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“You can do as many brain scans as you want, but you'll never be able to distinguish an impulse that wasn't resisted from one that's irresistible.” — Sally Satel on why social media addiction can't be proven in court When Meta and YouTube lost the so-called landmark social media addiction trial back in March, there was jubilation inside and outside the courtroom. Finally, Big Tech seemed a bit less big. Justice, it seemed, had finally been done. Or maybe not. (Full disclosure: my wife is head of litigation at Google, so I might be a bit biased). But today's guest, the psychiatrist Sally Satel, doesn't have a dog (or husband) in the fight, and she's a skeptic of the trial's outcome. A senior fellow at the American Enterprise Institute and the medical director of a Washington methadone clinic, Satel argues that the concept of addiction — her clinical specialty — was distorted in the trial to serve a $1.4 trillion litigation pipeline. The plaintiffs' theory reifies addiction as behavior beyond control. If that were true, Satel argues, none of her patients would ever get better. Satel comes at this as a doctor rather than a moralist. Clinically, she acknowledges, social media addiction exists — excessive use, loss of control, continued harm — and the treatments are the same behavioral strategies she uses at her clinic. But legally, where causation is everything, the plaintiff argument collapses. No brain scan can ever distinguish an impulse that wasn't resisted from one that's irresistible. The mechanism of harm is unprovable — a ludicrously brittle foundation, Satel argues, for a trillion dollars of lawsuits against social media companies. So when is “addiction” really addiction? Satel's upcoming book Not a Disease: Rethinking Addiction in the Heart of America's Overdose Crisis, which will be out in early 2027, addresses this awkward truth. And we'll certainly have her back on the show to discuss. Five Takeaways • The $1.4 Trillion Distortion of Addiction. The March bellwether verdict awarded “Kaley” $6 million from Meta and YouTube, but the real story is the litigation pipeline behind it — four states suing Meta in a single day, with total claims reaching $1.4 trillion. Satel's objection is professional: the lawsuits invoke brain science at the most superficial level and reify addiction as behavior beyond control. If addiction truly extinguished self-control, her methadone patients would never get better — and they do. Kaley herself had fragilities that long predated the platforms, one therapist testified social media barely came up in her sessions, and her stated career plan is to become an influencer. • Clinically Real, Legally Incoherent. Satel's central distinction: in a clinic, social media addiction is a recognizable condition — excessive use, loss of control, continued harm — treatable with the same strategies she uses for drugs, from identifying idiosyncratic cues to self-binding tactics like grayscale screens and switched-off notifications. In a courtroom, where causation is everything, the concept falls apart. No brain scan can distinguish an impulse that wasn't resisted from one that's irresistible; the technology simply doesn't exist. The mechanism of harm at the center of the litigation is not just unproven but unprovable. • Demoralization Is Not Depression. At her methadone clinic, nine patients out of ten arrive reciting diagnoses — bipolar, PTSD, depression — that closer examination reveals they don't have. What's medicated as depression is often demoralization: the entirely understandable response to crumbling public housing and an abusive partner. Younger people now diagnose themselves by internet, because a diagnosis has become valorized — a built-in excuse, a victim category, less expected of you. Gratifying in the short run, Satel argues, and developmentally retarding in the long run: less engagement with risk, with challenge, with the world. • The Therapeutic Culture Meets Woke Therapy. Sixty years after Philip Rieff's Triumph of the Therapeutic, the medicalization of ordinary sadness is complete — grief becomes a prescription, and resources drain away from the seriously ill. The newer turn is political: counselor training now teaches that the therapist knows what's wrong before the patient speaks — oppression — and a congressional investigation is examining antisemitism within the American Psychological Association. Satel's emblematic story: a young man fired by his therapist for gently suggesting his rabbi's sermon had become too politicized. You don't fire a patient, she notes. The