Join Matt and Chris as they conclude their deep dive into the content of Dr. K, the streaming psychiatrist behind Healthy Gamer GG. In previous episodes, they explored his promotion of Ayurvedic medicine and his use of the rhetorical strategies often seen in Complementary and Alternative Medicine spaces. This time, they tackle his more controversial work: the (non)therapy sessions with influencers, focusing particularly on his challenging and controversial conversation with the late streamer Reckful.The episode considers how Dr. K navigates the boundaries between professional therapy and public conversation, examines his response to an official reprimand from his governing body, and questions whether his justifications withstand scrutiny.Matt and Chris critically assess the validity of legalistic defences, the ethics of publicly streaming sensitive conversations with vulnerable individuals, and broader concerns about mixing mental health care with entertainment.It's a lengthy episode and features discussions on patient-therapist power dynamics, definitional debates, and the complexities surrounding regulatory oversight and professional/general ethics.We warn you this is not a very light episode and deals with sensitive issues related to suicide and mental health.LinksHealthyGamerGG: Talking Depression with ReckfulHealthyGamerGG: EthicsHealthyGamerGG: Ludwig and Dr. K's Journey of Death and ConsciousnessHealthyGamerGG: Tired of Work, Society, and Life... (featuring response to reprimand)Dr. K's official reprimand by the Medical BoardDr. Mike: Debating The Value Of Eastern Medicine (Ayurveda) | Healthy Gamer Dr. KCritical Video by MrGirl: Dr. K - RecklessCritical YouTube video by Koubitz: Dr. K's Hidden AgendaThe New York Times: The Gamer and the PsychiatristHealthyGamerGG Official Response to Reprimand on Reddit
Hello and welcome to Decoding the Guru's podcast where an anthropologist and a psychologist listen to the greatest minds the world has to offer and we try to understand what they're talking about.
I'm Matt Brown.
With me is Chris Kavanagh.
He's the anthropologist.
I'm the psychologist.
He is the Cassius to my Brutus.
That's how I've always thought of him.
You get that reference, Chris?
You get that reference?
Cassius Clay.
Yeah, the boxer.
He was, yeah, Muhammad Ali.
I get it.
No, no, no.
You don't get it.
But that's okay.
That's okay.
He was probably named after that Cassius, wasn't he?
The one that killed Julius Caesar named after the boxer?
No, I mean, Muhammad Ali was probably named after his original name.
Is that not likely?
Look, it's all right.
I organized a spare.
I organized a follow-up because I knew that cultural reference would be over your head.
So with me is Chris Kavanagh, the Chewbacca to my hand solo.
I got that one.
Star Wars.
Yeah.
I meant to say Star Trek and then annoy people, but too late, too late.
Yeah, that's fine.
I'm Chewbacca.
That's about accurate.
I'm hairy enough to be Chewbacca.
You are, aren't you?
I could apply.
Yeah, naturally.
I am naturally, but I maintain my physique with various potions and shaving apparatus.
So this is not natural, Matt.
That's fierce.
This is a sculpted perfection from raw materials, rough, raw Irish salt-of-the-earth materials crafted into this massage.
Well, in all fairness, we probably have the same matter here.
Just yours is distributed all over your face.
And mine is all at the top, like a carrot.
That's right.
Like a carrot that has got its leaves grown out too far and they've wilted in the sun.
Yeah.
Yeah, that's right.
All white.
White and dry.
Yeah.
Yeah.
So, you know, this is something, Nomad.
I know banter isn't allowed in these episodes anymore.
No, no, no.
It's going to end very soon.
Don't worry, everybody.
It'll end very, very soon.
But just to say...
You know, we have a YouTube channel where Editor Andy deposits various snippets from episodes, usually from supplementary material.
You can go check.
And it never fails to surprise me, Matt, how many people say, you know, I thought Matt would look like Chris and Chris would look like Matt.
And I'm like, that doesn't.
Because I get, you know, the podcasters don't look like what you expect them to look like.
I understand that.
That's happened to me multiple times.
But I'm like, why do you think I look like Matt, why would you look like me?
This is the confusion.
We've got pretty stereotypical faces as it happens.
I think the implication is that you have an old voice and I have a young voice.
Is that it?
Wow, how insulting.
It's kind of insulting to both of us in different ways.
Yeah, in different ways.
Wow.
Well, yeah, I get that.
Actually, that does go along with it.
Oh, I thought Chris would look like a scraggly old man.
But instead, look at him.
Wow.
So, that's good.
I benefit from low expectations.
I guess you appear slightly older.
I look precisely my age.
That's what I think.
Agreed.
But banter finished.
A lot of time ended.
Don't worry.
No more banter.
This is a decoding episode.
This is where we look at a figure somewhere in the guru's sphere.
They might be not in the guru's sphere.
You know, you never can tell.
That's the whole point of...
Doing the decoding episodes.
However, this figure, we have already visited twice.
We've been to Dr. K, Alok Kanojoa's house, multiple times.
And here we are knocking on his door again.
So, why are we back here, Matt?
What takes us again to the Vata realm?
Is this a test?
Am I supposed to have memorized the agenda?
Yeah, I'm checking.
Do you know why we are here?
Why have we done three episodes of Dr. K?
Well, I know we've done two episodes, and I know we're going to do a third episode, and I think this third one is going to be looking at, well, a kind of a controversial online counseling episode.
That he had, which had lamentable outcomes.
Maybe nothing to do with him.
But, you know, and also a censor that he incurred from a professional body.
How am I doing?
Is there another thing?
You're about 30% accurate there.
And, yeah, because we will cover the interview he did with the influencer, Brechtful, who went on to...
Commit suicide after it.
And that is one of the very controversial things because he did a series of interviews with him on stream talking about quite personal traumatic stuff.
We're only covering that a little bit though, Matt.
And whether or not Dr. K's therapy sessions have anything to do with the...
Eventual suicide is not really the focus of this episode, though we can talk about it, but I think it doesn't matter.
I mean, not that it doesn't matter, but it kind of stands apart, the stuff that we're going to talk about in this episode, because it's mostly about we covered Dr. K's focus on Ayurveda and his kind of presentation about the limitations of Western medicine and how they are resolved.
By the individual focus that you get from Ayurvedic practices.
And we showed that this was an emphasis that he had on his work previously, quite significantly, talking about the different doshi types and the types of food that you should eat and all this.
But we also showed that that runs right up to the present because we looked at more recent content and his interview with Dr. Mike, where it was...
Pretty much doing very similar rhetoric that he was doing a number of years before.
So it isn't that he has stopped doing that as various other people have suggested.
But the reason that he attracts controversy primarily is not really that.
That was something that like struck us in his content.
But the reason that he gets controversy is for these interviews.
That he does on stream, typically with famous influencers or streamers, but it can also sometimes be with, you know, just non-famous individuals that have particular issues or this kind of thing.
And these streams became very popular because essentially it looked to a lot of people like a therapy session, but a therapy session that has been streamed.
So it's A therapist, Dr. K, a psychiatrist, asking these kind of probing and empathetic questions to a celebrity influencer, often about personal topics that they hadn't discussed elsewhere,
or if they had discussed them, you know, not in that level of depth and kind of openness.
So there's a voyeuristic aspect of it.
But Dr. K is clear in all of these encounters.
He's not doing therapy.
People might be under the mistaken apprehension that it's therapy, but from his point of view, it's not therapy.
It's purely a conversation about mental health and, you know, issues that people might be having, but he was not acting as a therapist.
And other people kind of disagreed with this, and we will see why.
And this has led him to what you mentioned, which is that he was disciplined recently by the relevant medical board.
Because a complaint was brought up about these therapy sessions, or at least, you know, the one that we're going to talk about.
So, we're going to cover a broad range of things, but not solely focused around recful or disciplinary things, but they'll all come in, Matt.
So, you went wrong.
Oh, no, I get that.
Yeah, you know, I was just getting you started.
Yeah, I think...
Just to preempt this a little bit, I mean, I think one of the interesting dichotomies there is on one hand, as you said, he portrays it as this isn't therapy.
This is just human beings having discussions on the internet and streaming them.
On the other hand, he also portrays what he's doing as an exciting new way to help humanity and bring his therapeutic skills, you know, not just one-on-one, but to actually...
Broadcast them and help many, many more people.
So there seems to be some contradictions there.
So yeah, let's get into it and explore it.
Yeah, so I can actually play a clip at the start that kind of talks about that and brings up this concept about area of effect healing, right?
A gamer term.
As we know, Dr. K runs Healthy Gamer GG.
This is a term from, like, kind of World of Warcraft, you know, these kind of games where you're doing a spell and it's having an effect on, like, a group of people, right?
Buffing people or healing them or whatever.
So, area of effect healing.
And actually, he suggested that this came from Recful.
Recful was the streamer that we'll talk about who was also a...
A World of Warcraft player, but who ended up committing suicide.
So he referenced about area of effect healing and Dr. K has ran with that term.
At least I think he said that in one of the things.
So here's him talking about his motivation and, you know, what he's trying to do.
And I'd like to start by sort of sharing a little bit of a narrative.
So when I started Healthy Gamer, the reason that I started Healthy Gamer is I was working with a lot of people who were sort of of the digital generation.
And the more gamers that I worked with, the more young people I worked with, I noticed I was having the same conversation over and over.
In fact, what I noticed was that What was really missing is not clinical treatment.
These were not people who needed prescriptions or even psychotherapy.
What they needed first and foremost was education.
I found myself having the same conversation over and over again, teaching the same things over and over again.
So I started to wonder, could I actually help 10 people or 100 people by having a single conversation online?
So that, yeah, that portrays the motivations in an altruistic light.
Yeah, exactly.
This is sort of a way to do more with the limited time that you've got here on Earth rather than speaking to just one person at a time.
You can have these educational conversations and thousands or tens of thousands can benefit from them.
Yeah, and maybe it's the wrong point to get into this, but just to mention that I don't think it's perfectly plausible that Dr. K isn't being disingenuous when he's talking about early motivations or a significant portion of his motivation being about the desire to,
you know, kind of help people with their mental health.
I mean, he got into therapy, right?
And he was streaming about, you know, mental health issues and that kind of thing.
So I think it's perfectly reasonable to imagine that he's not lying about, you know, that at least being in the matrix.
Motivations for him to enter this area.
Yeah, I mean, sure.
Isn't this, in a way, what every broadcaster, podcaster, dare I say, Chris, sort of aims to do?
Like, it's meant to be at least somewhat educational.
Do we aim to do that, Matt?
Well, I don't know.
I mean, I don't know.
Tune in to Decoding Academia to find out.
Oh, that's true.
That's true.
We do have that.
But I guess I just mean that there's like, you know, there are degrees within that and there are people that are very clear that their motivation is altruistic and to help others and others.
Not really claiming that as strongly.
Yeah, I mean, I think, look, this is pointing to a fuzzy boundary between Educating people about the nature of, let's say, doshas and how different types of foods are going to affect your personality and what kind of personality type you are.
And advice on how to live your life and what you should do and not do, a la Jordan Peterson.
And then getting into, well, this is what your problem is.
It all comes down to this.
And there is this shades of grey as you get towards something that starts looking a little bit.
Like clinical counseling.
Yes.
So Dr. Mike did discuss this at the beginning.
We've covered the Dr. Mike interview.
Mainly we focused on the debate around Ayurvedic versus modern medicine.
But at the beginning of the episode, they did focus more on this issue about interviewing streamers and whether what is being done could be classed as therapy.
So here's...
Some of the discussion around that, because I think this is also a point where Dr. Mike offered quite valuable pushback, and you get to hear Dr. K respond to it.
I think we have a challenge, right?
So like everyone says, so we have a mental health crisis.
Suicide rates are increasing, depression, anxiety.
We're seeing an evening out of body dysmorphia between men and women.
We're seeing an evening out of ADHD, equality, and all things.
So we've got this mental health crisis, and the question is why, right?
And this is where we have, you know, organizations that will advocate for destigmatization of mental illness.
So the question becomes, how do we do that?
Right?
So now, because mental illness is a little bit different because we've been so careful about talking about it, which I'm all for, right?
So I don't conduct clinical interviews.
I never have my patients on stream or anything like that.
And at the same time, like, what does destigmatizing mental illness literally look like?
Like, how do we do that?
That's kind of framing interviewing influencers as a public health service.
Right.
So to destigmatize it.
So it's not something that happens behind the veil.
It's not a thing you should be ashamed of that has to happen in private, in an office or something.
It can be something that by bringing it out into the open and by showing people that everybody has mental health problems and talking about it openly, we can destigmatize these issues.
Is that the...
Yeah, I think that's it.
And also that, you know, the people, the influencers that people might look up to, you can discover that they too have struggles with anxiety and issues from their life, traumatic events that affect their confidence and that kind of thing.
So I think that's the positive.
Spin on it, right?
It's about awareness.
It's about increasing education.
And it's about people not seeing, talking about these issues as being, you know, something that we need to hide away.
Some would say, Matt, that we need this message more than others because of our cold-hearted ways.
All right.
Okay.
Fine.
Fine.
All right.
We're setting all this up.
This is good.
Yeah.
And you get Dr. Mike, you know.
Talking directly about the issue of potentially getting in trouble.
It's very rare that I sit in front of someone who has significantly more experience discussing health to a huge audience online.
Because there's not many people doing it, period.
But to do it for the amount of time that you've done it, not just years that you've been online, but also when you stream, you spend a lot more hours in front of the audience.
For me, when I make content online, you know, we hyper-edit a fast-paced moving video, 10, 15 minutes.
Now I'm entering a little bit more into the podcast space.
How do you do it and not get in trouble?
So, you know, it's a great question.
So we'll see how much trouble I get into.
Well, let's get into troubles today.
That'll be fun.
And so I think...
A couple of things to keep in mind, right?
So I think just being super careful about what you say, what you don't say.
I think steering clear of like medical advice.
So I think the way that I kind of frame things is when I make content online, I almost think about my target audience as like residents.
So if I'm talking about, let's say, a clinical condition like borderline personality disorder.
I frame it in the way of, okay, if I was teaching a group of residents or medical students or even pre-meds, how would I explain this condition?
So that's really what I usually think about.
And then I'll prepare lectures and just keeping it more educational.
I have a small bone to pick there, Chris, because on one screen I have a window I have you in it.
On the other screen I have Healthy Gamer GG's YouTube stream.
And, you know, the topics of things like what does gooning do to your brain?
Why brainwashing yourself keeps you stuck in life and so on.
I mean, and I've watched many of these.
To be honest, I don't feel like the content of these videos is the same as if you're actually having a conversation with residents in a hospital, that is other doctors.
That's not the tone of these YouTube videos.
No, that is true.
And I think here he could argue the defense.
Well, he's talking about when he does the interviews, right?
Not necessarily the YouTube short videos.
But I actually think he would meet with the right receptive audience.
He would meet the same point that like his tone there is.
Sure, it's not like formal, but it's trying to give accurate information about complex medical topics in an understandable way.
So I think you're right that there is a surprise.
Surprising lean towards more click-bitty content than you might expect given the way that he talks with Dr. Mike.
And similarly, we'll see if the way that he's talking here matches, like how careful he is when he's talking to people on stream.
But here he is also presenting that he's very careful about what he says.
You know, they don't say things out of hand.
Yeah, very careful to frame things appropriately and so on.
I guess the other aspect of this too is the, you know, it is flattering to the audience.
This isn't always a terrible thing, but it is something that we do see with some of the gurus that we have a problem with, which is that the impression is given that you are not speaking down to your audience, right?
You go straight into the very high-level ideas.
You know, Eric Weinstein will launch into a thing and Drop all of this extremely abstract physics.
You know, and it's flattering to the audience.
Same with Brett and Heather.
And I think that is at least part of the appeal there.
So, you know, I just noted that.
That's all.
Yeah.
Well, let's continue with the clips.
So, he talked about how he avoids getting in trouble.
And Dr. Mike pushes a little bit more.
What about when you're having conversations with a guest?
And I've struggled with this myself a lot.
I've had difficult conversations on this podcast where someone brings up either a past trauma or you could see that they want to talk about a past trauma.
And I get uncomfortable, and I'll explain what I mean by uncomfortable, that I don't want to become their doctor on camera, right?
So I know what next question my doctor mind wants to ask.
But I also need to be hyper-aware that I don't ask that question and become their doctor.
So how do you kind of ride that line and make sure you're doing this ethically?
Yeah, so it's a great question.
So I think we have a pretty rigorous informed consent process that not many people are aware of.
So, you know, most people will see like the final product, but we go through a rigorous informed consent process.
We also have like a boundary setting call before we meet someone or we offer a boundary setting call for anyone who wants to take advantage of it.
And that usually is a chance for people to say we don't want to talk about this or I do want to talk about this.
And I think the main thing to keep in mind is that if you think about your job as a physician, you know, the process of a diagnostic interview is very different.
So a rigorous informed consent process, Chris, this means that people...
Sign something or agree to something?
I believe so.
I believe there is a consent sheet that they're required to sign before taking part, saying that they understand it's not therapy, anything they don't want to comment on, or this kind of thing that they aren't obliged to.
And I'm sure there's stuff about terminating the interview and whatever, your usual ethics thing.
Dr. Mike raises the questions that people would have about, you know, well, if you're having an interview with someone in the public stream and people start talking about private and sensitive issues, you know, that would make me a little bit uneasy as a medical expert.
But how about you?
But Dr. K is quite clear.
No, it's not an issue.
We've got that covered.
Yep.
We have the form.
We have the form.
He's come across as at least having considered these issues, you know, like he's like, no, this is ethically fine because of X, Y, and Z. Yeah, because there's a consent process and because he says that the tenor of the conversation is not the same as one in which one was making like a diagnostic interview as you would with an actual client.
Yes.
Okay.
And he also wants to be clear that there are things which distinguish what he does from therapy for various reasons.
And we'll get into the legalistic arguments for this a bit more, but with Dr. Mikey offers this summary.
So you're usually thinking about what are the alternate diagnoses, you exclude certain kinds of things, you assess every patient.
So for example, like for psychiatric intakes, we assess for suicidality, homicidality, you know, psychotic symptoms.
So if you really look at the process of diagnosis, it's not just talking to someone about their life.
It's literally assessing for any number of conditions.
And I think that's where it gets a little bit tricky because talking to someone about their life, which is usually what we do, and then sometimes we'll also educate about conditions.
So there's absolutely like a concern there.
I think we try to get through it by using a rigorous informed consent process, really taking a more educational approach.
And it seems to have worked pretty well so far.
So, just bang the drum, consent, educational approach, you know, it's worked well.
Yeah, yeah.
It's an interesting, like, again, like, all of this comes back to this fuzzy boundary because you can say it's education, but if someone tells you, okay, I'm feeling very depressed with my life at the moment, feeling like life has no meaning, and then you say, and then you educate them by letting them know that The reason they're feeling they're depressed is because all depression stems from some trauma they've had in childhood.
And it's due to the fact that there's a misalignment between their doshas and their life choices or something or whatever.
And you could frame all of that as education if you wanted to, couldn't you?
Yeah.
And if you remember last time...
In this conversation with Dr. Mike, he kind of flipped things around right at the end by pointing out that Dr. Mike was being aggressive and kind of was closed-minded about Ayurveda, right?
And this worked later in the conversation.
There's a little bit of a similar move attempted here.
So Dr. Mike has been pushing Dr. K about the ethics of what he does on the stream.
And then Dr. K raises these points.
So part of what I think is really important is that if we sort of think about it and we think about the concept of mental health like equity, right?
So physical illness and mental illness should not be treated differently.
So a lot of people like would you be thinking that question if you were talking to someone about their experience of being a cancer survivor, right?
So we don't have those same We're open to discussing some of our struggles if people feel comfortable.
Of course.
And the whole point is I think that's the way we should be around mental illness, is that people should be able to discuss, hey, I struggled with this, I struggled with anxiety, I struggled with trauma, here's my story.
And then to also recognize that the practice of medicine is different from talking about your experience of life.
And so the North Star that we try to use is people should be able to come on and talk about whatever they feel comfortable talking about.
That we don't want to say, we don't want to put guardrails that, okay, you can talk about your difficulties at work, but the moment that you mention something that touches mental illness, we're actually going to muzzle you.
Because that's sort of what goes on right now.
And like, no wonder we have a stigma on mental illness when literally no one
So by suggesting that there's...
You know, ethical issues at play.
You're actually preventing people from addressing an important topic.
And aren't you, like, suggesting that mental health needs to be stigmatized and hidden by this line of questioning?
And it's not as strong as it is later, right?
Because at this stage, it's early in the interview.
But it's that framing of, well, this is about equity.
Are you against mental health equity, Ben?
There was an interesting little wriggle there because when he said equity, I thought equity in the way that people normally think about it, which is, you know, different people get treated equally.
But then he goes on to talk about equity as equity in terms of treating psychological issues on an equal par and in the same way as physical issues.
So that's an entirely different application of the word equity than what I've ever encountered.
Yeah, but one that would be effective if you are somebody that might be susceptible to somebody invoking rhetoric or invoking equity as a concept that you should be concerned about,
for example.
Yeah, yeah.
You can't be against equity, against all things.
Shouldn't we treat corporations the same as people?
That would be more equitable.
Shouldn't we?
Dr. Mike also gave good pushback here again about this particular point.
And by the way, I don't disagree with the notion of that it's important to break the stigma.
I'm kind of just playing devil's advocate or creating the conversation.
For the idea of talking about, let's say, cancer or heart attack in comparison to talking about mental health, On one hand, I see the value of that, right?
That we should treat mental health like a physical symptom.
Like, you have a broken bone, you need to go get it fixed.
The same way that if you have a mental health issue, you can get it fixed and talk about it.
But on the other hand, there's really subtle differences that are super important.
For example, if a primary care doctor who saw a patient in urgent care for a sore throat ends up dating that patient, there's less of an ethical dilemma than if a psychologist or psychiatrist ends up dating their patient.
Do you agree with that?
I don't know on a technical sense if I agree with that, but on a practical sense, sure.
I think there's a very different level of clinical relationship if you're evaluating a sore throat, which in a one-time clinical scenario, versus generally speaking if you look at a psychiatrist who...
Our therapist who has a long-term relationship with a patient, I think there's a big difference there.
Correct.
Correct.
Yeah.
No, you're right.
He does well there and he hones in on the key point, which is that in the kind of relationship that a therapist can have with a client that is experiencing psychological issues.
Then they are psychologically vulnerable and there is a kind of a...
Well, what's the word?
There is a dynamic there that should be kept separate from other things.
And when someone is talking about, oh, you know, yeah, I broke a bone or I had some sort of physical injury, I had cancer, now I'm getting better, then the doctor that's...
Treating you or the person that is counseling you about that, it's an entirely different thing.
You do not have the same level of psychological vulnerability and there isn't the same dynamic at play.
No, and there still is an issue.
There can be online streams with people.
private medical conditions and giving them all this health advice that is you know frankly often bullshit but yeah that still is you know putting them in a vulnerable position but dr mike is exactly right that you know somebody talking
about their personal trauma that has had a huge impact on their mental health or their family clinical history of depression or whatnot these are
More personal in a sense than talking about a family that has a history of cancer.
There's a clear distinction in a way because one is recognized to be like that it doesn't require, you know, apart from say Gabor Matei streaming, it doesn't relate to your character or anything to do with that or your personal experiences.
It can just purely be that's genetics or environmental.
You just got an illness.
But when it comes to mental illness, it depends on the mental illness, but there can be a lot more issues about privacy there because there is often more things involved with relationships,
with intimate...
Information and that kind of thing.
So, yeah, it just feels like Dr. K is trying to say, well, you wouldn't feel bad like talking about, you know, somebody got an infection.
But if it was an infection for a sexually transmitted disease, yes, people would be more concerned about talking publicly about it.
So he's like wanting, you know, to say, well, it should all be the same, but it obviously isn't all the same.
Yeah, yeah.
I think it's bound up with the fact that, like, psychological issues or relationship issues or, you know, like you said, like an intimate sexual issue or something like that, some kind of dysfunction.
Those sorts of things are bound up with our concept of ourselves.
They are kind of who we are.
And we can detach ourselves from saying, oh, yeah, you know, like, I broke my toe a few days ago, Chris.
