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Host: Peter Buch, MD, FACG, AGAF, FACP Guest: Naga Chalasani, MD It's recommended that if patients with cirrhosis are using acetaminophen long-term, it should be a limited dosage. But should we be avoiding nonsteroidals in patients with decompensation cirrhosis? To walk through the impacts of analgesics in patients with cirrhosis, join Dr. Peter Buch as he speaks with Dr. Naga Chalasani, David W. Crabb Professor of Gastroenterology and Hepatology at Indiana University School of Medicine.

Host: Peter Buch, MD, FACG, AGAF, FACP Guest: Benjamin Schmidt, MD It's become clear that social media is here to stay, and it's become a way that people get their information and spread information. Dive into this episode to learn about the benefits and challenges of social media in healthcare from a recently published article with Dr. Peter Buch and Dr. Benjamin Schmidt, Gastroenterologist at Esse Health in St. Louis, Missouri. He's also the author of the article, titled “How a GI Fellow Found a Following: Harnessing the Power of Social Media for Education and Fun,” which was published in Digestive Diseases and Sciences in 2023.

Welcome back to Analyze Scripts, where a psychiatrist and a therapist analyze what Hollywood gets right and wrong about mental health. Today, we are rereleasing one of our favorite episodes where we were joined by one of Dr. Furey's favorite teachers from residency, Dr. Zheala Qayyum. Dr. Qayyum is the Training Director for the Child and Adolescent Psychiatry Fellowship Program and the Medical Director of the Emergency Psychiatry Services at Boston Children’s Hospital. She has published on the use of fairy tales in teaching child psychiatry and joins us to discuss the first "Harry Potter" movie. In this episode, we discuss many interesting themes including the psychological effects of early childhood trauma and neglect, the attachment styles of the three main characters, and the importance of friendship in identity formation. We also reflect on the mirror of Erised and the importance of exploring dark feelings and themes in childhood from a safe space, such as through this magical film. We hope you enjoy as much as we enjoyed speaking with Dr. Qayyum! Instagram TikTok Website [00:10] Dr. Katrina Furey, MD: Hi, I'm Dr. Katrina Fieri, a psychiatrist. And I'm Portia Pendleton, a licensed clinical social worker. And this is Analyze Scripts, a podcast where two shrinks analyze the depiction of mental health in movies and TV shows. Our hope is that you learn some legit info about mental health while feeling like you're chatting with your girlfriends. There is so much misinformation out there. [00:30] Dr. Katrina Furey, MD: And it drives us nuts. [00:31] Dr. Katrina Furey, MD: And if someday we pay off our student loans or land a sponsorship, like with a lay flat airline or a major beauty brand, even better. So sit back, relax, grab some popcorn and your DSM Five and enjoy. [00:50] Dr. Zheala Qayyum: Don'T. [01:17] Dr. Katrina Furey, MD: For a very special episode of Analyze Scripts, because one of my favorite attendings for my residency training is joining us to talk about one of my favorite movies, harry Potter and the Sorcerer's Stone, or The Philosopher's Stone, depending on which country you're watching it in. So today we have Dr. Gila Kayum, the training director for the Child and Adolescent Psychiatry Fellowship program and the medical director of the emergency Psychiatry services at Boston Children's Hospital. She holds faculty appointments at Yale School of Medicine and Harvard Medical School, and she's the associate director of medical student education and Psychiatry. She's also serving as a lieutenant colonel in the United States Army Reserves Medical Corps and deployed to Afghanistan and was later mobilized in support of the COVID-19 response to New York. Dr. Kayoom has published on the topics of medical education, autism spectrum disorders, inpatient treatment of early psychosis, and LGBTQ, plus youth, the use of fairy tales in teaching child psychiatry, and the risk of youth suicide and firearms. She has a particular interest in the areas of supervision and mentorship, which she's so good at psycho oncology and palliative care. And I feel like we always called her Dr. Q. I guess I'm allowed to call her by her first name because I'm a grown up now, but I still feel kind of funny about it. But you were one of my favorite mentors, and I feel like you're really special because sometimes when you have a mentor, it kind of feels like they're trying to mold you in their image. But I always felt like you just wanted what was best for me, and you were so encouraging, and I just always loved working with you, and you hold a really special place in my heart. [02:58] Portia Pendleton, LCSW: So this is really fun to talk about. [03:00] Dr. Zheala Qayyum: Harry Potter no, this is, like, making me teary. This is just a lovely intro I have gotten. And it's just such a thrill that the people that you invest in grow up to be such amazing child or adult or psychiatrists, but more so, just people. And you're very dear to me as well. The best part of being an educator and a clinician is that not only are you trying to sort of transfer your skills or your wisdom, but you get to see your kids grow and become they're meant to be and their best versions. And if you think you're a part of that journey, I think that's just the most amazing privilege. [03:50] Dr. Katrina Furey, MD: Well, I know you were for me, and I know you were for a lot of my co residents, so it's so true. So I am dying to talk to you about this movie, given your interest in using fairy tales to explore development. So I just kind of want to jump right in and hear what you think about the first Harry Potter movie and kind of what jumps out at you. [04:13] Dr. Zheala Qayyum: So I think one of the loveliest things about Harry Potter was that it was a modern fairy tale, and we've had a lot of lovely fantasy series, but there was something very special about Harry Potter that just captured everyone, whether it was kids or adults. It's interesting, whenever I ask people what their favorite children's book is, inevitably, for a lot of them, it's Harry Potter. And I read it in med school. So I was much older, but I still stood in line at midnight yes, where I was standing next to like, ten year olds in their robes, and I was like, Am I in the right place? But you felt like you were in the right place. And I think that's what it communicated was it was or is a modern fairy tale for all ages. It just has that essence of a fairy tale, that it means something different to different people at whatever stage of development or life they're in. So a child can interpret it in their own way and have things that they resonate with. And as adults, we might find things that resonate to us, whether based on the hero's journey, these ordeals and call to action and your helpers that bring you along, but also the trepidations, the challenges, the times you doubt yourself when things are there. How do you overcome challenges and this power of transformation through a journey and a story that you're not the same person that you started off as, but with all of the things that you've had to experience? How does that evolve and transform you till you come full circle in some way? Not the same person that left, but so much more wiser grown. I think it's the transformative journey that we see from the first book that started, but there are these just themes that just feel like so relevant to today about loss and difficulty and when you're seeing this drive for power around you and how do you fit in the whole picture. And we usually have a reluctant protagonist in many stories that is not fully sure they want to take on the adventure and the call for action, and yet they do. But I think most importantly for me, the biggest thing was the importance of hope and friends. [07:04] Dr. Katrina Furey, MD: Yeah, I totally agree. And it's funny you mentioned hearkening back to standing in line at midnight at, like, Borders Books or wherever you were. I totally did the same thing. I think I was in middle school and then high school. But it is really fascinating how Harry Potter and other fairy tales like it. But I feel like especially Harry Potter, it is such a cultural, communal enjoyment and not just in American culture, but certainly worldwide. It's just such a really cool thing that it just really spans ages, genders, cultures, nationalities, languages. Everyone loves it, right? And I feel like this movie rewatching it now as an adult with my children was so meaningful and fun. So I have a seven year old and a four year old and they were just enraptured by it. They wouldn't stop talking the whole time. They wouldn't take their eyes off and this isn't like a cartoon, so they're still at the ages where really it's cartoons that catch their attention for two and a half hours. But this one did, and that was really interesting to me and really special. And I love some of their commentary. Like, with her, MayAny always raising her hand. My daughter, which I was so happy, said she's got a really big brain. And I was like, yes, she know. And then when Draco came on the scene very early on, my son was like, oh, he's a bully. And I was just you know, it's just really cool to kind of see kids watching it too. [08:40] Portia Pendleton, LCSW: Yeah. I think it's worth mentioning something interesting. When I was starting to read the books before the music, the movies had started kind of coming out. I remember very distinctly the religious organization that I was a part of at the time was very split with people thinking that you shouldn't be reading it. It's magic. It's witchcraft. Witchcraft. And then the other half being like, if you know the story, it's like this good versus evil. Good always triumphs. There's hope. There's, like you were saying, friendships. I mean, it's such a positive message. And there's so many interesting. [09:23] Dr. Zheala Qayyum: I don't. [09:23] Portia Pendleton, LCSW: Know, like, spiritual parallels and parallels throughout all of the books. But I think it was just an interesting time to be know, hearing this spoken series is bad or evil and then reading them. Know, in my family, we were very pro Harry Potter and loving the messages. And I think that was just like I don't know. I'm sure some other people might have had that experience. [09:45] Dr. Katrina Furey, MD: Oh, I totally remember. [09:48] Dr. Zheala Qayyum: Right. [09:48] Portia Pendleton, LCSW: Like, we come to see this boy in, I would say, a pretty abusive home with a lot of neglect. And I think it's funny watching it or thinking about it now versus in. Like, I'm curious what even your kids picked up of the scenes. The parents certainly seem mean and right dismissive. And you picked that up even as a child, like something not right. Why does Dudley receive all of these gifts and Harry not his clothing? [10:18] Dr. Katrina Furey, MD: Yeah, my kids were asking about that? [10:21] Portia Pendleton, LCSW: Like why are they so mean to? [10:22] Dr. Katrina Furey, MD: Why is he living under the stairs? They certainly were asking those questions. [10:29] Dr. Zheala Qayyum: Yeah, no, I think it's a really lovely depiction of how prevalent and difficult it is for kids that have neglect. And I think also it really sort of from starting from him being under the stairs and just watching Dudley get 36 presents and counting and him thinking about, like he has to get hand me downs to go to school and what that would be like. Just that differential that was created and that sense of otherness or I don't belong or I'm not good enough. It really, I think, beautifully highlights how a child will internalize that, because you see that then play out throughout, which partly keeps him humble when everybody thinks he's this amazing everybody knows him, but he's coming from where? Nobody. Knows anything about him. And he held on to that for a very long time and it really changed his I think we see him work through it, but his sense of belief and faith in his own abilities and his self because they told him he wasn't good enough for a good eleven years. And that sense of feeling like you're worth something that he didn't get initially. And how does one young child actually grow to develop that? Partly it kept him humble in the face of, I don't know, magician dumb or stardom or whatever that was that he got later on. But also, it really impeded his ability to rely on other people. And we see. This in the later books as well, but whenever he has to do something, he's very like the avoidant attachment style. I can't trust people to be there for me. And we know later in the books there are other losses that sort of reinforce that for him. But he embarks on everything on his own and working with others and trusting others comes very, very it's very challenging for him, comes much later. [12:52] Dr. Katrina Furey, MD: And I like that you brought up his attachment style. Can you explain a little bit what avoided attachment is or the kind of kids or adults we might see that in and how Harry either fits in or doesn't quite fit in. [13:09] Dr. Zheala Qayyum: So the avoidant attachment style is when a young child has inconsistent caregiving where their needs may not be consistently met. And so rather than clinging to their caregiver to get their needs met, they're like avoiding contact with them because they don't know are they coming, are they going, or are they going to be there. So the child starts to avoid that contact and doesn't get need or avoids contact with the caregiver to get soothed and self regulated. So we see the same thing, that since the Attachment is our template for forming relationships, that we carry on in life, we see Harry particularly later on as he's growing older, that even in adolescence, whenever there is a challenge, he goes off on his own rather than relying on anybody else because he doesn't know. Are people going to really be there for him or not? Are they going to leave? Are they