• Visit Dr. Barrett’s website and connect on YouTube and LinkedIn.

Joe Sanok 00:00:00  You're someone with a vision for your practice, for your side hustle, and for your personal journey. But when it comes to establishing your path and how to get to where you want to be with your practice, things get a little messy. You're also someone who'd prefer to go in person instead of to groups and listening to everyone else's story. To me, it sounds like you could benefit from one on one consulting with our experienced practice of the practice consultants from 595 a month and up. You can work with a consultant that will give you more direction and practical, tried and tested tips matched to you and your goals. For more information, visit practice of the practice. Com forward slash apply. Again, that's practice of the practice. Com forward slash apply. This is the practice of the practice podcast with Joe Santos. Session number 1222. I'm Joe Santos, your host, and welcome to the practice of the Practice podcast. I am so excited to have you here today. we are here several days a week, helping you to build a thriving private practice that you absolutely love.

Joe Sanok 00:01:18  you know, we want both sides of that. We want it to be thriving. We want you to financially do well clinically, do well for your clients to get great outcomes. But we also want you to love your practice. We want you to be able to say, I can't believe this is what I get to do with my clinical career. so we cover all sorts of issues here on this show. And, I got to give a shout out to Josh. Josh is one of our staff who has been researching and reaching out to guests, and just the caliber of guests that he has been reaching out to and connecting with. as you just saw. And before this, we had our Future of series where we had some top researchers, neuroscientists, just amazing people talking about the future of a variety of different things. We talked about the future of trust, the future of dying, the future of listening, the future of brain health, the future of learning all sorts of different really interesting topics.

Joe Sanok 00:02:08  And today we are continuing to dig into topics that are just interesting. We're going to be talking about how do we use science to actually help ourselves, the nature of reality. I mean, these are big topics that we're talking with. Doctor Lisa Barrett. Lisa is a University distinguished professor of psychology at Northeastern University, with appointments at the Massachusetts General Hospital and Harvard Medical School. Doctor Barrett's among the top 1% most cited scientists worldwide for her revolutionary research in psychology and neuroscience, having published over 270 peer reviewed scientific papers. She has tons of awards that she's done. has been cited as just such an amazing researcher. In addition to that, she has popular books and articles with two bestselling popular science books, How Emotions Are Made, The Secret Life of the brain and seven and a Half Lessons About the Brain. Her popular TEDx talk has been viewed more than 6.5 million times to date, and colleagues have called Doctor Barrett the most important effective scientists of our time and the deepest thinker on since Darwin. Lisa, welcome to the practice of the Practice podcast.

Dr. Lisa Barrett 00:03:20  So happy to be with you.

Joe Sanok 00:03:22  I am so excited to have you here. I love when people have dug deep into research that I don't know very much about. Even though I'm trained as a psychologist, I practiced as a therapist. I do this work. I've done over 1200 episodes, and I still feel like as I read your bio, I'm like, oh man, we're in for a ride today.

Dr. Lisa Barrett 00:03:43  I'll do my best to deliver.

Joe Sanok 00:03:46  Well, okay, so let's start with an easy one the nature of reality. So you're you've been you and I were just talking about this. You know, I always love when. When people are maybe known for something like a Ted talk to ask them beforehand, like, what are you into now? Like, what are you sick of talking about? And, you know, you're known for emotions. You've written books about emotions, but, you know, kind of one thing you said that you're getting really jazzed about and even that you have a book coming out that you're working on right now is kind of using science to help ourselves, but then also kind of the very nature of reality, like I'm interested in.

Joe Sanok 00:04:20  How did that kind of bubble up out of the work that you were already doing? How did the nature of reality kind of insert its way into into your brain?

Dr. Lisa Barrett 00:04:29  Well, if you look at the arc of my career, I went to graduate school. I actually trained, to do a PhD in clinical psychology. And while I was doing research for part of my PhD, I was not studying emotion, but questions came up and that really led me to turn my attention to the fundamental nature of emotion and in the process of studying that. I started to ask questions about the basic function, structure and function of the brain and the brain's role in regulating the body and how emotions emerge from that transaction, and in the process of really understanding brain function. I mean, I can't profess to understand everything about brain function, obviously, but in the process of understanding, I started to realize that this neuroscience work had implications for really big questions like, how do you know what's true? How do you know? You know? Are you is there a reality out there separate from you, or are you part.