I don't think I mentioned that to you.
All right?
No.
Shocking.
I'm always kicking it on things.
It's very annoying.
But, you know, like I'm detached from that.
That's an issue.
It's not really attached to my sense of self or who I am.
That would be very different if I was talking about some sort of sexual dysfunction I was having or something like that or some sort of deep-seated relationship issues that I've got with my parents or something like that.
Those are entirely different things.
I think need to be treated differently when you're talking about them publicly and they have different scope for, I think, talk therapy or just talking about it potentially causing complications, causing issues.
Yeah, so Dr. Mike pushed back there and actually in this whole section he pushes back quite a few times and hears him talking about Isn't the way that,
you know, you do interviews with people, isn't it like close to psychoanalysis?
And Dr. K responds in the way that you'll see.
I think they're more comparable, but still with mental health, I think in knowing the influence one can have with the power of words in an intimate setting, the mental health situation is still different.
Okay.
Do you feel like that's fair?
Yeah, I think it's very fair.
I think it's very fair.
Yeah, that's why, like, I don't know, like, when I watch your interview that you did with Graham Stephan and Jack, and I'm watching it, and there was, like, a section where you were doing some psychoanalysis of them, and I'm like, how do you do that?
Because, like, I wouldn't even feel comfortable discussing a sore throat on a topic.
Where's that line for you, basically, is my question.
Yeah, so if we look at what I did with Graham and Jack, so I wouldn't call that psychoanalysis.
So I think this is where a lot of people don't know what psychoanalysis is.
So he's referencing something that we actually played in the previous episode, where he started talking about the personality traits and the potential Ayurvedic classification of these two Like YouTube interviewer characters,
right?
Of a relatively superficial engagement with them.
So he's saying he wouldn't, you know, diagnose someone who he just met with like a sore throat, but you seem to be talking about their deepest personality traits very confidently.
And Dr. K is like, well, I wasn't diagnosing, right?
Let's be...
Yeah, that's right.
It might have sounded like diagnosis.
That's only because you don't understand what diagnosis is.
Diagnosis is completely different.
It might have sounded like psychoanalysis or whatever, but actually that's completely different.
But you are taking it on trust.
And, you know, I'm not a clinician, but I know people that are clinicians and I know a fair amount of the academic literature around clinical psychology.
And, yeah, I mean, I'm not quite sure.
Where is this bright line between what he's been doing?
Oh, Matt, Matt, I'm glad you asked.
So, first of all, I'm just going to play the clip of him talking to those two influencers so you can hear what he actually, you know, kind of did, right?
Just here's a little snippet of it.
We'll leave that without comment, and then we'll move to Dr. Mike's response about that and the issue of, like, what he was doing and what is the line.
You've been kind of more running the show than he has, right?
So you've been talking about meditation.
We're talking about this thing.
And oh, by the way, what do you think about this?
And if we go for 15 more minutes, your mind will jump to something else.
So my guess is that you get bored easily.
My guess is that you can dive into something for a long period of time, but then you may leave it alone for a little while or move on to something else.
So these are all consistent with vata, which means that your mind is like the wind.
It can blow really hard in one direction, and it'll blow hard in a different direction later.
So it's quite powerful, but it's not necessarily very consistent.
That doesn't mean that you can't consistently have a career.
It just means that the more variability that you have within your career, I think the more you will have your best mind.
Whereas if I told you, hey, you're going to work a nine-to-five job and you're going to climb the corporate ladder for a decade, he'd be better at it than you would.
I 100% agree with that.
Graham is extremely good at grinding.
Like putting his nose to something.
He's guffa, which is earth and water.
So stability, like low acceleration, high top speed.
High acceleration, low top speed.
That's really funny.
Interesting.
So we have this joke.
I'm the kite, he's the string.
Absolutely.
Yeah.
That's our joke.
He's the rock, you're the kite.
Yeah.
That makes complete sense.
That's very interesting.
So the cool thing about Ayurveda is that you're able to make these diagnoses because there's physical correlations with mental attributes.
So if you look at like the veins on the backs of your hands are going to be more visible than the veins on the backs of his hands.
He has a roundness to his face.
You have more angularity.
So what could you tell about that, about like facial structure?
So your face is round.
Right.
His is more angular.
Your nose is round.
His is more angular.
His ears stick out more.
My ears stick out more.
By the way, what do you think I am?
And so I want to know, maybe, for Graham, what would you say to somebody like Graham that thinks maybe something will Continually make them happy, but they continually find themselves in this lower vibrational state.
I would never say something to a person like that.
Why?
I would ask them questions.
So I think like there's like the fundamentals are different here.
So like you think he needs help, right?
And you've diagnosed some problem because you know him really well, right?
So you preface this with I've known you so far.
So you started out by stacking the deck of like, here's all the evidence for why my opinion is correct.
Right?
And then you said, this is what I've observed.
It's clear to me that you love the guy and that you want to help him and your heart is in the right place.
But if you kind of pay attention, how did he respond to what you said?
He combated it.
Absolutely.
Right?
Some of it I agreed with.
The stress I agree with.
Sure.
So you're self-aware and stuff like that, but affectively, like emotionally, like he did not like that, bro.
Like, y 'all can go back and watch the tape or just, like, watch.
There's a lot of good...
How did you feel about it?
I'm indifferent about it.
I think there's a healthy amount of, like, back and forth that Jack in a costume.
Oh, yeah.
Like, I was giving Jack crap for his haircut.
So it's, like, back and forth.
I totally agree that there's a lot of health here.
I'm not trying to create a mountain out of a molehill, but I saw something called micro-expressions.
Please, no.
Dive into it.
I love this.
I love this.
Okay, so there you go, Matt.
That's that.
Okay.
All right.
There we go.
All right.
So now, after that, Dr. Mike's kind of needling about this.
Specifically, I was pointing out certain dynamics that they have.
And I was talking about Ayurveda and a couple of these other like things.
And I was educating about that, using them as examples.
But if you look at that, you know, I'm not assessing them.
If you kind of think about that, let me put it this way.
Let's say that that is the interaction that I have with someone who is presumably a patient.
Would you consider that medical care?
Would you say that that is...
So if someone comes to you and that's the kind of interaction that you have, does that qualify as diagnosis or treatment in your book?
I think it partially is, yeah.
How so?
I think when you're getting a history of present illness from a mental health condition and as a trained individual in that area...
Asking questions about mental health and then giving your read on it is partially a history assessment, etc.
What would be the condition that you would say I was assessing for in that situation?
Personality disorder, potentially mood, asking those questions and then giving your read of it.
I think when you're interpreting what someone is saying from your state and they're looking for you to have the answers, I feel like, is that potentially making a diagnosis?
And maybe I'm wrong.
No, I think this is a fantastic conversation.
It's something I've thought about a lot, and I really appreciate your perspective.
So let's just think through that, right?
So here's the way that I think through it.
Oh, okay.
Once again, this is preempting stuff I think we're going to look at later on.
Dr. K is quite amazing in his instinct is always to lean into criticism.
So as soon as somebody starts to cut a little bit close to the bone, he's like, no, no, no, this is fantastic.
This is so good that we're digging into this.
I'm jived to be talking about this.
He only says that when things are getting a little bit close.
But I'm with Mike here.
Basically, if it looks like therapy, if it sounds like therapy, if it feels like you're giving a diagnosis, if the person...
Perceives you as being someone with authority and special knowledge that is able to advise them, and it looks like you're giving them advice about what they should be doing, then it is, for all intents and purposes, the conditions.
So, I don't really have much sympathy for Dr K's sort of legalistic denying that there's any issues there.
Well, here's his argument that he was about to, you know, respond, that he was so grateful to have the chance to outline why Dr. Mike is wrong.
Like, if I was precepting a medical student or resident, and they did what I did, and they said, I have assessed this person for a personality disorder, I would fail them.
Well, of course, that's why it's not complete.
Right?
But I think there's a difference, because if that is, if you're saying that this is not sufficient for a personality assessment, then it is also not sufficient.
For a personality assessment.
So if someone did that and they said, I assessed this person for a mood disorder, I was like, no, you didn't.
You didn't assess their sleep.
You didn't assess their anhedonia.
You didn't assess their guilt.
You didn't assess their energy levels.
You didn't assess their concentration, psychomotor, suicidality.
I didn't assess any of those things.
So if we really look at the – this is my read on it.
The technicality of what it means to do a diagnostic interview, right?
We have a – we literally have textbooks that say These are the questions that you should ask.
So the DSM-5 has sample, you know, algorithms for assessing diagnostic interviews.
And I think the big difference is if we sort of say, okay, what constitutes the practice of medicine?
Assessing someone for a mood disorder, if you do what I did and I bill an insurance company and I say I assessed you for a mood disorder, I could be sued for malpractice because I didn't actually assess for a mood disorder, right?
And so that's kind of the way that I think about it, is if we say assessing for a mood disorder or a personality disorder, and I'll get to your point because I think there's validity there.
If we say that this is what it is, did I do that?
And the answer is, in my opinion, no.
Therefore, I didn't do that.
Does that kind of make sense?
Yeah, that you're saying it's not complete, so that therefore it's not actually happening.
I would even say that it not only is it not complete, it's not like I did assess eight out of the nine criteria.
Usually speaking, I'll assess zero to one out of the nine criteria because I still won't do a clinical assessment.
Chris, let me check my understanding here because we've heard Dr. K do what can only be described as an extremely half-assed diagnosis of someone.
Say, oh, you know, within 30 seconds of them telling him.
Him about their problems.
This is all because you haven't got enough meaning in life or something.
So, undoubtedly, by his criteria, that is an incredibly poor kind of assessment that wouldn't be recognized as a good assessment in any rigorous clinical setting.
So, his argument there is because as long as he does very bad clinical work of a very low standard, Online, and it doesn't meet clinical criteria for rigor, then it's fine.
Is that the argument?
Yeah.
Well, we know, because he'll cover this in another episode that we'll look at various clips from, that he focuses on the kind of technical definitions.
You heard him there about the technicality of a diagnostic interview, you know, the DSMV-5 textbooks and the diagnostic criteria, right?
So if you're not taking, you know, if you're not following the diagnostic manual, you're not really doing appropriate diagnosis.
Like in a medical setting, that could be presented as malpractice if you don't follow, you know, the proper clinical procedure.
So obviously, Dan, what he's doing is not...
Clinical therapy, because it doesn't fit with those criteria.
But Dr. Mike is right in saying, well, right, but you can still be using the tools and techniques from clinical therapy and therapeutic settings, but not doing all of them,
or not adhering to the whole thing.
And he's saying, so if you're not doing it all, you're not doing it.
And Dr. K kind of responds to that saying, but no, look, I'm not even doing like a bit of it.
Maybe now is a good time after this to play some clips to show, you know, what happens in the interviews.
Because he's saying, you know, basically I'm hardly doing anything like that, right?
It's just a conversation we're having.
Yeah.
Okay.
All right.
I'll reserve my comment until after we've played those clips.
So here's a clip of him talking with the streamer, Rekful.
This is, I think, the first interview.
And very early into the interview, he brings up the issue about Rackville struggling with depression.
This is an issue that was well, he was well known as somebody that went through bouts of depression that had suffered with suicidal thoughts and had a family history of it, right?
But in any case, so here's the conversation with Rackville.
So tell me, what do you mean by depression?
Let's start there.
Well, I've been diagnosed with bipolar type 2. Ah.
And when I was six, my brother killed himself.
He also had it.
How old was he?
He was 21. Very big age gap.
Okay.
And then because of that, when I've gone to get treated, they can never give me SSRIs.
I've never tried an SSRI.
Because he's tried an SSRI, and then that's happened after.
Okay.
Prozac.
Okay.
Okay.
I've tried a couple things.
I was on a really high dose of lithium at one point.
How did that make you feel?
Very bland.
The same thing people always say, kind of dead.
Yeah.
Yeah.
And then...
God, I've tried a bunch of other ones, but they're not super memorable.
One of them gave me some eye pain, so I had to stop taking it because I was really sensitive to light.
Maybe you know which one I'm talking about.
Okay.
I don't know.
I tried a bunch of different ones.
This is like 14 years ago, most of it.
So now I don't really remember.
Okay, so to the untrained ear, Matt, that sounds like someone taking, not a completely deaf one, but a kind of medical history from...
Someone with some details.
So what I would get as a non-clinician from that conversation is family history of depression, close family member committed suicide, issues with medication, and so on and so forth.
And I'm not a trained psychiatrist, so this isn't the kind of conversation I usually get in with people or that I hear in any other...
So I guess Dr. K would be saying, well, this is, you know, what talking about mental health looks like.
But it does sound much closer to someone talking to a doctor about their experiences than someone talking to an interviewer.
Yeah, getting their medical history, finding out what medications they've been given, what they've been diagnosed with, you know, history of the illness in the family and so on.
So, yeah, so that is the tone.
I guess the point is, I mean, the most important point is how is it perceived by, in this case, Rickful, right?
How is it perceived by the person that he's talking to?
Yes, yes, that's true.
Though, just to give a little bit more of the flavor of that, so here's a bit more of that discussion.
So tell me what your experience of depression is.
Okay, it's very hard, very hard to explain.
The easiest way to explain is I've had years of my life like this where I wake up every day and I don't see a purpose to doing anything.
I don't see a purpose to getting out of bed.
I don't care if I stream or don't or if I go eat or don't.
At some point I get really hungry and I'm like, okay, I guess I have.
I feel like it forces me to kind of, you know?
Yeah.
But I don't really care one way or the other.
And then I start to think I don't care if I...
When I go to sleep, I don't care if I wake up.
I'd prefer not to.
Actually, the sleeping was the most peaceful part of my day.
Okay.
And how long would this stretch last?
Years.
With...
Okay.
I've had it since I was 14. And there's like 14 to 16. And then I remember when I found photography, I was like a little inspired for a little bit.
And then it went away and then maybe 17 to 20. Like it goes for years and then I'm happy for a little bit and then years and I'm happy for a little bit.
How long is your period of happiness?
My shot would know better than I do, but it's pretty short.
I don't know.
Like two months maybe?
Okay.
Yeah.
One of the ways you could tell a difference between a clinical conversation and a conversation you're just having with a friend is that it's generally not, it doesn't have reciprocity.
So when you're talking with a friend, you'll say, oh, I was feeling, you know, really down last week.
And you go, oh, no, that's terrible.
Yeah, I've had these problems too.
And the conversation shifts.
You talk about yourself.
The other person talks about them.
There's this sort of back and forth.
What you tend to see with a more clinical interview, as anyone knows who's gone to a GP, is that the GP isn't going, oh, you stubbed your toe.
Oh, I stubbed my toe last week.
Do you want to have a look?
No, no, they ask you questions about this, right?
And it's quite neutral and it's really an information gathering exercise.
That's what a clinical conversation looks like as opposed to, Yeah, and, you know, there is an issue about building rapport, right, because, like, doctors do tell you things just because they're humans, right, and also they want to build relationships with patients,
but they typically, as you say, are not divulging deeply personal elements of their life, especially not psychiatrists and psychologists, for obvious reasons, because that would kind of confuse the therapeutic.
And here, in this interview with Recville, Dr. K does talk a little bit about various things in his past, but it's mostly about gaming and some experiences he had and whatnot.
It is not this kind of openness about, you know, the history of mental health.
And also there, just a note, Matt, he asked how long was the duration of these episodes, right?
How long did they last for?
So you're getting history.
About depression and the experience of depression, but also some details about how long do these periods last?
Is this an episodic thing or is it a chronic thing, right?
This will be relevant later.
But on the back of that, just listen to this.
You hear about people like that?
Yeah, so I think this is a really common misconception.
I think you may have clinical depression, but I think what you're describing is not clinical depression.
So I'm going to explain to you guys what clinical depression is.
I think your problem is that your life is empty.
That's different.
And in fact, that's what we were going to talk to the other person about today, and we will.
So I got a bunch of questions about this because...
Wait, so you're saying you think I was diagnosed incorrectly when they said I have bipolar depression?
You may have depression on top of that, but what I want you to understand is that there are different flavors of depression.
One of them is a biological, organic, neurochemical kind of thing.
And what I'm hearing from – but there are certain features of that that you're not – you don't really fit that bill.
So I'm going to describe what that is.
So you may be depressed on top of being unhappy or having a life without you.
Okay.
Chris, is this education or is this a diagnosis?
He's saying your problem is that your life has no meaning.
That's the symptoms that you're describing.
Rekfel specifically says, because he says, you know, look, I don't think this is clinical depression.
And then when Rekfel says, you're saying I was diagnosed incorrectly, I don't have bipolar, he says, well, no, you might have.
I'm not saying no.
But, you know, biological depression has these kind of characteristics.
And what you're talking about, I don't think...
It really meets that.
So, like, what your real problem is, you might have depression, that's the same thing, but your other real issue is your life is empty.
And, like, this is a very short conversation to, one, raise doubts about somebody's clinical diagnosis, and two, to tell them that their life is empty.
And this is their fundamental problem, right?
This is a conversation of a couple of minutes.
It comes on the back of, you know, the kind of conversation that you would have with a clinician.
Yeah, yeah.
So Dr. K's defense, referring back to his conversation with Dr. Mike there, is that this couldn't possibly be a therapeutic interview because it's so half-assed.
No real therapist would, like, make a diagnosis within, you know, a couple of minutes of just starting to talk to somebody.
But for me, the key thing is...
How Recfall perceives it, right?
So, if he perceives it as he's talking to a credentialed psychiatrist, this psychiatrist has been asking him probing questions about his medical history and has been asking him questions about the issues in the family, what medications he's been given and so on,
has heard about the symptoms and now has told him what his problem is.
And clearly, by his response there, he's saying, wait, you're saying this?
That's the issue.
That's what causes the ethical issues, right?
Like, you can't go off and swindle somebody, pretend to be an accountant, and then take all their receipts and throw them down the drain and then tell them that their accounts are, you know, they need to buy gold and Bitcoin and say, well, no, I wasn't doing accountancy because no accountant would ever do that,
right?
Like, the important thing is that the person that you've been interacting with...
You've given them the strong impression that you are a responsible accountant.
Well, this is why this relationship with Rackville ends up quite fraught, because there are points where Rackville refers to what they're doing as therapy and Dr. Kez as therapist, and then, you know, does air quotes and all this kind of thing.
I don't like to be in detention so much.
Beautiful.
Yeah, so I'm in detention of, is he going to be my therapist?
Or are we going to be friends?
Because he said if he's my therapist, we can never travel together anywhere.
It changes how it is.
I was thinking it'd be cool to go to Japan with Dr. K. That sounds nice.
That would feel nice.
Just see how he experiences things and have fun.
I don't know.
Actually, I really want a friend.
I'm thinking longer term.
I'll have friends.
So what I need is a therapist, maybe.
Yeah, so I think rather than resolve that issue, Recful, I think the important thing is that you said something really, really beautiful, right?
Which is that you do not like the tension.
But then Dr. K also in later streams will correct him that, you know, we're not doing therapy here, right?
Okay, I want to update the viewers on what happened off stream because they missed one therapy session.
That isn't therapy.
It's not therapy, right?
So that's actually what we talked about, right?
You know this.
So there is this blurring of boundaries.
And there's even a case later where Dr. K says that what Recful is suffering from this clinicalness can be cured if someone is willing to love him unconditionally for two years.
And Dr. K is willing to do that.
So, Recful, I am confident in...
Okay.
I'm confident there's going to be someone around in your life who will be there for you most of the time when you need them, hopefully, for at least a period of two years.
Okay.
How can I be confident in that?
How can you be confident?
Yeah.
Well, you probably...
You find me simulating a talk to and I'm not demanding too much of your time or spamming you.
With walls of text.
And even if I were, you'd feel inclined to answer me because you love helping people.
It's your passion.
So from your perspective, maybe you can feel confident.
But then if you put yourself in the shoes of any other human being, I don't know that they'll really spend two years with me unless there's...
So Rekful, I'm not counting on them to spend two years with you.
What are you counting on?
I'm counting on myself.
Oh, that you'll spend two years with me.
Yeah, that I believe.
That I can believe.
So I can't trust any of them.
True.
It's nice having someone to come to every week like this.
I'm going to try to love you for two years.
At a minimum.
I really appreciate it.
*cough* *cough* *cough* *cough* Thank you.
He then does another conversation shortly after that, a few days later, taking that back and saying what he said was hasty and that he shouldn't have said that and it was, you know, irresponsible to say that.
But that whole thing happening is only happening because this conversation is not a normal conversation, right?
Yes, I was crying.
I said my piece.
He was saying that he wanted to be there for me for the next two years, but the problem is that he kind of said it in a flurry of emotion.
I don't know if flurry is a good word.
While streaming, he was getting emotional himself.
He wanted to be there for me, so he said it, but he hadn't actually thought it through and what that entails because he is not a licensed therapist in Texas and just a lot of things.
You'd have to live in Texas.
To be my therapist in Texas.
Is that how it works?
Yeah.
So we also did talk about, you know, whether you want me to be your actual therapist and what that would entail.
And the other thing is that bit of research, which is important to remember, is that the research on people on BPD, it's two years of someone who's actually a romantic partner.
So it's unclear whether a friend...
So yeah, I need to get in a relationship with a girl for two years and have it actually work out.
And that might cure my BPD.
It's a...
Barrier-crossing, blurring conversation.
And this is the worst one, especially because the outcome ends up that wrecked after the series of conversations, but not immediately.
Four or five months later, killed himself.
And I think it's very important to note that it's very likely that there's a host of other factors that could have played into it that, you know, this conversation could have...
Like, had nothing to do with the motivation at the final end, right?
Like, he had a history of suicide attempts.
He had long-term depression, had a family history of suicide.
And so, you know, it's tragic, but it doesn't have to be Dr. K's fault for there to be significant ethical issues with what he did and what he perhaps...
continues to do, but maybe not to the same extent, because like, I think that this is a particularly extreme example.
Dr. K does continue in this vein,
Yeah, one suspects that Dr. K learned a lesson there.
And yeah, I think it is fair to say that Most of his broadcast pseudotherapy sessions are with other influencers and streamers and personalities who are not suffering from serious and life-threatening issues.
So, yeah.
Well, so just to carry on a little bit, Dr. K goes on to talk about Maslow's hierarchy of needs, which I know you are big into, Matt.
But I think that this is like...
Your problem is that you're at the top of Maslow's hierarchy of needs.
Are you familiar with that?
No.
Okay.
So Maslow basically said we have a hierarchy of needs.
That at the bottom we need food and shelter and then we need community and all that kind of stuff.
And at the very top is something called self-actualization.
That at the end of the day we have a need to become fully actualized human beings who derive...
I mean it's a need for us to feel like we're accomplishing what we put our mind to.
Okay.
And so I think what you are is unfulfilled.
And that you've probably been inappropriate, insufficiently challenged since you were a teenager.
And that life has not, like, given you anything that was worth fighting for.
That it's just, like, it's been, like, easy mode.
Now, you may be depressed on top of that, so let's talk about that for a second.
So clinical depression is an episodic illness.
That's the first thing to understand.
So major depressive disorder or bipolar disorder is episodic, which means that for periods of time you're well, and then you enter a period of depression, which lasts two weeks to about one year, maybe a little bit over a year, and that you have a period of like,
and then it sort of naturally gets better.
Oh, now one thing, now I'm worried that what if I incorrectly remembered my...
What passed when saying I've gone years of being unhappy.
That's very possible.
Now I'm getting misdiagnosed.
No, no.
Maybe I haven't gone years.
Maybe it's been one year.
Sure.
So that's possible.
So like I said, I don't think that...
How long would the happy periods be?
It depends on the person.
But generally speaking, I'm looking for a few months to a year to even over a year.
So there, Matt.
Self-actualization rears its head again, right?
We'll never escape it in these waters.
But so Dr. K starts explaining, right, look, clinical depression and bipolar disorder is episodic.
It shouldn't be lasting for multiple years, right?
So that means, and then Rackville is like, whoa, maybe, you know, maybe I'm misremembering the time period and now I'm being misdiagnosed because I'm giving you You know, the inaccurate information.
And Dr. K doesn't stop him and say, no, no, no, I'm not diagnosing you.
