Dr. Drew Pinsky and Dave Rubin dissect the rise of narcissism, linking "toxic empathy" on the left to policies like defunding Medi-Cal and framing them as life-or-death issues to project superiority. They analyze how digital reliance on AI like ChatGPT erodes medical student retention while adolescent exposure to explicit pornography causes emotional constriction. The conversation critiques untrained social workers in California's homelessness crisis, advocating custodial care over ideology, and concludes that restoring institutional trust requires humility and apologies rather than centralized authority. [Automatically generated summary]
But I thought first might be interesting because you deal with so many people with different addictions and conditions and neuroses, all of these things.
This is my ninth year going off the grid.
And partly when I did it for the first time years ago, it was just because I was just getting that internet headache, that thing that we're all obsessed with, the endless scrolling, you feel like your attention span is fraying.
Well, I mean, there's a lot packed into what you said.
I would not exclusively blame screens for how you were feeling, right?
I mean, when people have a busy schedule, they need to take breaks.
You just do.
You cannot do so.
I was a profound workaholic early in my career, and I could only manage sort of three-day breaks.
And I would take two days to wind down and then to spend the next day having dread.
So I was like, not a vacation.
But then I had to return.
But we do need to do that.
But we have this added problem of screens.
And so I'm guessing you're saying that not only do you take a break from work, you also take a break from anything online, which is very, very helpful.
Everybody reports improvement in sense of well-being.
It's just a universal thing.
And of course, I think we all are becoming more and more familiar with the adverse impact on kids and adolescents.
I mean, it's just inescapable.
My friends who are psychologists, particularly those who work with adolescents, they do not allow their kids access to screens, maybe an hour or two a day, supervised, structured academic pursuits, that sort of thing.
Maybe some socialization here and there, but highly limited exposure.
Now, the real problem is, you know, in school, someone's going to go, look at this, you know.
So the schools also have to take a no-screen policy, and some do, or you got a homeschool.
So God knows a lot of people are heading that way these days.
But yeah, you're absolutely right.
It is something that is important, is a good idea, and it's healthy, and you're modeling healthy behavior.
So when you've done those shows, but particularly celebrity-related, like, do you think there's some element, you know, I'm in the public eye.
There's an element of ego that is being, you know, stroked for sure.
I go out, people, you know, been out with you.
People know who we are.
They say nice things.
They buy you a drink.
They want to, you know, they talk to you about this, that, the other thing.
That in some way, there's like a particularly unique case.
It used to be, oh, you'd be addicted to a substance or you'd be addicted to a particular behavior or something else, where publicness or fame, whatever the hell you want to call it, is like a differently insidious thing in some sense.
And that is also partly why I disappear so that I can be completely away from that.
Just be my version of it is very small relative to some people.
I actually have published research on this topic, wrote a book about it.
This book was called Mirror Effect.
And let me break this down in two ways to start with.
One is what I have noticed treating people who have a public life, there's a gigantic difference between somebody who has had a day job and whose day job has been being famous.
And so public speaking for me is that's my sweet spot.
I love public speaking.
And this sort of scratches that itch too.
And public speaking is a really interesting sort of coalition.
You know, it's coalescing of a performance instinct with a communication instinct with an intellectual pursuit where you're trying to, I mean, I just think about Jordan Peterson as the ultimate sort of representation of having captured all that.
And so there's all that.
And also people who tend to pursue these things often have got some childhood injury, and this is supposed to solve a problem.
And of course, it doesn't.
It doesn't solve any problems.
And if you expect it to, that's a problem.
The other thing is pursuit of fame as an autonomous motivator showed up in the 90s for the first time in human history.
When they went out and asked internationally, kids, what do you want to do when you grow up?
This is before the social media and the influencer thing, too.
That was all just getting rolling.
As opposed to, I want to be a doctor, I want to be a dad, I want to be a mom.
I don't, because somehow it was becoming democratized and everyone felt they had a right to it.
I think there also was a massive shift.
This is a big topic we're about to get into, a massive shift towards narcissism.
And I actually interviewed a physicist, psychologist a couple of days ago, a couple of weeks ago, who was saying we've now moved actually from, we were in it, he frames it as this.