Dr. Lisa Barrett 00:05:40  Are you part of what makes reality what it is? And this is really relevant for clinical practice because oftentimes you know, you as a clinician, you are experiencing a person as angry or sad or afraid. and or, you know, you're experiencing that person as, as, as having a particular being in a particular mental state and that person, your client, their experience is different. And then, of course, the question that we often ask is who's right? And that question, at least in the domain of emotion, can't be answered because there are no objective markers for any emotion, any category of emotion. There just aren't any that scientists have been able to come up with. And it turns out that that question, who's right, has a set of assumptions about the idea that there's this objective reality separate from you, your perceptions, and therefore there has to be a right answer. And that's what I think neuroscience leads us to question. So it has really big implications. Of course, it's very metaphysical and philosophical, and I do definitely find that interesting.

Dr. Lisa Barrett 00:06:57  But I also think it has really important implications in everyday life.

Joe Sanok 00:07:01  Yeah. Now when you look at those implications in everyday life, like what do you see being some of those?

Dr. Lisa Barrett 00:07:09  Well, I think that there are a number of questions that we ask, that are really based on a set of assumptions about what reality is like. And they they lead us to ask questions that are really not, not very helpful, like this question of, well, if if you and I are interacting and, you know, you experience me as sad and I am experiencing anger, you know, is it the case that you know I'm right? is it the case that you're right? Is that even the right question to be asking in a therapy session that can have important implications for what a person learns about themselves or what they do next. But in a legal situation that can determine a person's freedom, it can can determine whether or not they are put on death row for a capital crime. It can determine, treatment plans for in, in, you know, in a medical setting.

Dr. Lisa Barrett 00:08:13  It can determine, I mean, and people sometimes lose their lives. I mean, and that's not a that's not hyperbole, because clinicians, medical clinicians make decisions based on incorrect views that they can. This this incorrect belief that movements, facial movements, vocalizations are a language that can be read like words on a page and that emotions therefore can be recognized. And people have a sort of an unbridled confidence in their ability to recognize what even the word recognize implies something about objectivity as opposed to experience or perceive.

Joe Sanok 00:08:58  So this seems like a big problem that affects like every area of life. How are you thinking through this? From a research standpoint, from a just like how to communicate with the public. I mean, there's so many different kind of areas that you are connecting with, whether it's researchers or the general public or you're speaking books like this seems like a huge problem. If we have this general misunderstanding, as to just what the basis of how we experience reality is.

Dr. Lisa Barrett 00:09:28  Yeah, it's not even the basis of how we experience reality.

Dr. Lisa Barrett 00:09:30  It's literally what reality is. And I and and so the way that I do it with the public is, right now is that I use, really try to use really simple examples and some of those examples. You'll just have to take my word for it, because some of them are visual and we're obviously just talking to each other. you know, with our voices, there's no visual aspect here that we can show people. But, but I think nothing convinces people more than, their own experience. And so I usually start with something like the color red. You know, so are you, Joe, do you have a neurotypical retina with three kinds of cones so that you see red?

Joe Sanok 00:10:21  I believe I do. yeah, I think so important.

Dr. Lisa Barrett 00:10:25  No. That's important. So a neurotypical retina. Human retina contains three types of receptors that work together to produce what's called tri chromatic vision. So you can when you look at a rose, you know it. And it is reflecting a certain wavelength of light.

Dr. Lisa Barrett 00:10:42  You you see it as red. But there are animals that lack that cone, like dogs and rabbits and horses and so on. And so those animals don't see the flower as red. They see it as a muddy green. So common sense would suggest, right, that the flower actually objectively is red, and that those animals just can't see it, that they're colorblind. And similarly, there are other humans, right, who don't have, all three cones, they, they, they are also called colorblind. and so I want you to notice, first of all, that the idea that someone is colorblind is, you know, embedded in, in that idea is that the flower is objectively red and that other animals are humans without the proper cones, just can't see objective reality. And so what we're doing is we're implicitly defining objectivity by what's neurotypical for humans? But here's the thing. There are humans who have four cones, and so they don't see the the red rope. You know, what we see is red.

Dr. Lisa Barrett 00:11:54  They don't see that that flower is red. They see it as some other color. And if what was neurotypical for humans was to have four cones instead of three, then we wouldn't see the rose as red. We'd see it as some other color, so some other color would be. Now, what is objective for that? For that flower? So objective reality has a hidden condition. It secretly depends on what is shared by neurotypical humans. Because if we all had four cones, we wouldn't see. Nobody would see the flower as red except for people with three cones. And that we would consider that to be colorblind.