therapist's moral commitments bled into the room. • The Good News About Fentanyl. Fentanyl deaths are falling significantly — not because fewer people use, but because far fewer die. Narcan is flooding the streets, nailed up in boxes on telephone poles and handed out free at clinics; the Chinese supply has tightened and Mexican distribution has been disrupted; and, as in every drug epidemic, the upcoming generation is opting out — the same dynamic the rappers documented during crack. The morbid factor is real too: many long-term users have died. Satel's book Not a Disease — rethinking addiction from the front lines of the overdose crisis — arrives in early 2027. About the Guest Sally Satel is a psychiatrist, a senior fellow at the American Enterprise Institute, and the medical director of a methadone clinic in Washington, DC. She is the author or co-author of PC, M.D., One Nation Under Therapy, and Brainwashed: The Seductive Appeal of Mindless Neuroscience, and her essays appear in Persuasion and The Free Press. Her new book, Not a Disease: Rethinking Addiction in the Heart of America's Overdose Crisis (MIT Press), is out in early 2027. References: • Not a Disease: Rethinking Addiction in the Heart of America's Overdose Crisis by Sally Satel (MIT Press, early 2027) — drawn from her years on the front lines of the overdose crisis. • Satel's recent Persuasion essay arguing that social media addiction is more complicated than the litigation suggests, and her Free Press pieces on social media addiction and on why fentanyl deaths are falling. • One Nation Under Therapy and Brainwashed: The Seductive Appeal of Mindless Neuroscience — Satel's earlier assaults on the therapeutic culture and superficial brain science. • The Age of Diagnosis by Suzanne O'Sullivan — the book behind the episode's framing question: which comes first, the diagnosis or the anxiety? • Philip Rieff — whose The Triumph of the Thera...
Shermer and Satel discuss: how political correctness has corrupted medicine; how wokeness and social justice activism has corrupted psychiatry; what is social justice and who is really practicing it?; medical models of mental illness and addiction and why mental illness is so hard to treat; addictions to porn and social media; why some people are able to break free from their addictions while others are not; organ transplant markets, and more… Dr. Sally Satel is a visiting professor of psychiatry at Columbia University's Vagelos College of Physicians & Surgeons, a senior fellow at the American Enterprise Institute, a lecturer at Yale University School of Medicine, and a practicing psychiatrist. She holds an MD from Brown University and completed her residency in psychiatry at Yale University. Satel is the author of PC, MD: How Political Correctness is Corrupting Medicine, Brainwashed: The Seductive Appeal of Mindless Neuroscience (with Scott Lillienfeld), and One Nation Under Therapy: How the Helping Culture Is Eroding Self-Reliance (with Christina Hoff Sommers). Dr. Satel lives in Washington, DC.
For 25% off your first Aurate purchase, go to https://auratenewyork.com/mikhaila and use promo code “Mikhaila”! In this episode, Sally Satel and Peter Pischke join Mikhaila to talk about dependence-forming medications, the opioid epidemic, and the prescription-drug system that's partly to blame. Sally Satel is a psychiatrist and addiction medicine writer. She is a lecturer at Yale School of Medicine and the author of ‘PC MD: How Political Correctness Is Corrupting Medicine.' More recently, she co-authored ‘Brainwashed: The Seductive Appeal of Mindless Neuroscience.' Her articles have been published in The New York Times, the New Republic, and The Wall Street Journal. Peter Pischke is a journalist and health and disability reporter. He hosts The Happy Warrior podcast and has been on many top podcasts and TV shows. As a journalist who's struggled with chronic pain, he aims to educate people and raise awareness about issues as important as the opioid crisis—which is discussed at length in this episode. ———————————— Find Peter Pischke on Twitter @HappyWarriorP https://twitter.com/happywarriorp or hear him host The Happy Warrior Podcast at https://anchor.fm/happywarrior There's more Sally Satel on her website https://SallySatelMD.com and Twitter @slsatel https://twitter.com/slsatel Useful resources for people with chronic pain: https://nationalpain.org https://nationalpaincouncil.org https://painnewsnetwork.org ———————————— Follow Me On ———————————— Audio - https://linktr.ee/mikhailapeterson Twitter - https://twitter.com/MikhailaAleksis Instagram - https://instagram.com/mikhailapeterson