We were in a schizoid position for many years when hallucinations and hearing voices and encounters with God were like not considered pathological.
They were normal.
And then as the individual became paramount and sacrosanct, we moved towards narcissism.
So what would you as a doctor, I mean, if someone came to you and said, well, I guess you could do a couple of versions of this.
Let's say someone brings their 15-year-old kid who's crushed under the weight of all the incoming fire of cancel culture and just the general state of craziness.
They're inundated with the images and all this stuff.
Then someone comes to you.
Now they're middle-aged.
And then someone comes to you in older age.
Do you have to operate with these people differently to get them out of some of the ways we are hit with information?
And the pathologies tend to sort of be a little different, right?
With the young person, it's identity and self-esteem and who they are to their peers.
It's everything.
And you can imagine they can't escape it.
So you've got to get them.
You've got to help them build a sense of self and ability to regulate their emotions without the constant connection with the texting and the peers and all this stuff.
So, first on the older one, when we see these people, you know, it's usually older people that were outside Tesla screaming or they have Trump derangement syndrome.
We're saying, in some ways, when we've played videos, and it's usually females, when we've played videos of them, I'm somewhat sympathetic to them because although I think they're wrong about what's happening, I'm sympathetic that they're watching the boomer world disappear.
Yes.
And then they see all this stuff that they never saw before because of the internet.
And then it offers their brain this like bizarre sense of everything's falling apart.
And I'm somewhat sympathetic to that, that when you and I are their age one day, the world might be so cataclysmically different that maybe we'll be crazy because we'll have think that all the good stuff that we had was flitting away.
So when you see someone in that group that we're talking about, that let's say plus, they're really plus 70 now, but they're activists and they are out there.
I mean, do you think that for the most part, there's really no way to deprogram them at that stage?
It again, if you're dealing with somebody like that, it's a lot of questioning.
I wonder what this is about.
I wonder what that is.
I wonder why Elon Musk would spend his time trying to help out.
I wonder, you know, wonder, wonder, wonder, and just get them thinking and then expose them to different ideas as much as you can.
But there's all this theory about people's cognitive biases that when you convince them in one area, sometimes they double down in another in the sort of same category.
So it's to some extent, and you can't really use intellect.
You can't use argument because they will shape-shift right in front of you.
They'll morph into something where they, you know, they change the topic and literally.
But did you see this ad campaign with her in American Eagle?
You know, she's this very young, pretty girl.
And, you know, they're promoting genes, but they're clearly showing her cleavage and her pants are unbuttoned and all this stuff.
And I was thinking when I was watching it, and there's, you know, obviously a certain set of people on the left are outraged because she's white and blonde and too pretty and blah, blah, blah.
And then another set of people are like, oh, this is great.
It's sexual and it's like, you know, whatever.
What I kept thinking was there's something good about the course correction right now because sex has become so privatized, I think, because of porn.
If you look at all the ads of the last like 10 years, there was nothing sexual about it.
And certainly not only that, but the sexual, if you had wanted to have desire to see a sexual image, you're not going to see it in an ad.
You're already burned out by what you've seen on pornography.
It's like so much more than that.
I mean, listen, advertisers tell you about the current moment more so than the documentaries or the television productions.
Really watch television ads.
Adam, again, back to Adam, who really schooled me on this one.
You really learn a lot.
And right now, we've got those kinds of ads coming in, which suggest, I think that's the alpha coming in.
And we also see, you see Volvo ads where a guy's writing a letter to his daughter crying outside a lighthouse, and you see the truck ads voiced by Dana White.
So we are getting into this weird dichotomy.
And Adam calls it safe spaces and octagons.
And I said, Adam, we're literally going to have an octagon at the White House.
So basically that you had everything because porn was so accessible.
People could get all the sexual stuff out sort of privately.
And then there was nothing.
It's not that publicness needs sex per se, but then the only way we expressed it publicly was people in furry hats or dog masks or something.
So it was like you had to be ridiculous in some sense versus just, I don't know, a girl showing her cleavage to sell an ad kind of works for everybody.