Joe Sanok 00:12:39  Yeah. I mean, it's interesting. Just earlier today, I saw on social media there was a picture of a tiger in the wild, and it was, you know, orange and black, how we see it. And it showed how they looked to the majority of animals that live around them, and that most animals, you'll see the orange not as orange, but as sort of like a green, and the tiger just blended right in.

Joe Sanok 00:13:00  Whereas for us, we definitely can see the tiger. and so then it is like, well, which is quote, right. you know, for us, it's very beneficial that we can see a bright orange in the middle of the jungle because we can get away from that. Whereas, you know, in other situations that would not be, you know, for other animals, they wouldn't see that tiger coming. how do you think, through the value even of having an objective reality? Because it seems like part of this is then pointing to, like that. Maybe there isn't a I mean, of course there's purpose and there's reason that we need to define for society what our objective reality is our social agreements. But, you know, as you start to challenge some of these things, like how does that play out for you in regards to the value of objective reality then?

Dr. Lisa Barrett 00:13:46  Well, what it means is that objective, what we call objective is really, depends on what, you know, basically with respect to color anyways.

Dr. Lisa Barrett 00:13:59  We what we call objective reality is whatever neurotypical humans, are in consensus about. And we're in consensus, about, you know, red because most of us who we have neurotypical retinas, we we we then for the most part, although there are cultures that don't have a category for red and and we can come back to that. But the point here, I'm saying is that objectivity, objective reality secretly depends on consensus amongst humans. And this was also true. This is also true in physics, right? Like, the Newtonian equations for classical mechanics, which was thought to be like the objective reality, of how, you know, the physical world works, but it has certain hidden assumptions in it that Newton didn't know about, because, you know, we live on Earth and we, you know, he was dealing with objects of a certain size, and his equations have these hidden conditions in them. And when those hidden conditions are revealed, his equations don't work. And that's, you know, first relativity and then theory and then quantum quantum mechanics.

Dr. Lisa Barrett 00:15:22  So what this means is that what we what we think of as objective is really, is really just consensus amongst humans, a group of humans. And the temptation then is to say that there is no objective reality. But of course, that's also, I think, not a very useful, conception. I think instead it's useful to talk about reality being relational. And that means that red is not a property of a flower out there separate from you. Red is a property of the relationship between the signals, the wavelengths of light being given off the flower and the and your retina, the signals that you can detect. And this is. This means that not that there are many realities, but there's but reality is bounded. The signals that you can detect, like the patterns of things that are your feelings and your thoughts and your the objects you, you interact with and so on. These things are they exist in relation to you, right? So, you know, to you, if, if you're sitting at a desk or standing at a desk, you are surrounded by, solid objects, but to a, you know, mythical, subatomic creature.

Dr. Lisa Barrett 00:16:49  It would there would be no objects. There would just be empty space. So you everything we experience is it's not really helpful to talk about, you know, objective reality and our and our prior, you know, experiences like, bias us. It's really more helpful to think that reality is relational, that what is true. So, for example, if you and I are in a conversation and you experience me, you perceive me as as sad and I experience myself as angry, then what's true there? What's real there is the relation that is that we are in a situation where you're experiencing me in one way and I'm experiencing something else. That's what's true. That's what's real. Not that one person is right, because there are implications about that disagreement that then have to be worked out. And so what you're doing is you're basically, you're you're in a certain way, you're you're dialing down the authority of any particular position. Right. Because to claim that there's an objective reality rather than. So I'm claiming reality is created relationally.

Dr. Lisa Barrett 00:18:06  I'm not saying that there's a, that there's no reality. I'm saying that reality is established relationally. And when you say that, you relinquish the very cherished idea that there's one objective reality that humans inhabit and that we can perceive or not perceive, you know, with bias.

Joe Sanok 00:18:28  How does that shift the way you view research?

Dr. Lisa Barrett 00:18:34  Well, I you know, I mean, I've thought a lot about the goals of research and, like, and I've thought, you know, let me say it this way. I've thought a lot about how it could be the case that decades. And I would even go so far as to say, a century worth of research has called into question, or I would say, confirmed a set of ideas about emotion that remain dominant in the in mainstream culture that remain dominant in economics and in fact, in, in clinical treatment, that remain dominant in the law and that are still treated seriously in science. And I'm asking myself, how could that happen? because we're not talking about 1 or 2 studies and we're not talking about 1 or 2 fields.