Facebook - https://facebook.com/mikhailapeterson... Lion Diet - https://linktr.ee/liondiet Telegram - https://t.me/mikhailapeterson ———————————— Show Notes ———————————— [0:00] Intro [02:37] Introducing guests Peter Pischke and Sally Satel [05:59] What is the opioid crisis? How did it get started? [09:07] “Just between 2020 and 2021, we've hit our highest number in a year yet for deaths, which was about 90,000 related to opioid addiction” - Peter Pischke [11:02] Peter shares his personal story of addiction and recovery from opioid use [14:25] Mikhaila shares her experience with painkillers for childhood arthritis and the difficult choice between using a habit-forming drug or feeling miserable day in and day out [15:21] "It's like woah, I'm in a lot of pain, I full-on have an autoimmune disorder and there's a reason I need these pain killers, and in the moment it's the difference between being in chronic pain or sleeping but being on a pain medication that is dependency forming" - Mikhaila Peterson [15:54] Sally's experience working at a methadone clinic in Washington DC [20:36] “Some of our patients say they can't handle this on their own and get on a replacement medication for the opioids. And this is not the right medical analogy, but metaphorically it might be like taking insulin: it's just a medication you take every day. Some people do get off completely, but those are the more rare cases"- Sally Satel [21:02] “It takes a long time to repair your life, and people use drugs for a reason” - Sally Satel [22:40] The mixture of drugs in many cases of overdose. The difficulty in prescribing necessary meds post-2016 legislation restricting doctors' ability to prescribe certain drugs [34:39] The extreme pressure on doctors to see more and more patients. Its effect on prescribed patient care [39:35] Dependence-forming medications [44:05] American culture and the constant war between addicts and legitimate patients in legislature and treatment [51:53] “It could well be that many people on high-dose opioids today didn't need to be on that high of a dose [...] That's all true, but once you're on a high dose that's working, and you want to stay on it, to me it's unconscionable that doctors would take you off of it” - Sally Satel [52:16] A message from Peter for those struggling with chronic pain [54:43] A message for people who may be using or considering using [55:21] Wrapping up #MikhailaPeterson #Addiction #OpioidCrisis #MedicalSystem #ChronicPain
Recommended Reads - Blaming the Brain by Elliot Valenstein, Magic bullets: Anatomy of an Epidemic by Robert Whitaker, Brainwashed: The Seductive Appeal of Mindless Neuroscience by Sally Satel and Scott Lillenfeld, The Myth of Mental Illness by Thomas Szacz. In this episode I will talk about: what harm means, do not steal, feds and private citizens coming to people's homes, CV 19 stuff could be a diversion, a note about tolerance, people must stop believing that they cannot control themselves, the human will is more powerful than any drug, involvement or other person, what needs are met by an addiction, "the addicted brain", mental illness is a metaphor, biochemical theories about addiction and psychological problems are flawed at best, how drugs interact with the brain is what has been discovered not mental diseases, psychiatric drugs cause biochemical imbalances, the idea of magic bullets is a fantasy, reductionism, NIDA, most people recover from addiction on their own.
It seems like a week can't go by without a news story about how neuroscience has discovered the neurological basis of love, morality, addiction, you name it. Yet how much explanatory power does neuroscience really have -- and are we putting too much trust in its findings? On this episode of Rationally Speaking, Massimo and Julia explore these questions with psychiatrist Sally Satel and professor of psychology Scott O. Lilienfeld, the authors of "Brainwashed: The Seductive Appeal of Mindless Neuroscience." Sped up the speakers by ['1.0', '1.0']
Our guest is physician and author Sally Satel, MD. Dr. Satel is a resident scholar at the American Enterprise Institute and staff psychiatrist at a local methadone clinic in the Washington DC area. She earned a bachelor's degree from Cornell University, a master's degree from the University of Chicago, and an MD degree from Brown University. She has written widely in academic journals on topics in psychiatry and medicine, and has published articles on cultural aspects of medicine and science in numerous magazines and journals. She has testified before Congress on veterans' issues, mental health policy, drug courts, and health disparities. She is the author of numerous books including The Health Disparities Myth: Diagnosing the Treatment Gap with co-author Jonathan Klick and, most recently, Brainwashed: The Seductive Appeal of Mindless Neuroscience co-authored with Scott Lilienfeld. SHOW NOTES Sally Satel, MD: Twitter and Website“The Hypocritical Oath” (in Persuasion online community)The Health Disparities Myth: Diagnosing the Treatment Gap (with co-author Jonathan Klick)Watch the episode on YouTube