This is a conversation.
Like, stop.
You're getting the wrong impression.
He says, no, no, no.
It's probable that you're not remembering it.
And, you know, and starts talking about the duration that it would be this kind of long time with this month.
So, again, what happened to...
I never talk about...
Diagnosis or, you know, this kind of thing.
Like, as you said, Reckful's impression here is clearly that there is some diagnosis going on and that it's important that he gives accurate information because then the particular disorder that he be identified with is wrong.
And this is not the thing that you worry about with, you know, someone that you're having a casual conversation with about mental health.
Yeah, exactly.
And it goes to my point, which is...
The key thing is not whether or not Dr. K is satisfying some legalistic definition or whether he's jumping through the hoops of the DSM-5.
The key thing is how he's perceived by the person that he's talking to.
And if the person that he's talking to perceives him and is relating to him and taking his advice as a professional, then there are serious issues.
And just to quibble there, Chris, he just blithely says, no, no, depressive disorder is an episodic thing, lasts for a couple of weeks and then goes away again.
No, no, no.
There are other forms of depression.
It's true.
Major depression tends to run like that, but there are persistent forms that can last for longer.
And it just feels incredibly cavalier to me to just, after talking to someone for a matter of minutes.
A couple of minutes.
Yeah, to just go, no, no, no, you don't have depression.
You know what I mean?
Can't be, because what you're describing has been lasting for a really long time.
And what you lack is meaning and purpose in your life.
But what Dr. K would say in response to that is he didn't say he didn't have depression.
He said you might have depression.
But I'm seeing a more fundamental issue.
He was very clear at one point, like he's not...
Ruling out depression, right?
But then he is going on to explain why it doesn't fit the criteria for the kind of depression.
So, yeah.
And so what he is talking about, Matt, which, again, will be so familiar to anybody that's about time in, like, self-help, wellness, or alternative medicine spaces, is, like, the issue is a lack of meaning, of challenge.
And he implies that, like, Rackville is so good.
That his life has been without challenge, right?
Like he's kind of eased everything since he was a teenager.
So this has left him with a feeling of, you know, life being meaningless because he hasn't been challenged enough.
Yes.
Yeah.
And this is what Dr. K clearly wants to focus on, right?
Because then you can start to talk about how to generate meaning and what, you know, purpose is.
But this is why I had to seize upon his Blythe dismissal of the depression issue as being just purely an episodic thing and discounting the...
Or biological.
Yeah, like chronic and persistent forms of it.
He discounts that very quickly because it's very clear what he wants to move to, which is, oh, no, no, you don't have a disorder.
Because he wants to talk about meaning and purpose and being challenged and stuff like that.
So that's what he wants to talk about.
Yeah, so that's just a dangerous thing to do with someone that is clinically ill.
Oh, yeah.
Well, let's stick with this a little bit more.
So here's where this leads to next.
So we're going to talk more about how you were insufficiently challenged, because I still think that's your problem, but we'll get to that.
So tell me a little bit about...
So it doesn't sound like...
I'm not hearing anything about depression when you were in high school.
You said 14, but you're not describing anything to me that way.
Oh, yeah.
No, because it's hard for me to really dig deep and remember.
I mean, I listen...
Okay, I remember I listened to a lot of sad music.
I was idolizing a lot of people who killed...
Listen, I was idolizing a lot of people who killed themselves at the time because I was listening to Nirvana and then Elliot Smith and then, I don't know, a bunch of other...
I can't remember.
I mean, it sounds like you were...
Yeah, it could be.
But the lyrics were very relatable to me.
Okay.
What was relatable about the lyrics?
I guess just this overall lack of purpose and meaning.
I feel like I'm not doing justice to my own life, to my own memories.
I can't remember exactly.
Well, you're not going to be able to.
Right?
So I'm kind of digging around and you're not expected, like, I don't remember much about when I was 14. Like, you know, people don't really remember much about when they're 14. And that's okay.
It's just, I'm trying to figure out where the money is.
And it's sounding like it's not...
So, Matt, just to say here, okay, like, if I...
Talking to someone and explaining everything that Breckfell has said about his history and his family history.
And then he told me when he was a teenager that he idolized people that killed themselves and listened to depressing grunge music.
My picture here is of someone that has a persistent long-term problem with suicide in particular.
And yes, people are goths and that kind of thing.
This is a goth where their family member killed themselves and they're no longer a 15-year-old goth.
They're, you know, talking about something 10 or 15 years later and they're still persistently feeling depressed and lack of motivation and all that kind of thing.
Like, this sounds like a problem.
And Dr. K is saying, you know, I'm digging around to find the money.
And like, in a therapy session, this would be a reasonable thing to do.
Digging around in someone's past to try and find the trauma or whatnot.
But you have to remember the context here is there are thousands of people watching this stream while he digs into the depressive past of someone.
It just strikes me as I would feel the need here as a non-clinician to tread extremely lightly with this person.
Well, given everything that he said up to this point in the interview, yeah.
The history of the family members committing suicide, all of this treatment, all of the symptoms he described.
What he described as a youth is not a fashion statement, which is how Dr. K implies it is.
Yeah, he didn't really respond to that.
He's incredibly dismissive of the idea that this guy is ill.
He wants to talk about meaning and being challenged and stuff like that.
Really, anyone...
This is just my genuine feeling.
I feel like any responsible professional who'd heard all of those things would have stopped the recording and, you know, taken steps to have this person get actual concrete help and certainly not release this thing.
That's just my opinion.
Well, but the problem is this is live.
This is all live.
Right.
Yeah, so it continues.
And, like, if all of this wasn't worrying enough...
When I was 16, I tried to kill myself.
When I was 16, I took 22 sleeping pills and I drank a bottle of wine and I tied a plastic bag over my head and I fell asleep and I woke up later and I had ripped the bag off my head and I was alive.
What were you going to ask?
Do you remember what you were feeling when you tried to kill yourself?
He was really dumb.
There was a game I was playing called Asheron's Call from when I was 10 to when I was 16. And then that game was no longer popular.
No one was playing it.
And I had no one to play with.
And he goes on to explain this being the cause.
But there as well, Matt, you heard the little live chat chime.
I think it's someone donating money or whatever, right?
When, Dr. Cass, do you remember what you were feeling when you were trying to kill yourself?
Yeah.
You know?
Yeah.
Yeah.
I mean, and also, just again, returning to the tone of the conversation, like imagine if you and I were having a deep and meaningful chat, Chris, which hopefully will never happen, but if it did, right?
And I said, Chris, I tried to kill myself when I was 16. I tied a plastic bag over my head and so on.
And you went, right?
Okay.
And what were you thinking?
You know, like that tone, that's not...
That's clinical.
No, it's not uncaring, right?
Because that is like what a clinician would do, right?
Like if you were talking to a therapist, yeah, and they said, you know, like, yeah, if you told them some traumatic, and I was sexually abused by my caretaker, right?
They would respond probably by saying, you know, I'm sorry to hear that.
And like, how did that...
Right.
They're not going to react by going, fucking hell!
That's awful.
Yeah.
I'm like, I'm so sorry.
Yeah, exactly.
Yeah.
And, you know, all of that stuff matters because it contributes to how the interaction is perceived by the client slash interviewee, which is wreckful in this case.
Yeah.
And, you know, as we've seen with the Ayurvedic stuff, Dr. K has a very heavy interpretive frame that he brings the conversations.
And yes, he's the expert here, so you would expect that.
But like when you've had 15 minutes with someone or 20 minutes, you're a very thin slice of information about them, right?
So to get...
Deep into, well, you are like this or whatever.
It's akin to a psychic, in a way.
Like saying, right, well, I know what your problem is after, you know, 10 minutes.
Maybe, maybe there's signs that you recognize from your, you know, clinical years of clinical practice.
But if anybody is coming to diagnose you in about, you know, a space of 15 minutes for some severe mental issue and the cause of it, that should be warning flags.
Right. And so he mentioned this game that he played and again, Matt, here, a game stopping popular.
So his response was to attempt to kill himself.
That's a seriously depressed person with not logical reasoning.
Maybe logical reasoning is the wrong way to put it, but that's somebody reacting in a way that...
The majority of people would not do that stimulus, right?
And Dr. K continues.
Yeah.
Great.
I mean, not great, but I think I'm starting to see a pattern.
Okay.
Great, great is a funny response.
Great.
Okay.
So let's just think about that for a second, Reckful.
Let's think about that, right?
Yeah.
What do you think was going on in your head there?
So I think now that you're leading me to the answer, but the astronauts call was giving me fulfillment and, you know, a place to try as hard as I could and be competitive and whatever and meet friends and all these things, all these natural human desires.
Was it hard?
It was hard.
Yeah.
Yeah.
And then then it went away and I didn't have that anymore and I was unfulfilled.
Uh huh.
And then when did you get your camera?
It was around a little after that.
Yep.
Yeah, around, yeah.
And then I started, like, photography.
So, tell me about the photography.
The bit at the start there, by the way, Matt, was Wreckville got emotional when Dr. K talked about, like, he kind of pushed a bit more about why he felt sad when the game stopped.
And he said it was the only thing I cared about, the only thing I practiced my whole life and I really loved and it was now irrelevant.
And then he starts to break down, which is what you heard, like that kind of response at the start.
And then Dr. K goes on to, you know, talk about, you know, what was going on there, but then moves back to the camera.
Like, when did you get your...
And this is in reference to Rexville saying that, like, he was depressed, but then he got into photography, and then he was okay for a couple of years, and then Dr. K has a thesis on that.
But he, just to be clear, he hasn't heard this detailed information about, you know, the history of photography or whatever.
It's been a brief mention that, you know, he got into photography.
Yeah, and that helped them.
Well, so hold on.
Let's talk about this.
So I think you're on to something, but that your solution is half correct.
So why do you think it is that photography, like, do you remember when you started doing photography?
Like, how old were you?
I was 16. My dad bought me a camera for my birthday.
And I remember taking a bunch of pictures, a film camera.
And then when I got it developed, I looked at him and I was like, oh, I really like this.
This is fun.
And that's it.
Nothing more to it than that.
And then Dr. K talks about this.
So, Rackville mentioned that he won an award as a teenager for a photo...
He got put into an exhibit.
And Dr. K thinks this is very important.
So, tell me about the photography.
It's really hard.
When it's about artistic things, I can't remember the feeling and why.
I don't know.
But I took pictures for a while and then...
My parents took me on a trip to Europe to show me where they used to live in Switzerland and neighboring countries.
I took a lot of pictures there and I came back and I got a bunch of my pictures printed out and then I walked around South Hollywood and like into art galleries and showed them my pictures and one of them put my pictures up in the gallery and then I remember feeling good that that happened.
And when did the depression come back after the pictures?
Thank you.
Could have been around the time with the gallery, because everyone liked other people's pictures way more than mine.
So, Dr. K's thesis is like, Reckful is so good at, you know, naturally gifted individual, and he was very good at...
photography and he was rewarded by his photography being displayed in an exhibit.
So this kind of made him feel like he'd won the game.
I mean, life went back to being born because there's
I think the thing that the reason that photography may have lost its interest is...
This is going to sound really bizarre.
It's not because other people's photography was better than yours, because something tells me that when someone is better than you at something, that actually pulls you out of your shell.
Oh, I actually want to try.
It's a drive, yeah.
What happened, your fucking problem was that you were young.
You were how old?
16. And someone put up your artwork in a gallery in Hollywood.
And that means you won the game.
That doesn't mean you lost.
That means you fucking won.
Okay.
I didn't feel like I won, but yeah, okay.
Yeah, I know you didn't.
But I think the real problem there, because it's weird, right?
Like you would think that...
I won!
You would think...
So we have to just understand that like we would think certain things, but we have to look at the data of your life and interpret it.
What was disappointing, what got you out of photography or when it lost its luster was actually at the height of your career.
And you could have kept going.
This is the issue, like a lack of challenge.
But you heard that Reckfold said, well, you know, I didn't feel like I wanted.
But that's not Dr. K's thesis, right?
So he says, even when you feel it doesn't match, like, you know, we have to look at the data of your life and see, you know, the patterns that are there.
But he only knows the absolute bare bones of our Reckfolds.
And now he's interpreting the patterns, you know, in a way that overrides what Grekfeld's reaction is to the description.
Yeah, yeah.
Just can't emphasize enough just how little information Dr. K is going on here.
It's a very short conversation, a very brief mention of buying a camera and getting into photography and the game Asheron's Call, is it?
And from that, Dr. K immediately moves.
To his grand thesis, which is that what Reckful's real problem is, is that he's not challenged enough when he gets to a point where he's no longer any hills to climb or whatever.
He gets that success, then he's not challenged and life loses all meaning for him.
And in a way, this fits his defense with Dr. Mike, because it's true.
Like, no professional therapy should ever look like this, right?
But...
The issue is the confidence and the degree of surety with which Dr. K is diagnosing it and telling Rekful what his problem is.
He's figured it out.
He's the psychiatrist.
He knows all of the theory.
And so you can see that this does have an impact and an impact where Rekful agrees.
Maybe this is it.
Maybe this is the thing.
So listen to this.
And the thing, Rekful, is that you don't like being yourself.
And so when you can pull yourself out of being yourself...
It's true!
It's an amazing feeling.
Because you don't have to be wreckful.
Right?
Because wreckful's life isn't worth living.
Like, you can wake up today and you can eat or not eat, but who the fuck cares?
It's just wreckful's life.
But when you're doing photography, you're like, you're not wreckful anymore.
Right?
You're like taking a picture.
You become kind of like one with the picture.
And then the problem is, like, once you get good at that, then you're, like, back to being wreckful.
Like, you've conquered that.
And so you're like, okay, well, now what?
Yeah.
I mean, Chris, this should come across to everyone as disturbing to listen to.
Mainly wreckful's responses.
Yeah, emotional breakdown.
Yeah, yeah.
And it happens quite a few times.
And Dr. K blithely moves on with his extrapolations.
Yeah, it's not pleasant to listen to.
No, and so there's...
Rackville is talking about making a game.
I mean, his motivation is, you know, initially that he says it just wants to make, like, a good game, and that's what he thought it's about.
Yeah.
I know I always wanted to make a game, for sure.
When I started playing an MMO when I was 10, it was because Gary wanted to make a Pokemon MMO.
And we were doing research on other MMOs, and then I ended up playing it for six, seven years from 1999.
So it's kind of funny.
I always thought it was a cool idea to make a game.
I started streaming on Twitch because some game company made a game called Forge and said that if I advertise their game, I could work for them or something or help design the game.
That, you know, their game didn't succeed, so they never hired me.
And then now I finally can make my own game, just, you know, because I was streaming for a long time and couldn't fund it.
But Dr. K says, you know, no, it's about giving people the purpose that you lacked.
And in interpreting his project like this, he again gets an emotional reaction.
What do you like about what you're doing?
I like that I'm trying to give people something I wanted as a kid.
Who is the focus on?
Who are you thinking about?
Just people haven't experienced what I did.
Yeah.
So I'll tell you, Rekful, listen carefully now.
Your depression, you're trying to cure the depression that is growing within kids out there today.
You're trying to protect them from what happened to you.
Yeah.
That, how does that feel?
That feels good.
Yeah.
Feels meaningful, yeah.
Good is an understatement.
It's the understatement of the fucking year.
It is vital.
It is crucial.
You must do this thing.
I agree with you, yeah.
Yeah.
I think it's the fucking understatement of the year when you say, yeah, it's like it gives me a reason to wake up in the morning.
Like, no, this is dharma.
I've talked about dharma.
You may not know what I'm talking about.
People who watch regularly.
This is dharma.
You guys are seeing it.
Right?
Oh, yeah.
One thing to mention is that actually, Reckfeld does raise this kind of interpretation in a way, like in a less emphasized way about, you know, his motivation being to give something that he would have liked when he was younger or whatnot.
So it isn't that Dr. K fabricates it out of nothing, but it's more that he spins a very elaborate interpretive web from a fairly...
Kind of throwaway comment, right?
This leads to elaborate interpretation.
But I do just want to say that, like, Rackville did bring up that point first.
So it isn't invented from whole cloth.
Just giving credit.
Okay.
So one thing to note here is that from these competitions and whatnot, Rackville felt that he was getting help, right?
Explained that and that he felt better after them.
And maybe he did.
I have no idea about the impact this had on him overall.
But regardless, you can hear him emotionally breaking down on the stream here.
And Dr. K is giving him this narrative about what the game means.
And that already seems to be a dangerous thing to do, to tell somebody...
Prone to over-interpreting things, that this is your life's purpose.
Because he told Dr. K earlier that he attempted suicide over a computer game.
And now Dr. K is telling him that finishing this game, completing, is the most important thing and everything depends on it.
And, you know, I just want to remind people that, you know, as you said before, this is a live stream.
There are people donating money to Dr. K live.
And this is monetized.
This is entertainment for the vast majority of people listening.
Yeah, this would be so different as a private conversation because there you could take issue with Dr. K's interpretation, but the issue is it's about that person, right?
It's solely about that person and the relationship you're having with them.
And you could say, well, this therapist gave bad advice or whatever, but the point was the...
The therapeutic encounter.
In this case, Dr. K is clear, this isn't therapy.
Remember, he said that's not therapy.
It's just a conversation with someone about mental health and, you know, educational things.
Is that what this sounds like?
Is this how you talk with residents?
No, it is not.
So this is why people were finding this to be something they've never seen before.
Yeah, look, Chris, I mean, look, absolutely.
It presents a massive conflict of interest, right?
Because Dr. K may well be this shittier therapist in private practice, right?
You know, they're a good therapist, a bad therapist, you know, who knows what goes on.
But the important thing, as you said, is that in that relationship, the therapist is getting paid to help that person, right?
That is the function of the interaction.
Maybe they do a good job, maybe they do a bad job, but that's their only incentive.
It's very different when you're broadcasting a live stream that is being monetized because then your incentive is entirely different.
It has nothing to do with, regardless of what Dr. K says, the financial incentives have nothing to do with helping the person in question.
That's the issue.
Again, I have to say, like, I don't like these clips, right, because they're showing somebody emotionally unstable and vulnerable.
But I think they're important to play to show, like, why it is that he got...
Why it's a problem.
Yeah, this is the thing that...
Yeah, it ends up with the official reprimand, right?
And we'll get to Dr. K's response about the reprimand, but this is talking a bit more about the video game and Rekful, like, the meaning that is invested in it and whatnot.
I don't think you're talking about playing a fucking video game.
I think you're talking about being alone.
I think you're talking about being abandoned.
And you don't want people to feel the way that you felt.
And so you're trying to make the world a better place.
Thank you.
Maybe.
What are you feeling right now?
I don't know.
It's just happening automatically.
Yeah.
I'm not thinking anything.
Take a moment.
It's nice to feel something.
Yeah.
It's kind of weird, right?
Because you're crying.
So most people associate that as like a thing that they don't want to feel.
No, I liked it.
Yeah.
How do you feel?
What do you feel in your body?
I feel like in my body.
I don't know how to describe it.
I don't know.
I feel like I just passed something.
Yeah.
Kind of hopeful, I guess?
Yeah.
In the future, maybe?
I imagine you feel a little bit lighter.
But what we can call it is leveling up.
A little bit.
You just leveled up.
Leveling up.
Yeah.
Okay.
So you can see, Matt, that like Dr. K is regarding this as like positive development, you know, helping Recful.
He's like getting to the bottom of all of these serious issues.
And yes, emotion is coming out, but that's just what happens, right?
But again, is that what happens in informal conversations with people?
Have I ever cried?
There's very few people I've cried.
Yeah, I mean, like, I feel incredibly uncomfortable, even us playing these clips secondhand.
I felt like, like you said, we need to because you need to document what the process is here and what the issues are with it.
I mean, Dr. K would have that this is a wonderful moment.
They're breaking through.
They're finding new insights.
Rick Fuller is discovering things about himself and moving on to the next level.
What I see is someone who's extremely socially competent and pretty manipulative playing around.
With someone who's incredibly vulnerable and in serious trouble.
And it's all being done in public for entertainment and monetized.
That's what I see, Chris.
Yeah, I can see that rating, though.
I think my perspective is actually slightly less cynical because I think Dr. K fully believes his self-story about him as a...
You know, this kind of unique fusion of Western and Eastern perspectives that is able to, like, get to the heart of people's problems effectively, right?
Because he's a good goddamn therapist, right?
So I don't think he regards this as, you know, like, not serious or plain, but he regards it as this is him showing.
Like, so when he's talking about, like, he wants to educate people about mental health, I think he does.
See this?
The way that he describes it, like, this is telling people about the proper way to process things and all that kind of stuff.
So, like, basically I'm saying, I think he buys a lot of his own self-narrative.
And his self-narrative is that he's helping Wreckful and, like, helping to resolve these, or at least identify, these deep-sated issues.
Well, you could be right.
I mean, I'm sure Tim Paul sees himself as an independent truth seeker, telling it like it is and not in the pay of the Russian government.
I'm sure Brett Weinstein sees himself as a very serious evolutionary biologist.
I don't really care, but, you know.
Well, I can put a tick in your corner.
So, Wreckful goes off the stream to go pee or something, you know, when they decide to take a break.
And Dr. K interacts with Wreckful's chat.
So listen to how he talks when Rackville is gone, like what he decides to focus on talking to the chat about.
If you guys want a Harvard, Andy, I trained at Harvard Medical School and I'm faculty at Harvard Medical School, which a lot of people seem to get a kick out of.
And my main area of interest until about one year ago was incorporating like Eastern medicine.
Like, Eastern ideas and philosophy.
So studying a lot of, like, yoga and meditation and Buddhism, Hinduism, some of the more esoteric spiritual practices as well, into mental health treatment.
And my experience has been that, like, our Western understanding of mental health is just woefully incomplete.
And there are a lot of reasons for that.
And I've had a lot of success through helping people kind of like Reckful by sort of getting to some root issues, which is what...
The Eastern system kind of conceptualizes.
Western medicine thinks about depression as something that you just treat with an SSRI.
You just give them medication, and you do some therapy, and then it's just a disease that you live with for the rest of your life.
There's this idea in Western medicine that once you get diagnosed with depression, you have depression your entire life.
I don't believe that.
I mean, I think some people do.
But in my experience, I've had some people in my practice who have had bipolar disorder who, like, are off of medications.
And they have these sort of really powerful spiritual or psychological experiences that really get to the root of where their illness comes from.
And by getting to that root, you can actually like have someone have a transformative experience, which is what I believe.
And in Rackville's case, I think that...
You know, he may fit criteria for bipolar disorder type 2. He gets interrupted because Ragpo, you know, comes back.
But so there you had so many classic things from the last episode as well, right?
Dr. K is fusing Eastern spirituality with Western science.
In that equation, Western science is coming out much worse, right?
As we saw last time, he's fixing the deficiencies because Western medicine is just about giving people like SSRIs without actually dealing.
It says when you've got a disease, you've got it for your whole life.
There's no actual cure.
It's just managing symptoms.
And like in his experience, even people who have had bipolar disorder and they're off their medications, that's when they can have transformative...
Spiritual experiences that help them resolve the root issues.
Like, that's something Andy got in the mention about, you know, his Harvard edgy.
Some people get a kick out of him being Harvard medical staff, you know.
That's right.
This is just a conversation between people.
It's not a professional dealing with him, but it is worth reminding people about his qualifications.
And he does emphasize that he's helping Redfall right now by getting to what he sees as the really root issues.
But again, it's not...
It's not clinical therapy of any kind.
That's just what he's doing.
And you saw, again, how at the beginning there, he very quickly sort of dismissed those clinical diagnoses.
You know, what you don't have is clinical depression because you don't fit the description.
What you really lack is, you know, meaning, being challenged, whatever.
So, like, he's fitting Rekful in to his grand theory of esoteric, cosmic...
I think it's the fucking understatement of the year when you say, yeah, it gives me a reason to wake up in the morning.
Like, no, this is dharma.
I've talked about dharma.
You may not know what I'm talking about, people who watch regularly.
This is dharma.
You guys are seeing it.
Right?
This is duty or responsibility.
It's not something that you're doing.
This is the other thing.
The really powerful thing about this, and we'll get to the roots of your depression.
The really powerful thing about this is that you're not thinking about yourself anymore.