It makes more sense to celebrate a pretty girl showing off her boobs for a shirt than it does to have, let's say, an obese woman in a Nike outfit where that makes no sense to the brand.
And that's what they push on us.
So we hit those two groups.
Let's go back to the first group.
So the 15-year-olds that are struggling with all of this identity stuff, as you said, and trying to match their way to the world to what the internet is showing them.
What do you think they will be like when they hit adulthood?
So now they're in their 20s, 30s, 40s.
What do you think the effects of them growing up in that distorted funhouse mirror will be?
I mean, I'll tell you in a second, but let me just finish the middle-aged and the porn thing.
Sex addiction is a real thing.
Don't think otherwise.
People get the meeting rooms are full.
Everyone's going on Zoom, do 12-step, do Zoom meetings.
Sex addiction is consuming and has consequences like any other addiction.
Please get help for that if you're suffering with that or struggling with that.
Back to the young people.
The biggest, biggest thing is the, I think, going to be the constriction of emotion and constriction of, let's call it intellectual curiosity, that everything is just on the phone.
I've had medical students say to me, and this was disturbing to me, I just recently heard this.
I was like, look, you've got to get it all in your head.
It's got to get there so you can use it.
It's like using a language or something.
And they go, well, why should I?
I just look it up anyway.
I thought, oh, damn, we are in for trouble.
Much like it's very different to listen to a language and understand it.
It's different when you produce the language.
It's a different brain mechanism.
And the same thing is true of our knowledge and intellect.
You have to use it and produce it.
It has to be sort of in you.
And that requires reading and study and experiential learning, not this.
This can be, this is not all bad, right?
I mean, I use Grok 10 times a day, but I'm using it to sort of guide my intellectual pursuits, not to substitute for them.
And then the same thing is true of their relationships.
Humans need bodies in space.
That's how we build our sense of ourselves.
It's how we construct our emotional landscape.
It's how we regulate their landscape.
To some extent, we can do it through screens like you and I are doing it, but it is only really because we already have a relationship that we can do it effectively.
It requires the bodies communicate in ways that are ineffable and don't get necessarily or fully transmitted through the screen.
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I got one that I think you can use.
I think you're going to like it enough to use it in the future.
You don't even have to credit me.
But basically, this thing is the tool to help you build a house, but it's not the architectural plan.
Yeah, that you can thereby, when you know all your deepest, darkest sort of sort of thoughts and motivators, imagine how you can be manipulated.
I mean, it's a scary thing.
It's a scary thought.
I do believe that humans, what tends to happen with technology is that humans get taken advantage of by it first, and then a new generation comes in and goes, I see what this is.
I'm not going to fall for it.
I understand how to use it.
So there is damage done, but it usually gets adapted to by younger people.
Do you think that's a fundamental, I discussed this with Roseanne Barr of all people a couple of weeks ago on Actual Friends, and she basically said it in her kind of crazy over-the-top way, but I thought it was so good that humans do have a course correction thing built into them, that the generations do.
It is a fundamental piece of the architecture of humanity that we have this way that every time everything gets too far, and that doesn't mean an awful lot of people aren't going to pay or die or whatever.
But right when we're about to tilt off into the abyss, the next generation does have some way of doing something.
Sodom and Gomorrah was a warning about that, you know, one of those evolutions into trouble and people recoiled against it because they see what happens.
It's not something.
This is the problem with ideology.
Throughout human history, ideology is what hurts people.
That's it.
Doing ill in the name of good.
That is how humans hurt each other.
And it's what we're into right now.
We are in denial about the basics of how humans work.
And that is a very destructive thing.
I think we're moving back slowly, but we are moving back.
And it is gravely concerning when humans get into that mode.
And yes, we will, it's because young, I've always said this again, going back to the Loveline thing.
Young people are exquisitely sensitive to case studies, right?
If they see something happen to their peers, they get it.
They get it right away.
And then they course correct.
But they don't want to hear about it from adults, right?
They don't want you to tell me about it.
I can learn it if Drew's in a box telling me about it, but I won't course correct till I see it happening.
And so that experiential phenomenon, I think, is what is at the core of the course correction.
