr. Drew, thank you for stopping by.
Dr. Drew, for those who don't know, and you've been hiding under a rock for the last 20, 30 years, Dr. Drew, Is the original host of Loveline, which is where I first got to know his work, just like everybody else.
But he is currently a host over at KBC in Los Angeles on middays.
We got the Soul Patrol, which is a health and fitness podcast, and another one with Bob Forrest, the guy with the hat and the glasses that I did celebrity rehab with, called This Life.
It's about mental health and addiction, that kind of stuff.
One of the reasons that a lot of the people we have on, I think, are so popular is because if you view life as a journey through knowledge, I think that you have a much better time doing it, and also you're less likely to become ticked off.
So one of the things that's great about what you do is that you talk with a lot of people from a lot of variant points of view, but you're pretty even keel.
I mean, you're not in the business of getting angry.
So before we get into any of the deep stuff, I first want to get something off the table, because obviously there's an elephant in the room for those who know our history together.
So the first time that we ever met in person is when I was on your show back on CNN Headline News.
And it became sort of a cause celebre because there was an incident with Zoe Terzou.
Zoe Terzou is a transgender woman, a man who is, in my opinion, believes he is a woman.
And Dr. Drew is hosting the show.
And in the middle, there was a bit of a conflagration when he started calling me names, suggesting I was a little boy.
Let's just jump into, first some health issues, and then I want to get into sort of your personal philosophy.
So, as a medical doctor, And somebody who, as you were telling me before the show, now gets to spend your days talking about things rather than working 5a to 10p.
I want to ask you about a couple of things that seem to be plaguing the country.
So the opioid epidemic is obviously a major issue on a lot of people's minds.
And there are a lot of debates over the cause of this upswing in opioid use.
How much do you think that the opioid epidemic is a result of overprescription from doctors?
And how much is a result of the influx of heroin into the cities or moral collapse?
I talked to Sam, and what I call him, all I said is, how did you get it so right?
Because I lived through that, and that book describes it accurately.
Mostly perpetrated by my profession.
If you look at the history of opiates, we've had two major opioid crises in this country.
One was about 1880 after the Civil War.
It's when we had the hypodermic needle.
We created the hypodermic, we invented the hypodermic needle and invented morphine sulfate.
These are wonderful drugs.
For the first time we could affect human suffering.
We got carried away.
We created a bunch of addicts.
We didn't know what to do.
We treated it with Methamphetamine, and cocaine, and all kinds of other crazy things.
We've always made the same mistake, which is we become over-enthusiastic, we don't understand what addiction is, we create addiction, and then we try to treat it with other drugs.
We've made that mistake many, many times.
We're doing it again now.
This time was extraordinary.
There are a multiplicity of forces that came together to create it.
There was, you know, the insurance situation.
Insurance companies sort of took over the practice of medicine.
Everything had to be very quick, and there's no quicker way to end it.
And an appointment then opening a prescription pad.
That and the fact that a group of physicians decided that they would stake their reputation on the fact that opioids are not addictive and you could treat pain liberally.
Pain became the fifth vital sign.
The attorneys got involved with that and started not just suing doctors for malpractice but criminally suing them, civilly suing them for inadequate treatment of pain.
The state medical boards got involved.
The Joint Commission on Hospital Accreditation.
All these forces came together and said pain is as important as your pulse.
And pain controls what the patient says it is.
Pain experiences what the patient says it is.
We have these great medicines.
Use them and you are a coward.
You're actually a dangerous person if you don't.
And so I was living through all that trying to get everybody off them.
My peers were putting them on them.
And I just will tell you it was a catastrophe.
And you would know 90% of the opiates on earth end up being prescribed in this country.
And now we're beginning to find our way out of it.
What happened was the heroin problem, as it was documented in Dreamland, there was a group of people who learned how to distribute it very effectively at a time when my peers were cutting off patients.
They were beginning to learn that, oh my God, we were creating drug addicts.
So as opposed to bringing the patient into the office and going, look, we didn't intend this.
I didn't mean to make an addict.
We have now a second problem.
We have to get this treated.
What do you think the solution to all this is?
that you're a bad patient, you're diverting your drugs, you're overusing your medicine, you're out of my practice.
Well, when you kick an opiate addict out, they're going somewhere, and they're going somewhere cheaper and better, and that was heroin.
And that's where we got the heroin. - What do you think the solution to all this is?