I don't know.
I'd like to feel selfless like that, but I don't know that it's true.
You know, I'd like that thought.
We'll get to how you're thinking about yourself.
So I think now we also understand the roots of your depression.
Rick Foley plays a part.
And yeah, it just gets to the real ethical...
It's about his brand and it's about the audience.
He's not helping Rackfall.
This is one of the last steps from this where there's an emotional aspect to it.
Again, just look at the questions and think, is this therapeutic or not?
Is this like a normal conversation about mental health?
Let's see.
Yeah, so I mean, this is going to sound like kind of a weird question, maybe a leading question, but I can see a certain beautiful purpose with five-year-old you in your life.
Right?
Like, what was your purpose?
Five-year-old me?
Yeah.
What was five-year-old you's purpose?
Fuck, I don't know.
I just wanted to play.
I wanted to be as good as my brothers to play games with them.
Something, I think.
Yeah, right?
It's like simple, but it was pure and it was simple and it was absolutely there, right?
Like, you were excited about that.
Like, that's what you lived for.
Like, you came home, and you would, like, watch them play?
Yeah.
Yeah, it's simple, yeah.
I fucking came out of nowhere, sorry.
Yeah.
That's okay.
What are you feeling now?
I don't know, it just happens automatically.
That's really fucking painful.
Like, I don't know, just...
He's talking about one of his brothers committed suicide, right?
His memories of them and about what he wanted to do when he was a five-year-old and just played games and all this.
And he's already been distraught or emotionally vulnerable during the episode.
So talking about that topic already that's needling or you can say digging, getting to the root issue.
But his response is showing he's emotionally vulnerable and then Just that therapist speech of, so how does that make you feel?
What are you feeling now?
And like, I just, I know that's what therapists say, right?
I know in a therapeutic setting, that might be a reasonable thing to say, so why are you crying now?
Or that kind of thing.
But just in this setting, it just feels like...
Exploitative.
Yeah, exploitive.
Like, tell me why you're fucking breaking down on stream.
Yeah, it's been a few weeks since we listened to the full recording and listen to these clips again now.
Sorry, it's making me incredibly angry.
It really pisses me off.
This is, yeah, not good.
Yeah, and okay, we'll round the corner with this.
We've only got a couple more clips with this interview, but so to see how this is tied into the interpretive framework, okay?
Here you get, you know, Dr. K responding to that.
So, Rekful, I think you love five-year-old you a lot.
And I think you have a lot of hurt because something really bad happened to him.
Yeah.
Like, you love that kid.
And something that was just terrible happened to him.
Do you see how, like, that kid is not you?
Yeah!
Fuck, it's not!
Yeah, it's not, it's not.
It's not, right?
It's a different...
No.
But you love him so much, and the problem here is that you're trying to protect him.
You try so hard to protect him and take away what happened to him, but you just can't do it.
And you don't know how to help him.
Yeah.
What does he need?
Sure.
I don't know.
Come to terms with reality?
Nope.
That's what you need.
No, just think about it for a second.
Like, what does he need?
Like, what do you want to protect him from?
I have no idea.
Okay.
So, but you understand that he's different.
And you understand that something happened to him.
What happened to him?
Let's start there.
He got quickly shoved out of his...
Comfort zone of family and things he cared about?
Yeah, I think comfort zone...
I'm not buying this idea.
Comfort zone is a weird term.
Yeah, so what happened to him?
It's way more powerful than comfort.
Oh, it's true.
How do I word it?
Well, he had...
He had family, and then he didn't.
Absolutely.
There you go.
Right?
It's so simple.
Yeah.
Like, Matt, even with the best of intentions there, that's asking someone in a vulnerable state to confirm your Like, he gave an answer, right?
It's about getting out of my comfort zone or whatever.
No, no, no, no.
That's not what it's about.
Like, what is it?
Think harder.
Think what it's about, right?
And you can hear him being like, you know, I don't know.
Like, what should I say?
And to me, I'm, again, not a therapist.
Let's be clear.
But that sounds to me like someone searching for approval from, you know, somebody that considers authority and wanting to say the...
The right thing, right?
And not because he, like, doesn't believe it, but because he probably believes that this person can help them, right?
And is actually identifying the issue, right?
So Dr. K wants him to say it's about giving, restoring that kids, like, you know, giving him the family that he lost or the, you know, the happiness or this kind of thing.
And then he, you know, gets, okay, so it's about family.
And Dr. K's like, yes, that's it.
That's...
And he's like, yeah, you know, great.
And it sounds to me like even if he was right, there's so much feedback that is pushing you in the direction of, say what I want to hear here, and you'll get the emotional payoff and the kind of positive feedback.
Say something else, and I'll be like, no, no, no, come on, try harder.
Yeah, well, your instinct there that this is not what...
Responsible therapy looks like, I think is completely correct, Chris.
I mean, in a way, this isn't new.
You know, Dr. Phil, the celebrity psychologist from the Oprah Winfrey show, I mean, this has been pioneered in the United States before, which is to do a kind of sham therapy on air for entertainment.
And it's not therapy, but it is...
Like a shambolic imitation of like wham, bam, bang, we've solved it.
Wow, look at this insight.
It was all to do with the mother.
That's what it was all along.
You know, it's entertainment.
But the problem is, is that this is a real person.
It's a real person, right?
Who is not just like, you know, a celebrity or influencer person who's coming on for shits and giggles.
And yeah, it's quite staggering that the...
That the red flags weren't raised there for Dr. K if he is a proper psychiatrist and he didn't just say, look, I'm sorry, like 30 minutes in, 20 minutes in, just said, look, sorry, everyone, this was a mistake.
I'm going to stop this now and we're going to talk offline and I'm going to do these things.
But he doesn't.
He continues and gets more enthusiastic and more into his stride as the interview goes on.
Yeah, and he actually, so there's these two clips, Matt, that are kind of related.
You heard him saying that, you know, what's this about?
Why are you making this game?
Because this is what relates to the game, right?
The motivation is, from Dr. K's framing of it, there's the heel five-year-old wreckful or others that may follow in his path by giving them, you know, the means to be happy, like through this game that he's going to make.
And Dr. K links this to his...
Kind of karmic destiny.
What does he need?
Family.
Absolutely.
Absolutely. Absolutely.
Fuck, dude.
Okay. All right.
you.
It's nice how simple it is.
Yeah.
The things that fuck us over always are.
Now, this is the really profound thing, Reckful, is that while this seems like it fucked you over, in a sense, of course, it did, but in a sense, it didn't.
This is your karma.
This is what happened to you, and this is what's made you the person that you are.
This is the religious destiny stuff coming in, which, you know, already...
He had earlier when he was talking about Reckful being this kind of genius from an early age who isn't challenged, right?
He's been chosen by his karmic destiny to make this game.
And just to put a pin on that before I let you respond, this is the last clip about that.
And then now I finally can make my own game.
Just, you know, because I've been streaming for a long time and can fund it.
Yeah, so Recful, this is really important to understand, okay?
And I'm going to reference some stuff that I've talked about before.
So I want you to understand that everything that's happened in your life has brought you to this point.
You've always wanted to make a game, but that's a desire.
That's just like, man, I've always wanted to make a game because I'm a gamer and that's kind of cool.
I've wanted to make games.
I'm interested in that.
I bet a lot of people are.
What got you to where you are, it has to be the right game.
The stars have to align for you to make the game that you need to make.
And there's been one really big star missing, which is purpose.
And I think the reason that this game is different, and it's got to be.
Because you're trying to solve something with this game.
And that's going to give you the strength that you need to actually solve it.
Yeah, I'm a little worried.
I don't know that I'll initially solve it on first release right away, but I want to always be patching and iterating to get there.
Yeah, I mean, again, notice the tone of authority there at the beginning.
He uses phrases like, now what you really need to understand, and so on.
He's telling Recfall exactly how it is.
The other thing that makes me super uncomfortable about what he's doing here is that Throughout this thing, he's latched on to making this game as being...
This is the key thing for finding meaning and accomplishing his goals.
That's the absolutely key thing.
Any professional should appreciate that that's a risky thing.
Someone that is clearly at risk.
Clearly extremely vulnerable.
Clearly unwell.
And you've said everything is riding on you.
Completing this game.
Having a successful computer game release as an independent creator, that's an incredibly risky thing.
And you're saying, yep, it all rides on this.
This is someone who's committed suicide several times.
And he's very casual about that.
Doesn't seem to notice the risk involved in putting that onus on Rec.4.
Yeah.
I mean, that strikes a game.
I keep feeling like I'm not a therapist and I'm noticing the huge warning lights of telling someone who's talked about killing themselves because the game ended when they were younger.
Like, now, put your purpose, everything you are, your karmic destiny is for you to produce this game to save the world, to heal people.
This is...
This is why you, and just like, one, as you say, what if the game never gets made?
What if it doesn't?
What if it never, for various reasons, it doesn't work out?
What if it's not popular?
What if it doesn't fulfill any of that?
Does that mean you act fulfilled?
Is life's purpose?
Right?
That's a lot.
That's a lot.
And it would be kind of reasonable, I feel like, if you were talking to someone about it, you know, if you were talking to just me.
And saying, Chris, you know, it's your purpose to make this podcast.
This is what you need to do, right?
Because I would be like, all right, Matt, cool it, cool it.
You know, don't get so...
But, you know, you could say that and it wouldn't be this big.
The injurious impact for me if the podcast went away, right?
I'd find something else.
But if I said to you, I'm an expert at psychiatry.
I'm from Harvard.
I've got all this experience in counseling patients.
I can see to the very heart of you.
And I've figured you out.
And you're, at this point in time, incredibly vulnerable, Chris.
Your life is falling apart.
The hope that the podcast to Cutting the Gurus is going to go well is the only thing that's keeping you going.
I lay all that on you.
That's not a good thing to do.
I mean, look, I'm not a clinical psychologist either, Chris.
I'm just like a normal psychologist.
But, you know, there's probably people listening who are clinical psychologists.
So, you know, we'll post the link to the full interview.
And, you know, by all means, if you guys want to listen to it and let us know if we're wrong, if we're seeing red flags that you think are totally fine, please, please drop us a note.
Let us know.
Yeah, it's hard to tell, right?
So I'm curious how other people interpret this, but there's one last clip from this conversation I forgot about.
It's actually from the start of the conversation, like way, way back, right?
And after Rachel's talking about his depression and whatnot, Dr. K asks him about Like, why exists?
What's the point of existence, right?
And just listen to this.
And is that all you are?
You're just a biological organism?
And I have consciousness, which we can't really explain the hard problem.
Okay.
Right.
Yeah, so what do you think about your life?
Do you feel like your life has purpose?
Most of the time, no.
But recently, I've started to think yes, because I realize I can start trying to help.
Other people who have had my same problems, so I relate to them.
And then I hope by making this game I'm working on that they can find friendship and a sense of community.
Because I'm making an MMO.
Like a really...
Yeah.
Okay, that's awesome, man.
Things I wanted as a kid.
Yeah.
Okay.
So I'm going to just dive into Sanskrit for a second, okay?
So Sanskrit...
The yogis like back in ancient India like thousands of years ago basically started to believe that the world was false.
And the reason that they started to believe the world was false is because they sort of understood that like the sense organs can be falsified.
So either through the use of hallucinogens or dreams.
But ultimately that the experience that they have within a dream is actually the same experience that you have within reality.
That even though a dream can be fake or real.
Your experience of a dream is the same as your experience of life.
You can feel suffering, you can feel joy, you can feel hope, you can feel sorrow, abject terror.
And so what they realized is that ultimately the foundation of reality is actually consciousness.
And that the foundation of reality is experience.
And that the external world is false.
The external world is false, right?
Yeah.
And, Matt, just the last bit that follows after that.
The act of observation that our consciousness has creative power.
Now, the interesting thing is that if you...
So now we get to Sanskrit, and this is kind of a real roundabout way of getting to this idea.
So the yogis actually came up with two words for reality.
One is maya.
Maya means illusion.
And the other is lila.
And lila means play.
And so interestingly enough, both of these sort of imply a falseness to the universe, but I think what's happening is on some sense you've had an experience either through psilocybin or other things, and I suspect other things, and we'll get to that later, that has given you a sense that something about the world is not real.
And what happens is when you're happy, yeah, we'll get to that.
When you're happy, you can exist in a Leela state, which is like it's no big deal that the world isn't real.
It's play.
Like, let's just have a good time.
It's actually just like a video game.
It's like an experience machine.
Yeah.
Seeing the issues there?
Telling someone who is suicidal this philosophical point of view that the world is false and reality isn't real, that it's all just a game.
Yeah, I see some issues there.
And...
Rekvold, by the way, on this last stream before he killed himself, talked multiple times about whether life was just a simulation and if he kills himself, whether he'll go to the next level.
Yeah.
Now, he was a gamer.
He was a gamer, right?
So it's probably just the vocabulary he had.
I'm sure he had that thought before.
But, you know, that would...
Be a point of concern, right?
Because even if Dr. K isn't the person that put that idea there or whatever, it shows that that idea could be on someone's mind just before they kill themselves.
So talking about it here seems very irresponsible, especially when it's not necessary.
Like he's inserting the...
Ayurvedic, you know, like just the kind of general philosophy.
What if we're all, you know, what if this is all a dream and stuff?
Yeah, it's all an illusion and, you know, when you die, you'll level up.
Like, yeah, it's not the right thing to be talking about with someone in this state of mind.
It's just not.
Anyway.
So there we go.
That's a conversation with Recful.
Very cheerful topic.
But there's more, right?
So this is conversation one.
Five more sessions with Recful.
This is the one that I think caused a lot of problems while other stuff happened in other streams.
And so compare all of that to what Dr. K described his conversations as being with Dr. Mike.
Now, we're going to move on to look at his response after this event.
Where he's got criticism or he's being officially reprimanded related to his handling of these streams.
And let's see how he frames what he was doing and has done in interviews and see if they match up.
Sounds good.
Let's do that.
So if I'm a mental health professional and I talk to people...
About their mind or their mental health, does that qualify as clinical care?
That's your concern, right?
It's not a concern.
I'm just curious how you toe the line.
Yeah.
When do you decide that you will talk about anhedonia or you've talked about one now you don't want to stray into the two, three, four or five?
Yeah, so it's a good question.
So a couple of other mental things that I do is if there's a conversation that I would have with my kids or a loved one, that's something that I would...
okay in a weird way right so like for example when I'm teaching someone about their personality and the way that they react to things I have those conversations with my kids I think it is a part of my parental duty to teach people like my kids like how
their mind works and how they respond to situations now if we say that that qualifies as the practice of medicine that means that I'm committing a ethical problem every single time I try to teach my kids about their mind.
Yeah, it's an interesting argument he's got there.
So, he says that if what he does in one of these online sessions resembles what he does with his children or his partner, then by definition, it's like real life.
So, it's not therapy.
And I think there's a problem with that.
Firstly, I mean, we've sort of heard in some previous recordings that he doesn't necessarily talk to his...
Family in a conventional kind of way, as we heard in his conversation with his wife there online.
Right, so you're saying basically this sentence.
I feel like I'm dragging the relationship down despite her telling me that I'm doing fine as long as I'm working on myself.
Listen to her.
Yeah, so I think the perspective, this person is asking for my perspective because I've been closer to that situation than you have.
Tell them to listen to her.
No, I mean, that's not sufficient.
Go ahead.
So...
I'm a little bit concerned with how disrespectful you are to me on stream.
Okay.
What do you think about that?
I'm serious.
Um...
Okay.
Do you understand what I'm saying?
Tell me more.
So, like, when you say go ahead, it implies that you're giving me permission to speak.
Oh, that's because we were both talking, and then I was saying, you can talk.
You can talk.
Right, and I will stop talking.
So when you say, like, you can talk, that implies permission.
What should I say?
Um...
I think maybe you should...
Yeah, I think it should be a little bit more...
Like, if I'm speaking, you should ask me if you want to interrupt to begin with.
Okay.
But the other thing, too, is that, I mean, this really doesn't matter.
Like, what you do in your personal life and whether it's normal or unusual or sounds like therapy is beside the point.
As we said earlier, what matters is...
Whether or not what you're doing appears to be therapy to the person that you're talking to, and if you're representing yourself as an expert, as an authority, someone who is telling you what your problems are, and it sounds like you're getting their case history, diagnosing them and then telling them what to do,
if that's how it's perceived by the person that you're dealing with, then you've got a problem, I think.
Yeah, and I also think the way that you speak to loved ones and close family, Members, you know, people that you have intimate relationships with, it's usually different, right, than people that you've just met and are talking to in front of an audience.
And if it isn't, there's something odd in one of those categories, right?
But even setting that aside, for me, the strong rhetorical move there is to say, well, I'm being criticized for having these conversations with...
Influencers, which people are describing as therapy.
But I have similar kinds of conversations with my kids.
So am I violating ethics by just giving advice to my kids?
I'm like, no, nobody is saying that you're violating ethics by talking to your kid about their mind, right?
So there is no confusion there because it actually is a very different thing.
You're doing that presumably in private, not with an audience, not with a celebrity figure.
And talking about the mind is...
Different than digging into the individual traumatic history of someone or their, you know, potential mental illnesses in front of an audience.
So he's saying, well, these things are the same, but actually, no, they're different.
And that's why nobody objects to you, talking to your children about like how their mind works.
Yeah, I mean, there are no professional guidelines that rule over how people talk within their families, right?
That's irrelevant.
Is that true?
Like, I'm sure there must be things that say you...
When engaging with family members, that you must also adhere to medical ethics, right?
I'm sure there's the boundaries and whatnot are different, but I doubt there's something like anything goes with like family, you know, use your skills as you see fit.
I mean, I don't know.
I haven't read the fine print of these things, but I thought that mainly that they pertain to your professional activities.
Well, I'm sure they do, but I think this is why you can get in issues around like family members and friends, right?
Like if you're in a professional role.
So you have to be careful.
And actually, Dr. Mike raises issues like this.
So listen to this.
I've had people in my personal life, friends, loved ones, etc.
that we would either get into an argument or they would come to see me for advice.
And I'm like, I don't know where the line is here.
Should I be doing this?
Because there's such a clear conflict of, you know, you might be my girlfriend, you might be my close childhood friend, you might be my brother.
How far can I go without saying that I'm practicing medicine?
Yeah, so let's ask that question, right?
So let's say that you're dating someone and they just had a bad day at work.
Are you allowed to use reflective listening and empathic statements when you're talking to this person that you're in a relationship with?
What do you think?
I think empathic listening would be fine.
I think when you cross into the line of them asking, well, you're trained.
Why do you think this is happening?
Do you think this is related to episode X that happened 10 years ago?
And now it's starting to cross into more medical questions I would ask my patients.
Yeah, so I think that's where the line that I use is we have clear, very clear diagnostic questions.
Yeah, that's right.
I mean, it isn't cool.
Like, do you remember that?
There was like a comedy based in New York about a, and it was based on a true story about a therapist who uses his power over this guy to sort of control him and manipulate him.
I've forgotten the name of it, unfortunately.
But, you know, basically that's the case of them blurring.
It starts off as a clinical relationship.
But this guy definitely is...
It's played by that very funny guy who's in Tala Dager Nights.
You know, that very funny guy.
Ricky Bobby, man.
Yeah, yeah.
Will Ferrell.
That's a good...
Yeah, Will Ferrell, thanks.
So, that's a good illustration for anyone who's seen it of what could go wrong, right?
So, you've got this therapist who's supposed to give us help with this person.
Then they start blurring the boundaries between this is a clinical relationship versus like a deeper...
You know, friendship, kind of life partner, type business partner, something or other type relationship.
But he's still maintaining all of those sort of clinical hooks and using it to manipulate this guy.
And it's very clear in that show that he's using it for his own ends, right?
He's using that manipulative power and the way that this guy perceives him as an authority over him to basically benefit himself, not Will Ferrell.
Now, I think that's a perfect analogy for what's going on here.
If you have a relationship with someone and you're dating them or whatever, and you start, you know, building up this perception of yourself as this authority of them, maybe they've got some sort of mental illness or struggling with something or whatever, and then you use it to control them,
to get them to do what you want for the relationship to suit you, then obviously that's a massive problem.
So, I think that there's a huge analogy here.
To what he's doing with this online streaming, performance, entertainment, therapy stuff.
Because clearly, his interests are not aligned with the people that he's talking to.
His interests are aligned with the revenue and the profile that he's building on this show.
It's not an exercise in disinterested whatever.
Let me give you the devil's advocate argument against that.
You know, yes, promoting himself as an authority and, you know, growing his channel and that.
But what if he can help influencers by these conversations as well?
So what if, you know, if the people were having terrible experiences and they were finding themselves traumatized by it and whatnot, then...
That would damage his reputation.
He wouldn't be able to get people to come on and whatnot.
So the fact that many people are feeling that they're helped, that other people are seeing them and saying, you know, I realize from this that I too, you know, might suffer from anxiety and stuff.
Isn't there a case, and I know that he does make this case, that everybody is doing this voluntarily.
Everybody is adults and most...
People, like the Rackville competition we played, but a lot of other people will have said, you know, I had an interesting conversation.
I learned things about myself.
So, in that sense, aren't their interests aligned?
No, I don't think their interests are aligned.
Like, I could take money from the gambling industry, right, who could be funding me to do stuff that is actually genuine research.
And, you know, they're not putting pressure on me to sort of...
Change the things to the results or falsify things or anything like that.
But there is still a conflict of interest there in terms of the benefits that I'm getting in terms of that research funding and their interests.
And it doesn't matter if in a particular case or something like that, it turns out to be no problem.
It didn't affect me.
I did good research or whatever.
There's still a major issue there.
Now, I kind of agree with you that when he's doing this...
Live therapy, whatever it is, with someone who is there casually, you know, who maybe is an influencer or an online person themselves and they're there casually.
They don't have any major issues and they're there for a bit of fun, you know, maybe talk about chakras and their experiences as a kid and everyone goes home happy.
I'm sure that's the case.
But, you know, we see in the case of Recfall what happens when it actually...
When it is serious and it's not just for a bit of fun.
So, yeah, look, I kind of agree with you that I think in some cases the risk may well be minimal.
Yes, it's good entertainment.
People enjoy listening to it.
The person who he's talking to is happy as well.
His brand grows.
It all works out.
Like when it becomes real therapy, when the person really perceives them as a therapist, when they really perceive that they've just been diagnosed, like in 10 minutes flat, he's figured out what's wrong with them and they really agree, yes, I need to change my life based on this 10-minute chat and it's all spurious,
then...
So I guess there's basically two scenarios.
One is that it's light and fluffy and it's kind of bullshit but harmless or the scenario where it's actually like perceived as real.
Perceived as important, in which case it's not harmless.
There is a specific example, I believe, where somebody that he interviewed on stream, not Recful, went on to indicate that he had become their therapist, like formally.
So that leads to, you know, that's the kind of blurring line business.
But in any case, Matt, so one of the things that we heard about in the earlier content is about like, You know, Dr. K has this, he's looked up the definitions and he understands what goes into a clinical therapeutic relationship.
And he's clear that that's not there on the stream.
So here's him kind of reiterating a summary format, this position to Dr. Mike.
I think there's a big difference between talking to someone about their problems and the practice of psychotherapy.
And you think that's because of the specific defined guidelines that you have to hit within the conversation?
Not just the guidelines.
It's also things like if we think about like a, so when I'm doing psychotherapy, I have to put together a formulation.
So this is usually a biopsychosocial formulation of what's going on with a patient.
And this kind of is like a map.
This is really like analyzing everything from their upbringing to biological genetic factors.
And we kind of put that together.
So there's a lot more formal robustness to it because we have guidelines to kind of like you said, right?
The practice of psychotherapy is like you spend usually a long amount of time with someone.
You do an intake with them.
You spend like two hours running through all kinds of different questions.
Then you put together a formulation.
Then you put together a treatment plan.
And as part of that treatment plan, you do like A, B, C, D, and E. I think having conversations about mental health does not touch that.
Like what I do with my patients in my practice is very different from what I do on stream.
Yeah, I mean, this is the consistent defense he's got in different ways, which is that he says, oh, what I do professionally is quite different.