Dr. Lisa Barrett 00:19:32  Right? I mean, the in my book, How Emotions are made, I go over some of that evidence, but I certainly there's just it's just scratch that's just scratching the surface of a much larger, accumulation of knowledge. So you know that there aren't, you know, five or 6 or 12 or 20 or 24 basic emotion categories. there isn't there aren't diagnostic expressions for these categories. I mean, there's just there's not there aren't diagnostic physical, states for these categories. I mean, there's no evidence that is consistent and robust to make such claims, but yet people still believe it. And I'm really curious to try to understand why. And what it led me to do was really start to think about the nature of science and the nature of how we communicate science. When I say we, I mean scientists, how scientists communicate, Indicate what they've learned so that people can actually use it. And what I've discovered is that we're not discovered. I mean, it's not a discovery, but it's my thinking this through is that, you know, reality is complex.

Dr. Lisa Barrett 00:20:41  Causation is complex. We often say, gee, why did you do this? But there isn't, you know, why did this? Why did this happen to you? Why do you feel sad? Why? What is the cause of your trauma? And or why did you behave this way? As if there's a single simple answer to that question, when in fact causation is very, very complex. and meaning there are lots of small little nudges that all interact in a way, usually to produce a big shove. And that is, you have to think about cause as an ensemble of weak causes that work together to produce a big effect. And in science, what scientists do is they take this really, really complex world and they simplify it by leaving out details so that they can figure out what questions to ask and what questions and how to answer those questions. So every natural law is a simplification. Every experiment is a simplification. Every hypothesis is a simplification. We're always leaving out details. We're deciding what details that count and what details are irrelevant.

Dr. Lisa Barrett 00:21:53  And this is simplification or abstraction is also you could call it as a you could call it an abstraction. But when we communicate science to the public in an outward facing way, we simplify even more. And in fact, good science writing is knowing what to leave out. and but then when that that, you know, information gets even further distilled, even further simplified, In say, for example, the wellness industry or in self-help books. And it simplified so much that, it no longer is useful anymore, I would say.

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Joe Sanok 00:23:16  All you have to do is click the link below or type promo code Joe on their website over at Therapy Notes and receive a special two month trial. Absolutely free. Again, that's therapy notes. Com and use promo code Joe on the website. If you're coming from another EHR therapy notes will also import your demographic data quick and easy at no cost, so you can get started right away. Trust me. Don't waste any more of your time and try therapy notes. Just use promo code Joe at checkout. Yeah, it's interesting because I forgot where I saw it, and it may not be a legitimate source, but, you know, someone was talking recently. I think it was on a podcast where they were talking about how there's there's not many specific things that these, like, top achievers do. Some people wake up early. Some people wake up late. Some people cold plunge. Most people don't cold plunge. Like there's all these things that, that people say, oh, here's the, the hook to, to make you more productive or here's the thing that's going to help you achieve What? Whatever.

Joe Sanok 00:24:19  Fill in the blank. But a lot of the times, it's latching onto something that does work for some people. And then that group then kind of coalesces around that thing, rather than it being that that thing is actually that cold. Plunging is the thing that's going to make you become successful in business or things like that. how do we like when I think about taking science and even just reducing it from the actual scientific study to then talking to highly educated people that want to implement that? There's just so much you'd be leaving out. And then so thinking about the task of your new book of using science to help people without doing that too much, like, I guess, how are you thinking through that? How? I'm not even sure fully what I'm asking. Just it feels like such a large endeavor. that what's what's the model of how you're walking into that?

Dr. Lisa Barrett 00:25:12  Yeah. So I that's I think that you summed it up really well, Joe, in the following sense. I mean, cold, a cold plunge, for example.