Because there's a lot of talk about, you know, putting a lot of government funding behind things, and it doesn't look like there's a very clean solution, and the government's always throwing money at them. - There's not, and I want to say, too, that the soil in which this thing took place was about us, right?
I mean, there's a, I don't know how else to describe it except to say, and this is a deeper conversation, that we are in the midst of a deep spiritual vacuum in this country, if not a crisis.
And in a world where life has no meaning and the interpersonal experience is void and painful, you're going for opiates.
You're going for something.
You're going for something to try to relieve it.
That's a different problem.
Your other problem in terms of solution, your question in terms of solution, is very controversial.
I spoke to the head of the addiction program at Harvard just yesterday for a podcast coming out soon.
And he and I both believe that they've got to get behind mutual aid societies, which are available in every corner and are free.
And he's publishing a Cochran study that's going to show that these treatments, mutual aid societies like 12-step and smart recovery and these sorts of things, are as effective or more so than any other treatment.
in terms of sustaining abstinence, if abstinence is a realistic goal.
Of course, professional services are necessary and be required, but here's a free service that has a good scientific basis, that has evidence basis in science, and it's a good treatment.
We've got to get behind that.
There are replacement therapies out there like suboxone and methadone that people are scaling up, and I'm for that.
It's just the excessive enthusiasm is deeply concerning to me.
If you got opiate addiction or I got opiate addiction, we'd be trying to work on an abstinence-based program because you wouldn't be able to do what you do without being off everything.
Unfortunately, We're taking half measures with a lot of patients, and that may be required.
There may not be a realistic possibility of surviving this disease and attaining abstinence.
And although his thinking is kind of, I think more neurobiologically about it than I do the way Buber thinks philosophically about it, but I do think that there's something magical about the human relationship, the human experience.
And I think there's a lot more that goes on between and amongst people than we yet even know.
And that landscape of connectedness and intimacy and parenting and family has been forsaken for about 60 years.
If not forsaken, demeaned.
And the result has been a group of adults that are empty.
And if you're empty and you can't find meaning in other people, in relationships and being service to other people and contributing to society, I don't know what we're doing here. - So why do you think that happened?
Why do you think that 60 years ago there was this breakdown in sort of interpersonal, I have my own theories, but I'd like to hear yours. - I will, at some point in this conversation, I'm gonna have to tell you about my theory, but not theory, but the theories about how interpersonal connectedness works neurobiologically.
But why it happened, my suspicion, it depends what you mean by why.
You know what I mean?
If it's why, my suspicion is it was some sort of reaction to the world wars of the first half of the 20th century.
That those were so traumatic, and the children of those wars, somehow that trauma was rained down upon them.
At the same time, we decided families are not important, or relationships aren't important, or families don't matter, or it takes a village, or whatever it is.
I mean, families are the cornerstone of everything, and have always been throughout human history and every culture throughout time.
And whenever that has fallen apart, It has been to the detriment of the society.
I can only think of, you know, only extraordinarily totalitarian systems like Sparta pulled that off and they didn't pull it off for long.
Otherwise, it is about the family and we developed some sort of spiritual, some sort of philosophical, political I can't really think of where it started or why it happened, but it certainly was there in the 60s and 70s.
So my theory is that there, I agree with you that in the aftermath of both World Wars, there was an existential angst that sort of washed across the land.
But I think that a lot of that existential angst had to do not only with decline of religion, which you can see statistically taking a nosedive after World War II, but also having to do with this unfulfilled longing for community that had once been filled by either religion or a bunch of bad ideologies.
So, the feeling of communal purpose was lost, and without that communal purpose, we saw ourselves as atomistic individuals.
When you read existentialist philosophy, it's always me versus the world, right?
You read Sartre, and everything is about, here I am in this chaotic universe as this atomized human being, and it's my will that's going to shape the world around me.
Well, that doesn't leave a whole lot of room for a connection with other human beings.
It does leave a whole lot of room for you to be by yourself.
And yet, though, something unique happened in this country, because Go to Italy or maybe not Italy is a good example, but there are plenty of other certainly Western and even Eastern European countries.
Where there was marked decline of religion, but the families remained.
Families remained.
And they did not have the same kind of BS that we've had.
They've not had it.
I mean, when you go... We have then started filling ourselves with so many things like money and cars and extreme activities that don't fill.
It's a never-ending pit that we do here in this country.
While there, they still have their families.