going to neglect him? So he might as well do that for himself and just go off on his own. So that sense of avoiding closeness with people because they might leave or not be there for you, is that sense that avoidant children internalize and so they don't keep looking for closeness with people. It's good that we see Harry work through this over a great many books, which also tells you that it runs in parallel with the life experience of a young child who's had early life neglect and avoidant attachment style might need a lot of reinforcement of positive interactions to say, no, you can rely on other people. If you do get close to people, it'll be okay. And yet loss is a very, I think, integral part of our human experience and life. And for an avoidant child, there is that risk that it just might reinforce that belief that people are not going to be there for them. [15:18] Dr. Katrina Furey, MD: And in addition to Harry having that early childhood neglect and abuse, he also had early loss of his parents, who seem like lovely caregivers, who were likely very attuned to his needs, at least as far as we can tell, and that he was present for their murder. And so I was really curious about your take on that, given around the age they depict that and then what it must have been like for him at age eleven to start learning the truth about that loss at the same time as he's learning their loss is why he's famous or special. I just imagine that's got to be so confusing. [16:03] Dr. Zheala Qayyum: Absolutely. And I think that's such a lovely point of there's so much magic instilled in that power, of that parental love that he carried with him that it literally burned. Professor Squirrel. [16:22] Dr. Katrina Furey, MD: Right. [16:23] Dr. Zheala Qayyum: It was so powerful. I think it does show, though, however, that it was at a very sort of vulnerable time period in his life when that death occurred. He was still a baby, and we're thinking, like, till from infancy to toddlerhood, maybe the first part went well when his parents were attuned and taking care of him, but later on, and still in that very vulnerable time frame, he had a lot of neglect. And so as you're entering into your preteen years, your sense of, how do I relate with my peers? Who am I in relationship with them? Will they accept me as? We're thinking about later, latency age and early preteens going into your identity formation, who you are is so sort of determined by who are the people in your life? Who brought you here? What is your story? How did you start? And I remember as a child, my mom would tell me stories about, well, when you were little we did this things I wouldn't remember. But still you create these memories based on the things that your parents tell you as well when you're younger. But those things are so important in our development, and now he had to figure that out on his own. Who was he? What were his parents like? That question of when he goes and sees his father's name on the trophy room and he's like, I didn't know he was a Seeker. There's just so many knowns for him to figure out who he is because he doesn't know where he's coming from, and your legacy or your lineage or what are the wonderful stories about how amazing you are. Your parents tell you he never had that. And now he has to create his own narrative about who he is, which is the whole process through the book. [18:26] Portia Pendleton, LCSW: And speaking of like, identity formation, he went from being told that you're such a burden, you're unwanted. Your parents were horrible, they were weird or strange, to being praised or whoa, Ron's reaction to it's. You with the scar on the train, know, having all of this wealth suddenly and this importance in this world, it's just so interesting. You had written down with Hagrid, like him just going with that to this magical place that if somebody had told an eleven year old me, I think, and I'm hopefully that I'm securely attached, I would have been afraid to go with Hagrid. [19:08] Dr. Katrina Furey, MD: Right. [19:09] Portia Pendleton, LCSW: This big, burly, giant, half giant man who's telling me all these things that we're going to go to this magical place. I think for a securely attached child, they probably wouldn't have gone. But he didn't have any attachments. And then I think anything is better than living with the directly to finally. [19:29] Dr. Katrina Furey, MD: Take him out of that situation. [19:31] Dr. Zheala Qayyum: Right. [19:31] Dr. Katrina Furey, MD: It's like almost like this savior has come to rescue him. What were your thoughts about that, Dr. Q? The way he so know, latched onto Hagrid? [19:41] Dr. Zheala Qayyum: Yeah, I think just like Portia said, it's like that insecure attachment, there's nothing to hold him there. But he's also, I think, like you talked about at a point where he's thinking about things and his life. If he's going to go to the same school as Dudley, what is that going to be? He's getting into trouble constantly. And imagine the message you internalize after you're told that everything you do is wrong or you're a bad kid, and you get told that long enough, you start believing it. So maybe it wasn't such a far fetched thing to say, I'm going and I'm taking off. [20:19] Dr. Katrina Furey, MD: Right. [20:20] Dr. Zheala Qayyum: What's the worst thing that can happen whenever anything I do isn't good anyway? [20:27] Dr. Katrina Furey, MD: Right? And I think we see that in clinical work. And probably you see a lot more, given your line of work, in kids who maybe will go off with not safe people. That sort of increases their vulnerability for those very situations. [20:43] Dr. Zheala Qayyum: Because at the core of it, every kid just wants to belong. [20:48] Dr. Katrina Furey, MD: Yeah. [20:49] Dr. Zheala Qayyum: And so if it was what Hagrid said, is that's where you belong? He hasn't had that sense of belonging at the Dursleys. So he will try. And go and find if he belongs somewhere else and what other people. [21:09] Dr. Katrina Furey, MD: And he does find. [21:10] Dr. Zheala Qayyum: I feel like I'm going to cry. [21:11] Dr. Katrina Furey, MD: Talking about Harry Potter and also just thinking about Hagrid is like, I just love Hagrid. He's such a gentle giant, but I couldn't think of a better person to come scoop up Harry. Right. Like, even just imagining him sort of putting him in the little sidecar, he's, like, nice and cozy and secure and contained and I hope just feels safe next to this big old guy who. [21:40] Portia Pendleton, LCSW: Stood up to the dursleys, right? Chased found him. I remember my blood boiling even watching the movie again or rereading the book when they keep taking his know you know, it's such. [21:58] Dr. Katrina Furey, MD: His letter. [21:59] Portia Pendleton, LCSW: Yeah, that's the one thing he has. [22:02] Dr. Katrina Furey, MD: But then Hogwarts is like, well, we'll send you more. We're not going to give up. And I would imagine for, like, how wonderful. That must feel like, wow, they really. [22:12] Portia Pendleton, LCSW: Are trying to get to me. [22:13] Dr. Katrina Furey, MD: No one has wanted me like that before. And they're being like Hogwarts or whoever. Dumbledore's love for him is so transcendent and powerful that it wins. Out against the neglect of the know. [22:29] Dr. Zheala Qayyum: Just beautiful and sort of how teary Hagrid was when he was first dropping him off when he was a baby and dumbledore saying it's not goodbye for. [22:42] Dr. Katrina Furey, MD: Oh my gosh I feel like, that's how I am. Every year the new school year starts, you're just like, oh, my gosh, they're growing up. [22:51] Portia Pendleton, LCSW: And then hermione I think it's worth mentioning. So she has, it seems, securely attached, supportive parents. But is living as a muggle her whole life until receiving these letters and going to Hogwarts and then learning that she is like a mudblood and that she is not good enough. Her blood is like, dirty. And yet she is so brilliant, and I think that's such an interesting reversal of her and Harry's experience. She's still really smart, but it's like it's not good know are calling her names like Draco. And I don't think that she experienced that. Prior know the little bits that we get of her pre hogwarts. [23:40] Dr. Katrina Furey, MD: And interesting to think about her parents. Like getting this random letter and sending her. Right? [23:47] Portia Pendleton, LCSW: Yeah. [23:51] Dr. Zheala Qayyum: That's the wonderful thing about secure attachment and great parenting is know, we're all about you. So if this is who you are and this is your success and this is where you're going to thrive, sure. [24:03] Dr. Katrina Furey, MD: We don't know anything. Go for it. [24:06] Dr. Zheala Qayyum: And I think that is part of Hermione's own resilience as well is that that secure attachment, as difficult as those interactions with Draco are, allows her to stand up for Harry and Ron and build friendships and sort of extend that beyond the parental unit onto her friends, new people and say, because I have a good sense of attachment and security and I know people will be there for me, I can be there for other people, too. And then you can carry it forward. So I think Hermione is a really nice example of a secure attachment. And then I think you see that play out a little bit more. Not in the first book, but later on at the Yule ball, where she can put Ron in his place for not asking her out and sort of take ownership of her own. Know, next time you want to do this, pluck up the courage and ask, right? [25:10] Dr. Katrina Furey, MD: Boundaries. [25:11] Dr. Zheala Qayyum: I think that's a really nice illustration of how important attachment is as a child is growing and then into adolescence that the same things play out in your other relationships. [25:25] Dr. Katrina Furey, MD: And how amazing to have a girl character like Hermione, right? Like, I think all the things you just said, like her bravery, her intellect, her self confidence, her boundaries, I just think so lovely to have a girl character like this for girls and boys and adults to read about and identify with. And she can maintain that sense of herself in the face of draco and the slurs and the comments, even when people even know who she goes on to marry down the road. Spoiler alert. Even as he's kind of putting her down for being smart, she doesn't stop raising her, know? And I remember as a middle school girl who loved school, just loving that, just loving that. And I loved watching now my daughter, watch her, and I'm just like, soak this up, soak this. [26:20] Dr. Zheala Qayyum: Yeah, such a lovely little bottle for girls. And then since we're on the topic, like, you think about Ron, who is like this lost soul in this big family of redheads. And so you kind of see his sort of anxious style come through that, particularly when he was asked to relax and he couldn't. [26:44] Dr. Katrina Furey, MD: Yes, he's like, I don't know how. [26:49] Dr. Zheala Qayyum: Right? And all the hand me down. Not that he got, but also the same sweater that he gets every year, that there is love in that family, there is care, but also with so many kids, they're kind of lost until they get into trouble, that they get into parental they get parental attention and you hear about their concerns. And so even though there is not a lot of any mal intent anywhere within the Weasley family, but you can see where Ron's anxiety and anxious attachment style comes in and you see the same thing in the Eubolic. And the anxious attachment style is, you know, the child that doesn't know how to get through, they're like, all right, please pick me up. No, now put me down. No, pick me up again. I'm not sure. They're just taking time to self regulate and self soothe and sometimes they can get pretty irritable and upset too, and so they might lash out. And you see that in the U ball scene, too, where I know I'm jumping ahead, but rather than asking Hermione, he gets really sulky and irritable rather than owning up, but he wants it, but he doesn't know how to do it. So you kind of see that tension and that sort of clinginess but not sure what to do sort of thing. So I think the whole series really highlights these attachment styles really nicely. [28:19] Dr. Katrina Furey, MD: Isn't that amazing? How did JK. Rowling do that? And I thought the fact that they're all eleven, it was just perfect, right? Like at that age and kind of with all the books following them through is just really beautifully done, I think. [28:39] Dr. Zheala Qayyum: And you can kind of play out in the carriage scene when they're first on the Hogwarts Express together, where I think Hermione comes in looking for Neville's Frog frog. And you see how confident she is and she's you're and who are you and have you done this? And so self aware, self confident. And then you have Harry just sitting by himself, not sure he wants to talk to anybody. And poor Ron, who's trying to get his presence known again, just like a young child in a big family would feel lost, that I have to make my presence known, otherwise I won't get the attention I need. And poor Scabbers that he's trying to turn yellow and that's not working out. So you kind of see it play so nicely in a very simple scene. [29:36] Portia Pendleton, LCSW: Definitely something that I noticed, and I think it's just my interpretation of things, is that Ron seems to have the most obvious shame about his finances compared to the other siblings. I don't really notice or even Jenny's younger in this book, but being so visibly upset, I know that there's the interaction in the robes shop with Draco and then on the train, even with his little sandwich, right, he can't buy the treats. And then there's like whoa when Harry has those gold coins. And it really does seem to impact him even throughout the rest of the story. Just that intersectionality. He's a pure blood, but he is poor. And then how that really goes up against Draco and his Pure Blood and wealth family. [30:34] Dr. Katrina Furey, MD: I think that's an interesting thing to think about the intersectionality