More than 50% of complaints to off physical medicine doctors are originating in the mind. The increase in pain that you're having, the GI issue, maybe it's fibromyalgia, it's autoimmune phenomenon, pain in your joints, rash, your six entirely different things are coming from one thing. Dr. Paul Conti, the psychiatrist who helped Lady Gaga, the Kardashians, Mel Robbins, the author of What's Going Right, a powerful new method for optimizing your mental health, who sees how we can all make it better. If we don't address the traumas in our lives, they don't go away. It spins off symptoms and some panic attacks and pressure. Substance, my youngest brother died by suicide. I was in my mid-20s at the time, and life was going in such a bad direction. I had no hopefulness about the future. I had unhealthy relationships. I was drinking more. It was so embarrassed to get help and then someone started bringing order and I started just learn the mind and the body aren't just attached. They're interwoven. And what goes on in one dramatically affects the other. We treat the symptoms as if they were for problems. Let's give you an SSR. I'll give you a sleeping medicine. Of course they're not getting any better. Let's look for what could be root causes everything worth having in life requires some work, but here's the good news. We can understand it, we can get at it, we can change it. Hi, I'm Ian Bialik. I'm Jonathan Cohen. And welcome to our breakdown.

You know what? Today we're going to do something different. We're going to talk about what's going right. Why are we doing that, Mayan? We're doing that because so much of the field of mental health and really the field of pop culture, social media is focused on what's wrong with me. What's my diagnosis? What pill do I need to take? my parents do that messed that messed me up? We're going to be talking today with the author of What's Going Right, a powerful new method for optimizing your mental health, Dr. Paul Conti. He is a psychiatrist, the president of Pacific Premier Group PC, which is a comprehensive mental health clinic that provides therapy, coaching, and consulting services. You may be familiar with Dr. Conti because he is publicly known as the psychiatrist who worked with Lady Gaga, who had fibromyalgia ended up in the hospital with a psychotic episode. He is the doctor who helped her connect her fibromyalgia to a previously unmatabilized trauma of sexual assault. So Dr. Conti is known for working with people like the Kardashians, like Mel Robbins, Whitney Cummings, Tom Billu, Lex Friedman, Rich Roll, Danica Patrick, Tim Ferris, his list of clients and colleagues and collaborators is incredibly significant for the place that we are in right now. But I think what's most important for this conversation today is that this is one of the most compassionate clinicians who is in the field, who works with patients, who sees what the industry is doing wrong and how we can all make it go better, not just for psychiatry, for therapy, but for us as individuals. We are so thrilled to welcome Dr. Paul Conti in person to the breakdown. Dr. Conti, welcome. Break it down. Thank you. Thanks for having me. I mean, I'm always eager to talk about what's going right because it feels like nothing is going right. Isn't that the problem that we feel like nothing is going right? And so much of the approach to trying to fix things is like, well, what's wrong? Why is that the wrong approach? There's enough that is going wrong in the world around us that we can start to make the story inside of ourselves about that, that nothing's going right, nothing can go right. And we can see that outside of us, but then that also impacts our feelings inside of us where we can feel like there's nothing going right inside of us and we're not going to be able to move forward or get back on our feet or whatever it is that we're trying to achieve. And the truth is if we're here, there's a lot going right in us and a lot of that is a birthright of being human that our brains and our minds have evolved over many, many, many, many thousands of years in order for there to be a lot going right in us. Perseverance, resilience, the things that we can seize upon, understand better and use to make more go right. So it's not a blind optimism. It's looking at what's real and true about us and saying, hey, there's good reason to find hope in all of this. I believe you and I want to double down on someone who is listening, who thinks I've seen so much mental health content. And I've been told so much about mindset and like even in the last three years, right? The amount of information has exploded. And they're still like, I don't feel good. I'm anxious. My mind is racing. Some might argue that the more we've given labels, boxes, diagnoses, and everyone knowing what the DSM is, right? Yes. Some would argue that we're almost in like a crisis of overdiagnosis. Absolutely. The field has not been in a position of leadership at all to help say to people, hey, here's how to understand yourself. Like you can understand yourself and there's a process that you can go through, not just to gain understanding, but to make that understanding lead to change. Instead, what we've done is glorified a book of taxonomy. And the DSM is this thick and it's got more numbers in it than we could possibly count, and enough to give us all a bunch of diagnoses. And all it's doing is labeling. You know, it's looking for, let's figure out what's going wrong. And there's a whole bunch of things we can identify in that giant book without any explanatory mechanism of like, where does all this come from? What can we do to bring change? So we're glorifying the negative. And so of course, with more information, it doesn't help people feel any better. And we take this book of taxonomy and we make it the heart of the field. And I think at that point we're lost. There's been an explosion in conversation about mental health. You know, when we started this podcast, it was still sort of something that was whispered in a lot of circles. And we believed that kind of democratizing mental health and even a conversation about mental health was something that we were hoping to do. Many people, we started this really at the beginning of the pandemic, right? Many people who had never experienced anxiety were wondering why with a global pandemic upon us, they couldn't sleep. They were eating weird food. They were feeling shaky and didn't know why. And those of us who've had anxiety our whole lives were like, oh, what's happening? Let me explain. This is called anxiety, right? There has been this explosion. In the last years, we see so much on social media. Everybody is sort of claiming to be the person who can help you figure out if you're on the spectrum, If you're neurodivergent, all these things, why is it that in some cases more information is not necessarily better? If more information doesn't help us understand, then more information just confuses us, or it makes us feel overwhelmed. Now I have more information. I still can't get a handle on what's going on inside of me. And the problem is that we don't have a mechanism of understanding. Do you think about the difference between physical health and mental health. If you broach the topic of physical health, most people can be interested and attuned to that, because we know that we all have bodies and the bodies have hearts and lungs and muscles and we need to eat well and exercise. We have an understanding that can say if there's something I'm not happy about, or if I want to be healthier,