Dr. Lisa Barrett 00:25:20  It's not just that it works for some people and not others. It will work for you maybe on some days, but not on others, right? So this is the point about complexity. So I think that there are a couple of. So let me step back and say how I'm going to approach this issue of how to communicate. how am I going to what is this next book about? It's really about, two things. I think it's going to, take the best available knowledge that I have, or that I have access to scientific knowledge that I think is justified on the basis of scientific evidence. And then it's going to simplify it in a way that, doesn't remove the complexity or the variation or the contextual nature of things. So, I'm also going to be trying to explain kind of how to use the tools of science to develop a set of useful tools for you that for yourself that, that you can use in your everyday life. So I'm going to show people how I develop these tools myself, and then I'm going to show people how they could, for example, when they read a newspaper article or they come across something on a website that, you know, is, offering the ten, 12, eight, five things that you must do to make, you know, give yourself a better life or craft a better life for yourself or or create meaning, or reduce suffering, or improve your health or whatever, you know, make you a better lover, a better parent, a better teacher, a better whatever that you'll understand how to you'll have the tools to translate that into something actually useful for you.

Dr. Lisa Barrett 00:27:14  And the first. The first idea here is that, you know, that rules are oversimplification. They're, they're they're like a scientific laws in a way. Like a scientific law. A scientific law is like a rule, a scientific law, like Newton's law, for example, or let's say the, the periodic table that you learned in chemistry in high school. Those are actually fictions, meaning they have so much context removed from them that they are not useful in the real world. The periodic table tells you, I mean, of course it's you know, the elements are ordered by the number of protons in the nucleus. And that's, that's, you know, that there's no question that that's true with a capital T, but it tells you nothing about how no chemist could actually use the periodic table on its own to predict anything about how chemicals work in the real world. They have to add back in all kinds of context, because causation is complex and there are lots of little factors that are important that are not captured by the periodic table because it's a simplification.

Dr. Lisa Barrett 00:28:27  And the same thing is true for Newton's laws or any set of laws. Laws are considered by philosophers of science. They're considered what are called theoretical kinds, which means they're fictions and they're not useful on their own. You have to add back a whole bunch of context in a specific situation to make them work. So, for example, I'm saying the same thing about rules. So take the rule. You know, you have to get eight hours sleep. I find this rule to be particularly problematic for a number of reasons. One is that not everybody needs eight hours sleep. What you want is to sleep enough that you feel well rested, and on some days that might be eight hours, and on some days that might be five hours, and on some days that might be ten hours. And it might be the sort of, you know, modal amount of sleep might be different for different people, but also, you know, maybe you can't get enough sleep to be rested every single day. That's happens to people.

Dr. Lisa Barrett 00:29:31  It happens to me. I, you know, I make decisions about how to spend my time that, I'm not just weighing how much sleep I should get. I have a whole bunch of things, like most people do, that they're weighing the importance of. And so if I know that, I'm not going to get enough sleep or I didn't sleep well the night before, that means that my day to day will be. I'll have to think about my day differently and plan my actions differently than I might on a day when I got enough sleep. And so some things might work well and some things might not work well on that day. I might do certain things to take care of my self, because I know it's going to be a harder day if I didn't get enough sleep than if I did. So that's the kind of thing I mean that in science, you know, we often will run studies with large numbers of people, and then we take some kind of average of that person, of that group, that sample, and then we make inferences about from the group average or the group pattern back to the population.

Dr. Lisa Barrett 00:30:37  But that group average is a fiction. It's a simplification. Right. There may be 3.13 people in the average middle class American family, but no family has 3.13 people in it. And so once you understand that, you understand that how you now have a bit of a clue about how to start interpreting all of this information that's being thrown at you and building a knowledge base that will work for your own life.

Joe Sanok 00:31:13  Lisa, I'm interested in how do you and you kind of touched on this a little bit around the sleep discussion, but for you personally, in your own life, how do you comb through research that you know is going to impact yourself? And I know you're going to be writing an entire book on people being able to do this, but I would love to hear, like, what are examples of how you try to enact this nuance and to push back against the oversimplification? Like, what are some ways that that has manifested itself in your own life?

Dr. Lisa Barrett 00:31:42  Yeah, I'm really happy to talk about that.

Dr. Lisa Barrett 00:31:44  And I'll just say, but before I do, I just want to say the whole idea for this book came about because I was on a PBS talk show with a couple of other scientists, and the hosts asked, and what was interesting is this this segment was not aired, and you'll see why in a minute. The host? The host asked, well, where do you go for wellness in, you know, information? Like what? What website do you go to? And, one person said, you know, listed a, a couple of popular websites and another person, the other person said, I go to, you know, PubMed or no, I'm sorry, I just gave away the punchline. I go to the CDC, the CDC, and I said, I don't go to websites for information. I go to PubMed, I go to references, and I do I do a reference search and I look up what I want to know. And then I read a bunch of papers and then I make a decision.