Our guest is physician and author Sally Satel, MD. Dr. Satel is a resident scholar at the American Enterprise Institute and staff psychiatrist at a local methadone clinic in the Washington DC area. She earned a bachelor's degree from Cornell University, a master's degree from the University of Chicago, and an MD degree from Brown University. She has written widely in academic journals on topics in psychiatry and medicine, and has published articles on cultural aspects of medicine and science in numerous magazines and journals. She has testified before Congress on veterans’ issues, mental health policy, drug courts, and health disparities. She is the author of numerous books including The Health Disparities Myth:Diagnosing the Treatment Gap with co-author Jonathan Klick and, most recently, Brainwashed: The Seductive Appeal of Mindless Neuroscience co-authored with Scott Lilienfeld. GUEST: Sally Satel, MD: https://twitter.com/slsatel (Twitter) and https://sallysatelmd.com/ (Website) LINKS: "https://www.persuasion.community/p/the-hypocritical-oath-054 (The Hypocritical Oath)" (in Persuasion online community) https://www.amazon.com/Health-Disparities-Myth-Diagnosing-Treatment/dp/0844771929 (The Health Disparities Myth: Diagnosing the Treatment Gap) (with co-author Jonathan Klick) RELATED EPISODES: https://accadandkoka.com/episodes/episode144/ (Ep. 144 John Mandrola: Why Doctoring and Politics Shouldn't Mix) WATCH ON YOUTUBE: https://youtu.be/tLjnCEVVt7I (Watch the episode) on our YouTube channel SUPPORT THE SHOW: https://www.patreon.com/accadandkoka (Make a small donation) on our Patreon page on and join our discussion group or receive a free book. Support this podcast
Psychiatrist Sally Satel, resident scholar at the American Enterprise Institute and author of the book "Brainwashed: The Seductive Appeal of Mindless Neuroscience" on her piece in the Atlantic Monthly, "The truth about painkiller addiction." What the late Irving Kristol said about social justice warriors in his book, "Two Cheers For Capitalism." See omnystudio.com/listener for privacy information.
Sam Harris speaks with Sally Satel about addiction. They discuss whether addiction should be considered a disease, the opiate epidemic in the U.S., the unique danger of fentanyl, the politicization of medicine, PTSD, and other topics. Sally Satel, M.D., is a practicing psychiatrist and lecturer at the Yale University School of Medicine who examines mental health policy as well as political trends in medicine. Her publications include PC, M.D.: How Political Correctness Is Corrupting Medicine; When Altruism Isn’t Enough: The Case for Compensating Organ Donors; One Nation Under Therapy (coauthored with Christina Hoff Sommers); and Brainwashed: The Seductive Appeal of Mindless Neuroscience (coauthored with Scott Lilienfeld), which was a 2014 finalist for the Los Angeles Times Book Prize in Science. Website: sallysatelmd.com Twitter: @slsatel
Chemda Khalili is a singer and podcaster. She is the co-host of the long-running podcast, “Keith and the Girl.” Sally Satel is an American psychiatrist, lecturer at Yale School of Medicine, and resident scholar at the American Enterprise Institute. She is the author of several books, including, “P.C. M..D.: How Political Correctness is Corrupting Medicine,” and “Brainwashed: The Seductive Appeal of Mindless Neuroscience.” Her writing often appears in such outlets as The Atlantic and the Wall Street Journal, where she penned the article titled, “Does it Take a Shrink to Evaluate Trump?”
Chemda Khalili is a singer and podcaster. She is the co-host of the long-running podcast, “Keith and the Girl.” Sally Satel is an American psychiatrist, lecturer at Yale School of Medicine, and resident scholar at the American Enterprise Institute. She is the author of several books, including, “P.C. M..D.: How Political Correctness is Corrupting Medicine,” and “Brainwashed: The Seductive Appeal of Mindless Neuroscience.” Her writing often appears in such outlets as The Atlantic and the Wall Street Journal, where she penned the article titled, “Does it Take a Shrink to Evaluate Trump?”