And he could talk about creating a full psychosocial life history map and ticking off checkboxes or whatever.
But I mean, one, you're taking that on trust.
But two, I really don't think that matters.
What matters is how it's perceived by the person you're dealing with.
Like, to give you a hypothetical example to illustrate this point, you could be...
A genuine therapist, you do genuine therapy with real patients, then you do your show therapy and your show therapy looks completely different, right?
It's got nothing to do with it, right?
It's completely made up or whatever, but it's extremely convincing.
You sound very authoritative.
You're giving the person that you're talking to the distinct sense that you're diagnosing them, that you're figuring out what's going wrong with them.
You know the sources of their problems and you know what they need to do, right?
Doing there, like in the technical details, isn't following good therapeutic practice.
In fact, it makes it worse that you're following this different thing.
But if it's perceived as such by this vulnerable person, then you have a problem.
So, I just don't feel like these defenses stack up.
He sort of makes the same defense, I think, in many different ways.
But that, I think, is what it boils down to, don't you?
Yes, yes it does.
Well, there's one last clip from this Dr. Mike thing, then we'll get to the specific episode he released to respond to questions about his ethics.
So this ties in, Mark, to things that we previously saw related to life coaching and spirituality.
And that being something of a way to go past some of the ethical constraints that...
Potentially are there if you are practicing modern medicine or kind of licensed therapy, right?
So listen to this.
And when you talk about like the spiritual aspect of it or the coaching aspect of it, where you would take on consultations online, not as a doctor, how is that different?
I mean, so I spent seven years studying to become a monk and I learned a lot about the nature of happiness and suffering.
And so I think we're starting to see that blend into clinical practice.
So we'll see things like dialectical behavioral therapy or psychotherapists will teach mindfulness.
So let me kind of ask you, so do you think mindfulness is a treatment?
Of course.
Okay.
So if mindfulness is a treatment, do you need a license to practice medicine to deliver treatments?
No.
And if you have a license, you delivering the treatment carries different weight.
So you think that it is okay for people to give treatments without a license to practice medicine?
Correct.
So how do you decide, so for example, like if I'm a random person on the street, I can give IV fentanyl to people and that's okay in your book?
I think that there's a difference between medications that are supplement form.
It's basically based on the regulation.
Again, I think this is an example of, you know, rhetorical tricks.
He wants to make out like, oh, you know, would you agree that massage can be a therapy?
Yes.
So you're saying that if you give a massage to your partner, then you're doing therapy with them, right?
Yeah.
You know, you don't have a license.
It's, you know, we don't need to break it down too much, I suppose, but it just doesn't stack up that reasoning.
And same with the...
You know, making that analogy to prescriptions, right?
Oh, so this is therapy.
Well, isn't giving fentanyl to someone a therapy also?
Well, if you're not a doctor, then it's okay to just be giving fentanyl to people willy-nilly.
I just, I find it very slippery.
I don't like it.
Yeah, and there's also this aspect that Dr. K acknowledges that, like, spirituality and life coaching gets you around.
Various ethical constraints, right?
So if you frame it that way, you then are not practicing medicine, but you're allowed to do that, right?
You're allowed to give people advice and whatnot.
So, like, he can be a doctor, but give spiritual and life advice without it being therapy, right?
Which is true.
But there's a very fuzzy, ethical boundary around that whole field.
And it's a bit like supplements.
And medicine, right?
That, like, supplements are not regulated the same way medicine is, but they often want to make similar sorts of claims, right?
And you can make the point that, well, a supplement isn't a medicine, right?
So it should get regulated in the same way.
And it's like, yes, but there is a lot of ethical issues then around.
And there's the fact that maybe a company can get away with, like, as long as it doesn't say it directly cures cancer.
But that doesn't mean there's not a...
You know, an ethical issue there.
Yeah, yeah.
I mean, like, this is the real world, so there's lots of grey areas.
But like you said, you know, you go to the chemist, you'll see heaps of, you know, bottles full of multivitamins and echinacea and all kinds of things, and there'll be a bunch of vague promises.
On the back label that'll sound and read very similar to the promises on the back of your shampoo bottle, right?
With just as much validity to them, right?
And that's kind of a problem.
You know, you and me don't like these things, right?
But it's less of a problem because in a way, like, our society knows not to, like, believe what's on the back of a shampoo bottle in the same way that when we go to the GP and the GP says...
You have cancer or you are sick, you need to take X and it's going to do Y. Like, that's the difference.
And that's why these professions, medical professions, are regulated.
And in the olden days, right, in the United States, for instance, you know, like the phrase snake oil salesman, that was when in a time when this stuff wasn't regulated and you'd have people going around doing a song and dance show up on a stage.
You know, somewhat analogous to Dr. K, what someone might say, and selling something with miraculous treatments, figuring people's problems out on the cuff and promising these great outcomes.
And that was a problem, and that's why we have regulation.
And maybe you should go and listen to our episodes about what Dr. K mentions about, like, when you incorporate Ayurveda and how it supercharges the effectiveness and how you can cure people that haven't been able to be cured for decades or years by...
The standard medical procedures.
But in any case, so all of these issues come up.
You can hear Dr. Mike pushing back on them and whatnot.
And whenever the event with Redfall, like his suicide happened, obviously there was a lot of criticism of Dr. Ken.
He released a video that was about ethics.
All right, specifically.
And we'll take a look at some of the arguments there.
Some of it is familiar, so we don't need to go over all of it to what he raised with Dr. Mike.
But here's the way that he introduces that episode.
Hey, y 'all.
I'd love to talk a little bit about ethics today.
There have been several concerns in the community, a lot of questions about whether what we do at Healthy Gamer on stream is therapy, whether what we sort of do at Healthy Gamer as a whole is ethical.
And I'd love to sort of talk y 'all through the ethics of what we do.
Okay, so there's that kind of folksy term there.
Hey, y 'all!
Some people are saying I'm an unethical, manipulative person taking advantage of vulnerable people.
Let's have a chat about that.
I'm here to help you understand how seriously we take...
Yeah, why people might be making that error.
Yeah.
So this is very much on par for Dr. K, of course, leaning into criticism in a kind of love hug, bear hug, rather than fighting against it.
But yeah, he is so casual.
He is so relaxed.
He's kind of emoting throughout this that there's no problem here.
This is all good.
And also listen for the authoritative tone when it comes to explaining.
The first thing that I kind of want to acknowledge is that most people don't really get an opportunity, even in higher education, to really understand or learn about medical ethics.
Medical ethics aren't really a matter of philosophy or even opinion.
So just because I believe what we do is ethical doesn't actually make it ethical.
If someone else believes what we do is unethical, that doesn't actually make it unethical.
The truth is that medical ethics are actually very, very clearly defined.
There are standards of practice that are actually codified in state, federal, and international laws.
And licensing boards are very specific about what is ethical and what is not ethical.
So ethics aren't really a matter of opinion.
There's two separate things there, right?
There's the fact that ethics are regulated in professions by professional bodies, and that you may, if you are accused of breaking ethics, there's a whole process, right, where people will go through and check, and you might then be found to be,
like, officially reprimanded, for example, or you might have your license provoked, or you may be found not to be violating things.
But that's actually a separate thing from whether...
There actually is ethical concerns because it can certainly be the case that one ethics board decides that what you're doing is okay and another ethics board would not or another set of people.
So you could also get by technically that you haven't broken the letter of the ethics requirements.
But you have in spirit.
So Dr. K's presentation here is, like, on the one hand, he's right, you know, it's people online saying, does this violate ethical regulations or not?
That's just their opinion, man.
But on the other, that, like, ethics is purely a matter of legalistic technical definitions, and whether you are officially found guilty by an ethics board, no.
Yeah, yeah.
Yeah, yeah.
It's another rhetorical trick he's using here because I guess there is, like, there's obviously the trivial but stupid point that, yes, it's not just anyone's opinion.
Just because someone on Twitter says that you're unethical doesn't mean you are, of course.
On the other hand, there may well be like a kind of like a legalistic case that happens at some point where there is some determination made whether or not you're going to be sanctioned or punished or disbarred or reprimanded or something else.
And, you know, that can be somewhat legalistic.
But just like any legal case, ethics boards are pretty similar.
Like you said, it is a matter of opinion.
You know, like it is a vague thing.
And, you know, you and I have had hundreds together projects that have gone through ethics review boards, have dealt with questions and...
Done modifications and had a bit of argy-bargy with them from time to time.
It is absolutely a matter of debate and opinion.
There's subjective assessments that go in.
So there are clear issues that would violate.
There are often rules that you cannot inject someone with an unknown substance without them knowing.
That's clear.
That will be written down.
But there are also areas where it will be a matter of judgment, like whether this crosses the line or this is reasonable.
So he's not...
Technically wrong.
You know, he's kind of saying there are clear-cut rules, which there are, but it isn't always so clear-cut.
Well, there are clear-cut principles, and it is not clear-cut.
And every case is evaluated on its own merits.
But the other thing, too, is that he deliberately conflates two things.
One is the kind of deliberations and final evaluation of some ethics review board, right?
And then there's the question of...
Like, is it ethical?
Is it the right thing to do?
Is it a thing a good person would do?
And those are not quite one and the same thing.
No.
Yes, ethics review boards aim to kind of hit that.
But, you know, and so the way he presents it is, it's an extremely technical process that you guys don't understand.
You know, only proper professionals like me do.
It's extremely legalistic.
And there's a kind of a flow chart and this logical thing.
You know, no matter how unethical it might seem to you, don't worry, it isn't.
Because of reasons.
So, yeah, and he first talks about very general, broad principles of medical ethics.
So, what are some of the central principles of medical ethics?
The first principle is beneficence.
So this is essentially to try to maximize the good that we do.
The second principle of medical ethics is non-malfeasance.
So this is to try to minimize the harm that we do.
The third principle of ethics is autonomy.
So this is sort of when doctors, we provide information to people, but it is ultimately their choice.
Whether they engage in something or not engage in something.
As a patient, you have the right to refuse a treatment, right?
So doctors can't make decisions for you.
And the fourth major principle of medical ethics is justice.
And that's where we try to deliver medical services in a fair way.
So this is the kind of content where you might say that he's delivering educational content, right?
Because that's all...
That's all fine and dandy, right?
Like, that is very general principles about medicine do no harm and the other issues that he reeds.
So, that description, there's nothing wrong with that, right?
Mm-hmm.
Nothing wrong with that, per se.
I think he's left out a few aspects of ethical principles that we can get to.
Yeah, but I think, you know, if you look at an introduction to medical ethics book, I'm sure you can find ones that say there are three core principles or four core principles.
These are what they are.
So he's going to argue that he meets these criteria in terms of medical thing.
But that's the baseline, because the actual issue
And what I want to dive into next, which is a really, really big question in our community, is what we do therapy on stream.
So a lot of people will sort of look at what we do on stream and sort of assume that this is the practice of therapy.
After all, I'm a therapist, and I'm talking to someone about their emotions.
So is that actually therapy?
Potentially reasonable.
Question.
And here is the answer.
And so as I started to investigate that question, even before I started streaming at all, the first thing that I looked into is whether it was possible as a psychiatrist to have public conversations with people about their mind and mental health.
The answer that I discovered was yes, you can, provided you do it in a very specific way.
So people may think that what I do on stream is therapy, but the truth is it is Actually, very clearly, not therapy.
And what do I mean by that?
Let's explore that for a second.
So first thing to understand is that the practice of psychotherapy is very tightly regulated.
So I can't just, I mean, I can because I'm a psychiatrist, but, you know, the average person can't just open up an office and say, I'm doing psychotherapy.
In the same way that someone can't hang up, you know, open an office and say, I'm doing surgery.
So there are some things, psychotherapy is a very restricted practice.
And so as a result, it's very clearly defined.
So what constitutes psychotherapy and what doesn't constitute psychotherapy?
So there you go, Matt.
Problem solved.
He's not doing therapy, right?
Because there's technical definitions and obviously he doesn't do, like intake, he doesn't do treatment plans.
So it can't be, right?
That's a restricted thing.
It's a protected term.
So resolve?
We'll see.
Perhaps some issues there, but worth noting that professions want to protect their professional qualification, right?
So they don't want anybody to be able to claim to be doing psychotherapy or licensed therapy.
And so they do have things that they will say, you know, you need to be doing each of these.
You need to have a qualification.
You need to be following this procedure and whatnot.
And if you're not doing that, you're not following the therapeutic regulations.
Now, that is usually done so that they distinguish themselves.
But it's interesting here that's kind of flipped around to be like, because we don't do that, that means that we can't be...
Accused of doing anything that is therapy, right?
Because we are not meeting the criteria that they use to protect the profession.
And that's a convenient thing because that would mean that, like, if you were aware of that stuff and you didn't want to, like, most people want to be mistaken for being therapists, right?
It usually goes the other way.
But in this version, it's like...
You can just avoid a couple of the steps and then you can say, well, I don't meet the criteria.
So that's it.
It's kind of illustrative to just imagine a different profession.
You could imagine an accountant or a medical doctor and say, well, yes, look, it looks a lot like I'm doing a diagnosis here and it looks as though I'm recommending a course of treatment, but I never even looked at their broken leg.
And if I was actually doing medicine...
I would have taken a careful look and I would have gotten an x-ray, but I didn't do that.
So we're fine, fam.
Yes, the person I was talking to went away.
They didn't walk away.
They hobbled away with their broken leg with the impression that they had some guidelines for what they needed to do.
And they felt like they'd gotten the diagnosis.
They felt as though they had a course of treatment and a course of action for themselves all lined up.
You know, there wasn't medicine because I didn't get an x-ray.
What he's going to do is identify some features about practicing medicine and, you know, related to the therapeutic setting.
And he's going to show that in each of these cases, he doesn't.
Meet the criteria.
So here are the key features.
And the practice of medicine is actually very clearly defined.
There's a clear line between what is medicine and what is not medicine.
So, for example, prescribing medications or doing surgery fall under the practice of medicine.
Psychotherapy falls under the practice of medicine.
And while the practices of medicine may vary a little bit from state to state, each state has its own guidelines, each country has its own guidelines, there are three incredibly common and conserved things no matter where you look at the practice of medicine.
Those three things are, first of all, the formation of a doctor-patient relationship, the second is diagnosis, and the third is treatment.
So wherever you go, medicine constitutes these three things.
Got it, Matt?
Doctor-patient relationship, diagnosis, and treatment.
If you have those three things, you have the practice of medicine.
It's beyond debate, I would gala from the way Dr. K. frames it.
But if they're not there, it is not medicine.
It may look like medicine, it may look like therapy, it's not.
You need those three things, okay?
Gotcha.
Okay, just remind me.
So, doctor-patient relationship, diagnosis, and treatment.
Diagnosis and treatment.
Yep.
Unless all those things are there, there's no therapy going on, not a problem.
No.
So let's start with the first one, the commencement of a doctor-patient relationship.
So I know this sounds kind of weird and it may sound kind of simple, but this is actually very, very clearly defined.
So the AMA actually clearly defines what constitutes entering into a doctor-patient relationship.
And the key thing here is that there's a voluntary agreement by both parties that we are entering into a doctor-patient relationship.
This may sound a little bit weird, like...
But just think about it kind of logically, right?
So you can't walk up to me or any other doctor and say, hey, you're my doctor now.
Similarly, I as a doctor cannot walk up to a random person on the street and say, hey, I'm your doctor now.
The patient has to agree to be a patient and the doctor has to agree to be their doctor.
He doesn't actually need the other criteria then even because on that basis, he is clear in his disclaimer material or In various statements that he might make on the stream, he is not the doctor of the person on stream.
Ergo, he cannot be practicing medicine.
Ergo, he is not subject to the epic considerations because it isn't a medical thing.
It's done.
He doesn't need the other two because, you know, I'm sure there's a disclaimer there.
I'm sure he never said, I am your doctor.
I am your therapist now.
We have a therapeutic relationship.
It reminds me a little bit of, like, imagine a financial advisor and they kept going on about how they've correctly predicted all of these things in the future.
They know what things are going to go up and things are going to go down.
They've made so much money for all of their clients.
They understand about what's going to happen in the stock markets, whatever.
They project this incredible impression of expertise.
They do have qualifications, right?
Maybe they've got PhDs in economics from Stanford and so on.
And they're telling you, you know, you need to buy gold, you know, lots of gold.
Don't buy it from this particular place or whatever.
And down the bottom they say, you know, this does not constitute financial advice, right?
They're not your financial advisor.
No issue.
It's ethically fine.
No.
Yeah, and also, you know, like, those things where you have the disclaimers come up, this is not a financial advice, this is not a medical instrument that is, you know, like, that is used in the same legalistic way, say, well, and actually,
like, people like Mr. Beast recently has gotten hot water because he did some things which might be lotteries without the disclaimers.
But the point is, if he had the disclaimer, That's fine, because that's the legal thing.
But actually, maybe that's fine technically.
Like, he wouldn't be in the same potential legal trouble.
But ethically, is it fine if you just put the disclaimer?
Yeah, so anyway, I think it's interesting that Dr. K frames this very much as like, because obviously nobody thinks that if you walk up to someone in the street and say, you're my doctor now, yes, clearly that would be unfair, and you cannot expect doctors to do that.
But say you went on stream with someone, talked about their family history, talked about their life problems and their previous diagnosis, and you did it over eight hours continuously over a number of months.
Might that person have a better case for thinking that you were in a therapeutic relationship with them, right?
Like that's the reason there's a controversy, not because somebody's saying...
They're going to come up the street and Dr. K and just say, he's my doctor now, right?
Yeah, I think we'll hear throughout this that he's decided to take an extremely legalistic defense, which to me, that already rubs me the wrong way.
But yeah, I don't think the legalistic defense stacks up, as you said.
Yeah, and he gets into, you know, he starts talking about specific exceptions, like, you know, can you transfer a patient to another doctor if you're ill?
And, you know, like, kind of saying, well, let's look at the specific, there's very specific exceptions, but he's not addressing the specific issue which revolves around his circumstance.
Like, nobody's concerned about this stuff, about, like, if a doctor's on holiday, can you transfer his patient or whatever?
That's not...
The issue, right?
Yeah, well, this is also why I smell the rat, because this video is in response to a very concerning event, right, and something which clearly must have bothered him reputationally, if not personally.
And he, first of all, adopts this tone like, look, you guys don't understand ethics.
We're going to have this nice fireside chat and I'm going to explain ethics to you and why nothing that I did was in the slightest bit unethical.
And then it's a two-hour long talk.
Where he takes a lot of care to keep emphasizing all the time that he's the ethics understander and you aren't.
And in fact, it's extremely technical.
And there's always complexities.
What happens when a therapist wants to transfer a patient, whatever?
All of this stuff.
And avoiding the actual stuff that happened specifically in that issue.
Yeah.
And so just to say, one arm up.
This is one arm.
I might have felt like two hours, this particular one.
52 minutes.
So let me just play that bit where he talks about the exceptions, because he's talking about these exceptions, but there's actually only one reason that he's talking about the exceptions, and it comes up at the end of this clip.
So sometimes, for example, if you've got cancer, you may seek a second opinion from a different doctor, and you still have your primary doctor, but you're allowed to engage in a limited doctor-patient relationship with a separate doctor as part of a consultation.
The key thing here is that a doctor-patient relationship is very clearly defined.
It's a voluntary commitment by both parties.
The other key thing is that the exceptions to the doctor-patient relationship are also clearly defined.
There are two major exceptions which we just talked about, and those are the only ones.
Talking to a psychiatrist online is not an exception to the voluntary entry of a doctor-patient relationship.
That's what he wants to say, right?
That is not the exception.
But again, nobody's confused that talking to a psychiatrist in a conversation automatically makes them have a professional relationship.
Nobody thinks that.
A clinical psychologist can't talk to anyone for fear that that person can't go and buy a loaf of bread because they've entered into a...
Nobody thinks that.
He's not actually addressing...
The grounds for concern.
And he does what I would describe as an indulgent pizza analogy where he talks about you can't just say anything as a pizza.
Pizza has to have a crust.
It has to have, you know, like blah, blah.
So, you know, it's not a matter of debate.
There's definitions that we apply to these things.
But of course...
One, there's debates about, like, well, there's a sandwich or whatnot.
There's a lot of debates about what constitutes pizza, but that aside, a lot of angry Italians online.
The next thing, so, right, okay, let's say he's right.
You know, he's clearing off, he's got this disclaimer, the doctor-patient relationship isn't there, right?
So he's okay on that.
Let's give that to him.
What about diagnosis?
So let's listen to what Dr. K says he doesn't do on his stream.
And I want people to think back to this conversation.
So I'll give you guys sort of a quick overview of what I do in my clinical practice and basically what other therapists should be doing as well, because it's the standard of care.
So the diagnostic process involves a lot of different stuff.
So it involves taking a history of present illness, which includes like a symptom assessment.
So what are the things that you're experiencing?
It includes things like duration, frequency, severity of symptoms.
So how long have you been experiencing this?
You know, how often does it happen?
How bad is it?
What are the character of the symptoms you experience?
In addition to the HPI, we also assess medical history.
So do you have any other medical conditions?
Have you had any other psychiatric conditions?
Have you ever been hospitalized?
Have you ever had surgery before?
So there are lots of different things that you collect for the medical history.
The next thing that we sort of collect is we'll collect things like substance use history.
So do you use substances?
We'll ask Questions about your social history.
So where do you live?
What do you do?
Are you sexually active?
What are your relationships like?
Is there any chance you have an STI?
And yes, I do ask each and every one of my patients, whether they're 13 years old or 85 years old, about their sexual history because it's standard of care for physicians.
Other things include family history.
So has anyone in your family ever been hospitalized?
Does anyone in your family have medical conditions?
And y 'all may sort of recognize this kind of stuff because if you go to a doctor's office, they're going to give you a bunch of forms that you fill out.
And we don't ask any of those questions on stream, right?
So people may volunteer some information kind of from a narrative perspective about what their upbringing was like, but we do not do diagnostic assessments on stream.
Other parts of the diagnostic assessment include laboratory testing and imaging.
Sometimes I'll order MRIs of the brain.
Sometimes I'll order lab tests.
So the process of diagnosis is actually very, very specific.
It's not something that, it's not just like you ask a couple of questions and then you sort of suddenly have a diagnosis.
Yeah, so we did hear, didn't we, questions in his conversation with Rick Falk that were to do with family.
History, about the life history, you know, previous diagnoses, a lot of stuff which sounded pretty similar to some of the things he was listing off there.
Duration, frequency, severity of symptoms, how long have you been experiencing, how bad it is, do you have a medical history, what other psychiatric conditions, you have substance abuse, how do you take substances?
Wasn't Rackville talking about...
His experiences on psilocybin and, you know, his previous history on medications, family history about intake.
And he says, we don't ask any of those questions.
Like, people might volunteer some of those information.
But as we saw in the previous clips, Dr. K often saying, you know, how did that make you feel?
And how long did that last for?
And so, yes, he didn't ask, Greg, all about this.
STIs and sexual history.
Yeah, like, yes, he didn't order an fMRI for Rick Fall.
Yeah, and how many psychiatrists, by the way, order fMRIs?
I think it's incredibly rare, unless there's a head injury or something.
Incredibly rare.
Okay, because, yeah, like if someone came in suffering from depression, is it routine that a psychiatrist would order an fMRI?
I don't think so.
Maybe she knows what they do in different parts of the world.
Yeah, and it really, again, is beside the point.
He really is resting his argument on this case.
He's painting, first of all, that there is this incredibly specific criteria.
This is an incredibly specific process that one follows when one is doing clinical evaluation.
And that unless the thing that you're doing matches that exactly, then boom, it's not therapy.
I think that's incredibly...
Well, first of all, as we pointed out, it's not true, right?
He was hitting a lot of those points, actually, in that conversation with Rectfall.
But even if what he was doing with Rectfall bore relatively little resemblance to the practice of very good, careful, responsible therapy, but it gave the impression to someone that they're getting therapy,
then you have a problem.
Right?
Because if you tell people that you're a doctor, if you give them the impression that you're doing doctory things, like you're going over to a machine that goes ding and you're sort of shuffling your papers and you're giving the very strong impression that you're doing medical stuff, then that's equally problematic as if you were actually doing the real thing.