They still have their family units.
The existentialism you're talking about, I mean...
I don't know how we go down this path, because I hate Sartre.
But it's how we think about neurobiology now, in a way.
And what I want to say about that neurobiology is that we've moved away from a single skull system.
You know, in the 90s we talked about the decade of the brain.
A single skull, we're going to understand how the brain works.
Turns out the brain does not work without other brains.
And it really is, everything's in an interpersonal context.
Where does your self emerge but out of a relationship with mom and dad?
And it emerges out of this relationship.
There's another phenomenon that is just poorly discussed, which is what people like me call affect regulation.
The ability to be okay in our own skin, to be able to regulate emotions so they're not too prolonged, too intense, too negative.
And it turns out that the normal interaction, normal frame for that to develop, it starts with mom.
It starts being attuned to and being an object of scrutiny and learning that brains have content and learning that when I have a feeling, the mom reflects that back to me on her face and may offer me some soothing affects alongside that.
That frame of closeness, of intimacy is what that is, is really where all meaning sort of resides in terms of feeling good about life and feeling good about yourself and experiencing yourself.
And then we can move away from that and regulate autonomously.
Well, when we've been traumatized, or when trauma is reigning through intergenerationally, that close frame becomes dangerous.
A lot of unpleasant material gets reigned through, if not shattering material.
Physical abuse, sexual abuse, abandonment, whatever it might be.
And so, the frame of closeness, in which we can find so much meaning and satisfaction, becomes a dangerous place that we don't go to.
Okay, so I want to have you expand on that a little bit in one second.
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So it's why I, I know you just interviewed Jordan Peterson, it's why I love him so much, because he would not disagree with anything I've said so far, but he takes all of this into a sort of a deeper frame, and he has a religious overlay to it, an anthropological overlay, and looks for the patterns of human behavior that are sort of reflective of what our neurobiology is.
And what I was thinking about is how we've sort of, I don't know why I'm jumping all the way to this, but I'm gonna go.
We've missed, in terms of understanding the human experience, we've become too relativistic in the sense that we just look at the superficial blush and not really ask the question, why do humans do that?
Why are they like that?
Why do the Aztecs tear somebody's heart out and throw it down the stairs every morning?
Oh, it's because they believe the sun will come.
Oh, okay.
Okay, we can stop there then.
As opposed to, oh my God, this was a population that had something called a codex, which was a systematic way to create a warrior by abusing the crap out of children.
I mean, vicious abuse.
And when you take a bunch of people that are severely abused and you put them together, they have a hard time not acting their aggression out on one another.
But if you focus that aggression out there in somebody, That you sacrifice every day, then there's this sort of a catharsis that goes on within the mob, now we're okay today, we did it to that one.
And I mentioned to you before we started, before the cameras heated up, that I wanted to mention human sacrifice.
And to me it's an informative phenomenon about the human being that no one ever looks at and it's in plain sight here at all times.
And that is that if you look at every print of religion, you find human sacrifice, right?
And it's always there, it's always around.
And then it sort of started, in Judaism, it started percolating over to, well, we'll have an animal substitute for the human.
Yeah, that's right.
But, I mean, if you look at what Abraham, if people talk about the Abrahamic religion, what was Abraham doing when God sent the angel down to grab his hand?
He was going to sacrifice his son.
He went to kill his son.
It was part of the ancient sacrifices that people did, and then some hallucination or whatever came through to him, and it changed everything in that moment.
No more human sacrifice.
Until, evidently, we started getting into it again with our aggressions, and then we decided, well, there's this one guy.
This one guy died for us.
And so now we don't have to do any more of that, because we can focus on the one guy.
We drink his blood, eat his flesh and stuff, and do these cannibalistic things to help us feel better.
Whatever it is.
Deep in that is this primitive primate stuff that we never really look at.
That's a constant reminder of human sacrifice. - Right, but it's not people who are saying that it is good to go out and participate in human sacrifice, they're saying the opposite. - No, they deal with it by focusing on this one guy that did the sacrifice for it. - And this is sort of the point that I'm trying to make, which is that the Judeo-Christian tradition, in attempting to eradicate human sacrifice, The Bible is very harsh about human sacrifice.
It's one of the big things, and it's one of the big puzzles about Abraham.
So the traditional Jewish read on that is that this was Abraham's struggle, is he's being told to do something he knows is immoral, because God has already told him it's immoral to do this.