Dr. Lisa Barrett 00:32:43  And I realized, yeah, most people don't have that capacity because they don't have that skill. Just like, you know, if I'm picking new paint colors for my, you know, a house that I'm redecorating, I have no clue about how to do that. I have to go to an expert who knows something about color theory. You know, if I want. I mean, you know. So I realized, well, actually, I have a set of skills that, I can comb through literature and find, try to fashion a solution for myself that most people don't have that capacity. And maybe I could, maybe I could help there. You know, I could actually, first of all, take some of the I've been offering people tools based on my own research and the research I've been writing about for almost a decade now. I've been just doing this in podcasts and in how emotions are made and and so on and so forth. And so I could probably basically more formalize it. And I could also teach people how to do it.

Dr. Lisa Barrett 00:33:45  And so here's an example. and I'm, I'm going to be using personal examples from my own life in the book, not only in my own life, but here. Here is an example that I can that I can talk about now, my daughter. when? When she was an adolescent, became clinically depressed. Like many people have, have, you know, their children, they watch their children. I mean, it's like an epidemic of mood disorders and anxiety and so on. And, you know, my daughter, there was no hint of any, any mood disorder disturbance in her at all until she went to middle school. And even at the beginning, I just thought she was leaving Lacey. because she. She was such an exuberant kid. I mean, and she was a kid who, you know, learned to read when she was three, and she was doing rudimentary algebra when she was eight. And, you know, she was she's a high achiever and a really happy kid. So, but it became really clear that, she was depressed.

Dr. Lisa Barrett 00:34:55  And it became also clear that, that across a couple of years that she was really suffering and, and that there was, there weren't a lot of options to really help her. And so I went to the literature and I started to read one of the whole reasons I got really interested in the brains. The, you know, one of the things I often will say now is that, you know, your brain's fundamental job is not thinking or feeling or even sensing. It's regulating your very, very complicated body and everything that your brain does thinking and feeling and all these other things it does in the service of that regulation. And of course, we don't experience ourselves that way, but that is literally what's happening under the hood. And I learned this because I started to read and read and read and read. And what I learned is that depression is a metabolic. It has a metabolic Basis. I'm not saying depression causes, I mean is caused by a metabolic disruption because there are depression is is complicated.

Dr. Lisa Barrett 00:36:08  And by that I mean it has complex causation. But it's important to understand that there is a metabolic problem. Either the brain believes there's a metabolic problem or there actually is a metabolic problem. And once I realized that, I developed a whole program of treatment for her, and she was still seeing her psychiatrist and she was still taking SSRIs, but everything else about her life changed. And I'm lucky, and that I had a really strong relationship with her. And she basically did what I said when it mattered not. She didn't always do what I said. And, and but the most important thing, I think I just want to make two points about this because I think they're really important. One is that, you know, I've been talking about this for ten years at least, and I wasn't talking about my daughter's depression because, you know, she's now past the age of 25 and can give me consent to discuss this, and so I do. but before that, you know, I wouldn't use her specifically as an example, but I might use other examples.

Dr. Lisa Barrett 00:37:17  But, you know, here's an important thing to understand. Your brain is always predicting based on the way things are right now in your body and in the world. It's predicting what's going to happen next. And it starts to plan action in your body like movements in your body, like regulating your heart rate and your, your breathing rate and so on. And also starts to prepare motor movements like facial movements, eye movements and so on in anticipation of, what is expecting to happen next. Those predictions can be correct, or they can be incorrect if your brain is predicting that, that you're that there's some kind of metabolic deficit and there and it's mis predicting like maybe you had a, you just lived through a really stressful event and your brain hasn't updated yet its predictions. Or maybe, you know, you're recovering from an illness and, you know, your immune system, it's very expensive metabolically to run. And so, you know, maybe it just hasn't updated in those kinds of cases. An SSRI will work really, really well because it kind of gives the brain enough juice to be able to update its predictions.

Dr. Lisa Barrett 00:38:28  And then, people get better. And the symptoms of depression, the fatigue and the, you know, failure to move around very much and the distress and the lack of context sensitivity, like, all of these things are really symptoms of a brain trying to reduce its spending, you know, but in the case where there actually is a metabolic problem. Maybe you have heart disease or diabetes, or maybe there's some kind of, you know, mitochondrial inefficiency or, you know, there's a real metabolic drag. You maybe you live in a, in a really chaotic, environment that is, you know, all things considered, more expensive, than, than, you know, you can bear. I mean, there are all kinds of both intrinsic and also environmental reasons why you might be running a deficit for real, because there's a real problem. If you give that person SSRIs, things will get better for a couple of months, and then their depression will get worse, or they'll remit or they'll gain weight and they'll become more fatigued because the brain is still down trying to down regulate.