In fact, it's more problematic, right?
No, no, but Matt, if you just tell them you're not doing that, doesn't that resolve it?
Like if you just say, but I'm, just to be clear, I am not.
Giving medical advice.
No, that does not make it all better.
Just like the disclaimer about, oh, but this isn't financial advice.
But it's a strategic disclaimer.
It might get you out of an ethics tribunal if you add enough disclaimers.
But have you done something unethical?
That's a separate question.
So one thing that he also says he doesn't do is what you need to do, Matt, is differential diagnosis.
You need to be saying people don't have certain things or they're not showing...
The other thing to consider about the diagnostic process, which is standard of care, is also a differential diagnosis.
So it is actually not enough for me to ask all of those questions.
As a doctor, the practice of medicine constitutes developing a differential diagnosis.
So if someone comes in with symptoms of depression, I also have to assess them for bipolar disorder.
I also have to assess them for schizoaffective disorder.
I also have to assess them for a substance-induced mood disorder.
So when he was talking to Rectful about why his depression didn't display the characteristics of bipolar disorder...
But that wasn't differential diagnosis.
That was just a conversation about mental health.
I just find the specific things that he referenced.
Like, yes, you didn't talk to him about schizoaffective disorder.
But also, I don't think you have to assess everyone for every potential mental illness.
There surely is a thing whereby...
It would be, you know, do these symptoms relate to this disorder, this group of disorders?
So, in any case, I don't know the specific things that you have to flag up, but if it is every mental illness in existence, the intakes must take a hell of a long time.
No, no, it's about differentiating between, like, equally plausible diagnoses that explains the symptoms being presented, right?
And actually, we did hear Dr. K. Do that, right?
He ruled out very quickly severe depression because severe depression is episodic, right?
And he'd eliminated that diagnosis based on the fact that Rexall had been feeling bad for a long time.
Oh, careful, Matt.
He didn't eliminate it.
He said it might also be there.
Oh, yes, of course.
It's not the real issue.
Yes, good pull-up.
Thank you, Chris.
Thank you.
Yes, so let's hear just a little bit more.
The next thing that I want to point out is for people who think, okay, do I diagnose things on stream?
I don't.
And so let me actually show you.
So someone talking about their depression does not actually constitute diagnosis.
Here are what actual diagnoses are.
This is from the ICD-11.
So this is the International Classification of Disease.
So this is an international consensus about what constitutes diagnosis.
So when I'm seeing a patient in my office, I will actually diagnose them with one of these things.
recurrent depressive disorder, current episode mild, or current episode moderate, without psychotic symptoms, with psychotic symptoms, severe with psychotic symptoms, in partial remission, in full remission.
These are actual diagnoses.
We do not tell people on stream that they have these.
We do not ask diagnostic questions to the extent of what is necessary for major depressive disorder.
So, depression is not a diagnosis.
Anxiety is not a diagnosis.
Anxiety is an emotion.
The actual diagnoses are things like generalized anxiety disorder, socialized anxiety disorder, anxiety disorder induced by a substance, unspecified anxiety disorder.
Those are actually diagnoses and we do not Assign those labels to anyone on stream.
So there you have it.
Although we might have thought the thing that we saw in the conversation with Rackville was diagnosis.
Like, Dr. K did not give him a technical label of an existing disease, right?
Ergo, it's not diagnosis.
So, problem again, gone.
People thought...
There might be an issue with him giving Rackville the impression that maybe some of his previous diagnoses were in error from Rackville raising that point.
But no, because Dr. K didn't say the name of a technical recognized illness.
Therefore, it can't be diagnosis.
Yeah.
Yeah, no, I get it.
It's this very legalistic logic chopping approach to whether or not.
He's doing something unethical.
I have my own opinions about a different approach for determining unethical behavior, but I might say that...
Well, so he goes on to...
So on the subject of treatment, Matt, that was the third pillar, right?
And he says, you know, treatment is not just giving people advice.
Treatment is developing a multi-pointed...
Treatment plan where they have set goals and, you know, times that they need to deliver things and report on and they have exercises that they need to do.
So, you know, vague advice is not a treatment plan, right?
It's not a specified thing.
So, therefore, all three things are lacking.
There is no patient-doctor relationship formally established.
Diagnosis is not done to professional standard, even if there are some questions, you know, that might look like it.
And treatment is not of the variety that you would normally expect in therapy.
There is no written out treatment plan.
There are no prescriptions of medication.
So people are just making an error.
It is not a matter of opinion.
So everything we do on stream is not the practice of clinical medicine.
In order to sort of figure out what is okay on stream, we can define what the practice of clinical medicine is or understand the definition.
So that's not something we define.
That's something that we exhaustively looked up by looking through, you know, hundreds of pages of medical ethics documents, state laws, federal laws, regulations, licensing board things.
Ethics, you know, sort of opinions on ethics from the American Medical Association, the American Psychiatric Association, and what we sort of decided to do on stream is actually clearly outside of those things.
The other simple gut check that I have for y 'all is when you go to a doctor's office, how similar is it to what happens on stream?
And the short answer is like, not at all, right?
Because doctors are practicing clinical medicine.
And what we're doing on stream is having It's strange that so many people who've had experiences with doctors make the mistake then,
isn't it?
Like, because Dr. K is saying, you know...
Don't you realize it's completely different?
But yet so many people seem to be under the impression that there's a blurring of lines there.
So you'd wonder why.
I guess it's just a lack of education about what therapy entails.
But also, this delivery, by the way, Matt, I commend Dr. K because it gives the people that follow him a very clear set.
of responses.
Here are the three things that make up medicine.
I don't do any of them.
So, yes, it's reasonable for people to be confused who aren't in the know, but we don't meet them, right?
So, you know, go forth and spread the word about how they feel.
And I would bet you that after this video, you would see a lot of Dr. K followers repeating, he doesn't do any of these three things.
Yeah, yeah.
Like if you define the practice of clinical therapy, talk therapy, extremely precisely, extremely carefully, and you seize upon technical differences between what you do on stream with that, and you say, well, look, it's different.
So therefore, I'm not bound by any of the rules around professional practice.
There are no ethical problems.
Whatsoever.
And it doesn't matter that, you know, like it sounds like I'm doing therapy.
Like I'm asking about their clinical history.
I'm sounding like one of the, like a dispassionate neutral therapist saying, how did that make you feel?
And what happened before then?
And talking about the family history of the problem.
And then it's sounding like I'm diagnosing the problem.
But actually, no, no, no, no.
Technically, I'm not diagnosing the problem.
But just people get that impression.
But the problem is, Rexful's getting that impression.
Because he's giving a very, very good impression of being an authoritative clinical practitioner and talking to him.
Well, no, Matt.
Why are we and other people making the mistake that there might be a blurring here or an issue?
Why is it that...
People get this wrong.
It's understandable.
So then the next question, very naturally, is why do people think that what we do on stream is therapy, right?
So where does this idea come from?
What do we actually do on stream?
And are there any overlaps with therapy?
So it's a really good question because I don't think most people, like we sort of mentioned, most people haven't studied medical ethics.
They don't really understand the definition of the practice of medicine.
They're not trained in diagnosis.
They're not trained in developing treatment plans or doing psychotherapy.
So where do they get this idea that what we do on stream is therapy?
So it's a really good question.
So what we do on stream is we have conversations with people that are about their mental health and I use some skills.
So I'm a very good listener, for example.
I'm very good at asking questions.
I'm very knowledgeable about things.
So I'll build some amount of an alliance with the person that I'm talking to.
I'll be a very active listener and I'll ask very insightful questions.
So sometimes people think that that constitutes therapy, whereas no, that doesn't constitute therapy.
Easy for people to get confused.
Isn't it?
Yeah.
But that's really on them, I guess.
Yeah.
It's because they haven't studied medical ethics.
So, you know, like in our case, Matt, you and I are not therapists, but we have been through various ethics guidelines for doing research with subjects and how to deal with data of sensitive things, right?
We've run experiments on people that involve deception, all these kind of things.
So, I have taken...
Ethics courses, not medical ethics courses, but very related, right?
And the history of psychology is full of various ethical lapses from researchers that led to many of the developments that are now there in medical ethics.
And yet I found myself confused by some of the issues here actually being genuine issues.
But I guess...
That's just me, like a foolish social scientist, not really getting it.
And Dr. Mike also having, you know, these questions.
Like, Dr. Mike is triant.
He's, you know, practicing.
He's confused too.
Also confused.
We're all just confused.
I've gone through ethics boards literally hundreds of times.
I'm not exaggerating.
And, yeah, I have issues.
So I don't think he can play on the ethics understander and, you know, you lay people, you know, you're just confused because you don't understand ethics properly.
Yeah, and so this next bit, I think it really, it's laid on the rhetoric here because you get the repetition of the point and you're also getting the pre-empting of, well, let's see, he's basically responding to what we are saying here.
Listen to this.
So, like, what if you kind of make the argument, for example, that even though I'm a medical doctor and I'm not entering into a doctor-patient relationship, I'm not diagnosing anyone with anything, and I'm not providing treatment plans, right?
So I'm not doing psychotherapy, I'm not...
You know, providing medications or anything like that.
I'm still a medical professional who is like listening empathically, which sometimes is done in therapy.
So therapists are absolutely empathic listeners.
So if I'm a medical doctor, am I allowed to empathically listen to someone and ask someone insightful questions?
Or is that something that I'm no longer allowed to do except with my patients?
And that's kind of like absurd because the answer is clearly I'm allowed to do that with people without entering into a doctor-patient relationship.
So, for example, I do that with my kids.
I do that with my wife.
I do that with my friends.
When human beings talk to me, I try to be an empathic, active listener.
Bit of a sort of deflection here.
Nobody is saying Dr. K cannot have empathetic conversations with people or do streaming.
They're suggesting that the particular interviews that he does with influencers about, you know, traumatic incidents or their mental health might...
Cross the barrier ethics-wise.
They're not saying you can't speak ethically to someone about their struggles or whatnot.
Why is it that it's only Dr. K or Dr. Phil or Dr. Oz that these issues tend to come up with?
It isn't all people that have a background in psychiatry or therapy of one form or another.
But yet...
It's presented here, like, do you not want Dr. K to be able to talk to other humans in a, you know, a considerate way?
Yeah, I agree.
So just to kind of reiterate that, like, if you really think about it, like, if that were true, if I weren't allowed to have emotional conversations with other people, like, I couldn't interact with other human beings in an empathic way.
And this is what's sort of brilliant about the way that clinical medicine is defined, because it's defined about what's the goal.
Is it diagnosis or treatment?
If yes, then it's clinical medicine.
If no, then it's not clinical medicine.
So there you go.
You know, those three criteria are not there.
A medical doctor is allowed to, are they not allowed to ask insightful questions?
Are they not allowed to do that except with their patients?
And he actually goes on to say, you know, other people have these abilities, like customer service people.
Are they not allowed to speak empathetically with other people?
And you're like, again?
Think about it.
You're saying, well, this is just the CM.
But the reason that that is not coming up is because they're different.
They're different.
Nobody's saying, like customer service people who were streaming on Twitch and were being considerate, they're unlikely to get into the CM baller, right?
So there's a difference.
Yeah, yeah.
I mean, it's just, he leans very hard on this legalistic defense, which just simply doesn't stack up.
To give another example, imagine that I wanted to do something that is not research.
I just wanted to collect some data.
I wanted to talk to people.
Am I not allowed to talk to people, Chris?
People talk to each other all the time.
I just want them to, you know, I've got a form.
I want them to write down some stuff for me.
I mean, are people not allowed to give forms?
I mean, you know, people fill out forms all the time at the bank and stuff like that.
And, you know, I just want to then, you know, I'm just curious.
So I want to find out some stuff from this.
It's not research, right?
But I am going to do some stats.
On the information that I've gotten from them after I've typed it into the computer.
And I might publish it.
But, you know, it's not research, right?
I'm just curious and I'm just writing some stuff.
I'm just talking to people about stuff.
That happens all the time.
It's a really weak, legalistic, you know, logic-chopping defense which doesn't actually grapple with the fact, to use my little example there, if it looks like research and it...
Talks like research and smells like research, then the ethics review board is going to say, Matt, you're doing research.
I don't care if you say that you're not.
You know, a comparative example, which is Peter Bergossian, Helen Pluckrose, and James Lindsay with the SoCal Squared coax.
Peter Bergossian got in trouble.
And people thought this was an unfair targeting of him.
And to me, it reeked off people who don't understand.
Like the ethics procedure at university, right?
Because Bogossian's a philosopher.
He'd never done empirical research.
Neither had Helen or James, right?
So they didn't get it.
And what they did is they did this thing about submitting their articles to journals and seeing if they get through.
And they described it as a study.
They put it up and they had a method section and they had a sample of results and they described it as a research study.
And that immediately You know, led to Peter Magosian being pulled by the IRB board and saying, hold on, you can't have done a study as a, you know, an academic on people without having got approval from the university.
And he took this as, you know, being witch hunted and all this kind of thing.
He got a very mild slap in the wrist.
You know, he had to go to training, seminar, whatever.
But like, for one, I know how they could have got around that if they'd have framed it as a journalistic expose.
Where Peter Boghossian had give them advice as an academic.
That would have avoided it.
But also, I actually think in that case, they brought the ethics board onto them because of what they did with framing.
That led to the ethics board being able to take it as this is a study and you're an academic.
And I think the ethical issues there are not so great.
Although Boghossian is an idiot and they didn't even consider whether that...
Would meet the criteria.
I don't think, you know, people are potentially, are really that harmed by...
No, there wasn't a substantive ethical, you know, worry there.
In contrast, I think, to Dr. K. Right.
No, of course, the ethics board would take that there is because they'll say you're using people's time and people will just like, you know, so this is the kind of thing that ethics board...
Oh, yeah, no, no.
Yeah, I know.
Like, technically, yes, right?
The ethics boards...
Judge, as you said, any study, anything that an academic does involving human public participants or not has to go through those boards because it's also about protecting the university legally apart from anything else.
Right.
But there are ways, what I want to point out are there are ways where you fall under an IRB and there are ways to get round it and you could be doing almost the exact same thing that's just in the framing.
It's just in the framing but the...
Ethical issues may actually be entirely similar, but you've just legalistically managed to avoid...
Yes, that's right.
I take your point, which is that, you know, this goes to what we were saying before.
Like, there's ethical behaviour in the common sense, human, natural way that we mean it, right?
Not being a bad person and potentially causing risk to people.
Then there's the letter of the law.
And as you said, if you want to sidestep the letter of the law...
Then you could do something like frame it as a journalistic investigation, and then it doesn't fall within the remit of an ethics review board.
Now, Dr. K is working extremely hard to say, what I'm doing doesn't fall within the remit of an ethics board, therefore I can do anything I want, right?
Now, that may well work in a legalistic way.
It doesn't mean you're being a good person and you're behaving ethically in the normal, human, everyday sense of the word.
And on the subject of IRBs, Dr. K references going through IRB procedures.
So this is institutional review boards.
That's the jargon, okay?
So the first example that I'll give you all, and this is in many dimensions of our company and our work, but the first is research.
So for example, for all of our research studies, we submit them to something called an independent review board or an IRB.
So there's a third-party organization which is not affiliated with us at all.
And when we want to do research, we'll take our research study and we'll pass it to the IRB and we'll say, hey, we would like to do this research on human subjects.
Will you please evaluate it and tell us if it is in alignment with ethical principles?
And the IRB is essentially, they were developed kind of after people did predatory research on human subjects.
And so we've actually had five independent reviews of our research, and a sixth that's ongoing for another study that we're doing, that have all sort of met an independently reviewed ethical criteria.
So we got the green light from an institutional review board, which is a third-party kind of ethical organization that approves the research that we do.
So if you pass an IRB, Matt, you know, that's basically, you know, you have to be an ethical person and doing reasonable things.
Yeah, yeah, yeah.
I noticed he corrected himself.
He said independent review board, but he corrected himself to institutional review board.
At the end, yes.
Yeah.
In Australia, we call them, like for humans, human research ethics committees, HREC.
That's our jargon.
So I will say there, Matt, as somebody, as you mentioned, that has gone through an IRB multiple, multiple times, that they're often a pain in the arse because the people on the IRB board may not have expertise in a particular area, and they might have very subjective interpretations of particular rules,
right?
But I will also say, so I passed much more than six IRBs, and I've never took it as indicating that This is meaning that I'm an ethical person or that my research is fundamentally ethical.
All it shows is that you can meet the requirements of an IRB review.
And actually, people that have done more of them know the things that will...
Ring up red flags and how to avoid them.
So, like, it is being presented here.
Like, this is a very significant thing if you are passing an IRB.
But it's actually a mundane thing.
That's a baseline measure for academic research.
And it does not mean that the research is actually...
Valid, reasonable thing.
Technically, it's supposed to mean that the ethical issues have been shown to be considered, and now the institution is liable because they approved it.
But there's been plenty of research that's got through IRB boards, which has turned out to be deeply unethical or pointless, bad research.
So going for an IRB board, it's slightly presented there as more of a significant achievement.
That it is.
Still, at the same time, I'm saying Bogossian not going through that shows that he lacks a particular expertise, but overselling IRBs also shows either a willing misrepresentation or a lack of familiarity of IRBs being not a particularly significant hurdle.
Yeah, of course, professional ethics.
It's a little bit different from our research ethics regulation.
You know, different issues tend to crop up.
I mean, one of the ones that I think most people are familiar with is when there's a conflict of interest.
So, for instance, very famous cases, especially in the United States, where doctors are getting approached by pharmaceutical companies, and the pharmaceutical companies, the representatives, are very keen to sell their particular drug.
Could have some addictive properties or something like that.
And they basically pay or reward the doctors in various ways for prescribing that drug.
Now, why is that a problem?
Because the drug may work.
The drug may be effective.
The patients may be very happy to be prescribed the drug.
It makes them feel better.
Why is it a problem?
Because there's a conflict of interest.
That's the issue, right?
The doctor is meant to be acting in that relationship.
Purely on behalf of the patient, are totally motivated for the best interest of the patient and have no other motivations in terms of their diagnosis and treatment.
Now, I want to ask you, Chris, what do you think the motivations might be for someone who is an aspirational YouTube celebrity and a streamer and somebody who gets most of their revenue from...
The audience, and in fact, probably isn't getting paid by the person they're talking to at all.
Where might their motivations lie?
Yes, there might be a conflict of interests there coming in because, as we noted earlier, the focus is not solely on the patient or client.
There's an audience and there's an ecosystem and a brand and so on to be built up there.
And yeah, that introduces incentives that might make the best interest of the individual secondary.
Yeah, secondary, not the principal focus of the interaction.
And that would be fine if what you were doing didn't look or sound or appear at all like therapy wasn't perceived as such by the person that you're talking to.
And it might be fine if the person is incredibly healthy and robust and is treating the thing as just a bit of fun, right?
But when that's not the case, then you're in serious trouble.
Yeah.
And so I think he oversold the ability to pass IRBs as really a mark of ethical quality.
He also, I think, oversells informed consent.
No, we'll talk about why this is important, but listen to this.
So how does someone come on stream?
What are the protections that we use?
What are the standards that we hold to?
And so this is where there's another really important part that I want to talk about, which is kind of an ethical standard that we hold ourselves to, which is informed consent.
So before people come on stream, they...
They meet with a producer and the producer sort of lays out with them what stream is, what's allowed, what's not allowed.
We make it very clear to them that this is not the practice of medicine, that Dr. K is not your doctor, and we make sure that they agree to that.
So we go through an informed consent process.
So if there's any confusion there or they're looking for some kind of medical advice, that's where things end.
Right?
So we inform them and then we go through the consent process.
And this is where the ethical principle of autonomy comes up.
So we at HG believe that a human being, an adult, who wants to come onto the internet and voluntarily talk to someone about their mental health should be able to.
We believe that human beings should have the autonomy to make their own decisions.
It's just about respecting autonomy, Matt.
It's about equity.
It's about autonomy.
Do you not think adults have the right to make their own decisions?
Yeah, that's interesting in defense.
It sounds good because you're saying, hey, look, I'm not talking down to a person like Recfall.
No, no, they're a powerful person.
They have agency.
They can make their own decisions.
But what it does do is it absolves you of responsibilities because they're a free person.
They're making free choices.
They get to do what they want.
And actual fact, Chris, as an interesting example, this is the very same line that the gambling industry takes in terms of not providing player protections because people are coming in there of their own free choice.
Nobody's forcing them to play the...
The pokey machine.
Nobody's saying you have to keep sitting there for three hours and spend all your money.
That's their choice, right?
Are you saying you're not going to respect their freedom to decide what they're going to do?
You don't know what's going on with them.
Don't mollycoddle them.
Don't be like a nanny state and kind of say what they can and can't do.
So it's a very convenient thing when you want to have an exploitative relationship with someone.
Yeah, and so informed consent, Matt.
Right?
Important in research.
It is a principle of modern medicine and so on.
However, anybody that has run studies or been involved with research will understand that there's the theoretical model about what informed consent involves.
And this is what Dr. K has just outlined, that it's all about the individual.
Being given the information and making a choice of their own free will, their autonomy, understanding all of the implications, having everything laid out to them so they're clear, you know, in non-technical language.
Right.
But also, a lot of informed consent procedures are essentially to protect universities and researchers from being sued.
Because when somebody comes back and says, I didn't consent to this.
I didn't agree to this has harmed me or whatever.
They can point to the consent sheet and say, we informed you of everything that would happen.
And you agreed that you understood that that was not the case and that these were the limitations of the thing and so on.
So Dr. K here is emphasizing this is for the guest's own understanding of the relationship.
But just...
You know, by happenchance, it also happens to protect Dr. K and the organization from any subsequent claim that anybody was under confusion or whatnot.
No, they have the document that is signed.
And I feel like this doesn't address the reality that people can read things, they can be told, you know, this is not therapy.
He is not your doctor, right?
You understand that.
You're not going to be...
Prescribed medication in this encounter.
Anything that's uncomfortable that you, yes, yes, yes, yes.
And then you sit down with someone who for hours listens to them empathetically, talks to you about your family history, talks about, you know, previous diagnoses that you've had and whatnot.
And they start to get to the root issues of your trauma and so on.
Yeah, sure, you've got a disclaimer.
You can show it and you can say everybody understood, everybody agreed that this wasn't.
And I said multiple times during the session, I'm not your doctor.
Dr. K. frames that as being very careful not to confuse people.
And I think you could also frame that as covering your butt.
Oh, yeah, of course.
It's a waiver.
It's a waiver.
Sign this waiver.
And people do.
We all sign them.
Every time we download something from Apple, we sign these very complicated waivers.
And it's not, yes, legally it could be helpful, but it's not a get-out-of-jail-free card.
So, you know, there could be in that waiver.
You know, if you're feeling upset at any point in time, you have the right to terminate the session whenever you like.
You're talking to someone that's mentally unwell.
And if they're breaking down online and then you're encouraging them to dig deeper and you're not terminating the session or anything like that and they're not, well, that's on them.
That's on them.
And it totally fails to take into account that they're a vulnerable person and actually the onus is on you to take care of them, not for them to take care of themselves.
Yeah, yeah.
So Matt, one other concern Dr. K has, and this is the end of the ethics thing, right?
He's basically addressed that he doesn't violate the ethics.
It's not a fair session.
That's done.
But there is a concern, Matt.
There is a concern about some groups of people online.
We might be said to be in these people.
So let's hear what he has to say about hate farmers.
The next thing that I want to talk a little bit about is something that's a little bit more negative, and that's hate farming.
There's been an increasing and disturbing trend on the internet recently of people sort of being increasingly critical and essentially farming hate.
And I want to talk a little bit about what we've learned sort of in terms of our platform and sort of the reach that we have and how we try to behave in an ethical manner.
So as a content creator, you know, I feel like I have a duty to use my platform for good.
The unfortunate thing is that there are some people out there who will use platforms essentially for negative reasons.
So they'll hate farm or criticize or things like that.
And like I've said, we're actually completely open to criticism, assuming that it's sort of fair and based in fact and is well cited.
So we're completely open to criticism and quite responsive to criticism like that.
Unfortunately, what we're seeing on the internet is an increasing amount of like toxicity, right?