And the only point that I'm making is we somehow got from people who sacrifice each other on the steps of giant temples to the place where we have such an innate now, almost innate, abhorrence of this idea.
But it didn't take everywhere, right, because the fact is that 70 years ago, there was a human sacrifice of literally tens of millions of human beings, and we're fine with that.
You're talking about genocide and how, you know, well, look at my theory.
My theory would be that the reason that we're able to focus and not be that way is because of families.
Because our experience in development and our experience of self and other and the ability to develop affect It includes the experience of love, and ultimately, if we do enough connection with other people, we develop something called empathy.
And with empathy, no way we're going to do stuff like that, right?
So that's the highest order of human development, is deep empathy of other people, to be able to really appreciate other people's contents of their minds.
If you're being traumatized and beaten or in war, or you're living in horrible circumstances, You're going to be prone to aggression.
This need for family and this need for community and this need for interaction with the fact that we live in an individual rights society that suggests that you as an individual are the highest point of our system.
How do we build a system that balances these two things?
Chronically severely mentally ill, and we're allowing them, and I've been through the experience a number of times where you get them and treat them and they look back and go, who the hell let me sit like that?
They're angry.
So their civil liberties are being protected?
I mean, that's way too far.
And by the way, There's going to be an infectious disease outbreak here in Los Angeles this summer off of these encampments.
I promise you.
It's not going to be pretty.
And so we have sanitation failure, we have human suffering in the streets, we have inability to intervene on their behalf to make them help them, and we're endangering the entire population of Los Angeles because of sanitation failure.
People who are pushing radical communitarianism will completely deny any of the possibilities of those things going bad, because obviously, how could it possibly go bad?
And that's one of the things that I find so fascinating about the American founding in particular, because the American ideology from root was that it was your job to, it was government's job to stand up your way, but it was your job to be virtuous.
We deny that that's what we're doing, but in reality there's a lot of that going on.
I'm sure you see it much more.
In terms of broken interpersonal relationships.
It's out of control.
I get so many letters from people who listen to my show, and I don't talk about this stuff particularly often on my show, but because I'm younger and because I talk about my relationship with my wife and all this, I get a lot of letters from people who say I've really screwed up relationship with this other person, and typically that's happening because they're not even talking to one another.
They're talking past one another.
They're not seeing each other as independent human beings with a set of values, and then they're not basing their relationships off that shared value at all.
But a lot of what you're describing is shared intellectual experiences, which is again about listening to each other and appreciate each other's values and points of view.
But there's a deeper piece where they're not even experiencing each other as wholly there.
There's the other person's mind having real agency and content.
It's just sort of somebody that I use to feel better.
So I'll ask you a practical dating question that I've gotten a lot, because this is fun.
I mean, as long as I got you here.
So the practical dating question that I get a lot is, should people who have different value systems or different religions, for example, date each other?
So my typical answer on this is no.
Is that if you want to have a long lasting relationship with somebody, you're both going to get old and wrinkly, and you're both going to not be as handsome and pretty as you once were, and you're not going to be as sexually attracted to that person as you once were.
But what you see from the studies is that levels of committed love go up over time, and levels of infatuate love go radically down after the first six, seven months.
And so if you actually want to build a committed love, then that has to be built on a shared purpose, which can only be found in a shared set of values.
I'm going to defer to my host, which is that if you look at common scripts, things tend to go better.
Life scripts, family scripts, family of origin scripts, things where everything is already self-evident to one another.
That tends to help relationships go along.
But having said that, of course, the exceptions are always the radical differences where people form these new phenomenological experiences together, and that's very rich, and it's dangerous.
There is a risk-reward ratio, but I wouldn't discourage somebody from that just based on that, for any more reason than I would discourage you and I from having a good dialogue, you know?
Unless you're careful, you get assigned to the American Independent Party.
So I think that's actually one of them.
Because I was going to go libertarian.
I thought, now that would change who I could vote for and stuff.
And I'm not really a libertarian, but I kind of am.
And my daughter, who's pretty way left, said, you're libertarian, you're just right-wing.
I'm like, I'm not.
And then I started talking on the radio about solving the homelessness problem, and I'm concerned about the lack of government functioning, basic functioning.
And people started going to me, Leo Terrell, you know Leo Terrell?
Although, the libertarian philosophy, I mean, I consider myself fairly conservative slash libertarian, and I think that most libertarians, there's different branches, and you and I agree on this.