of all their identities in this sort of fantasy world, right? There's so many parallels. Like even if you think about different intersectional identities in our culture today, and it's just interesting to think about it's an older book. [30:55] Portia Pendleton, LCSW: I mean, again, it's so easy to talk about these more seemingly popular nuanced ideas. They've been around for a while, but everyone kind of talks about their intersectionality or different identities. And it's so clear in the book, right? [31:13] Dr. Katrina Furey, MD: It does seem like the type of series where you'll always get more from it. I reread the series I think, last year, and I loved it, and I feel like I got more from it as an adult than I did as a kid. And it's one of those things where I feel like every time you read it, you'll get more and more from it. [31:31] Dr. Zheala Qayyum: It just means something different. Yeah. [31:35] Dr. Katrina Furey, MD: So one thing I was hoping we could talk about is the mirror of Irisev, which is desire spelled backwards. I totally choked up watching this part again, as an adult, I was curious to hear about your experience. [31:52] Dr. Zheala Qayyum: Yeah, I had so many thoughts about that. I mean, it's such a powerful thing. And the fact that if you're truly content, then you can see yourself as you are, only the happiness, and if that is the measure of happiness. And it was like, wow, just the visual illustration of happiness, that you could see yourself and just see yourself as you are. Because I just felt like, yes, it is desire spelled backwards, but it is so prevalent throughout with starting with those 36 presents that you want more, and Voldemort wanting more, that defeated and needing to come back and needs to get more and more power and even kills a unicorn for it. [32:46] Dr. Katrina Furey, MD: Oh, my gosh, that was devastating for my four year old daughter. I regretted that part horribly. [32:51] Dr. Zheala Qayyum: Like, yes, moving but jarring scene. And then the fact that your heart's deepest desires that you're desperate for and you'll see that, but anything that's too much is going to consume you. And those people who sort of run after the things that they really, really want, I think it was a very powerful way of giving that message of too much consume you and there'll be nothing left. Like it does not do to dwell on dreams and forget to live. So I just thought it takes so much courage, though, to ask yourself what it is that you really want in life. I mean, a lot of us may want all these things, but what is it that you truly, truly want? I think that's a very powerful question to ask. And how many of us really can look at ourselves in the mirror and say, this is what I really, really want in life, and to be able to face that and own it. [33:59] Portia Pendleton, LCSW: It's a good question to ask a client, even, because I think you can always get to the feeling right under it. So if someone's they're saying that their deepest desire is financial gain, it's like, okay, but what does that mean? Does that mean you want to feel secure? Does it mean that you want to be powerful in a sense of authority? Do you want people to look up to you? It's always like a feeling. [34:26] Dr. Katrina Furey, MD: And why? Where does that come from? [34:28] Portia Pendleton, LCSW: Yeah, it's a good place to explore with yourself and maybe with a patient as well. [34:33] Dr. Katrina Furey, MD: Can you imagine, like, starting off a session, they come to see you. For the first time. And you're like, here is my mirror of IRISET. [34:39] Dr. Zheala Qayyum: Yeah. [34:40] Portia Pendleton, LCSW: Looking at what do you see and. [34:42] Dr. Katrina Furey, MD: What does that mean? [34:45] Dr. Zheala Qayyum: It'll make our job so much easier. [34:47] Dr. Katrina Furey, MD: I know, right quick, right real quick. [34:50] Portia Pendleton, LCSW: We'll get to the deep rooted issues in 10 seconds. [34:54] Dr. Katrina Furey, MD: Easy peasy. Managed care will love it. So we see what Harry wants, which is his parents. And again, I was so struck by him going back to that mirror repeatedly and I was just like, of course he is, right? Like his parents are moving. You see his mother, his father touch his shoulder. I was just like, oh, I so feel that for him. Then we see him drag ron so excited to share that experience of his parents with him. But Ron sees himself as head boy and winning the quidditch cup. And again, that totally makes sense based on everything we just talked about with Ron's family. We didn't see hermione. And I was curious what you guys thought. What would hermione see, if anything, or would she see herself? [35:46] Portia Pendleton, LCSW: I think maybe if anyone would be seeing themselves, it would be her. Especially like in book one. I think she does seem so content and excited and authentic that I think it might be her. Maybe it's her being top of the class. [36:04] Dr. Zheala Qayyum: I think she is. [36:05] Portia Pendleton, LCSW: She already kind of is. [36:08] Dr. Zheala Qayyum: I have a feeling that the one thing she grows to develop were friendships. That I wonder if she might see herself surrounded with friends. [36:17] Dr. Katrina Furey, MD: Yeah, I think at her age again, I agree. Portia of the Three know. Harry rod hermione. I feel like she would be the one closest to seeing just her true self. But I wonder if at that age of eleven, as a girl, if there's something deeper she's not able to articulate yet that we might see like friendship. [36:38] Portia Pendleton, LCSW: Yeah, I think that's accurate. I think sometimes you get the books confused or what's, like maybe a fan fiction thing online or something. But I am pretty sure that she does say that she did struggle with friends and so to have these deep friendships build at Hogwarts, I think that might be it. [37:00] Dr. Zheala Qayyum: Yeah. I'm just thinking know, she is very brilliant. So seeing herself as like the know, graduate or something of her class probably isn't far fetched. But if that intimidates other kids when she's correcting them over livio saw yes, that might rub kids the wrong way. That maybe that peer acceptance and those close friendships might be something that we see sort of develop over time as well. [37:33] Dr. Katrina Furey, MD: And so as we start wrapping up our wonderful episode today, let's talk a little bit about their friendships. Because I just feel like, gosh, I thought the movie did such a good job explaining the book, which has so many concepts, so much magic in it. It's had to do so much in just two and a half hours of just like background, like this is where we find ourselves. This is Hogwarts. This is Quidditch. This is Voldemort. Like here it is. And capturing all these complex concepts in such like a beautifully visually appealing way. The music is wonderful but we certainly see the triad between Harry, Ron and Hermione starting and forming and we know that just grows and grows and gets more complex over time. And I was really curious Dr. Q about your thoughts about first of all that it's a triad. There's three of them, two boys and a girl and what do you think of all that? [38:36] Dr. Zheala Qayyum: I just love the idea and particularly since you have the girl be somebody like hermione and I thought it's really nice to see their parallel processes. Each one of them is trying to sort of discovering that they're each really good at something but not good at everything. Like Hermione realizes she's not good at quit it. How humbling for someone who's really good and smart to know quidditch is not for, you know, Harry discovering that's what he's really good at and very early on know Ron playing chess and how it was reinforced with all the points even Neville's like standing up to your. So I felt that that was such a lovely way of saying that some of the reasons why friendships are important is that no one is whole in themselves and so much stronger when we all complement each other. But how do you explain that to an eleven year old? But if they saw the movie they would understand that we are so much more when we're all together and how those friendships last over years even for many of us. And I also felt like the complexity that you talked about. I think another movie that highlights it really nicely is Inside Out. [40:06] Dr. Katrina Furey, MD: Yes, we love that movie. [40:08] Dr. Zheala Qayyum: Our emotions are one color when they're younger and as you grow older they get more complex and those marbles are multicolored because emotions are more complex than just feeling sad, mad and glad. And similarly as we're thinking about I think this goes very nicely in a parallel of fairy tales and development that when children are younger they can only see good and bad. As long as you're giving me what I want you're the good parent. When you set limits you are not. [40:43] Dr. Katrina Furey, MD: Oh I feel this every day older. [40:46] Dr. Zheala Qayyum: You can hold the things together in the same person that there are things that are great about them and there are things that are some weaknesses. And when we're children we look at our parents as these idealized giants and as we grow older we see them for human beings that have wonderful strengths and flaws that we can still accept and love them still the same. So I think that is a big developmental challenge but I think the books highlight that really nicely with them being able to sit and tolerate that complexity. [41:29] Dr. Katrina Furey, MD: That nothing is so and again with them starting this journey at age eleven. I feel like that's the perfect timing for all of this to start. And I wonder if even the darkness of Harry Potter in watching the first movie, I was like, all right. I think it'll be several years before I show my kids the second movie because each one gets a little darker, a little grittier. But I think that maybe contributes to why it sort of captured all of us. And it is darker than the Disney version. Like, Inside Out is a great example, but I think that just speaks to the reality. [42:12] Portia Pendleton, LCSW: Like, the books get more complex, the books get darker, the characters get more complex, the characters get know. I think it was just such an interesting time to read it as a child as they came out, because it really kind of aligned perfectly with my own development. [42:28] Dr. Katrina Furey, MD: Yeah, exactly. [42:29] Portia Pendleton, LCSW: I remember my mom read me the first book, and then I remember the last one coming out, and I think my grandma said it to me. It was like raft in the Muggles, right? Like Muggles can receive on whatever date, and then I read it for myself. So I think it's so uniquely that way that led to so many people being a part of it for years and still feeling really connected to it now. [42:53] Dr. Katrina Furey, MD: And now getting to share it with your own children, like I'm starting to do, is so special. [42:59] Dr. Zheala Qayyum: Yeah. And that's the power of fairy tales, is that even if it may be really dark, it creates this metaphorical, imaginary, special place where you can still explore this darkness in a very safe way. [43:13] Dr. Katrina Furey, MD: Yes. [43:13] Dr. Zheala Qayyum: Go process it. Look what it's like to be angry. Oh, my gosh. Cruel people, mean people. And then you come back to the safety of reading this with your mom and everything's going to be okay. [43:27] Portia Pendleton, LCSW: Yeah. [43:27] Dr. Katrina Furey, MD: It's so beautiful. It is. It's very special. Very special. Well, Dr. Q, is there anything else you were hoping we could touch, know, talking about Harry Potter, the first it. [43:42] Dr. Zheala Qayyum: I think it's just a wonderful part of my life. I wish I was in Hogwarts, and that was the life I lived. Sometimes I'm looking forward to having a real Harry Potter birthday someday. But I think the thing that resonates most with me is this quote from Neil Gaiman that says, fiction is a lie that tells us true things over and over. And I think that's the power of Harry Potter is that the reason it spoke to so many of us is that we all connected at some level with something that was very true for each one of us. [44:18] Portia Pendleton, LCSW: I like that. [44:20] Dr. Katrina Furey, MD: That is a really beautiful place to leave it. Well, Dr. Q, thank you so much for joining us. We would love to have you back for the next seven movies over the course of time. It was so nice to personally reconnect with you again, thank you all for listening to this very special episode of Analyze Scripts. If you'd like to hear our take on Inside Out, we do have an episode about that from several months ago. I don't know. Dr. Q, did you know they're making a sequel? I think it's supposed to come out in the next couple of years, so that's really exciting. I hope it's about Riley's adolescence. Yes, and we really hope it also shows her living through COVID. Like, we could really use that for all the kids. We could, right? But you can find us at Analyze Scripts podcast on Instagram and TikTok and catch us next Monday for our next episode. Thanks so much. [45:24] Dr. Zheala Qayyum: See you next time. Thank you for having me. [45:32] Dr. Katrina Furey, MD: This podcast and its contents are a copyright of Analyzed Scripts. All rights reserved. Any redistribution or reproduction of part or all of the contents in any form is prohibited. Unless you want to share it with your friends and rate, review and subscribe, that's fine. All stories and characters discussed are fictional in nature. No identification with actual persons, living or deceased places, buildings, or products is intended or should be inferred. This podcast is for entertainment purposes only. The podcast and its contents do not constitute professional mental health or medical advice. Listeners might consider consulting a mental health provider if they need assistance with any mental health problems or concerns. As always, please call 911 or go directly to your nearest emergency room for any psychiatric emergencies. Thanks for listening and see you next time.