Dr. Lisa Barrett 00:39:50  it's trying to reduce its spending. And that describes like half the people who are on SSRI. So it's really, really, really important. And I can give you examples of things I did differently with her that. I mean, it's not like I knew for sure that this is what was happening. I just thought that, you know, adolescence is a time of great metabolic upheaval. It's a time when the brain can't predict very well what's happening inside the body, because, you know, the brain doesn't actually know what's happening in the body. It only knows. It only is receiving the sensory signals from the body, which are the outcomes of some set of changes. So locally, it doesn't know what's happening in your heart or in your lungs or in your blood or whatever. It's making guesses. And it's those guesses are hard. They're hard during menopause. They're hard during, during, puberty. also, you know, puberty is or adolescence is also a time when there's a lot more social uncertainty.

Dr. Lisa Barrett 00:40:58  so there's, you know, there are big metabolic loads. And, once I understood that, I, you know, I changed really a lot about her environment with, along with her and, and she started to get better.

Joe Sanok 00:41:16  So wonderful. Doctor Barrett. The last question that I always ask is if every private practitioner in the world were listening right now, what would you want them to know?

Dr. Lisa Barrett 00:41:25  I, I think it's important. I think it's important to understand. I think curiosity and humility are really important. no matter how certain you are, no matter how much skill you have as a therapist, no matter how confident you are that you can read people, you can't. You're just guessing. And your guesses partly based on who you are and what experiences you yourself have had. And so I think I'm what I'm suggesting is that, I, I think it's important not to interact with your clients as if you're an authority on them. I really think that part of the reality of what's occurring in a session is about the relational and, what's true in that session, what's true is, what's, the relational transaction, between the the two of you.

Dr. Lisa Barrett 00:42:35  And that means that you know, who you are with one client isn't going to be the same as who you are with another client. And it also means that when your client is with you, who they are won't necessarily be the same as who they are when they go back to, you know, their everyday life. And rather than seeing that as error, seeing that as really meaningful, reality to to me is, is is really helpful. And it's really helpful for me in, in moments where I absolutely think I'm right.

Joe Sanok 00:43:10  Well if people want to get your books, if they want to follow your work, where should we send them.

Dr. Lisa Barrett 00:43:15  Pretty much everything that I've written is for the public can be found at. Lisa Feldman Barrett both books you can find access to them there as well as podcasts. popular science writing that's free to download lectures that are free to view. And and these are, these are all of the sort of public facing, science communication pieces that I've done. I also have an academic website which anybody can find just by googling my name.

Joe Sanok 00:43:49  So amazing. Thank you so much for being on the show today.

Dr. Lisa Barrett 00:43:52  My pleasure.

Joe Sanok 00:44:00  I'm so glad that Lisa is writing this book, because it feels like in the same way she used that analogy of like color theory. you know, it's like I looked stuff up in grad school and, you know, when I was writing Thursday's The New Friday, brought in some, some people that can double check the research and dig in deeper and help me with some of that. But, yeah, just that idea of not just taking at surface level the simplification of how often these really complex just topics then are distilled into science and then distilled into something the public can consume. And then we distill that into our own lives. to look at that nuance that's happening to me, that's that's exciting to to know about that resource coming out in the next year or so. We'll have to have her back on the show when that book releases. Also, we couldn't do this show without our amazing sponsors Therapy Notes as our sponsor for today's show.

Joe Sanok 00:44:54  They are the best electronic health records out there. They help you stay organized. They help you with your billing. If you're doing tele therapy, it's all embedded within their system. Head on over to therapy. Notes. Com use promo code. I'm gonna leave that in. use promo code Joe at checkout. you get a couple months for free. Thanks so much for letting me into your ears and into your brain. Have a great day. I'll talk to you soon. Special thanks to the band. Silence is sexy for that intro music. And this podcast is designed to provide accurate and authoritative information in regard to the subject matter covered. It is given with the understanding that neither the host, the producers, the publishers or guests are rendering legal, accounting, clinical or other professional information. If you want a professional, you should find one.