Are you worried to the backdrop of all the stuff that we've talked about a zillion times related to COVID and the institutions failing us and all of those things?
That the fundamental things that you care about in your career, I mean, helping people not be addicted to things and getting their lives in order and things of that nature, that people will be less willing to hear the correct analyses because people will just not trust anyone at some point.
We have had such a tough time getting young addicts into any kind of 12-step process because I don't relate to it.
It's not my thing.
We're special, we're different, whatever.
And yes, that is gravely concerning.
I've seen lots of, it's interesting, I've seen lots of scorn and concern about exactly that issue from people who created the lack of trust during COVID.
But ultimately, what, again, back to thinking you figured it out, what really was amiss was the centralization of authority in healthcare.
That is how bad things happen.
You've got to get people back under the care of their doctor, under the care of a healthcare system they trust and they communicate with, and not things from on high.
You know, mandates from on high.
I mean, it's never been intended to be that way, ever.
And one of the interesting things, I'm not blowing this because the show came out 20 years ago, but one of the interesting things is in the second to last episode, there's been a through line that Dr. Melfi, his therapist, has been struggling over the course of the years, trying to figure out is she actually helping him at all?
Or is she actually by allowing him to talk, is she in some ways emboldening the lies and where he can compartmentalize his life.
And then her therapist, because she also goes to a therapist, basically presents her with a study about a certain personality disorder and says, this is what you've got on your hands.
And she breaks it off with him in the second to last episode.
It's really incredible television.
And I'm wondering if you've ever encountered any of that sort of thing where you suddenly, not necessarily in your private practice, where you suddenly just say, there's nothing that actually can be done here, at least within my skill set.
And there's a sort of a subset of it that I deal with more than not, which is not ready.
These people to change, much like addicts, they have to be threatened with survival, frankly, before they're willing to change.
And that's true of what you're calling personality disorders.
And there is, you know, sociopathy, and which is what we're talking about here with Tony Soprano and antisocial becomes criminal at a certain point.
And the only way to solve that is with constraint, with some sort of external force, because they just will not trust.
They will not enter the frame.
They will not change.
They see everything as the problem, not them.
And anybody trying to help them is sort of full of shit.
So why would they listen to them?
And it's funny.
I had a patient of mine who was very much in that zone.
It was a woman.
And she started with, it was funny.
She started with, I had somebody in the room with me.
We were working with her.
And she started with sort of an open position.
And then she put her hands over her head like this, which is a position that primates make when they're acknowledging a superior position and an openness to the other person.
And then she went from that.
And I thought, oh my God, we're making progress to this and then just this.
And I thought, wow, that's the full evolution of criminal thought right there in front of you.
What's that like for you when you've been in practice dealing with somebody where you get to the end of the road with them and you don't get the, you know, I'm sure there's been moments where you get to the end of the road and you go, boy, I've set this person up properly in life.
And I was listening to a podcast recently where a guy, one of these therapists, a psychiatrist was in there and he said, you know, this severe narcissist was in there and he was telling me this horrible story of abuse in his childhood.
And he goes, I don't normally evoke emotion in the interpersonal context of therapy, but I started to cry.
And the narcissist went, why are you mocking me?
So that's how much they distort the outside world.
You see how that works.
The addict, they become disruptive.
I give them three strikes.
They're out.
You know, that's that.
And I cannot tell you there have been many, many, many times that the person I kicked out of treatment, and sometimes they surprise me.
If you offer drugs to somebody else, you're out immediately.
If you have sex with somebody else, you're out immediately.
But if you use drugs yourself, I actually give them chances.
I give them other chances.
But if you hurt somebody else, you're out.
I can't tell you how many times people come up to me three, five years later.
I don't even recognize them.
They're so different.
They come up and shake my hand.
They go, I'm in a PhD program for psychology now.
I wasn't ready to hear what you were saying at the time, but you setting that limit with me and kicking me out is something that helped build my motivation where I finally got better.
Is it the ones when you had like the intimacy of the clinical practice and they're coming in, meeting with you all the time?
Or is it that you can do this at scale now and someone who you've never met will come up to you at the airport or whatever and say, boy, Drew, I did listen to Love Lines way back when and I had some weird stuff going on and you helped me sort it out.