I can anchor to understanding and I can use that to bring change. Mental health still creates stigma. There's a reflex of stigma and of guilt and what is someone bringing up mental health for? What are they going to try and find wrong with me? I know there's a lot wrong with me. I don't even know what it is. That's because we don't have a mechanism of understanding mental health and building good mental health like we do for physical health.

So me. I know there's a lot wrong with me. I don't even know what it is. And that's because we don't have a mechanism of understanding mental health and building good mental health like we do for physical health. So information has to be useful to us. And the point that I'm moving forward in the book is that we know enough about our brains and our minds to say there is a process of understanding just as there are with our bodies. We have all these similarities in body and in mind. And if we just take the concept of physical health and make it part of how we view mental health, now we're empowered to understand and to bring change. And that's why I very much hope for this book to bring real change in an overarching way that says, we can understand and build good mental health, just like we do with physical health. We don't have to be afraid or stigmatized about the topic. I'm really excited about the next part of this conversation because we're gonna talk about the mechanisms and the ways to have that type of change that will benefit people. Just before we get there, let's explore a little bit this notion of mental health because that word even is off putting to some people because they'll say I'm fine. And what I sort of am struck by is that fine is actually the enemy of improvement, meaning that most people are stuck in some pattern that they don't even realize and they would not be considered to have poor mental health, but they're not optimized. They're not living in a way that is expansive and they're seeing opportunity and they're feeling connected and they're just living at this low, lethargy baseline. They don't even realize they're living in. Can you kind of explain to us or even set the picture for how we should be actually thinking about improving our lives, even if we never have even considered that mental health could be an issue. He said, fine is the enemy of improvement. And I would argue even one step earlier than that, that fine is the enemy of inquiry. That often fine just means, I don't want to talk about it. I don't feel great, but I don't think anything good is going to come of a conversation about it except me feeling worse. So very often our our response is to avoid inquiry because there's not an expectation that inquiry will bring understanding and that we can use that understanding to bring change. The fact that stigma is still with us is because it's a black box and a giant book of numbers doesn't tell us how to understand.

But if we have a route to understand, now everything is different. And that's what we want as human beings. You know, I very often thought if all I did was help people understand and then we just stopped right there and we didn't go, well, how might we change that? There'd be a tremendous amount of change. There is that comes just from understanding because it's what we want as human beings we can can bring ourselves to bear. So we just need a method so that we can say instead of saying fine, like how about let's bring curiosity to ourselves and think of what is going on with me, what's going well, what's not the way that I want it to be. Let me take a look at that so that I can make change. That's the difference. Obviously, when people understand anxiety, they understand depression or lethargy. Maybe they understand feeling unsure, self-doubt, rumination, but what are some of the other places that you see people making significant change in their life? Well, if there's a mental health complaint that someone has, or if I feel like I'm doing okay, but I don't feel so strong in case something difficult comes my way Then we want to be able to approach our mental health just like we do our physical health So if someone comes in with a physical health complaint to see a doctor, there's a process Right, there's a process of taking a history. There's a process of doing a physical exam There's a process of maybe ordering some labs We need to bring the same regimen to mental health and to say, okay,

we all have a structure of self inside of us. We all have a function of self inside of us, just like we have organs in the function of our bodies. And if we start there and we say there's a process to go through, that's how we bring understanding. It's not by just a shot in the dark, right? It's by going through a process. And if we do that, and we look at the elements of the structure of our self, and we look