Do we know enough about psychology to use psychology as a guide when it comes to policymaking?
Because if you look back at the history of the use of psychology, there's a whole wing of people right now who say, if we just thought scientifically about things, if we just brought all the data to bear, then policy would inevitably arise.
And you look back at the self-esteem movement, the self-realization movement, which was based on a fair bit of bad science.
Disaster.
And it just manufactured an entire generation of people who were incapable of functioning outside the realm of, I have to be in my own little bubble.
I'm gonna let you answer the question.
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I love the people that are in that space and trying to make sense of things.
But technically, they're not really sciences, right?
You can't do placebo-controlled studies.
You can't do Create a hypothesis and create an experiment on giant human populations and then have a null hypothesis and you can't do science in the real sense of doing science.
And it's in itself sort of infinitely complex, right?
And so here it is something we can't do science.
It's infinitely complex.
We can be informed in our decision making by psychology and we can sort of see if we can help but guide good decision making.
But to have it be the sort of 1984 style, you know, way politics or history is created.
No, no, no, no, no.
Absolutely not.
And I had a personal experience with this just recently.
When Trump was coming on the scene, I was trying to understand.
I couldn't get it.
I was like, why?
What's this guy for you?
And people were, there was a lot of enthusiasm.
And then he's elected.
And then people are asking me to evaluate his mental health and he's manic and he's this and the other thing.
She is!
And I started sort of looking at his personality and his, you know, mood stuff and I thought, wow.
My very favorite president had all these same characteristics.
Teddy Roosevelt was essentially the same guy.
Same guy, same dude.
You couldn't sit and have a conversation.
You'd have to walk through Central Park with him or Washington, D.C.
or whatever because he was so manic, he couldn't sit still.
He had some, later in life, some real problems because of that bipolar stuff.
But as president, it was spectacular.
It was crazy.
It was a lot of crazy-making, but it ended up Because of his judgment, and because of who he is as a human being, and because of his instincts, and the way he adjusted to some of the decisions he made, and the philosophy, and the intent, and the thinking going forward, Teddy Roosevelt, ended up where it needed to go.
And the same is true, like, not that this is kind of a weird sidebar, but, you know, in medicine, we make decisions.
You make your decisions based on your instinct, and you're informed by your experience.
You don't expect to be right, necessarily.
You have a backup plan, and you watch, and you adjust, and you think, and you're careful, and you set the table around the decision you made so you make sure that things don't run amok.
That's what presidents are supposed to do, I think.
And that takes a lot of energy and it's a lot of leadership in a way that I've been thinking lately.
So, I mean, in that vein, one of the things that is becoming clear is that one of the reasons our politics is broken is because everyone is tempted to jump to psychologically diagnosing one another.
So what you see so much in the public debate is you're saying X.
The real reason you're saying X is because you really believe Y or because you're crazy or because you suffer from narcissistic personality disorder.
So in this last election cycle, there is constantly what you would hear from people is that the real reason that people were voting for Donald Trump is because they were crazy or because they had suffered when they were children or because they were poor.
And there was a wide variety of people who voted for Donald Trump.
I didn't vote for Donald Trump.
I doubt that you voted for Donald Trump.
But the attempt to kind of diagnose everybody who is opposite you as suffering from some sort of personality disorder actually has pretty deep roots going all the way back to the post-World War II kind of Eric Fromm school of diagnosis where there is the authoritarian personality.
And if you support Trump because you have an authoritarian personality type, Do you think any of that sort of stuff is appropriate, or is it just overrated?
But it really has echoes of something much more sinister, which is labeling people as your ex, your whatever, your other, whether it's psychological or in color, religion or philosophy, whatever it might be.
The tribalism is just insanely, it's so prevalent and it's so much a part of how our brains work.
It's had some evolutionary adaptive advantage to it, but it's running amok right now for some reason.
You can still believe I was, which is interesting.
You and I had a little conflict once on Adam's show.
Yes.
When me and Adam were at your show and you were telling me that the news was so biased and I was like, man, no one's ever told me what to say or not to say or anything, which was true.
At HLN we were sort of doing true crime and sort of C and BD stories in the news and no one ever, ever came to me about the way I should present my opinion or the news.
Seems like a different era.
Seems like a different time.
And you assured me that I was naive, and I started thinking about it.