World renowned psychological skeptic and evidence-based treatment advocate Scott Lilienfeld joins us to explore the topic of pseudoscience and misleading claims in the field of mental health. *** PATREON *** http://patreon.com/myownworstenemy *** BOOKS MENTIONED *** "50 Great Myths of Popular Psychology" by Scott Lilienfeld (co-author) https://amzn.to/2zoyQff "Brainwashed: The Seductive Appeal of Mindless Neuroscience" by Scott Lilienfeld (co-author)https://amzn.to/2Nx28ks "Facts and Fictions in Mental Health" by Scott Lilienfeld (co-author) https://amzn.to/2MR4ZQ4 "The Demon Haunted World" by Carl Sagan *** SOCIAL MEDIA *** Facebook: http://facebook.com/myownworstenemyorg Twitter: http://twitter.com/dannydwhittaker *** CREDITS *** Theme Music: Falling Down by Ryan Little http://youtube.com/user/TheR4C2010 Podcast Image: DJ Spiess http://www.fermentarium.com/ DISCLAIMER: My Own Worst Enemy is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.co.uk and affiliated sites.
Scott Lilienfeld is professor of psychology at Emory University. Here, he talks about his 2016 article evaluating the psychological literature on microaggressions and his 2017 article about revoking the Goldwater rule. Scott is an Association for Psychological Science fellow, and he has published numerous studies in personality psychology, social psychology, political psychology, and clinical psychology. He also has an interest in debunking popular myths. His popular books include Brainwashed: The Seductive Appeal of Mindless Neuroscience and 50 Great Myths of Popular Psychology. Timeline: 1:06 The history behind Scott’s micro-aggressions critique 7:01 Two big weaknesses in research studies 15:23 Real-world implications 20:05 Reactions to the article 26:05 The Goldwater Rule, and revoking it in 2017 You can learn more Scott Lilienfeld at his website. A gated copy of his paper on micro-aggressions, entitled “Microaggressions: Strong claims, inadequate evidence” is here. And it is summarized in this blog post by Musa Al-Gharbi. His paper on the Goldwater is here. Selected Quote: “One big criticism concerns the nature of the construct of micro-aggressions itself. Do we understand what it is? And one of the points I raise is that even though there’s something there, it’s so vague and so nebulous, it could, in principle, include almost anything that could offend almost anyone. And I think that’s part of the problem. It lends itself to too much abuse, too much misunderstanding.“ Other episodes of Half Hour of Heterodoxy.
Aug. 30, 2014. Psychiatrist and author Sally Satel appears at the 2014 Library of Congress National Book Festival in Washington, D.C. Speaker Biography: Sally Satel is a psychiatrist and a resident scholar at the American Enterprise Institute. An academic of psychiatry and medicine, she was an assistant professor at Yale University from 1988 to 1993, where she remains a lecturer. Satel is the author of many scholarly articles and books, including "Drug Treatment: The Case for Coercion" and "PC, M.D.: How Political Correctness Is Corrupting Medicine." In "Brainwashed: The Seductive Appeal of Mindless Neuroscience" (Basic Books), she pairs with psychologist Scott O. Lilienfeld to reveal how many of the real-world applications of human neuroscience gloss over its limitations and intricacies, often obscuring the myriad factors in psychology that shape our behavior and identities. Satel and Lilienfeld analyze what brain scans and other neurotechnologies can and cannot tell us about ourselves, and the authors stress the complex nature of our selfhood, free will and personal responsibility. "Brainwashed" was a finalist for the 2013 Los Angeles Times Book Prize in Science. For transcript, captions, and more information, visit http://www.loc.gov/today/cyberlc/feature_wdesc.php?rec=6406
It seems like a week can't go by without a news story about how neuroscience has discovered the neurological basis of love, morality, addiction, you name it. Yet how much explanatory power does neuroscience really have -- and are we putting too much trust in its findings? On this episode of Rationally Speaking, Massimo and Julia explore these questions with psychiatrist Sally Satel and professor of psychology Scott O. Lilienfeld, the authors of "Brainwashed: The Seductive Appeal of Mindless Neuroscience."