Welcome back to Analyze Scripts, where a psychiatrist and a therapist analyze what Hollywood gets right and wrong about mental health. Today, we are covering two popular documentaries that have recently been getting a lot of attention, "Escaping Twin Flames" on Netflix and "Love Has Won: The Cult of Mother God" on Max. We discuss how cults prey on vulnerable people, some red flags to look out for and discuss similarities between these two cults as well as others. We hope you enjoy! Psychology Today Article Instagram Youtube TikTok Website Dr. Katrina Furey, MD: Hi, I'm Dr. Katrina Furey, a psychiatrist. Portia Pendleton, LCSW: And I'm Portia Pendleton, a licensed clinical social worker. Dr. Katrina Furey, MD: And this is analyze scripts, a podcast where two shrinks analyze the depiction of mental health in movies and tv shows. Portia Pendleton, LCSW: Our hope is that you learn some legit info about mental health while feeling like you're chatting with your girlfriends. Dr. Katrina Furey, MD: There is so much misinformation out there, and it drives us nuts. Portia Pendleton, LCSW: And if someday we pay off our student loans or land a sponsorship, like. Dr. Katrina Furey, MD: With a lay flat airline or a major beauty brand, even better. Portia Pendleton, LCSW: So sit back, relax, grab some popcorn. Dr. Katrina Furey, MD: And your DSM five, and enjoy. Welcome back to another episode of analyze scripts. We are doing something a little bit different today. Usually we focus on fictional tv shows and movies, but we have decided to take a stand against cults. And we have decided that we will make an exception and talk about cults when they're in the media, because they are honestly just so atrocious. So we're going to try to walk a really fine line here and still be ethical. We're not trying to analyze anyone specifically in terms of the people that are talked about and the two documentaries we're going to be talking about today. But we want to use this material to talk more broadly about cults in general, again, because it is really pervasive, it's really dangerous, it's heartbreaking, and we see it a lot in the media, but there's still so much confusion about it. So, again, if you want to hear more, you can also revisit one of our older episodes about yellow jackets season two with Dr. Jesse Gold. We talk a lot about Lottie's cult. And so, basically today what we're going to do is I watched a documentary about a cult. Portia watched a different documentary about the cult. A different cult. And we didn't watch each other's documentaries. And we're going to tell each other about the different cults. Right? Did I explain that? Yeah. Okay, so do you want me to get started, or do you want to get started? Portia Pendleton, LCSW: Portia, why don't you intro yours and get started? Dr. Katrina Furey, MD: Yeah, not my cult, but the cult. Too short. Okay, so I'm going to be referring to a recent Netflix documentary called escaping Twin Flames. I think that's what it's called. It was only about three episodes. They're about an hour long each. Interestingly, I watched them on an airplane when we were flying down to Disney World. So it was like an interesting juxtaposition, like going to the happiest place on earth and then watching all of this sadness and heartbreak and intensity sitting next to my children. It's interesting. This documentary follows an organization which obviously they don't call themselves a cult, but they have some experts kind of weighing in who do call it a cult, or also a high control group is like another phrase used to describe cults these days. And basically it's run by these two people, Jeff and Shalia, who I was just looking up their Wikipedia before we got started, Portia. And they both have had different names throughout their lives, according to Wikipedia, which I just think is interesting. And they run something called the Twin Flames University. I had never heard of twin flames until Megan Fox and machine gun Kelly. Right. Like, weren't they all about twin flames? Had you heard of this before? A little. Portia Pendleton, LCSW: Like, it's like an extra. Like, that was my understanding of what. Or, like, not an extra, a soulmate to the right. Dr. Katrina Furey, MD: Right. Yeah. So I again looked it up on Wikipedia, because doctors use Wikipedia, too. Portia Pendleton, LCSW: Did you donate? Dr. Katrina Furey, MD: No, it's Christmas time. I'm a little stressed. But basically, according to Wikipedia, it says, the term twin flames was coined by the english novelist Marie Corelli in her novel of romance of two worlds. And since then, it has sort of evolved into a lot of new age spiritualism. Kind of focuses on twin flames. It's kind of like, it's my understanding it's like your soulmate, but even greater than that. So it's almost like meeting your counterpart and that you have to find each other in order to both achieve your full potential. That's kind of what it is. And then I guess these two folks started this twin flames university where you could take classes about bettering yourself and finding your twin flame. And again, like we talked about in our yellow jackets documentary, always be very careful when someone calls themselves a guru. Someday we'll have merch that has that slogan on it. Right. But just always be careful. And I was looking, and their class that they sold was over $4,000. That's a lot of money. A lot. But again, I see this. I don't know if you see it in people you're treating or evaluating, but I see a lot of people coming to me who are paying a lot of money out of pocket. They don't take insurance. They're also not advertising themselves as clinicians. They might advertise themselves as, quote unquote, life coaches or a coach of some kind, but you can charge whatever you want for whatever you're selling. And it's just interesting to me how some people get hooked and some people charge so much money. Anyway, what the premise of the documentary, Portia, is, is know. So these two people start this twin flames university, and they kind of use themselves as, like, we found our twin flame and this is how we did it. And look at how successful we are and how happy we are and stuff. And then people start joining, and it kind of becomes. I feel like they always become these MLM type things, right? Portia Pendleton, LCSW: Yeah. Dr. Katrina Furey, MD: Where it's like you buy in and then you become the teacher. Did you watch that documentary about the Nexium cult? Portia Pendleton, LCSW: Not that one, but Portia, I think I did the Lululemon. Not Lululemon, the Lula Rowe similar. Dr. Katrina Furey, MD: So the nextium was really good. Also, like, heartbreaking and awful, but it's a really good expose about typical cult psychology. But again, it's like we are up here on a pedestal. Typically, cult leaders are like, malignant narcissists who want to be idealized, and they want people to obey them no matter what. And they have this sociopathic flair to them. Again, I'm not analyzing anyone specifically or individually. I'm just talking about, in general, what we see. They have this sociopathic flare where, again, they kind of get off or get a rush from controlling people. So those tend to be the people at the top of a cult, and then below are people who are vulnerable to this type of influence. And I think that's where the psychology is really fascinating. Like, how do people get hooked and kind of. It's not always like someone waiting on the end of the road, like, hey, come sign up for my cult. No one would do it. Right? So it tends to be people who are vulnerable in some way. Whether there's been a history of trauma, I would say really common. If there's developmental or intellectual disability, if there is some type of mental illness that can be exploited. Like, I remember in my training, a colleague of mine was treating a patient with psychosis who was getting sucked into these cults. And for someone like that who's already struggling to tell reality from not reality, you can see why you're vulnerable to this. And other times, I think you can just think of it as an unclear sense of self, like someone who maybe is feeling a little lost or who's looking to feel connection or community or love. I think those types of people might be more apt to, I don't know, just, I guess, feel, like, enticed by someone saying, I have all the answers. Look how great my life is. Like, you can have this, too. If you pay me $100 million and do everything I say and change everything about yourself, isn't that great? I think people who have a really strong sense of self, who have more of a secure attachment style, probably will sniff out the bs and turn away and not be as easily manipulated as other people who maybe are struggling with that. I don't know. What do you think? Portia Pendleton, LCSW: I think that's pretty true. I mean, I think a generalization would be that people who tend to kind of fall into cults or even like mlms, it's like you're looking for something and then this organization is promising to deliver, and then there's this added layer of like, you're a family. And obviously that feels really strong in a cult as we know it. And then also we do see that show up in Lularoe and your team and your girl boss thing. So it can be obviously different levels of it, but totally. Dr. Katrina Furey, MD: I found a really interesting article that we're going to link to in our show notes because we know how to do that now on psychology today, that really explains cults, written by Stephen Hassan, a PhD I thought was like a really good, easy to digest description. And they also say you can see these dynamics not just in cults, but you can see it in mlms, you can see it in religious organizations, you can see it in schools, you can see it in families, you can see it in the workplace. Again, it's not like this phenomenon is unique to cults. I think it's just from the outside. Like when you're watching a documentary like this, you're just like, what? How on earth did these people stick around? And it's because it's so insidious and slow, right? Like we're seeing it in a three hour documentary. This has been going on for years. I think these people started this organization like 2007. It doesn't happen overnight, right? So usually the leader is really charming and charismatic and captivating in some way, but then there's a lot of nefarious things going on underneath. So we'll link to that because it's really interesting. And I think it's important just to note that these dynamics exist other places. And that's one reason we want to talk about it again, to sort of help educate and push out some information. So I guess with this one, with the twin Flames university. So again, the whole goal is like, sign up for this class. You'll become self actualized. I feel like that's another thing. All these cults sort of advertise like, you'll be your best self, and then that's confusing. Because I feel like Weight Watchers advertise this, too, and other types of self help advertise that. So how do you draw the line? But then you pay for this. And then as this documentary goes on, Portia, you meet different characters in it, and you meet, like, there was one. I was trying to just look up their names again really quick. Portia Pendleton, LCSW: So is this online mostly, like, the university? Like, I could sign up and take the class. Dr. Katrina Furey, MD: You could go right now. I went to the website, actually, to see if it's still there. And it is. So it is online. And then they started having in person meetups, which I think once you do that, then those connections are even stronger. Right? Like, now you're seeing each other in person, and it's like, this is our community. This is our. He did, the leader, Jeff did have a goal of eventually having an actual community. Like, we're all going to move to this place. I don't know if that ever happened or not, but so we meet a lot of different people involved. And one person involved that really struck me was this young girl named Marley. I think she was in her late teens when she got involved. And again, I feel like that's, like, the perfect person who's susceptible. Like a 17 year old with an Internet connection. Portia Pendleton, LCSW: You're really figuring out who you are. Dr. Katrina Furey, MD: Right, exactly. You don't have a fully formed identity yet because you're so young and you're just trying to figure it out. And we don't know anything about her background, so I'm not going to speculate, but basically, she was super young going to these classes. I don't know how she's paying for it. I'm not sure. And then what really struck me is basically, like, jeff and Shalia, the leaders would tell their participants, like, we know who your twin flame is. So, like, once you're self actualized enough, we'll let you know. Or we're going to help make the map. Yes, exactly. Like this ultimate puppeteer, right? This ultimate. And, like, they showed this scene where they were at the in person meetup, and they're all meeting for the first time, and they're talking to Marley and saying, like, well, is there anyone special in your life? Right? You know, they're showing this stuff, and somehow they have footage of it in real, like, they have the old footage. So someone was, like, filming all this, but then they're also showing Marley, like, present day, reflecting on the experience, and they're asking her, is there anyone special in your life right now? And she's kind of shy because she's like a kid and like, well, not really. And then Jeff's pushing her, like, are you sure? Are you sure? Sort of like, suggesting, like, he knows. And then she says, like, well, this guy has been texting me. And he's like, oh, that's it. That's it. This random guy who's texting her, and then that's her twin flame. Over time, she starts having a relationship with this guy. She moves in with him when she's really young. I can't remember the age difference, but there was a pretty significant gap. Not like 20 years, but maybe somewhere between five to ten years. And he had a criminal past. He was doing a lot of drugs. That's all we know. We don't know if there's any other trauma going on in the home as they're living together. I wouldn't be surprised if there was. And it just broke my heart that this young girl gets sucked in to thinking this is the person she's supposed to love, right? And you're just so brainwashed by it. So that was really captivating and sad. And then the other things that we see in the twin flames universe is we see a woman named Keeley, who's a key character in the documentary because she got in early and became, like, one of the teachers. So she was someone who was know. Jeff and Shalia are here. She's like the next level and trying to train other people. And how do you do the classes and stuff? And by the way, all these people are working for free. No one's getting paid. Eventually, Jeff and Shalia somehow incorporate to be a religion so that they don't have to pay taxes. And it's just like, again, all of this stuff is messy