I thought, well, yeah, I guess those guys kind of have their own point of view, and it just kind of does come across.
But it's not affecting me, and I don't feel like it's a system-wide sort of institutionalized sort of mandate of any type.
These were just these personalities, the guys they hired, and I guess that's what they like.
Well, then they decided to stop my show.
Okay?
Then I was on the radio.
No, no.
Then I was on, I was on... On Don Lemon?
I was on Don Lemon's show and he said, let's do analysis of Donald Trump's personality.
And I went, all right.
And I started, and I had thought of this Teddy Roosevelt thing at the time.
I said, you know, business people can be very hypomanic.
He's got all those hypomanic qualities, but, and there's no doubt some narcissism, like all politicians and, and, but I don't see malignant narcissism because his relationship with his kids is too good.
And the kids would not be putting up with that if it was really a malignant narcissism.
And then I went on Teddy Roosevelt, who really was a belittled narcissist, and I said, you know, you don't know just because somebody's one thing doesn't mean they're a bad leader or a bad president.
And I was sort of making that point.
I talked for probably 10 minutes on their air.
The next morning, my radio at KBC, my radio guy who you know, Drew Hayes, just goes, hey, that was pretty good.
Do 30 seconds for us on our website.
I went, okay.
So I did it in 30 seconds.
And as I was getting up and he goes, you know, you should really balance that out.
Do you have 30 seconds on Hillary?
And I go, Yeah, they just released her medical records today and it really bothered me what the doctors were doing.
So I did 30 seconds on, not her health, on the seriousness of her health and the kinds of decisions the doctors are making, which were bizarre.
Whenever I see Weird decision-making by a physician.
And it's a celebrity.
I know it's the doctors, you know, being addled by taking care of celebrities and sort of letting celebrity dictate.
I mean, I just look at Michael Jackson, look at Prince.
I mean, it's just everywhere.
It happens all the time.
And so I was just being critical of the care she was getting.
Well, Drudge picked that up.
And they portrayed it as, finally a doctor's brave enough to say, Hillary's sick.
Which is not what I said.
It's not what I said.
But then CNN picked up, and they came down on me like a ton of bricks.
And it was already a decision that had been made to stop the show.
So it was not like, we're going to fire her.
It was just like, listen, this is a very difficult time.
And upset people were calling me.
And I was like, I don't want to be in the middle of this.
So I'm out.
So I just didn't say a thing.
They announced two weeks later that I'd stopped the show.
Well, the world, social media, went, aha, see?
So they went from crucifying me because I'd say anything at all negative about Hillary, so her world was mobilized.
And then I became the sacrificial, I became the scapegoat for everybody by having lost my job and everyone sort of felt good and sided with me, even though none of it had actually happened.
Well, I think that one of the things that, you know, to bring some of this full circle, one of the things that has clearly happened is that the level of polarization in politics is leading to an enormous amount of anger, and that's leading to an enormous amount of reactivity.
And the level of just, I mean, I don't know, you have a huge following on Twitter, but you don't spend an awful lot of time on Twitter, it doesn't look like.
You know, I wrote that book on narcissism, The Mirror Effect, and I wanted to put an entire chapter, I actually wrote most of it, about other periods of history where narcissism had emerged so prominently.
And every time, I was looking at pre-revolutionary France, I was looking at times like that, and when you see a lot of narcissism, a lot of childhood trauma, then a lot of narcissism, and again, that's because of our destroyed family.
I think that one of the things that's happened is that the mob mentality has become so obviously tribal.
People are now rebelling against the tribalism.
It's become so extreme that there's this push against it.
So I see that mostly in the reaction to identity politics.
I see that there are a lot of people right now where if you state a fact, people will immediately accuse you of being a sexist, racist, bigot, homophobe.
If you say, for example, that the statistics that are usually cited about the wage gap are just plain wrong.
Or if you suggest that there are biological differences between men and women, because there are biological differences between men and women.
Obviously, every doctor ever has to diagnose somebody.
I mean, I was hearing from a doctor friend of mine that there was a transgender person who came in and the hospital had been instructed that instead of that person writing down their biological sex on their form, they should instead write down their gender.
They should write their perceived biological sex, their perceived gender.
And so the person came in and if they had not done, they were complaining of lower stomach pain.
Well, I mean, you're going to get a wildly different diagnosis based on whether that is a man or a woman if it's lower stomach pain.