Like we can all feel that the internet is becoming a more toxic place.
And so what I'd like to do today is talk a little bit about how I've come to understand hate farming and sort of what goes into it.
So the first thing to understand is that hate farmers usually are operating on an emotional level.
And the main emotion that they sort of target is a vague sense of righteousness.
So when you watch a video by a hate farmer, what you'll often find is that it's very emotional in nature, right?
So it's going to have very powerful imagery.
It may have sort of a very strong title, may have sort of a very powerful thumbnail.
And as they sort of, as they start to weave their narrative, like what you're going to be feeling is some sense of outrage or irateness or things like that.
Hate farmers, it's an epidemic.
And he's open to high-quality criticism, but the problem is...
Yeah, there's a lot of hate out there.
Always there is low-quality criticism.
Yeah, there's a lot of haters out there.
Yeah, that's us, I guess, right?
So he's preempting.
I'm sure he's already seen negative blowback.
I think this is directed at Mr. Girl in particular, a guy that made a thing which was actually showing various...
Clips of professionals discussing ethics and showing that what he is doing might violate that.
And what did I say?
His name is Mr. Girl, whatever.
He himself is a roller, heinous character online, various controversies.
Go look into it.
But the issues that he raised about Dr. K are valid.
And he may have been the person involved with submitting.
The thing which led to the ethical reprimand.
There's reasons to think that he is, and some to think that he's not, which relates to the timing of the official documents.
But a lot of people, including Mr. Garland, initially thought he was the person, because he submitted things to the ethics board, like a kind of package.
Yeah, I mean, I guess the meta sense that I get, though, is that combined with his extremely legalistic...
That he also follows it up by kind of like this pre-inoculating his audience against any, you know, you might be hearing stuff out there that people are saying that I'm doing bad things.
They're hate farmers.
They're people that are just filled with hate and are just trying to whip up emotion.
You know, I feel very sorry for these people, obviously, but yeah, it's not serious criticism.
I mean, it's all very strategic, though, isn't it?
Like, he's incredibly gifted.
At self-presentation.
And all of this is very finely crafted.
And the thing that actually does upset me a little bit, I don't want to be one of these emotional people that he's talking about, but the fact that this was a serious thing that happened, regardless of whether you think he did something right or something wrong or whether he was doing everything okay.
I mean, somebody died.
And stuff went down on that episode that clearly was pushing some boundaries.
And at no point does he seem to engage with that at all.
Instead, he takes an incredibly self-interested approach.
Which is all about minimizing damage, minimizing reputational hit, and inoculating himself through waivers and signing things, and also inoculating his audience against anyone that might be criticizing him.
This is clearly his intent with this thing that he released.
Yeah, yeah.
And he made the point about dramatic thumbnails and emotional content and whatnot.
And I wonder, has he seen his own channel and some of the various things that are popular?
There's certainly a lot of emotion in those interviews, and there's click-bitty titles going on there as well.
But the things that he's warning about are also real.
But like you say, it's very self-serving.
So listen to this warning about confirmation bias.
So they'll usually have some kind of narrative where they sort of will find a bunch of information on the internet.
And this is where, like, it's challenging as a content creator because, you know, we've probably streamed for well over a thousand hours.
And if you go through all of the content that we've done, you can stitch together basically whatever kind of narrative you want to.
So a really good example of this, if you all haven't seen it, is Dr. K interviews Dr. K, which is when someone takes clips of me and, like, stitches them together as if I'm having a conversation.
So you can sort of clip things into context to weave whatever kind of narrative you want to.
So the first thing to understand about hate farmers is that they work primarily on an emotional level and will really sort of encourage you to get your pitchforks out.
They may make some kind of narrative argument, which sounds very logical at the time, but this is where oftentimes what hate farmers do will come up with a priori arguments.
And what does that mean?
And that means that the judgment actually precedes the collection of evidence.
So I'll go into a little bit more detail there.
So oftentimes, if you look at people who are critical and people who are hate farmers, they sort of assume guilt at the very beginning, right?
So they haven't really done an objective investigation.
Something has happened and they've sort of decided that you're guilty.
And then something really tricky happens is that once they've decided you're guilt, they'll start collecting information.
The problem is that on the internet, Your search and the way that you collect information is going to probably reinforce your biases.
Very clever.
It's very clever.
So, you know, you may be seeing clips, people may be playing clips of me that sound damning, but, you know, you can clip together stuff from the internet that can make someone sound like anything.
I mean, there's clips of me interviewing myself, so that obviously didn't happen.
So, you know, that's...
Don't trust the clips.
And their arguments may sound very logical, but you see, what they're doing is that they're tricking you because they've actually started off with a foregone conclusion and they're actually assembling evidence to support that conclusion.
Yeah, I mean, I admire the craft, is what I can say.
Because he's not wrong about this being something that can happen.
You know, people can make these clip compilations of people doing that.
But however, Dr. K has put out a bunch of content.
But I bet it would be hard to make a very long clip compilation of him presenting that Ayurvedic is terrible and that we really need to drop it in favor of Western medicine or modern medicine.
Now, there are some...
I used to hit a clip that you could use for that purpose.
But it would be easy.
It would be child's play to show that that's not representative of what he does.
And we were able to play two episodes of multiple hours of clips of him disparaging modern medicine and arguing that Ayurvedic medicine was much better and was filling all the gaps in modern medicine because that's what he...
Yes, there's a couple of times where he adds in, you know, disclaimers and whatnot.
So there's that notion that, like, you can make anything with clip compilations.
And what Destiny, I think, refers to clip chipping, you can do that, right?
You can take isolated chips.
But it is also not the case that, like, therefore...
Everything.
You shouldn't believe it, right?
Like, you've seen these compilations of Joe Rogan saying right-wing conspiracy theories, like, no, that's not what he's...
Yes, it is.
That's an accurate representation.
So, there's videos of Dr. K crossing ethical boundaries in interviews.
Well, you know, that's not what it appears to be.
Is it not?
Well, in any case, Chris, I'll just point out that we...
Didn't do that.
We didn't go cherry-picking through thousands of hours of content.
The clips we've played are of a specific piece of content.
Well, yes, a few specific pieces of content, but yes.
So, Matt, you might be wondering how you could link Heat Farmers to IRBs.
I would wonder that.
Well, here you go.
And I'm not so sure that they're doing this like insidiously and on purpose.
Is it harmful?
Absolutely.
But I think that they sort of stumble upon some idea and then it actually shapes the questions that they ask.
And once you shape the questions that you ask, you're going to shape the responses that you get.
And this is precisely why if we look at a scientific standard...
Of how to collect information, making Twitter posts is like not a good way to collect information.
So if you submit a study to the IRB that has a loaded question in it, the IRB, the Institutional Review Board, will say this is a bad question.
You cannot ask this question because it is biased by its nature.
So we, this is where in scientific research, like, we understand this stuff really well.
When we formulate questions, when you ask a research question, it has to be approved by someone who sort of makes sure that it isn't biased.
But when it comes to hate farmers, like, they don't go to independent review boards to see if their question is biased in some way.
And so then what happens is you create a selection bias for information, right?
So that's how you...
Connect an IRB to heat farmers.
Heat farmers haven't gone through the rigorous scientific training necessary to be capable of passing an IRB.
And if they had, they would understand that what they're doing is, you know, doing things in a particular way.
So, E-Lormat, we are incapable of this because we've passed IRBs like Dr. K, right?
So, therefore, we understand this and that doesn't apply to us.
Or we're doubly damned.
Because we understand what scientific approaches are, and yet here we are still with concerns about what Dr. K does.
So aren't we the worst hit farmers of all?
We're people with scientific training of sorts, enough to pass an RB board, and yet we are here saying there's issues.
We are indeed.
We are indeed.
So are we done with Dr. K's...
Detailed defense about how he'd done no wrong.
Just one last thing, Matt.
One last thing from this.
You have to be sympathetic to the hitformers.
It's not their fault.
It's not their fault, Matt.
They're just, they're not scientists.
But this is why I remind you that especially when it comes to some of the criticism that we've faced, it's not a matter of opinion.
It's a matter of law, right?
These things are very clearly designated.
And we are in compliance with these kinds of things.
So when it comes to hate farming, be a little bit careful about this stuff, right?
Because this is happening more and more on the internet.
And oddly enough, I don't even necessarily blame these people because I don't know that the people who make hateful videos have done any kind of training with, like, how to formulate a good non-biased research question.
That's something that, you know, I learned through four years of getting a master's in public health in some amount of, like, as an MD.
Generally speaking, formulating research questions is actually like a very technical and difficult thing to do.
So I think what's happening is people will sort of come to an a priori conclusion.
They already decide that something is bad, and then they'll sort of ask questions in a way that reinforces their bias.
This is why the internet is turning into echo chambers, and this is what's leading to toxicity.
I love it when he plays the credentialist card, Chris, because...
Because that's my card.
I got a bigger card.
You got a bigger card on this particular card.
Oh, he's done four years of a master's in public health, has he?
He's worked as a practitioner.
I'm a professor, Chris.
I'm a professor.
I've done hundreds of these kinds of IRB.
You've developed your own skills.
I've done so many things.
You're a psychometrician, Matt.
You're a psychometrician.
You might say that I know a little bit about generating a research question.
So this is not something that he can tag on me.
No, I have a problem with what Dr. K has done and continues to do.
And I don't find any of his legalistic defenses very convincing.
And frankly, I find his total lack of engagement.
With what actually happened during that interview with Rekfall and the ultimate outcome, whether or not he was in any way to blame for that outcome, not saying he was.
I mean, a human person would have engaged with that honestly, not legalistically.
Just to be clear, though, Mark, he did release a video after where he cried on stream and talked about Rekfall being a hero and all this.
You know, that we lost a great hero and so on.
So he didn't address the...
It wasn't all legalistic.
No, I appreciate that.
But you can see how that can also be self-serving, I suppose.
Indeed.
Indeed.
The thing is that when addressing these issues about, like, the criticism, this was the thing.
This was the response, right?
This is the content that we're talking about now.
The death of Rekvold.
Was covered in a more emotional short video about his response to his friend dying, right?
But like you say, that didn't get into the issues around the streams that they did or whatever.
It was more about just the emotional response to that and also potentially that does have, even if genuine, some rather conflicted issues because it is also self-serving.
For your presentation.
Yeah, that's fair.
That's fair.
There's another interview that he did, Matt, that is more recent.
I just have a couple of clips from it that I think relate to those issues before we get to the final clips about, you know, his response to the reprimand.
But he did a...
Some streams with a streamer called Ludwig.
Ludwig is a very PC kind of...
He's like the anti-Destiny.
His streams are relatively...
He avoids controversy like the plague and he's doing gaming streams.
He looks like a very handsome young chap and whatnot.
Stay away from edgy stuff, as far as possible.
Sometimes get involved with it, but he's not a Hassan type.
He went on with Dr. K, and he was mostly very light, keeping things light and whatnot.
But he does, like most people, have some, you know, tragedy in his past.
And you can see when Ludwig was talking about his life story, he said like this.
Thank you.
Can you tell me a little bit about what growing up was like?
Grew up in New Hampshire.
It was chill.
I had like a nice house, indoor pool.
That's cool.
That's like a weird thing that people don't have a lot.
Dad died.
High school is great.
3.0, I would say.
Yeah, pretty good high school all in all.
Did you say your dad died?
Yeah, my dad died.
My dad died when I was 10. Yeah.
But also 3.0.
I was in choir, honors choir.
Wow.
That's impressive.
Can I just think for a second?
Go for it.
Go for it.
Varsity soccer.
How old were you when you were into the 10th grade?
So, you might have picked up on...
I also think Ludwig was kind of dropping that in as...
That's not a natural way to mention that a close family member died or whatnot.
But the conversation proceeds, right?
And Dr. K does the thing, Matt.
Where he gives the option about, should we dig into this or should we not?
It's got to be your choice, right?
But I also want to fully respect, you know, what you want to do and what you don't want to do.
We're going to ignore Twitch chat, don't care about what they think.
It's not about that.
We've got to go down the road, Dr. K. No, we don't.
We have to.
Nope.
I want to.
Do you feel beholden to?
Yeah, okay.
What does that word mean?
So, do you feel obligated to?
Or do you really want to?
No, I think it's a more hype road to go down.
And that's what I'd prefer.
Okay.
Why do you choose the hype road?
Well, because when it's hype, it's more fun.
It would be regrettable to not pick a hype decision.
Yeah, so once again, you gravitate towards fun and lightheartedness.
See, it's happening right now.
You're doing it again.
No, it's just like it's something that's hype.
I could go down the road that I had predetermined, and then I could think a week later, like, damn, maybe Dr. K had some shit to say.
He probably had some bars to drop, and I didn't go for the bars.
Is it okay to not go for the bars?
Sometimes, yes, but...
If you can, and it's not that problematic, why not?
Okay, cool.
There we go.
Issue resolved.
And also, Matt, just that reference to, you know, you made a joke.
So, you know, we talked about, like, that you can kind of weaponize therapy speak, or even if you don't put it as weaponized, there's a power differential when it comes to, like, a therapist talking to someone, right?
And one of the things they can do is stuff like this.
Do you have any advice on my YouTube videos?
Because I sent him a video I had made.
Oh, I see.
What are your thoughts on this video?
And that's what he said.
How did that make you feel when he responded?
It, I think, didn't matter because I had already quit at that point, but I thought it was cool that he replied for sure.
What was cool about that?
That he took the time for a young 16-year-old boy.
Yeah, so we're going to point something out, Ludwig.
What did you just do?
Uh, thanks the anonymous donator were in conjunction with you and brought up a story about, uh, eating my addiction.
Yeah.
So, so, so like you just changed your voice a little bit.
Uh, right.
Yeah.
And you kind of made a joke out of it.
You're like, Oh, like was nice for a 16 year old boy.
I can stop if it makes it.
No, you're so good.
You're so good.
I did do that.
Yeah.
How do you understand why you did that?
How I made the voice?
You make it more spicy?
No, no, no.
I mean, but why did you make the voice in that moment?
A little flair?
Yeah, but why flair at that point?
I completely agree it's flair.
You're cracking a joke.
You're making it a little bit funny.
Well, why then?
Because I guess it was a bit...
I was a bit goofy.
That I, uh, every chance of Pepe laughing, you got me.
It was a bit goofy that the whole entire situation, but it's something I look maybe fondly back on.
Yep.
Um, but you know, yeah.
Yes.
So it's kind of interesting.
Cause I, I think actually like what you're doing is lightening.
I think the significance of it.
Okay.
Yeah.
Why did I do that?
So, so I, I, I think it.
We can get to that in a second.
Let's notice it first.
We start with observations and then we can develop hypotheses down the road.
The more data we collect, the more accurate.
But I think that sometimes people feel uncomfortable, if I had to venture, sometimes people feel uncomfortable talking about things that are impactful to them.
Just normal conversations.
Not at all.
Like, therapeutic interaction, right?
Yeah, right, right.
And look, I think even apart from digging into Dr. K, I think this is really helpful for people to understand the way in which therapy speak can be used as a power play and as a way to manipulate people in conversations.
And as you said, it all lies on one side.
The powers within Dr. K to say, Why did you say it like that?
I mean, you smiled just then when you said it.
What did that mean?
How did that make you feel?
And it puts you on the back foot and you have to explain yourself.
The therapist is like a shield around them, right?
They are the one that asks questions and you are the one that answers.
And I think because people associate this therapy talk with being helpful.
Or kind or something.
They think that there can be nothing wrong with it, but it can be misused.
Yeah, and this is because Ludwig put on a funny voice when he was talking about a story that he told about something semi-embarrassing he did in the past.
And then that whole thing about, well, why did you do that?
If somebody asks you to break down a joke, it's kind of embarrassing in general.
But in this case, you know, Ludwig mentioned, you know, you're roasting me live on a stream.
And he's like, no, no, but, you know, it's more deeper than that, right?
And also these pauses, the pregnant pauses, where you're like, that's it.
Let me just think about that.
Like, again, this is things which people don't normally do, but can happen in a session where a therapist says, you know, let me just think about what you've...
Said there.
Also, podcasters occasionally do this.
It is fair to say, like, when they want to seem profound.
But it is well known.
It's almost a cliche of a power play, which is to let the silence sit.
Yeah, let's sit with that.
Let's sit with this.
And oh, by the way, Matt, just to say, I do appreciate this from Ludwig, because, like, they go on, they end up talking about his dad, and I'll play one clip related to that.
But Ludwig does actually show awareness of the kind of power play.
So listen to this interaction.
So, if you want to go down the road, enough of a...
Oh, shit.
Lost my pen.
Yeah.
You do it, too, Dr. K. Way to make a lighthearted joke in the moment.
No, I mean, seriously, my fingers are slippery.
Which is a whole different discussion, but I'm supposed to ask you about Coomers at some point, too.
Oh, geez.
Okay, sure.
Speaking of making things lighthearted.
So, tell me what...
I mean, do you...
You know, were you always kind of the joker?
Yeah, for sure.
Class clown.
Can you tell me a little bit about that?
So, you know, he dropped the pen and makes a joke and Ludwig is like, look, you, you know, you're making that lighthearted thing.
But Dr. K says, ah, ha, ha.
And then, you know, make some like kind of off-color remark.
But then this tone completely shifts.
You heard at the end when he's like, okay, but so tell me what did you mean when you said so like?
It's okay for him to pause and say, you know, but why did you make that joke?
But when Ludwig does it, it's just like, okay, yes, that's funny.
No, let's get back to the serious business here.
Yeah, and you hear the change in tone and the very focused question.
Were you always a class clown?
Yeah.
Like you were saying, this isn't how people talk, right?
This is a form of some form.
Of therapeutic communication.
And it is, like, Dr. K is good at it.
You can tell at all points in time, and he boasted about this earlier, he's good at controlling the conversation.
He's good at asking the insightful or the correct questions.
He's running it and using what he's learnt in his clinical training.
Yeah, and he likes these eureka moments.
So you picked up there, Matt, on the, well, you're always a class clown, right?
And Ludwig talks about, you know, like, this experience he had where he was a class clown, he did something, and he got a reaction, and, like, you know, since then, he's always kind of been performing in front of crowds.
And then I washed the dishes and took a shower at the same time.
And everybody thought it was the funniest thing ever.
And ever since then, I've just been on a high road.
I'm just riding that high.
What is that high?
They all laughed.
They thought it was funny.
It was a classic good one.
And how did that make you feel?
10 out of 10. It was a banger.
A certified good one live in front of all the people in my class and my crush and the cool teacher.
Sounds amazing.
Did I do the voice again?
Yeah, it was amazing.
It was good.
Yeah.
Dr. K, he often draws these connections, right?
So Ludwig mentioned the 10th grade whenever he had that story, right?
So listen to this.
No, he died when I was 10, not in the 10th grade, unless you're just wondering 10th grade.
Sorry, how old were you when the joke story is from the 3rd grade?
It was, on hindsight, I misremembered.
It's 5th grade, I believe, actually.
How old were you in the 5th grade?
8?
No, wait.
10. Wait.
I was 10, Dr. K. See, you did it again.
Oh, fuck.
Yeah, I was 10 years old.
A detective voice.
Do you remember?
What else happened that year?
Wait.
My dad died that year.
Wait.
Okay.
I'm using a voice, but I do think I have an erect.
Yeah, I guess that does add up.
Sure.
You're onto something here, I think.
I mean, maybe.
So, it's okay.
Let's just sit for a second.
How are you feeling right now, Ludwig?
I feel good.
I'm trying to remember dates.
Because he died in March.
I can't remember if it was before or after the story.
But I don't remember.
I can't remember.
So...
Dr. K's version is that Ludwig became the class clown in response to the sadness of his dad's death.
And now he's kind of repressing the actual significance of that event, even though, because when he's talking about it, he's kind of saying, you know, he processed it, it's very sad, but like, he's okay with it.
Yeah, so this is the really challenging thing, Ludwig, is I think you're doing great.
I don't think you're someone who has all these problems or things like that.
I don't mean to make a mountain out of a molehill.
At the same time, I think that there are still, like, areas that all human beings can grow.
And I think the real challenge here is that what we have to, what I think would help you move forward in life, which, by the way, I think it's just, you know, I don't know if you...
Because it happened a long time ago, and Dr. K is not so sure that that's the case.
But you hear at the end of the map where he says, like, maybe it's the same year, right?
Like, maybe.
Maybe it's unclear, right?
Like, but...
He's not sure if that event happened before or after.
So if it happened before, it wouldn't fit this whole detective case.
But that doesn't come up, right?
Dr. K moves on as if the connection is pretty much likely to be the case and kind of fixate, you know, in that interpretation as they go on.
And they talk about other stuff as well.
But it's that thing where...
So that explains why Ludwig is, you know, this kind of personality and he's a streamer and yeah.
Is it possible to be grateful for things and ungrateful for things at the same time or is it either or?
It is, but I think the energy spent reflecting on what you're grateful for is more valuable than what you aren't or upset about because that you cannot change and what you're grateful for is something that you can keep and Continue to grow and like,
you know, I think it's more valuable.
I can get behind that.
Mm-hmm. Mm-hmm.
Mm-hmm.
At the same time, I disagree.
Look, you know, I can be 15 mall that, you know, my Jonah had a dad until he was.
17 and then my dad died at 10. Or I can be like, damn, I got this sweet car because my mom is nice.
That's POG.
And I think that it's a better headspace to be in the second world.
I agree with that.
So there's one thing that I would switch in your words.
Okay, sure.
You can be mauled at whoever that is, at 15 because they have a dad, or you can be grateful for the...
The car.
And this is where I would say replace the or with an and.
But why be mauled?
Because you're only mauled at life, which you have no control over.
Getting mad at something I have no control over seems like a fruitless endeavor.
Thank you.
Let me think about that for a second.
Because I think you're right.
you.
What do you have control over?
Well, I mean, this is therapy as spectacle, right?
And just like a Hollywood movie or something, it's like within five minutes, right?
It's like...
It's Columbo.
Columbo.
This is to actual therapy and diagnosis as Columbo is to actual real detective work, right?
Unfortunately.
Yeah, I mean, this is my point, which is it's entertainment.
It's designed to be entertaining.
There's none of the careful stuff that actually goes on, which is actually quite boring and not fun to listen to.
Now, I mean, one little thing that I'll point out, Chris, though, too, is that it's just I'm kind of fascinated by those little tricks that he uses, for instance.
But, you know, I just want to check in.
How are you feeling right now?
Yeah.
Again, not therapy.
Not therapy.
Yeah, again.
Again, this is totally normal.
This is how people talk.
That aside, I mean, those sorts of questions, they can be asked in good faith.
But honestly, in the hands of Dr. K, then it can be used as like a double-edged sword where if you go, oh, no, I'm fine, right?
Okay, great.
Let's continue.
We can dig deeper.
And if you say, well, actually, I'm feeling a bit upset by what we've just been talking about, well, then you've got another avenue to go on.
But either way, the person that you're talking to, there is no way out.
The only way is further in for them to expose more of themselves and for you to take them where you want to take them.
Now, Matt, last clips, last few clips, just to play the finish of this long episode.
So, Dr. K more recently released a thing where he talks about his reprimand, his official reprimand from the licensing body, right?
The streaming that he was doing and including the interviews with Recful.
And he did receive an official reprimand from the Board of Registration in Medicine.
And the publicly available document is not that long.
It's eight pages long and it outlines the circumstances it talks about, the interviews he did with Recful.
And the conclusion at the end is that...
He has engaged in conduct that undermines the public confidence in the integrity of the medical profession.
The respondents' licenses hereby reprimand the sanction is imposed for each violation of lawlessness, blah, blah, blah.
Right, so they did find that he had violated the ethics of the profession, but not such that his license would be revoked, which would be a very strong one.
Just enough that he would receive an official reprimand, which goes on your record and which you need to notify employers of.
And you can look up Dr. K's kind of medical record and it's on there.
So it's not the harshest thing that they can levy, but it is also not just a minor thing which, you know, everybody gets a couple of reprimands in their career.
No, most people do not.
Now, obviously you needed to respond to this.
And he did.
So let's see how he framed it.
Before we get started with that, as some of y 'all may have seen, I was recently reprimanded by the Medical Board of Massachusetts.