at the elements of the structure of our self, and we look at the elements of our function of our self, we'll find if something is out of balance. So then we find what's there, and that's what gives us a route to change. And ultimately, we're trying to build empowerment and agency, right, directly and intentionally, interfacing with the world around us. trying to bring a sense of humility that we too can be human and we can have issues inside of us that warrant attention. We don't have to be ashamed of that. And through humility, we can approach life through a lens of gratitude and its active agency and gratitude that lead us to what we generally call happiness. And we can talk more about that. What are the components of happiness? And ultimately there are drives in us that are governing all of this. So the point I'm trying to make is that there is a process just as there is with physical health. And we can go through that process to identify what we want to change and what we want to make better. You know, as someone might be asked break down and supported by by optimizers, you know, I struggled to get good quality sleep, and I just assumed it was stress. But as I learned, during perimenopause and menopause, your hormones shift in a way that affect your magnesium levels. And low magnesium, it makes everything harder, not just sleep, focus, mood, your tolerance for stress. That's why I have added magnesium breakthrough by by optimizers to my nightly routine. It's a blend of seven different forms of magnesium designed to support relaxation and overall sleep quality. Try it. See if you wake up more rest and refreshed. You've got nothing to lose and a lot to gain by optimizers offers a 365 day. No questions asked money back guarantee. A magnesium breakthrough is a huge breakthrough to improve hormonal balance to help with focus, decrease brain fog, improve sleep hygiene overall. 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But I think it's really interesting this notion of, you know, kind of having, you know, some sort of strategic methodology in how we sort of approach mental health in the same same way that one would hope that that would exist for physical health and for physiological processes. My question though would be about where the role of the mind and body as they function together comes into this. You have some very, very prominent clients and one in particular was this story about Lady Gaga, having not connected a lot of her emotional and mental struggles with a physical, with a rape, right? Where does the mind and body come together for you when you think about how we can approach these things? I'll talk about the mind and body. I just wanted to point out you said, when you were in mental health care, right? Many years ago, it was a different approach, but I would argue then you could have gone to see five or ten different people and had five or ten different processes. Right. So we don't have an organized process to run through and gain understanding. We didn't then, and that's even more fragmented now. Right, no. And what I was referring to was that many girls were put on birth control, even if they weren't sexually active because they thought that would help. And many of us were given like Xanax and given things to stop panic attacks instead of anyone saying, well, why do you think you're dying while you're driving, right? You know, things like that.

So yeah.

Right. And that's the problem is if there isn't a route of inquiry that leads to understanding, is then you just to end up with reflex as well. Put everyone on Xanax and birth control, right? That comes from a lack of understanding. And then we're even another step away from understanding the integration of the mind and body. Like we're one entity, you know,

the mind and the body aren't just attached,

they're interwoven.

And what goes on in one dramatically affects the others. So stress, tension, anxiety in us, just was one example, impacts horror immune system functions and whether we're able to navigate life healthily or whether we develop an autoimmune disease or whether we're fatigued or we're subject to

infection. There's so much in the exchange between mind and body and when the body is in pain, it makes the mind more vigilant and we're less trusting and we're less likely to get help. So we have to look at ourselves as one integrated entity because to stay the obvious, it is true, Right, this effort to separate mind and body has done us no good whatsoever.

And it's taken us away from understanding how not just we're one But then we often have distress pinging back and forth between the mind and the body And if we can intercede in one area we can intercede in others So there are people who can't lose weight or having rashes that they can't explain, having terrible fatigue, have a litany of physical complaints with labs and examination results to show that person is having physical complaints, but the source of it can be all in mental health, which is just part of medicine. It's not a strange thing to say. It's not a stigmatizing thing to say. It's saying, if you have tremendous distress going on, you're going to impact how your body functions. The endocrine system, the immune system, the inflammatory markers inside of us. If we see ourselves as a whole, which is what we are, we actually simplify things. It's because medicine has become so siloed. So we're just trying to look at little facets of a person and understand, and all we do is mislead ourselves. So yes, we are very, very complex, but simple principles are always consistent with good health. It's just hard to get to the simple principles and the idea that we're integrated, one affects the other, and that we can go through a process of understanding.

It's not that complicated, but the field has strayed so far away from it. Well, and I think the stigma, at least in my experience, and from a lot of the people that we get to talk to, the stigma is less about, oh, there's stress and anxiety in your life, that could be causing, let's say, what's going on in various organ systems. But I'm more interested when I speak to people who do not seem to have any access to a conversation about mental health and they can't figure out why their body keeps betraying them. Right? I used to meet a lot of women with endometriosis and with all these things. And Gabar Mate and Bessel Vandergart obviously talk about the body is keeping the score. What is it like for us to have conversations as a society, right? With people who are possibly coming to doctors with physiological problems, which are real, right? Things like Crohn's even IBS, things that like many people were told,

it's all in your head or you'll be fine, right? How do we start to have this conversation with people to say, we don't mean to kind of poke at this, but have you looked deeper? Why is that so hard for people? I think because of the automatic stigma. So even the way of saying like, well, you know, not to poke at this, like there has to be, like we have to apologize, you know, for

saying, hey, there's what's going on in your mind really is likely impacting your body. How about looking at from the perspective of what's going right, of saying, all we're looking for is an explanatory mechanism, and most physical health complaints. So most complaints when a person goes to a physical health doctor are coming from a mental health origin. Is that 50% 60% 70% that we don't know but the studies clearly tells more than half of all complaints are coming from mental health and it does make sense because it can impact your endoconsystem. It can impact how you're perceiving and registering

pain. It can impact how your body is responding to infection. It all makes good sense. So there's good news here. Right? And anytime someone presents and says, oh, I have five different problems, six different problems. We hear this a lot, whether it's physical health, it's mental health, it's both. And people will often say that in a very negative way. Like, oh, there's no way you're you're going to help me.

There's seven different things going on with me.

And I'll say, well, oh, there's no way you're gonna help me.

There's seven different things going on with me.

And I'll say, okay, let's think about it.

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