And yet if you say so much as that, there are a bunch of people who are willing to come down on you and just Yeah, I don't understand why we can't say that there are populations that have been ill-served because of science or because of lack of sensitivity to certain things, and now let's talk about the science.
And let's hope, let's state up front that we don't want that science to be used to marginalize or condemn or be used improperly to hurt other people.
But let's just discuss the science.
How else do we create equality unless we understand the differences?
I mean, Lincoln said it.
He goes, we're not equal in all respects.
He said it in the Lincoln-Douglas debates.
But it's about creating a level playing field, an environment where everybody has equal opportunity, equal probability of success.
I would say even if we can, you know, if we know the differences and some people need a little help or something, we can talk about helping it.
If there's a biological difference that we can discuss or a scientific phenomenon that is relevant to helping one group out versus another, or keeping another group, whatever it is, let's just discuss the science.
Because if we can't discuss the science, we're not in reality anymore.
This is why I say I think there's a unifying moment that's happening because people on the political left, you know, Sam Harris, who is a Hillary Clinton acolyte and is a voter.
And he was basically thrown out of good company by people like Ezra Klein because he had the temerity to say that the IQ studies that exist about group differences are valid.
He was not saying that they're not environmentally caused.
He was just saying that they're just the raw data show that there are differences in IQ between groups.
It's almost like there was a chain of thought that happened where people said, okay, science is going to make policy.
And immediately, whatever science comes out, that will be the new guide for policy.
And then all this new science came out and people said, well, we don't like the policy that we think would come out of that science, so we'll just get rid of the science.
We won't do the science anyway.
When the reality is, as you were saying earlier, there should be a gap between science and policy, and that gap is called ethics and morality and values, and that has to fill that in.
That's a pretty deep well, that well to figure out, of what we do in between science and policy.
And that's another area that we as Americans don't spend a lot of attention and time thinking about, which is, I mean, I think virtue ethics people do think a bit about these days, but guiding philosophies and what's good for humanity, I don't think people spend enough time on.
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Okay, so now we get into the very, very deep stuff, the narrow.
So, what sort of guiding philosophy do you think people ought to use for life?
I feel like I need to either pace or lean back, or get on the couch for this.
I have found a great starting point, and for some people, the finishing place, too, is Aristotle.
I think he kind of figured things out.
And I like the way he approached science.
He was an empiricist.
I think that, speaking of empiricism, I think that the pragmatists have a role, too.
I think pragmatism needs to come back again, where the pragmatic outcome of what's good for humanity and human beings needs to take a seat at the table.
Where I want to go with this is a little bit different, which is that he felt in order to be armed properly to be able to achieve eudaimonia, you needed to have a certain amount of phronesis, wisdom, a certain amount of techne, skill.
He had a couple other criteria that don't stay with me right now as much, but phronesis and skill I thought were very important.
And this is the part that people miss.
They think that if I'm leading a certain kind of life, most people will come to the point that participating with other humans is what really gives something nourishing, whether it's raising a family, or being community, or whatever it is.
It's not necessarily layering soup in the homeless kitchen.
That's not, that does not feel, that's not that fulfilling.
It's good, I'm glad she does it, but it's not that fulfilling in the way that having a set of skills and wisdom to help another human being with something that they're struggling with.
That's why I'm so grateful to be a physician.
I have all that skill and wisdom of experience where I really am always loaded up and ready to do something like that.
I'm very aware that that creates, if you use it and use it For good.
Use it to help others.
And be aware that you're gifting somebody something with it.
It's tremendously filling.
It's always filling.
You always feel a certain kind of eudaimonia.
I hope people understand what I mean.
Balance, nourishment, being okay.
And I had to have a few years of therapy in there too.
I did.
But I've always been... One of the things I'm most grateful for is I got this piece.
I got this thing to offer.
And I think we all got to remember and think about that.
So the question is, and the reason I mentioned the teleology is, can you have eudaimonia in the absence of teleology?
Can you have the eudaimonia without that piece where you say it's virtue in accordance with right reason and the whole system of Aristotle's, the idea of the unmoved mover, the idea that you were created to do certain things and those things can be discoverable in the universe by virtue of what those things are.
So you as a human being, you were created to reason because this is what distinguishes you from the animals.
And if you are not actually acting in accordance with that right reason and using that right reason in order to There's a great book called After Virtue by McIntyre and his entire argument is that what's happened in the West is that Aristotle's version of virtue has fallen away and it's been replaced by this other weird version of virtue which is basically we define for ourselves what virtue is.