And I think it's really important to kind of talk about this.
So the first thing to understand is that this is like really, really important.
We've been cooperating with a board investigation that started about two years ago.
It's finally concluded.
And I think that this is like a very healthy and fair way to do things.
So I know a lot of people like the work that we do and they're like, oh my god, like this is so unfair.
No, this is exactly how things are supposed to happen.
It's fine.
It's great, in fact.
It couldn't be better.
And this is the exact opposite response of Jordan Peterson, in a way, right?
You know, real with fire and fury.
How dare they?
Who has the right to judge me?
But Dr. K is almost like, it is fantastic that the Earth Explored have, like, done this.
We have been holding hands with them every step of the way.
It's been a wonderful experience, you know, like, and let's explain why it's good.
Like, this is a good outcome for everyone involved.
Yeah, yeah.
This is the sort of lean in to the criticism.
Embrace any detrimental things in a love bear hug.
Dr. K is far more sophisticated socially than someone like Jordan Peterson.
This is much more effective.
Of course, his tone of voice, the way he's presenting it, he's relaxed.
He's happy.
Some of you will be upset by this, but this is fine.
This is a good thing.
Let me explain.
You people don't understand how these things work like I do.
Also, you may have noticed they said before we get into it, I need to talk about it because this video is not...
Highlighted my official reprimand response.
It's a separate video, and this is just at the start of it, right?
It's not in a segment that you would notice if you went to his channel.
But okay, so what does he avoid and what is the medical board?
You know, people have got things in their head.
Let's be clear.
So about five years ago, I saw a problem with mental health.
I saw a degree of AOE damage.
That was being done, where as a clinician working in an office, I realized that like there is no way, like the number of people who need help, we would need an army of clinicians that we don't have to try to fix this problem.
The extent to which people are suffering and the extent that the mental health crisis that we were facing required some kind of additional innovation or something needed to be done differently.
So I started streaming.
And when I started streaming, I did everything that I could to make sure that this was okay.
And then what happened is someone filed a complaint in 2022, and this is exactly why medical boards exist.
Right?
So medical boards exist because occasionally you'll have a doctor who tries to do something a little bit different.
And is this okay or is this not okay?
That's the purpose of medical boards.
Innovative doctors trying things and boards us and is it okay or is it not okay?
Yeah, that's why they exist.
His motivations in streaming these online therapy sessions, it's about area of effect helping because that's what he's all about.
He's trying to find new ways of helping because there's so much suffering out there.
He's just one man.
He can't help people one at a time.
He needs to help people.
En masse.
That's the only motivation to broadcast these things.
Important to remind people of that point.
Important to remind people of the good intentions before we get into the official reprimand.
But also, Matt, this process was fantastic, as we've seen.
It was great.
So we've been cooperating with the board for the last two years.
I actually think it has been an eye-opening, humbling, fair, and excellent process.
This is why medical boards exist.
Because when there is a problem, when I show up and say, hey, I'm here to help, is what I am doing harmful in some way, helpful in some way?
Where is the line?
I personally feel relieved that the board has gone through everything that we've done with a fine-tooth comb.
And they have placed no restrictions on my license, no probation, nothing like that.
And furthermore, and more importantly, no restrictions on the work that we do here.
So, they could have said, hey, you shouldn't do interviews anymore.
That's therapy.
No more streaming.
No more content creation.
This is not allowed.
This is the practice of medicine.
They did not find that any of those things were actually applicable.
So, I'm still allowed to interview people.
I'm still allowed to stream.
I can make mental health content on the internet, and I can see patients without restriction.
So, that feels really good to me.
It's been a complete validation.
He's been given a clean bill of health.
He's innovated because he needs to help more people.
And the IRB board, whose job it is to look into it.
No, sorry, not the IRB board, but the medical board.
Sorry, the medical board has looked into it and, you know, clean bill of health.
He's fine.
He's got the thumbs up.
Could you just remind us, because it wasn't a severe reprimand, but what was the reprimand who was given again?
Just those details.
The respondent has engaged in conduct that undermines the public confidence in the integrity of the medical profession.
The respondent's license is hereby reprimanded.
I guess he could say he's given that a positive spin.
He also said, you know, when I show up and say, I'm here to help, is what I'm doing harmful?
Is it helpful?
Did he submit?
The ethics violation thing to the board, was that what happened?
Or was it someone else that said that, you know, he might be violating ethics?
And yeah, so if he wasn't, why did he get an official reprovade?
It's a little bit confusing.
It might seem like there's a contradiction, but you'd be mistaken.
And he specifically here talks about rectful.
You know, a lot of people thought that I was negligent with recful and all this kind of stuff.
And this is where the board actually outlines this very clearly, that I operated within standard guidelines.
There's no evidence of negligence or malpractice or anything like that.
Now, this may surprise people because they're like, oh my god, what I did was so bad.
But, you know, I'm going to say this.
I've said it before, but I'll kind of say it again.
So, one of the challenges of this situation is that...
Because someone has a right to privacy, I cannot share everything that I know about the situation, right?
So people made allegations, and in order to defend myself, I have to violate someone's privacy.
And I'm not going to do that.
I'll never do that.
The good news, the relieving thing for me is that with the medical board, the right to privacy, because they are a medical board, they reviewed a lot of records, things like that, right?
They can look at patient information and they are allowed to make a determination after they've looked through all of the information.
And I don't even blame people for thinking negatively about me, right?
Because you guys didn't have all the information and you can't ever get all the information.
I can't give you the information.
It's just not possible.
And that's okay, right?
So it's part of what being a content creator is.
I think this is a really important, healthy process.
This is what oversight looks like, right?
This is what we need to be safe.
It's for someone to go through, it's totally fine to complain, and then the board goes through everything, and they make a determination.
I think it's been an incredibly fair process.
I'm personally relieved, and I'm actually really happy that I continue to do everything that I've been doing, right?
No restrictions on my license or content creation.
So, Matt, can I just mention that in the official reprimand document, it mentions about his friend contacting him about Rekful's declining mental health on June 30th.
And the point that I believe he's referencing here is that the board says, during his conversations with Rekful and his friends, The respondent followed standard referral guidelines, including referrals for outpatient care, higher levels of care,
and guidance around use of emergency services, right?
This is in reference to the conversation on June 30th, 2020.
And then on July 2nd, 2020, Recful died by suicide, right?
This was his last conversation with Recful on stream was in February 12th, 2020.
Okay?
So that's different.
Than what he's saying.
Now, there might be some other document where they say everything is okay, right?
But what that says there is that when contacted by Regful and his friends and when he was having an acute episode, he correctly followed the referral on standards of practice.
But that is not saying everything in the conversations was completely fine, right?
In fact...
They reference various examples throughout the document of stuff that doesn't seem fine, right?
And so I feel that this is putting a heavy dose of spin on, like, they said there was nothing wrong with any of that.
They said I followed all the standards carried.
No, they said, because, like, if he had not done that or that acute incident where somebody committed suicide shortly after his friends and he contacted them.
Yes, that would be a really big issue.
But he's presenting that as, like, kind of, that's a validation.
And no, that's the least that you should expect from someone with training.
Like, you know, that when people contact you and they're contacting you, which speaks already to how they see you.
Yeah, a perception of the relationship.
Yeah, why are they contacting him?
They were just a guest on the show, purportedly.
And he probably rightly told them that he needs to contact, like, help, like, and get in contact with doctors immediately.
That's what you should do.
But, yeah, so there's that framing of the relationship.
And, Naumat, you mentioned about a clean bill of health, right?
So, that's right.
So, overall, this has been, like, honestly, it's been eye-opening, humbling.
But I've really, I think it's a very healthy thing.
This is the way that things work in the world, right?
When you try to do something new, occasionally we need a third party that is objective, that is going to look at everything that you do and determine what you are doing right and what you are doing wrong.
I'm actually incredibly grateful to the board.
I know some people have been like, oh my god, this is no, no, like that, they're doing their job, right?
It's their job to make sure that I'm not doing something out of line or whatever, and then they take my license away if I am.
Like, that's what they're supposed to do.
And so I'm just really grateful to everyone who's been helpful to us, everyone who's given us feedback on what we could be doing better, everyone who's helped us create the processes that keep people safe in the work that we do.
I'm grateful to everyone for all that kind of stuff, right?
I'm even grateful to the American Medical Association and American Psychiatric Association for weighing in in what way they could in our processes for our attorneys and everyone else.
And I'm grateful to y 'all for allowing us to do this work, right?
So we showed up five years ago to help, and I think we've done some help in that time, and we will continue to do so.
And I think that's the most important thing, is that we don't need to change actually like a single thing about our process.
Everything that we've been doing, or I mean, it's not perfect by any means, but the board made no recommendations on restrictions to practice or any of the content or interviews that we do.
Wow, this is fantastic news.
Like, I wish I was officially reprimanded.
Yeah, yeah, yeah.
No, I mean, the overall impression you get is it's very much like a corporate damage control, but taken...
Like, amped up to 11. Yeah, but just, it's quite impressive, right, to like, you know, receive an official reprimand that the presenter does everything that you've done has been vindicated.
And like, the other way that they presented is, well, this was all issues from years ago.
We've completely changed things.
We don't do any of this stuff.
Like, it's different.
We wouldn't have a situation like that anymore.
And I do think that there is more care.
He's probably taking now about things.
But like that Ludwig clips that we're playing, that's not from years ago.
So like, yeah, they're just, I think they're overselling the extent to which.
So, you know, maybe they have crossed the T's and dotted the I's so that the board cannot point to.
You've got consent forms.
You're clear that you're not doing therapy.
You know, we're not going to.
Revoke your license.
But that's not one in the same as them saying there's no issue.
In fact, they've said something different.
They've said you brought the profession into disrepute.
That's a serious thing for a professional to do.
That doesn't happen to most therapists or most doctors in their entire career.
So to present that as you've actually been told that everything you're doing is fine.
It's quite impressive.
And I think one of the things that he's doing that holds up a shield is that he's so clear that the board is fantastic, that everybody involved is in good fear, right?
So there is no way that you can imply that he is arguing against what the board has said, right?
So, yeah, it's just...
It's impressive reframing.
It's really like that.
Yeah, yeah.
He's leaning in.
Incredibly so.
And, you know, totally gels with everything we've seen in terms of how he conducts himself and how he talks to people in that he's extremely socially competent.
He's very good at this.
So, yeah, he really makes Jordan Peterson look like a bit of a fool.
I think Jordan Peterson has his own motivations, right?
Jordan Peterson and their crews benefit by making a huge, you know, mountain out of a molehill.
But with Dr. K, he's going a different...
He's in damage control mode.
And, you know, he loves this.
It's fantastic.
It doesn't reflect badly on him.
Couldn't be better.
It's great.
I mean, it is a bit of a shame that a lot of what this medical board, you know, said, the advice they gave, the feedback they had, it's not all public, is it, Chris?
We don't have access.
No, I don't think so.
I think...
You know, you get the official reprimand being public, but I think there's a larger report because it's like, you know, two years and I'm sure lots of details of that are private, maybe for very good reasons.
But yeah, so who knows?
And Matt, one last thing.
There's just one last clip.
This is the last clip, I swear to you.
So do you think I'm reading too much into this?
So just listen to this paragraph and see what you...
I feel privileged that I will continue to be able to do this work essentially in the same way that we have been.
I'm not saying that, you know, this is like I will have a license to do this for the next 30 years.
Like we're going to continue to make process improvements, right?
There's always, you can always do better.
And that's like part of what we do here at HG is like continual process improvement.
It's part of the reason that our content does well.
It's part of the reason that our coaching program does well.
And by the way, the board looked at all that stuff too.
So did you note anything there?
Well, no, not really.
I was just catching the sort of normal corporate speak about we're always in a process of continual improvement.
We're always revising and looking over our processes to see where we can make things better.
What did I miss?
Well, the one line I got which I was like, is he says, you know, I'm not saying I'll have a license to do this for the next 30 years.
And then he goes on.
So, like, Why not?
Right?
Because that sounds like you're kind of priming the audience that maybe what we're doing will, you know, eventually it'll mean that I can't be using a license because it's too innovative or, you know...
Yeah.
Yeah, yeah.
Like, why would you say that?
Why would he use his license?
Yeah, actually, now you mention it.
That didn't click for me either.
He's implying that at some point in the future, they may well decide, look, no, you've gone too far.
We're going to take away your license.
And he's thinking ahead, which is like, that'll be fine, right?
He can be like Dr. Phil.
He can just switch over and say, no, I'm not a therapist anymore.
But why would they do that?
Because he's already outlined that he hasn't broken any ethical rules.
And also, I'm wondering, why was he reprimanded, given that he's very clear?
There are all these free things that need to be there.
He didn't do any of those things on any streams, even in the past.
He was talking about this long before.
So how could the board make this official reprimand if he had done nothing that would cross the line?
Maybe he was being too innovative.
That's probably what it was.
So yeah, I guess the board also doesn't understand the practice of medicine and therapy or what would bring.
Yeah, it is a little confusing because according to what he says, you know, he's been given a clean bill of health.
He can keep doing what he's doing.
There was no injunctions made about not allowed to do this or not allowed to do that.
He can keep doing it.
Yet he was given an official reprimand.
When he does practice and he has to broadcast it, he has to let people know that he's been reprimanded.
It's an embarrassing thing for a professional to have.
Now, presumably there were some reasons for that.
But the report is in public and Dr. K hasn't said what they are.
Yeah, well, it's kind of like it's unspecific in it, but it outlines, you know, basically the interactions with Rackville, which strongly it talks about like statements that he'd said about, you know, that he would be there for him for two years and so on.
So like it isn't specific in that argument, but it's very...
Clearly implied that it was through those conversations.
So yeah, so anyway, Matt, it's been a long jump through Dr. K content, but we're out of it now.
This is right at the Dr. K here.
We've got three episodes covering the Ayurvedic promotion, the kind of rhetoric around calm, which was surprisingly heavy.
And now we have this, which is another completely separate content.
Well, let me say my piece about, this is my genuine feeling about...
This type of activity.
And it applies just as much to Dr. Phil.
Perhaps not quite as much because Dr. Phil on a daytime TV show like Oprah is perceived by the audience and probably the people that are turning up as entertainment.
That's just my gut vibe.
And the thing about what Dr. K does is that he presents it as a deep and meaningful connection of souls.
It's deadly serious.
It may be educational.
But really, this is serious stuff.
It's not just light entertainment.
And I think most people tuning into Oprah and the people that apply to go on stage and appear on those reality TV shows, I mean, I don't like them.
I don't condone them, endorse them in any way, shape or form.
But I think in a way it's a bit less bad than what Dr. K is doing because there is the perception of it being somewhat light entertainment.
So what the issues are in doing this live-streamed broadcast stuff that looks a lot like therapy, first of all, is that there's a conflict of interest, right?
Because you're doing something which appears a lot like therapy to the person that you're talking to, but actually your interests are not aligned with the person you're talking to in the same way that it is when you are a practitioner who is getting paid.
To do that therapy session, it's in private.
No one else is seeing it.
Your only motivation is to help them.
Hopefully, you're not getting any kickbacks from some pharmaceutical company or anything else that's going to motivate your diagnosis and treatment.
So it's good.
Your interests are aligned with the patients.
That's not the case when it is...
Live streamed for someone who is building a channel, who's probably their principal sources of revenue are coming from clicks and views and subscriptions and all of these things.
So that's what's one, conflict of interest.
It's a big problem.
The second one is confidentiality and privacy.
That's one of the key things, that when you're doing something that looks like therapy, it happens in private.
So if you are breaking down, if you are saying incredibly embarrassing, You know, a whole bunch of stuff can happen.
You know, strict confidentiality always applies.
And that obviously, you know, is fundamentally violated when you're doing it on a stream where if something does go wrong, as things did appear to go wrong in his thing with Recfall, I mean, it's live.
It's live.
There are thousands of people watching.
So, your motivation when you're doing this kind of performance theater therapy is not about quality and depth of treatment.
But it's about providing a good show.
So you're going to have sensationalism and stuff like that prioritized over it being like a genuine therapeutic intervention.
And I believe Dr. K, when he's saying, oh, no, this isn't therapy because I'm not doing X, Y, and Z. Now, yes, it's clear that you're doing a very half-assed form of performance therapy, but that is not a get-out-of-jail-free card for you not.
Undertaking unethical behaviour.
The other thing, too, is in terms of post-therapy care.
Once you've engaged a client, you've got a responsibility to them.
There's an ongoing relationship.
And you've got a responsibility to them to follow up and make sure that things go okay afterwards.
There isn't that.
When people like Recful have signed these waivers and so on, you have none of the rights that apply to a patient.
You're just a guest on our podcast and once you're gone, we have no responsibilities to you.
And he's really big on emphasising how he doesn't have any responsibilities to the people that appear on the show.
So, you know, there's this very real risk of exploitation when you're saying, I'm going to have vulnerable people on that have genuine psychiatric issues and there's going to be titillation and fascination by all of the dark stuff that's going on.
There's an incredible potential for that to be pure and simple exploitation, which is going to generate clicks and views and revenue to Dr. K, but it's accruing no benefits to someone like Recful.
Now, I'll hand it to Dr. K that I'm sure that in the majority of cases, and he's probably learned his lesson, that if you keep it light...
If you're talking to fellow streamers and they're just having a bit of fun, they actually don't suffer from any serious psychological issues, then in those cases, it can be a lot more like a Dr. Phil, Oprah-type scenario where...
You know, people know the score.
Everyone knows that it's a bit like, it's not real wrestling, it's WWW wrestling.
And, you know, in that case, I acknowledge that the potential for harm is a bit less.
But really what he's doing here, what his motivation is, is to blur those boundaries, right?
He wants to take some of the credibility and some of the interest and the status that accrues to being like a licensed credentialed therapist.
And then he wants to use that.
In his broadcast streaming career, but he doesn't want any of the responsibilities that go along with those credentials.
So, I don't like it.
I don't endorse it.
And I think he's got a problem.
Yes, well said.
So, you offered, you know, your kind of big picture.
And I will say from mine that, like, I think...
Part of the reason that we split it up was because there is genuine, unique, ethical questions here.
It's quite an unusual thing that Dr. K is doing.
And yes, it does bear similarities to some previous cases with people who have credentials, who are doing public advice giving, but is it therapy, but is it not, and so on.
And I just think that part of the issue here is that Dr. K is clear.
He's considered all the ethical issues.
He's an expert.
There is nothing which they've really done which is wrong.
People online lack the expertise, which is why they get confused about this.
But I think that he uses a lot of rhetoric in making that argument and that there are other professionals.
There are other people with training and ethics and scientific objective ways of asking questions who are also saying that there are issues here.
It's not just internet trolls.
So, yeah, there's like an overlap of influencers and this kind of thing.
But I do think that he's not engaging with the criticism in the way that he portrays himself as.
And the conversation with Dr. Mike is probably...
The most direct that those points have been put with pushback.
And I think he slips into rhetoric quite a lot there.
So is he a secular guru?
Well, I think we'll see when we put him in the gurometer.
But I definitely think there's a lot of guru-ish techniques at play.
But he does lean heavily into the calm and spirituality side of things as well.
So yeah, I think he's...
He's doing something akin to secular guruizing, but it's probably more a combination of, like, influencer, power social stuff with a kind of Dr. Phil celebrity therapist.
So, yeah.
Yeah.
Yeah, yeah.
Like, I mean, in our defense, this has been a gargantuan triumvirate of episodes.
But, you know, I think we needed to play.
A lot of those clips to illustrate the points.
If we just played one or two, then, you know, he could be cherry picking and so on.
And I think we've established a fair few points.
Yeah, he's an interesting character.
I agree with what you said.
He's primarily, I guess, a kind of a Dr. Phil type character, a pop streaming broadcast therapist.
I mean, the appeal there is clearly therapy as theatre.
And, you know, it doesn't necessarily mean it's always toxic and that it's always hurting people.
I'm sure in many cases it isn't.
From the first episode we covered, we see that he definitely does have like a woo spiritual approach to clinical stuff that isn't grounded in evidence and science, but he definitely does take on the mantle.
Of being a credentialed expert authority.
So I think in that sense, that's where he's hitting our guru things.
And we see the same thing with this theatre therapy, where on one hand, just like the gurus do, they get to play it both ways.
They could appeal to the emotional woo stuff while claiming for it to be grounded in secular evidence and so on.
With the therapy theatre, he's digging into all of the...
The sort of drama and the emotions and the...
What's the word when you're sort of enjoying looking at other people do things?
Voyeuristic.
Voyeuristic, that's the word.
Tapping into that voyeuristic stuff.
But no, no, it has the highest of motivations, right?
This is education.
This is teaching people about learning about themselves, helping them level up and ascend Maslow's hierarchy of needs.
So, I'm not a big fan, I have to say.
I was more of a fan before I started looking for his contact.
The first exposure was interesting.
I haven't seen somebody doing these kind of conversations, this kind of empathetic listening.
It is getting to a deeper conversation with people, but then the more that you look, the more it seems potentially ethically fraught.
Yeah, just blurring of lines between all sorts of different things.
And this is not to say, just the final thing I want to say as well.
We keep making this point, and it doesn't seem to alarm with people.
This doesn't mean Dr. K cannot have given you good advice.
He cannot have been helpful to you or to the influencers that he's talking about, that he doesn't give advice which is useful and accurate about mental health in other circumstances, right?
All of that can be true.
This is a problem that I constantly bump into, where people assume that if somebody is doing the kind of things that we're showing Dr. K is doing, it means that we are saying he can never give accurate advice or be helpful to people.
And obviously he can.
Obviously many people of his community have found his advice genuinely helpful, have sought out help because of his things or have improved their life.
All of that can be true, as well as the criticisms about the ethics and the conflicting motives and manipulative techniques that are sometimes a part of his content being there.
So I just want to say, you're not an idiot if you find Dr. K beneficial or that you're interested in this stuff.
It doesn't have to be that somebody is completely all evil for there to be.
You know, potential issues that are not just from heat farming trolls, though we may be.
Yes.
Yeah, that's right.
And in terms of the kind of knowledge base of the stuff that he says, I mean, you know, he knows a lot of stuff.
And not everything he says is woo.
Not everything he says is illogical or a misrepresentation of evidence.
Some of it is.
Don't believe in the history of psychology, for example.
You covered that in a previous episode.
But yes, some of it is perfectly grounded expertise and clinical experience.
It's more about this way that it gets used.
Like Maslow's hierarchy of needs, it's a thing.
Some psychologists see some value in it.
But on the other hand, it has...
Like, essentially no evidence for it.
It's one of these things that kind of sounds good that there might be some truth in it, but, you know, whatever.
And you can take that and you can, you know, it makes you sound very smart, you know, about Maslow.
And it's the way you use it and the confidence with which you take that nugget of knowledge and throw it about as you're building these kind of rhetorical arguments.
And I have some issues with how he does that.
But anyway, yeah, look, Chris, thank you for bringing him to my attention, our attention.
He definitely is a unique snowflake.
He's a little bit different than anyone we've covered before.
And for that, Dr. K, we thank you.
We thank you.
Yeah, we give you...
It's a clean bill of help, basically.
So, it's a gargantum episode.
It ends the...
Or does it?
We'll see.
It's at least coming to the end of the streamer and academic season.
So there's not that much chance to play the theme music, Matt.
So I think I'm going to play that out.
Patreon shoutouts, the other things.
It'll have to wait for another occasion because we're out of time, folks.
I'm afraid we're out of time.
So you're just going to have to listen to this music.
And Matt and I will say...
Goodbye before that.
So, have a good night.
God bless and be safe out there.
Yep.
Let's not say sayonara.
Let's say matinee.
Very good.
Yeah, very good.
And I...
Some techno synth.
Streamers. America deserved 9-11, dude.
Fuck it.
I'm saying it.
Academics. Can they make a comment about canceling culture?
Streamers. Yeah, please explain this to me so I can tell you how fucking stupid.
And when I'm talking about that anagogic in and out of the imaginal augmentation of our ontological depth perception, that's what I mean by imaginal faithfulness.
Enlightening stuff.
You'll provide some interesting lessons for us today.
Decoding the gurus, streamers, and academic season.