and very classic for so. But what's interesting about Keely in this documentary is that she comes in, she finds her twin flame very early on and is sort of put on this pedestal of the ultimate example of, like, look, it's not just us, Jeff and Shalia, who found our true love. These people also did using our methods, and now they can teach you. So they're like the ultimate teachers. And over time, she starts to kind of doubt what's going on. She eventually leaves, and you really see her grapple with the shame and guilt of what she did while she was part of the cult. And there's a scene at the end where she meets another former cult member who she used to be, like, the teacher of and would really push to do unhealthy things. And they just have this moment, this conversation where she's so genuinely apologetic, and it's really heartbreaking. You really see how that whole thing about how someone who's been abused becomes an abuser, and it's really heartbreaking to witness. So she's a really compelling character. And then the cherry on top of this awful Sunday, Portia, is that. Portia Pendleton, LCSW: Just nervous. Dr. Katrina Furey, MD: I know. You should be like, hold on tight. So as if all of this wasn't bad enough, as they know, Jeff and shalia start morphing their teachings to include that everyone is either a divine masculine or a divine feminine. Okay? So they're saying you're either a divine masculine or a divine feminine. You don't have both characteristics of both. And you have to find, like, if you're a divine, if you are a divine feminine, you have to define your divine masculine and vice versa. Like, two divine feminines, two divine masculines can't be together. Okay? So then they start telling people whether they are a divine masculine or feminine, whether or not that matches with that individual's own sense of their gender, okay? And it's also not based on the person's outwardly appearing gender. So they're not telling all the outwardly appearing girls you're defined feminine, and all the outwardly appearing males, you are divine masculine. The reason why is because they had way more women as students than men. So I think they started running out of men to pair with people. Honestly, it seems like. So they started telling certain women, like, you are a divine masculine, and this divine feminine is your twin flame. You need to be in a relationship with them. And some of these people now who are being interviewed are like, I'm not attracted this person. I don't feel like I'm trans or anything like that. In Portia, it goes so far that some of the people got top surgery. I know. And so abuse 100% across the board. This is why I feel like we can make the exception and talk about cult like this, because it is so atrocious. It's like a human rights violation, I feel like. And what I really liked about this documentary, actually, is that. And I was, like, talking about this just socially with some of my friends who aren't in the mental health field. And they agreed that they really appreciated how in this documentary, they had someone who is, I forget exactly what their title was, but they work at, like, a university and gender studies and do a lot of advocacy for transgender rights and things like that. And they very clearly said, this actually is anti trans. Like, twin flames university is advertising itself as pro. Like, we support this. We'll support you when no one else in your family does. We'll support you getting your surgery and things like that. But they're like, this is actually completely anti trans because you are telling someone what they are and how their body should look, and you don't care if that matches their own inner experience. Right? And that is like, bad. So bad. And so this documentary does follow a couple of people in particular who ended up getting surgeries. And one of the most heartbreaking scenes is when they follow a group of mothers who have been disconnected from their children, who have joined this cult. And one of them is watching her daughter talk about getting top surgery because she was told she's a divine, masculine, and it's just so heartbreaking to see. And then the other two pieces of the documentary that just blew my mind were at the beginning, they advertised having, and there was a psychologist involved, okay? Like someone with real training. They advertised having some sort of treatment for PTSD, of all things. And I just think that is disgusting. It is egregious. It should be reportable to whatever medical or psychology board this person is licensed by because they're advertising like, we have this treatment. And really they're just like indoctrinating people. And so that was really disgusting to me. And the last thing I wanted to tell you about was we saw one of these moms as she's talking to the camera about basically her child cut her off. And she keeps trying to reach out. She's not hearing back, but she keeps trying. And I feel like that's a message I want to get out is like, if you have someone you love in one of these cults or high control groups, just keep reaching out, even if you're getting nothing back, because you just have to keep that thread of attachment going so that when the person is hopefully ready at some point to leave, they know you're still there. So this mom kept reaching out, kept reaching out even though she wasn't getting anything back. And then as she's talking to the camera, her child text messages her. And you see her very genuine reaction, just like. And all the text said was like, mom, it's me. I need help getting out of this relationship. And she's just like, I just got chills trying to tell you about it because it's so moving and it's so sad. And you see just such a genuine reaction of her saying, like, oh, my God, she got back to me. I want to say something, but I don't want to push her away. I want to keep this going, but I don't want it to be too much like what do I way? And then you see her telling the other moms that she heard from her child and how they're supporting each other. Oh my God. It's really intense. And I would say this documentary is very hard to watch because you really see how so many people have been exploited and traumatized and how they're trying to pick up the pieces and how there's still so many people in it. But I think it really speaks to cults and kind of what it's like. And I feel like twin flames to me always sounded like ludicrous. It just sounds like something that's so ludicrous. But I think that's also an important point is that to some people it's not ludicrous. Yeah. And it just depends on what you're searching for. Right. Whether it's like love or a family or money for MLM schemes. Portia Pendleton, LCSW: Right. So that key part, I think in your cult and that what you not. Dr. Katrina Furey, MD: Dr. Fairy's cult, I do not have one. Portia Pendleton, LCSW: I am not a guru. Right. So in love has won, which I watched, which is on HBO or Max, three parts, 3 hours. It sounds like there's a lot of people who are in general prior to joining are kind of like anti establishment. Some the government isn't working for us anymore, which a lot of people feel that way. Dr. Katrina Furey, MD: Exactly. Portia Pendleton, LCSW: So there's these know, I think sometimes really normal thoughts or feelings somebody could have. Dr. Katrina Furey, MD: And then it's like the kind of. Portia Pendleton, LCSW: Takes that and it's like, oh, yeah. So like we also believe this. And then they kind of continue to pull you in. I think we saw that a little bit with QAnon stuff. It's like some of what I'm sure they had out there is pretty believable. So that kind of draws the person to do more research and then all of a sudden you're in a cold. Dr. Katrina Furey, MD: Right. And again, it's like, I feel like it's certain types of people who are going to keep getting sucked in. And the leaders have an uncanny ability to sniff that out and they know who they can manipulate and exploit, right. Portia Pendleton, LCSW: No, totally. So speaking of that. So Amy Carlson or mother God. Dr. Katrina Furey, MD: Oh, mother God. Portia Pendleton, LCSW: Or mother Earth or divine mother was a young, I'd say attractive woman who had three husbands and some children who she ended up leaving all for her own kind of spiritual journey. So her mother and sister describe her as being really charismatic. She worked at McDonald's and was kind of immediately, like in a leadership role, she was constantly being promoted. Her team loved her. She had this way with people. During that time, she was with a partner, and she had several children, et cetera. So then she starts to kind of join these online chat groups, which I feel like is a pretty common start to the depths of the Internet. So she started with spiritual singles, and she ended up meeting this man who was much, much older than her, or at least he appears much older than her on lightworkers.org. So they were, like, messaging back and forth. It's basically just people who are, I would imagine, interested in spirituality, and you can chat with each other about the divine and mutually interesting things. So she meets Amorith White Eagle, and she ends up meeting him. Dr. Katrina Furey, MD: What's that name again? Portia Pendleton, LCSW: So it's amorous white eagle. Dr. Katrina Furey, MD: Is this person, like, indigenous? Portia Pendleton, LCSW: I don't know. Okay, so this all kind of then takes place in the Pacific Northwest, it appears Colorado, Oregon, kind of back and forth. So she meets him. They end up getting married. I'm not sure if it's a legal marriage or they just have a ceremony, and they start putting their message out online. So they're interviewing him. He appears, I don't know, like, 70, and she's, like, 30. But funnily, that is. She, though, seems like she's running the show still. So he's very peace and love, and he's kind of going along with whatever she's saying. So she wants to put more on social media. He's like, okay. And then she ends up leaving him eventually, I think, like, after a year, to kind of start an organization with people that she also met online who are then more close in age to her. Dr. Katrina Furey, MD: Did she use his money or something? Portia Pendleton, LCSW: No, it seemed kind of like they lived in nature. He didn't really have much. He seems like this is an opinion, like, sweet. Like, just like a hippie. Like, living on the land. Dr. Katrina Furey, MD: New ag. Portia Pendleton, LCSW: Yeah. Dr. Katrina Furey, MD: Okay. Portia Pendleton, LCSW: And so she then he, like, compost. Yeah, totally compost. She takes that and runs with. She gets. She meets this guy who she, um. So this is a big kind of part of her. So she heals him of cancer. Dr. Katrina Furey, MD: They always are healing people of cancer. Jeff and Shalia said they could do that, too, by the way. And they also call themselves the divine father and the divine mother. And they went through ivf to have a daughter who's the defined daughter, and I worry for her. But sidebar. Anyone who's calling themselves divine father or mother, run away. Run away. Yeah. Portia Pendleton, LCSW: And that always seems to be a theme of healing people. Dr. Katrina Furey, MD: Yes. Portia Pendleton, LCSW: So he comes to live with her, works with her, and then there's this other person who comes in who then becomes, like, the second father God, who he appears to not be in the cult anymore as he's being interviewed for the show. So he kind of has, like, a different stance than everyone else who is interviewed who appear to still really believe some of her messages. So this is not even the crux of the story. So she gathers these group of people who they talk about have pretty significant trauma histories, and then these beliefs come out where. So they believe that they are being led by, like, Robert Williams, St. Germain. Most of these people who are deceased, there's only one living person who is Donald Trump. So they have this board with all of their pictures, and she's constantly getting messages from Robin Williams and has been. So she's God who's billions of years old. She has been Marilyn Monroe, she has been Cleopatra. She's been all of these kind of famous women throughout history who've done different things. So I was like, you're Marilyn Monroe and you're like Joan of. Oh, okay. They're just different. Dr. Katrina Furey, MD: Like reincarnation or something. Portia Pendleton, LCSW: Only for her, it's not. Dr. Katrina Furey, MD: Ultimate exception. Portia Pendleton, LCSW: Yeah, so Robin Williams is telling know, I'm kind of skipping some things, but basically that she needs to be at a really low weight to be picked up by the starships. So she starts restricting her food intake, which is just interesting because that's what I do in my private practice. I was like, oh, here we go. And to be, like, 103 pounds, she has to be under 103 in order to be picked up. So other people in the group as well start restricting nutrition. The lighter you are, the higher frequencies you can tolerate. So they also believe that marijuana and alcohol are, like, tools of healing if used appropriately, which they do say, which I was like, okay. But apparently her use of alcohol combined with her food restriction seems to lead to her downfall. So she gets really sick, like, pancreatitis. I think her liver is failing, probably. And so she's very small. They go to Hawaii to try to heal her. She gets Kauai. They get literally driven out of Kauai by the people who live there because she is now saying that she is, and I'm not remembering it at the time, but she's like, there this goddess that they believe in, and she's saying that she's that person or that spiritual leader, and they're like, no, you're not. That's really disrespectful. So they leave Kauai go back to Colorado, and she's dying. And meanwhile, this whole time they're trying to save her, and she's ingesting high levels of colonial. Dr. Katrina Furey, MD: Oh, just try to heal her. Portia Pendleton, LCSW: Quote unquote. Dr. Katrina Furey, MD: Yeah, okay. Portia Pendleton, LCSW: And so she ends up passing away. And meanwhile, her family, before this, has put her on Dr. Phil to try to point out that she's a cult. Dr. Phil is involved. It doesn't work. She presents as just, I'm really spiritual and not giving culty vibes at all. Doesn't do anything. Meanwhile, they interview her daughter, who's just sad watching it. She feels abandoned by her mom. So Amy dies, and they are convinced, per her, that she is going to be picked up by the starships. So they have her body at home, or it happens in a hotel, and they are, like, holding up these freak. Dr. Katrina Furey, MD: These. Portia Pendleton, LCSW: They use them in the ghost stories where you hold up this instrument and, oh, the thing goes crazy. The frequency. So they're, like, holding it up to her dead body. Meanwhile, all of this, they have filmed. They've filmed and written down everything that she's ever done. She sleeps five times. She did this because she's