So we got rid of the Greek teleology and we replaced it instead with this idea that you were just supposed to be a nice guy.
And that's not actually what Aristotle is saying.
What Aristotle is saying is that you have to act in accordance with your reason as applied to the highest seekings of human beings.
And I think that the reason that I feel, you know, what I'm often saying is that Athens and Jerusalem is the Straussian model of what built Western civilization is.
The ethic of Judeo-Christian values combined with this Greek teleology, this search for reason, which unite in philosophers like Aquinas, where he's clearly trying to apply Aristotle to the Bible.
This is what has created Western civilization, which is where I was trying to go earlier in the discussion about the movement from human sacrifice, is that you have to combine a certain set of values and that people are actually not very good at discovering their own sets of values.
That when people are trying to discover their sets of values, very often what they come up with is either damaging to themselves or damaging to others or a way to try and control other people.
And what I mean by that is that- Is there evidence for that?
Yeah, well, I mean, I think that virtually the entire history of humanity between 1850 and 1950 is pretty good evidence of that.
And not that we become maniacs, but that we tend to prioritize our priorities over other people's priorities.
It's hard to get to a place where you are prioritizing the larger concern of somebody else's humanity as an individual human being over even your utopian wishes.
Ideology arises from your attempt to reach utopia.
And she ushered us into this beautiful mahogany room, just gorgeous room, 500 kids there, all of us at the top, the cream of the crop, the people who had done the best on the LSATs, which means we're very smart.
And we're all there.
And she turns to the entire audience and says, listen, you guys don't have to worry.
The competition's over.
This isn't the paper chase.
Everything is good.
You're all going to get jobs.
And then she said, the part that really disturbed me is she said, and now you are going to be the masters of the universe.
We have this number of justices on the Supreme Court.
We have this number of people who are in the Senate.
We have this number of people who are in the House of Representatives.
You guys are the smartest.
You're the best.
You know the most.
And you're going to be the ones who are making all the rules.
Whenever you think you know more than everybody, and by the way, there's a very natural sort of ebb from what she said to, well, I'll do whatever I want because I'm that guy.
You know, the literature shows it's very strange, but I'm going to piece together a bunch of different little things.
First thing you should do is make your bed.
The happiness literature is very clear that if you start your day by making your bed, you're more likely to be happy and it tends to set a tone for the day.
Like as you start doing something, get off your ass, start doing something.
Secondly, one thing you can do is to, I advocate this rather strongly, is to watch the relationships around you and watch who you avoid and who you sort of gravitate towards.
And start kind of hanging out with somebody you might not otherwise, doesn't have to be somebody you're aversive to, but somebody different than you normally hang with.
And tell them about yourself and find out about them.
You'll be stunned how often people have some moments of clarity about themselves as a result of something as simple as that.
I call it seeing yourself with a new pair of glasses.
We have lots of delusions and denial and stuff about ourselves and if we're not happy and we're in a bad spot, we're contributing to it somehow and we can contribute to getting out of it.
But if we don't really see ourselves as we are, it's very difficult to do that.
And I would attend to nutrition and exercise, all those simple things, and I would find some way to create meaning.
How can I do something meaningful?
Not, how can I get happier?
How can I make money?
What's meaningful for me?
And it may mean listening to podcasts and reading for a while and figuring out what, you know.
They put together, out of thin air, in the first time in history, a country based on ideas.
Never happened before and it has sustained us for 200 plus years.
Get behind that notion and learn what it is and see if you can't contribute to it at whatever that means for you rather than... I'm not even sure our politicians even understand the country that they're serving right now.
Particularly in the state level.
And to understand what it is and to Where it was weak, make it stronger.
But where it was a genius system.
And again, it was based on philosophy.
That's where they looked at what had worked and what hasn't.
And as another sidebar, I'm gravely concerned about California.
I'm gravely concerned about it.
And here's my biggest concern.
There's a million reasons to be concerned.
We've already gone over some of them.
But direct democracies never survive throughout human history.
And we are very proud in this state of our referendum system, which is a direct democracy system.
The rest of the country doesn't understand this.
That is destined for failure.
And I think when the history books are written, they're going to look at that as the reason that California implodes and becomes three states.
I think we might be three states sometime soon.
Wow.
I really do.
I would have been mortified by that thought about it.