I think a lot of people, it's hard to see because of the algorithms and because of our conditioning to negativity or what people click.
But it does seem to me that more and more people suddenly care about family or care about what they're putting in their body or are a little skeptical of COVID and blah, blah, blah, blah, blah.
I mean, even your very public evolution as it pertains to trusting some of the institutions.
I mean, it's pretty, it's powerful stuff, which is why every time we've talked about it, it goes viral.
I went from saying at the beginning of the pandemic, first of all, I thought the press was causing the panic.
I didn't realize it was coming from government other sources.
And I was like, don't listen to these people.
Listen to the CDC and Dr. Fauci.
I've worked with these people for years.
They will get us through this.
And man, was I wrong.
Holy moly.
I didn't know what had happened to those organizations.
And I went from that to, wow, these organizations that were advisory to physicians to help us make good decisions are now trying to usurp our, they're trying to tell us how to practice medicine.
That is insane.
And as that became more and more clear to me, how insurance companies and hospital employers and regulators were taking over medicine, I became a freedom fighter.
And then when my speech started getting constricted, that's just unimaginable to me in this country.
The First Amendment, the very first principle of the Bill of Rights is being infringed upon.
And people are questioning whether we should have less free speech.
Holy crap.
I can't believe we're there.
But it's been my evolution.
And there's been lots of other little sidebars to it.
But yeah, I am fully there.
We got to fight for these things.
I didn't, you know, Tom Sizemore once told me, I love Tom and I've known him for many, many years.
And he said he was preparing, I think he was preparing for Black Hawk Dog down.
And he went and he lived with a sort of colonel in the Air Force or something.
And the guy came to the door and went, all right, you can hang around here, but I'm busy fighting for freedom in this world.
I'd fight for the freedom of this country.
That's a full-time job.
And we both were like, ha ha, this guy thinks he's fighting freedom.
I think about that guy all the time now.
Thank God that guy was there fighting for freedom and the guys like him.
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Why do you think some people are wired in a way or conditioned in a way, or maybe it's just innate, that they are able to do the mea culpa, able to do what you did?
Say, boy, I missed that.
And some people can't.
I was watching a video just a couple of days ago of Nancy Pelosi being asked, Do you have any regrets around the election and the Biden and Kamala stuff and the way things went down or anything?
And she had no regrets.
No regrets.
That is completely insane to me.
And what you just said, which is very dear to your heart and career, is that you made a mistake.
I mean, do you think that that's conditioning?
Is that how we're wired?
That some people can do it and some people can't.
Is that just humility that you're supposed to learn along the way?
It's just like after all these years, all these people who got these big things wrong, you'd think like a simple apology, boy, it would inoculate so much of the attacks against them.
Well, now we have a better handle on what's coming across the border, but the drugs that you must be seeing these people hooked on now are way more addictive and dangerous, probably.
I mean, way more addictive is just gets more people hooked.
You know, in terms of once they're hooked, it's all kind of the same thing.
It's opiate addiction and stimulant addiction.
That's it.
And if you do not treat them, they will die.
This is the part.
There's a guy, you should interview him.
He wrote a book called Crooked Smile.
He's going to be in this documentary that I'm just working on right now.
And he told me he's now a carpenter.
He made it out.
He was an opiate addict and he got sober.
And he said that, first of all, everybody's doing drugs.
Everybody.
He never didn't meet anybody in the streets that wasn't doing drugs.
Number one.
Number two, he got his drugs from the social workers on the street.
They gave him the rigs, gave him the drugs.
And then he said towards the last couple of years, they would pat him on the back and say, once we get communism in place, this won't be a problem for you.
Can you imagine this taking the sickest, sickest, sickest brain disorder and not understanding what you're dealing with and having this ideological fog you live in where you imagine that it's due to the economics or the or that it's capitalism?
I mean, it's just, it's just so nutty cuckoo.
And they deny that this is a progressive disease.
This is the other part of the problem.
I don't care who administers or gives the drugs to a drug addict, the disease progresses to death.
And that's why we lose six to eight a day here on the streets of Los Angeles.