God. Dr. Katrina Furey, MD: And so they have a dead body. Portia Pendleton, LCSW: With them for a week, like a week or two. They end up leaving the hotel because people are really confused and concerned. They go back to the house in Colorado. The police end up coming. She's modified. Dr. Katrina Furey, MD: Yeah, that's what. Oh, my God. Portia Pendleton, LCSW: And it was never taken. And they still kind of were saying that they believe to this day that we are so curious what her autopsy showed. She has three hearts. I'm sure all the medical people were blown away and everyone still believe it. To kind of branch off and do something with spirituality. Again, it was a pretty small cult. There was, like twelve to 20 active members who were living there. Then again, they made over $350,000 that one of the members then stole after she died and took because all of it was in his name. Because there's always a theme of money, greed, power in a cult, in my experience. So I think we saw all of the key themes of a person with a really unique ability to have charisma and charm. It just seems like there's always common themes with cults which we see over and over again. And I think really what I was keeping in mind while watching this documentary is there can be such a fine line between spirituality and just having different beliefs that maybe are not mainstream, and that's okay. But there becomes this little line that gets crossed where there's like abuse and someone taking advantage over someone else. And it's like that, to me, is really the difference between anything you want to believe in or do or how you want to live. But when you're harming others or being harmed, it's like that's when it's not. Dr. Katrina Furey, MD: Okay. Right. And I think I had a friend recently ask me, how do you tell the difference between someone who's psychotic and someone who is running a cult but not psychotic? So the woman you were just describing to me, Portia, the mother God person, sounds like she may have had elements of both, which is possible, although I would imagine, although I don't know for sure, more rare. But again, I would say people who are cult leaders tend to meet criteria for what we call malignant narcissism. So, again, as we talk about with narcissistic personality disorder, they really elevate themselves into this God role. They believe God is talking to them, but then they also take advantage of other people, whereas I think someone who is just struggling with a psychotic disorder, who may have religious delusions, again, they might also believe that God is talking to them, but then they're not using that to their advantage and exploiting people to make money or for sex or some other kind of secondary gain. So I think that's something important to note. Portia Pendleton, LCSW: Yeah, no, I would agree. It's so hard. And I think we should, like you said, create some merch. We need, like, a clear checklist to ask yourself to disseminate to everyone. Like, is this a cult or not? Where are the red flags? Dr. Katrina Furey, MD: Seriously? Seriously. Again, I would say be very wary of anyone calling themselves a guru or using words like that who doesn't have the applicable training or credentials. That even goes, I think, for getting medical advice online, like on Instagram and TikTok, be really cautious and look into what is this person's credentials? Are they really qualified to be telling me these things? Be mindful of how much are they charging? What are you getting from it when they're charging you? And what does your gut tell you? If your gut red flags are going off, you got to listen. Portia Pendleton, LCSW: Yeah, that's a good one. I like the part about the cost, because things should feel balanced. If you're getting a worksheet or if I'm paying an insurance via insurance for therapy and I'm paying, I don't know, it can be anywhere from 90 to 150, depending on an insurance rate, for an hour. And that person is credentialed. Right. If you take insurance, you have to be a certain quality of practitioner. And so if you're seeing someone who's like a guru or a coach and you're paying privately and they do not have the credentials, and I'm paying maybe $800 for an hour sessions, it's like. Dr. Katrina Furey, MD: That just feels off. Portia Pendleton, LCSW: And I'm not talking about private pay or for someone who does have credentials, but if you can get therapy from a certified, licensed practitioner that generally, sometimes insurance covers, sometimes it doesn't, for around $100, depending where you are and someone, a coach is asking for hundreds and sometimes thousands of dollars, that just feels off. Dr. Katrina Furey, MD: Right. And that is a theme we've seen, at least in these two documentaries we're talking about today, is the cost of the classes or whatever it is you're buying seems exorbitant. I mean, like at twin Flames University, I read they were charging $4,000. That's crazy. That's really a lot of money. So you really just have to be mindful of what are you getting out of it. And as soon as you start to get a whiff of someone trying to change who you are or someone trying to convince you that they know you better than you know yourself, huge red flag. Run away. If you're feeling devalued around them and they're always putting themselves on a pedestal. Run away. If everyone's fawning over them and the people who bring up a criticism or have a question get ostracized. Run away. Run away. Portia Pendleton, LCSW: Yeah, that's a good point. That's on the sweatshirt. Dr. Katrina Furey, MD: Run away. Yeah. Portia Pendleton, LCSW: So you can find both of these documentaries. One of them, the one Katrina watched, twin flames, is on Netflix. And then the one that I watched, love has won, is on Max, both short kind of docuseries, which I loved that it wasn't 8 hours. Both sad and just the after effects are sad. And cults obviously can be so dangerous and abusive. There's many practitioners out there who specialize with treatment of people who have been in a. If you're. If you have more interest in it, like Katrina is going to link that psychology today article and then know, I think our biggest theme is please reach out. Dr. Katrina Furey, MD: Right. Portia Pendleton, LCSW: So in the one I watched, there was a mother who continuously was kind of getting police involvement and calling her daughter and contacting her, and they ended up reuniting at the end. And just as painful as it is, please don't give up. Dr. Katrina Furey, MD: Don't give up. Don't give up. Yeah, that's a big theme I want to get across, too. And we'll keep covering cults I think moving forward, again, we want to be mindful and be really clear. We're not analyzing any one person in particular. We're just using this media to talk about this phenomenon in more detail because it is so dangerous and so many people are getting hurt by these things. And I would imagine like coming out of COVID with so much more happening, think, you know, it's reaching more people these days, like cults, and all you need know, you can be in a cult of one. It doesn't have to be huge. So that's another thing to keep in mind is these dynamics can play out in smaller communities, smaller relationships, even within families. So we're hoping to try to shed some light on these toxic dynamics so you can protect yourself totally. Portia Pendleton, LCSW: Well, thank you for joining us today, and we look forward to catching up with you next time as we cover another movie or tv show. Dr. Katrina Furey, MD: Yeah, and find us on TikTok and Instagram and YouTube at Analyze Scripts podcast. Please rate, review, and subscribe and let us know what you think. And let us know what you'd like to hear us cover. Next. Bye bye. Dr. Katrina Furey, MD: This podcast and its contents are a copyright of analyzed scripts, all rights reserved. Any redistribution or reproduction of part or all of the contents in any form is prohibited unless you want to share. Dr. Katrina Furey, MD: It with your friends and rate, review, and subscribe. That's fine. Dr. Katrina Furey, MD: All stories and characters discussed are fictional in nature. No identification with actual persons, living or deceased places, buildings, or products is intended or should be inferred. This podcast is for entertainment purposes only. The podcast and its contents do not constitute professional mental health or medical advice. Listeners might consider consulting a mental health provider if they need assistance with any mental health problems or concerns. As always, please call 911 or go directly to your nearest emergency room for any psychiatric emergencies. Thanks for listening and see you next time.

Continuing our celebration of our podcast's 365 days around the sun (what could be more appropriate!), we are so happy to share Part II of our most downloaded episodes. Thank you for listening to our show and learning about the powerful science of Quantum Biology.   We want others to discover us.  Thank you so much for leaving us  a rating and review on Apple or Spotify - it means a lot and is a great contribution to the spreading of this message. If you want to tap into more knowledge and get personal guidance on applying this science, you can find the Quantum Biology Collective's directory of practitioners on our website or become a QBC member to get live info and access to the video library.  And, if you are a practitioner looking for more knowledge, check out the 8-week Applied Quantum Biology Certification program, which offers a comprehensive study of the new human health paradigm and its practical application.   Links   Number 1 Ep 038: Circadian Scientist Dr. Martin Moore-Ede Explains How Artificial Light At Night Leads To Diabetes, Obesity and Cancer https://podcasts.apple.com/us/podcast/ep-038-circadian-scientist-dr-martin-moore-ede-explains/id1657777911?i=1000625528281 Watch on YouTube: Circadian Scientist Dr. Martin Moore-Ede - How Artificial Light At Night Leads To Diabetes & More Website: https://thelightdoctor.com   Number 2 Ep 043: Is Avoiding The Sun A Health Hazard? Dr. Leland Stillman On The Importance of Sunlight to Human Health and Longevity https://podcasts.apple.com/us/podcast/ep-043-is-avoiding-the-sun-a-health-hazard-dr/id1657777911?i=1000629491567 Watch on YouTube: Is Avoiding The Sun A Health Hazard? Dr. Leland Stillman On The Importance of Sunlight Website: https://stillmanmd.com/ Dr Stillman's Substack: https://stillmanmd.substack.com/ Instagram: @stillmanmd    Number 3 Ep 036: You're Not ‘Just Tired.' Why Fatigue Is The Red Flag of Mitochondrial Dysfunction with Carrie Bennett, MS https://podcasts.apple.com/us/podcast/ep-036-youre-not-just-tired-why-fatigue-is-the-red/id1657777911?i=1000624018580 Watch on YouTube: You're Not ‘Just Tired.' Why Fatigue Is The Red Flag of Mitochondrial Dysfunction w/ Carrie Bennett The Adrenal Fatigue Fix: https://www.carriebwellness.com/offers/WTxqNo8b/checkout Carrie's Website: https://www.carriebwellness.com Instagram: @carriebwelness    Number 4 + Bonus  EP 050: Circadian Secrets To A Smoother Menopause (& Life) https://podcasts.apple.com/us/podcast/ep-050-circadian-secrets-to-a-smoother-menopause-life/id1657777911?i=1000635021685 Watch on YouTube: Circadian Secrets To A Smoother Menopause (& Life) Website: knightwellness.com Dr. Knight sees patients in person AND virtually Instagram: @knightwellness    Ep 035: Candice Knight, MD: It's Time To Go Beyond Functional Medicine https://podcasts.apple.com/us/podcast/ep-035-candice-knight-md-its-time-to-go-beyond-functional/id1657777911?i=1000623464042 Watch on YouTube: Candice Knight, MD: It's Time To Go Beyond Functional Medicine Website: www.knightwellness.com Social: @knightwellness   Number 5 Ep 033: Strongman Robert Jacobs On Circadian Timed Eating & Exercising https://podcasts.apple.com/us/podcast/ep-033-strongman-robert-jacobs-on-circadian-timed-eating/id1657777911?i=1000621741790 Watch on YouTube: Strongman Robert Jacobs On Circadian Timed Eating & Exercising Instagram: @robertcjacobs Website: www.outlawstrength.com   Follow on Instagram & Facebook: @quantumbiologycollective  Twitter: @quantumhealthtv    Podcast production and show notes provided by HiveCast.fm

Guest: Filipa Lynce, MD It's very common for patients with inflammatory breast cancer (IBC) to present with no underlying palpable mass, which may cause some challenges for clinicians and patients. So what are some unique challenges associated with surgery in IBC and the risks of deescalating? Join Dr. Filipa Lynce, Director of the Inflammatory Breast Cancer Program at the Dana Farber Cancer Institute and an Assistant Professor of Medicine at Harvard Medical School, as she reviews her research on IBC that she presented at the 2023 San Antonio Breast Cancer Symposium.

“If I can help someone else succeed in this craft or another craft, it helps the craft as an entirety” - Wes Breitenbach“I don't know anybody who's like: I hope they fail. Nobody's like that, and if they are, they're not running in any of our circles.” - Jesica BreitenbachWes & Jes  Breitenbach join host Chris McAdoo on the last episode of 2023! They've got strong, well-earned “big ideas” about everything from going to college (as in…”don't!”) to what it takes to master a craft, and what it really means to build a life on your own terms. They have been incredible members of the Maker City community, sharing their passions with the world, but also inviting the community to come along for the adventures - to learn and grow alongside them as they continue to grow Crown Upholstery. About Wes & Jes: Even Moving Cross Country Twice, One Thing Has Remained Constant. Upholstering Great Furniture. Wes's career in upholstering began in 1999, a few years after he arrived in Phoenix, AZ from Havre de Grace, MD/ It was in Phoenix that Wes learned the generations-old tradecraft of reupholstering furniture from Jesica's grandfather, Frank Ramey Sr (who originally taught both Jesica and her father, Frank Ramey Jr). Frank Sr, in turn, had learned the art of upholstery from his mother (who took it up from her own mother during the Great Depression in order to help make ends meet).After years in the Sonoran Desert of Phoenix, Jes and Wes decided to make the move to Knoxville, TN over a decade ago. For that decade, Jes and Wes have made it their pursuit to embrace and love the natural beauty of the region while practicing their well-honed skills for its diverse citizenry. While they still rely on the age-old skills of sewing and cutting as a business, the trade has become a passion as well as a career.Learn more about Crown Upholstery and follow the adventures of Wes & Jes: https://crownupholsterytn.com/https://www.instagram.com/crownupholstery/Listen to all episodes of the Big Ideas Welcome podcast, available now on your favorite streaming platforms and at bigideaswelcome.com.This Big Ideas Welcome podcast is brought to you by Knoxville Entrepreneur Center, hosted and curated by KEC chief of strategy  Chris McAdoo, and produced and edited by Palm Tree Pod Co.

Welcome back to Analyze Scripts, where a psychiatrist and a therapist analyze what Hollywood gets right and wrong about mental health. Today, we are covering one of our most favorite Christmas films, "The Grinch." This version came out in 2000 and stars Jim Carrey. In this episode we cover Reactive Attachment Disorder, Season Affective Disorder, Antisocial Personality Disorder and the impact of trauma and bullying in early life. We don't leave you feeling hopeless so we also share effective therapy for early childhood disruption and stories of healing. We hope you enjoy! Website Tiktok Instagram Dr. Katrina Furey, MD: Hi, I'm Dr. Katrina Fieri, a psychiatrist. And I'm Portia Pendleton, a licensed clinical social worker. And this is Analyze Scripts, a podcast. Portia Pendleton, LCSW: Where two shrinks analyze the depiction of. Dr. Katrina Furey, MD: Mental health in movies and TV shows. Our hope is that you learn some legit info about mental health while feeling like you're chatting with your girlfriends. Portia Pendleton, LCSW: There is so much misinformation out there. Dr. Katrina Furey, MD: And it drives us nuts. And if someday we pay off our student loans or land a sponsorship, like with a lay flat airline or a. Portia Pendleton, LCSW: Major beauty brand, even better. Dr. Katrina Furey, MD: So sit back, relax, grab some popcorn. Portia Pendleton, LCSW: And your DSM Five and enjoy. Hi. Dr. Katrina Furey, MD: Welcome to our December edition of our podcast. Portia Pendleton, LCSW: Happy Holidays. Dr. Katrina Furey, MD: Happy holidays near and far. If you are an international listener, which we did just get Spotify wrapped info, right? We're global, so thank you. Portia Pendleton, LCSW: We are global. Guys, it's official. Our top three countries on spotify were America, Canada and Norway. Dr. Katrina Furey, MD: Who knew? So loving the northern European aisles. So we are really excited to kind of continue the December edition of some holiday classics. So today we're going to be covering The Grinch, the Jim Carrey version. So there's many versions, obviously. I think at least I'm more familiar with the Jim Carrey one. Then there's the cartoon, right? The original. And then there's the new cartoon, which is really funny and silly, too. Portia Pendleton, LCSW: And the new cartoon has some pretty sick beats, has some good music. And, of course, I think we were, like, going back and forth about, do we cover the original or the Jim Carrey version? And I was glad when you agreed we should do Jim Carrey version because it's so good. Dr. Katrina Furey, MD: Yeah. And there's a lot there. Portia Pendleton, LCSW: Yeah, just like the costuming, the makeup. Every time I watch it, I'm just looking at The Grinch, like, did he just take 10 hours to get in this costume every day? Dr. Katrina Furey, MD: Probably. I mean, that is a fun fact. All of their facial constructions, the nose for makeup every single day. So I went to at my dance studio growing up, the girl I don't know her name, I should have walked who was climbing up the mountain at the beginning with the boys to, like, the grim. Yeah. So she went to my dance studio. Portia Pendleton, LCSW: No way. Yeah. Dr. Katrina Furey, MD: So I don't know if she's been in things since, but that was always so exciting. Portia Pendleton, LCSW: That's like a hot take. Dr. Katrina Furey, MD: Yeah. Anyway. Portia Pendleton, LCSW: And Taylor Momson was so adorable as Cindy Lou. I know. And that's obviously, like, pre Gossip Girl, but then she went into Gossip Girl, and then she was, like, the lead singer of that really intense heavy metal band. And I'm not sure what she's doing now, but she's just so adorable and was really perfect for the role. And I just loved all their hairstyles, and I'm assuming they were wigs, but just super cool. And then molly shannon, of course I know. Who doesn't love her? Dr. Katrina Furey, MD: Some of the people when I looked up the cast list, I was like, oh, yeah, duh. That's them. But their makeup and costuming was so good that it just never even crossed my mind that that was my Shannon. But, like, hello, superstar. Portia Pendleton, LCSW: Hello. Oh, my God, we should do Superstars, by the way, side note. Dr. Katrina Furey, MD: Yeah. Portia Pendleton, LCSW: And then I vividly remember this movie coming out. I think I was in late middle school, early high school, and it was like a year when my family was having a hard time and that Faith Hill, Where Are you? Christmas song came out. And it really was like I remember just being like, this is how I feel this year. And even still, it really gets you and I think really speaks to how emotional the holiday season can be as we keep talking about and emphasizing in our holiday episodes. That is a fact that holidays can be hard for people of all ages and backgrounds. And I really loved that this movie and the Grinch story in general really speaks to the meaning of the holidays and that beyond the commercialization of it, it stirs up a lot of big feelings for people. And that's yeah, yeah. Vividly remember hearing that song as a kid and being like just like, oh, speaks to Know. Dr. Katrina Furey, MD: I mean, Faith Hill is such a wonderful artist. And I think know it came out with the album because Cindy Lou, right? Like, sings in her little beautiful voice, too, in the movie. But then the Faith Hill version, I think, was just like a tear. Portia Pendleton, LCSW: Yes. And it reminds me of that song. My grown up Christmas list. Have you heard that one? Yeah, similar, right, where you're just like it's just like really I don't know, something about Christmas music really gets me. Dr. Katrina Furey, MD: I'm a music crier, so if it is hallelujah. Portia Pendleton, LCSW: Yeah, I can easily a lot of the Christmas, even a lot of the church hymns, even not for a sad reason, they're just, like, really moving. Yeah, right. They're so moving. Dr. Katrina Furey, MD: Yeah. Portia Pendleton, LCSW: I was just going to say that reminds me. I recently was at Disney World, and they're doing a lot of their Christmas stuff right now. And I went to what they call the candlelight processional show. I don't know if you've ever heard of it's, at Epcot. So it's this big show that's been going on for 60 years, and they have a big choir, a live band, and then there's always a celebrity narrator who basically narrates the Christian Christmas story, right. And then they sing all the classic Christmas songs with a huge choir. So it's like really emotional, really beautiful. And when I was there, Chrissy Metz from this Is US was the celebrity. Narrator do you know who she is? Dr. Katrina Furey, MD: Yeah. Portia Pendleton, LCSW: I loved. This is us. I feel like in our giveaway, which we'll talk about then in our episode, a lot of people have recommended that to us over the years. But anyway, she was like, balling. She was just, like, so moved by the Christmas story and the big choir. And I think it's just like the music, right? It's, like, so moving. Dr. Katrina Furey, MD: I attended the online version, but a conference for eating disorders. And it was in the Renfro conference. Yeah, she was one of the keynote speakers, just talking about her experience. And it was like, a couple of people who've been very open about their experience in a larger body and just, like, fat phobia and being an advocate. Portia Pendleton, LCSW: Oh, wow. Dr. Katrina Furey, MD: Yeah, I was really impressed with what she had to yeah. We both kind of just saw her in two different ways than this is us. So she's getting around everywhere. Portia Pendleton, LCSW: That's awesome. And actually, I just saw on her Instagram she's coming to New Haven with I guess she's like obviously she's a singer, but I guess with her band or something. Cool. Hey, Chrissy. Matt's, like, we love you. Okay. Anyway, back to the grinch. There's a lot we could talk about. So what jumps out to so I. Dr. Katrina Furey, MD: Was, you know, using Google as one does when they're looking for movie fun facts and something that I didn't see, but did pop out at me when I was watching the movie. Which is kind of a controversial disorder in the DSM and kind of in I don't know its use, its treatment, but it's a reactive attachment disorder. So I thought of him kind of immediately the Grinch with attachment. Portia Pendleton, LCSW: Right. Dr. Katrina Furey, MD: Like, he kind of came from somewhere. We don't know. Portia Pendleton, LCSW: The storks in the sky. Yeah. Dr. Katrina Furey, MD: And he landed outside and then he was cold and alone. I don't know for how long, not a long period of time. But it makes me think of some disrupted attachment and some neglect. And then the two sisters kind of take him in. And then he kind of goes on to continue, though, to not fit in and not have these connections with his peers. And so I thought, just for educational purposes, we could talk a little bit about reactive attention. I've worked I think that's a great idea over the years with it. And again, it's not common. But unfortunately, with the DSM, the current version of it, we only really have two disorders that we can diagnose and bill with. So it's reactive attachment disorder and then the disinhibited social where did it go? Disinhibited social engagement disorder. So everyone really wants there to be way more attachment based disorders. It would be more gentle, I think, with explaining some behavior. Portia Pendleton, LCSW: So anyway, like, from childhood to adulthood. Yeah, I think totally. Dr. Katrina Furey, MD: And we've talked a lot about borderline disorder throughout our movies and TV shows. And there's a lot of talk about borderline often, but not always stemming from attachment issues. DSM, I think Sick should work on that. Portia Pendleton, LCSW: Yeah. And I think, too, there's so many different schools of thought in terms of psychological development or schools of thought in terms of how do you do psychotherapy? What's sort of your lens that you see things through? And attachment is a big one. That's one that I find myself just naturally gravitating towards. And I've noticed we talk about it a lot on our podcast, almost every character. You and I are really curious about their attachments. Like with the morning show, we were like, oh, finally we saw Corey's mom. We're just constantly wondering, how did people get to be this way? And I think those early years are so important, right? Like between ages zero and five. That really sets the stage psychologically for how you will relate to adults. Really. Like, those early attachments we talked about in our Harry Potter episode with your caregivers are incredibly important. And, yeah, we see the Grinch as a baby, but like an older baby, like six to twelve months, I'd say, based on his head control and vocalizations and things like that. Dropped off on the stoop. So what happened before then? If anything, it's cold. And then he looks totally different from everyone else. And he's super bullied. Like all those scenes with Martha May when he's so excited to give her the valentine or not the valentine. The Christmas angel. Dr. Katrina Furey, MD: Yeah. Portia Pendleton, LCSW: And even the teacher. Dr. Katrina Furey, MD: I know everyone's like that one scene. Slow laughing, right? Portia Pendleton, LCSW: They're like, yeah, even the teacher. It reminds me of Stepbrothers when the mom gets involved singing songs. Brennan has a know where. It's just like even the adult who's supposed to be protecting you in that. Dr. Katrina Furey, MD: Space is like adding to it. Portia Pendleton, LCSW: I think a lot of people, even if you have solid, secure attachment, can relate to feeling bullied or laughed at in school. But he really got it. And we really saw how that made him isolate. Totally. Right. Totally isolate. And it's interesting, right? I think comparing how the Grinch responds to that type of early experience know, in a future episode, we're going to talk about Frozen, how Elsa responds and then isolates herself. It's interesting parallels to me. Dr. Katrina Furey, MD: Yeah. And a common theme in some child movies. I just think it's know something bad happens, which I guess is just a good story. And then how someone responds to that something bad happening or hard or, you know, how they kind of manage to do it. And ideally, if it's a Disney movie, they coped well and kind of come out the other side. But we see that with a Grin. Portia Pendleton, LCSW: So, again, when we talk about attachment, again, it's a term used to talk about the connection between an infant and their early caregiver. Usually it's a parent, but not always. It can be a grandparent. It can be someone at an orphanage. Hopefully it's someone that's a good place to start, is we hope there's someone. Right? Hi, scribbles. So then we think about and we've talked about in a lot of our past episodes, like Harry Potter, you a lot of different ones about the different type styles of attachment. We think about secure attachment versus insecure attachment. And then in that umbrella of insecure attachment, we think about avoidant attachment styles versus anxious avoidant attachment styles versus a reactive type of attachment style, right? So when you have a secure attachment, the child knows and feels secure in knowing that their needs will be met by their caregiver. And this develops over time, like for human babies, when you cry, your mother comes to feed you, to change you, to hold you. As the baby gets older, the child begins to be able to tolerate waiting for mom because they've been able to internalize, like, even if I'm crying, I know she will eventually come to me. It's something called object permanence, where I believe it's around 18 months old, where kids can realize, like, okay, even if I don't see my mom, I know she still exists, and when I need her, I know she will hear me and come to get me, even if it's not immediate. So you develop this secure feeling like your needs will be met. When you have insecure attachment, you don't develop that. You can't count on your needs being met, and you react to that in different ways. If you have an anxious attachment style, you're always kind of like wanting it to be met and not really being able to trust, like, will it be met or not? You're always anxious about it. If you have an anxious avoidant attachment style, you have that anxiety and then you kind of avoid social interactions in adulthood, you might not pursue romantic partnership, you might have a hard time making long term friendships, things like that. If you have a totally avoided attachment style, you don't interact with anyone, and you're just like, I can't trust anyone. And then this reactive attachment style is having a really hard time soothing yourself. So I remember seeing this in some kids when I did inpatient child psychiatry rotations who maybe grew up in I specifically remember one case where the child grew up in an orphanage in Russia or somewhere like that and was adopted by a family who'd also adopted like eight other kids but adopted them at like age nine or something. And the kid was having a really hard time adjusting, and it was just like a lot of emotional dysregulation, really hard time feeling soothed, really hard time trusting that anyone is safe to soothe them. It's really sad to see. And so we think that kids with reactive attachment disorder have a really disturbed internal working model of relationships. It's like the most severe version of an attachment disorder. And so that leads to a lot of interpersonal and behavioral problems later in life. Most of them have early childhood neglect, abuse or both especially in that ages zero to five range. Or early loss, like early tragic loss, which then leads to neglect or things like that where their needs aren't met. And I think it's been connected to I don't know the date off the top of my head, but things in adulthood like substance use disorder, mental health disorders, trouble maintaining jobs like stuff like that. But what's been your experience with it? Dr. Katrina Furey, MD: Similar, just kind of working. I think it's been some of the saddest cases I've worked with and just some of the ones that I feel like really sit with you and I won't forget. And I think that just speaks to how many painful and terrible things that we see and work with families for. It's like this, just for me, has really taken the cake, I think, because treatment feels really difficult and challenging because so much of it has to do with the caregiver. And the caregiver really should be in their own therapy because it's so difficult, really. You have to almost be like it's almost like an impossible expectation which no one's asking the parent to give or the caregiver to give. But you have to really be kind of coaching constantly. Everything's kind of a goal, everything's even a hug. Like a lot of kids with reactive attachment disorder don't like to be touched. So it's like how can you show important love? Portia Pendleton, LCSW: Regulate them. Yeah, exactly. Dr. Katrina Furey, MD: It's just hard. So there's like attachment therapy, play therapy, of course for little ones. There's some residential that they do rad. Sometimes they send them home with a puppy I've seen to develop a bond with something. Portia Pendleton, LCSW: Yeah, because I was just thinking, as you were saying, that so much of therapy, at least in adults, focuses on the therapeutic alliance which means the connection between the patient and their therapist. And time and time again studies have shown that is the strongest predictor of positive outcomes in therapy is having that connection with your therapist. And for so many patients. If not, I would argue all of them who have attachment struggles, whether they meet criteria for a full fledged attachment disorder or they just have some. Dr. Katrina Furey, MD: Interpersonal. Portia Pendleton, LCSW: Stuff with their parents that they're trying to work through, that gets replicated in the therapeutic relationship. And that can be, like, a great way to work on healing those wounds and learning how to trust other people, at least in the psychodynamic work that I do. And that's going to be so hard with someone with a reactive attachment style because they're going to really struggle to form that alliance with their care with a therapist. And I think that's like the whole goal probably for a really long time in the therapy is just to connect and be a safe place. Right. And similarly if you're adopting a child with this kind of attachment style, I think, but I'm sure we could do a better job that adoption agencies and stuff like help parents learn how to relate to these kiddos and over time but I don't actually know how much support parents get who are adopting. Dr. Katrina Furey, MD: Yeah, I think that's hard. I guess, even thinking of some of the cases where the belief is that some were from the kind of the international adoptions from places in Eastern Europe where we kind of know historically there seems to be a lot of neglect and then other just like horrific cases of child abuse and neglect here right. Early on adoption. So when we think of the Grinch, the point of kind of bringing up reactive attachment disorders, there's so many things. So people there's like antisocial personality disorder people have kind of talked about with him, depression, trauma, of course. Portia Pendleton, LCSW: But it's like I think this was. Dr. Katrina Furey, MD: Just like a little bit of a unique one. But he does demonstrate some of the criteria. So not liking physical touch, he wants to kind of be on his own, being unhappy or sad, it says, without a clear cause. I think we could take the trauma approach that there's always a clear cause with abuse in the case, it's always coming from somewhere but not really expressing emotions. So having a conscience, like struggling with remorse or guilt and then the detachment, withdrawal, kind of all of that. Portia Pendleton, LCSW: Yeah. And in terms of the DSM Five how, they also include some other symptoms that you might see in children with a reactive attachment disorder, which includes things like poor hygiene, not meeting motor milestones, having trouble with eye contact or social interactions, having blank expressions, appearing like unfocused, not responding socially appropriately to an interpersonal interactions, and stuff like that. And kind of all of that makes sense. Right. Because you learn how to groom yourself from your caregiver, right? Like your caregiver brushes your teeth, brushes your hair, gets you dressed before you know how to do that. So if no one's doing that for you, you don't know to do it for yourself. Right. And so I think you could also see how I just think, like, a trauma informed approach is so important because you could see how someone with this attachment style could be misdiagnosed as like ADHD, odd conduct disorder. And sure, I think there might be a proportion of people with this early childhood trauma and attachment style who go on to develop those things, but it might not actually be that. Right? Dr. Katrina Furey, MD: Yeah. Portia Pendleton, LCSW: That's important to emphasize. Dr. Katrina Furey, MD: The big years that I feel like that kind of comes out is more which is where the research with reactive attachment disorder is lacking and why it can be a little controversial because there's no long term studies, really about what it turns into. They know a lot from zero to five. But then after it's like, are the kiddos kind of getting a secure attachment, working on it, developing the ability to have close, safe relationships? Or is it kind of taking that other route where it's still not having any relationships and then the behaviors kind of naturally come out of that. It's not like the behaviors first, it's like you're kind of on your own in this big social world. Portia Pendleton, LCSW: Exactly right. It's like the former way you described it is like what we see in this movie with the grins who he can develop this secure feeling with. Cindy Lou. Interestingly. A little child. Right? And we always think like children are very pure and kind and so innocent. Right. And as adults, we often say like, gosh, when do we all become know when you're looking at little kids and interestingly, as you were saying that, Portia, I was just thinking like, well, in order to do a long term study, your participants have to keep participating, which in of itself is an attachment. So these people are not going to do that, right, if their attachment isn't healing righteous. Dr. Katrina Furey, MD: Yeah. And I thought his heart growing was to me just like so symbolic of him being and again, it's a movie and it's fast, but his healing and his ability to then connect and he kind of learns that through Cindy Luhu. And then it's safe to kind of try other attachments with his his caregivers. He kind know, reunites with and they put the sweater on him that's like itchy looking. Portia Pendleton, LCSW: Yeah, but he can tolerate even that. Know, it is like such a beautiful like for therapy in some, right? Like, I guess if Cindy Lou and the Grinch are engaging in play therapy, I guess if you're following my drift, that if you can develop that connection and it can feel safe and if someone in your life can see past all the acting out behaviors, stealing the present, stealing the you know, stealing all the lights. All this stuff the Grinch is doing in anger, which is sort of his way of projecting out all the pain he's holding inside from all his early life experience. If there's someone in your life again, hopefully an adult, not a child, hopefully someone will train someone in your life who can hold on to and keep mirroring back to you that you do have goodness inside. You are worthy of love. I see you for who you are despite all your acting out. I'm not going to leave you, baby. Is that powerful? And don't you wish everyone could have a person like that in your life? I'm just thinking of all the teenage boys I've seen in my work throughout the years who are just really acting out. And you're just like, god, you just need someone to love you. And it's tough. And these behaviors make it hard to do that consistently. Right. But you really need it because they. Dr. Katrina Furey, MD: Are so naturally kind of pushing others away. But it's like the core purpose of that is to protect. So it's like while others are kind of getting hurt or like, oh, yeah, he's a jerk. I can't believe he did that. It's like obviously some peers, I'm not asking them to have the capacity to do that, but like the caregivers or the adults around or the teachers or the supports, the therapist, it's like, well, why is this happening and how does it benefit him? But he also does have a dog. So now, thinking about animals, was that a tiny little way that even while he was by himself, he was able to develop an attachment with an animal, and that made it easier for them with Cindy Lou, who's also like a little bit, in a way, children are like animals. If you could go with me giving you that positive, unconditional, like, just the consistency. I feel like children in a way, are predictable in that way with just sometimes emotions. And so maybe that was the little crack that opened, allowed Cindy to kind of open the door. Portia Pendleton, LCSW: And I think that does speak to why could his heart grow? Why could he start to develop this? I think because there's some ability there for that. Right? He must have had some, however small thread of attachment that he knew it was possible there was something in there, whether it was those two sisters that he learned to trust, whether there was something there that led him to getting the dog. Right. And I mean, I've seen so many adult patients with a lot of attachment issues or trauma who really rely on their pets, right? And then there's all of the emotional support animals, which can be exploited, but when it's appropriate, it makes so much sense, right. Even if it's hard to attach to humans, because humans can be cruel sometimes animals, you can develop that attachment. So I think it does speak to the Grinch's ability to develop an attachment. However, it takes time, and it has to be in the right situation. But I think if he had been living alone like a hermit, with no dog, with no desire, then a there wouldn't be a story, there wouldn't be a movie. Right. He just wouldn't go to the Hubilation. He would just kind of be a hermit. Right. Dr. Katrina Furey, MD: I had a question for you, similarly, and I'm curious to hear your perspective about medication. So when I worked with some kiddos who had the diagnosis of reactive attachment disorder, it felt like a similar medication mix for borderline, right? Like an antianxiety, like a risperadol sometimes with respiradone, with aggression. So what else do you see? Yeah. Portia Pendleton, LCSW: So, again, I'm not a trained child and adolescent psychiatrist, but I would agree with you. In my brief training in child and adolescent psychiatry, during my adult residency training, it was hard because for a while I thought about pursuing child and adolescent, but then I didn't. And one big reason was because I felt like a lot of times as a psychiatrist, it was expected that you would medicate symptoms that at least like on the inpatient settings. I kept thinking, like, they're acting this way because of their home life or because of their parents or they're behaving and totally medicine isn't going to fix that. I would always say to my supervisors, I wish I could just prescribe them new parents. I just want to give them a loving parent. And Dr. Q, one of my favorite teachers of all time, when she would be interviewing kiddos and stuff, who were coming on the unit, she would get a good sense of what's their relationship like with their parents and then also ask them questions like, what do you go to when you're sad? Or who can you talk to when you have a question? Trying to gauge, like, is there someone else in your life? A coach, a teacher? Is there someone? And if there was someone kind of like the Grinch, there must been someone that you hope you can foster that relationship. But I would agree with you. I feel like in terms of the medication side, I think you often end up medicating certain symptoms in hopes it'll help keep the kid in, quote, unquote, behavioral control. And that always just rubs me the wrong way, because it feels like we're not treating the deeper thing or, like, the root cause, but then it's also like, well, how do you get to the root cause if the behaviors are interfering? It's really complicated, right? Dr. Katrina Furey, MD: Yeah. Portia Pendleton, LCSW: But yeah, I would agree with you. I think we see. And sometimes that's appropriate. Sometimes when you have patients with something like borderline personality disorder, it is helpful for them to be on a couple of different medications to help treat the different symptoms so that they're in a place of emotional stability, where they can make use of DBT or play therapy if it's a kid. It's just, I think, really hard with kids when the medications we're using can have so many side effects. So it's a really nuanced decision. Dr. Katrina Furey, MD: Yeah. And I think it just makes it hard. And I think we both have said ten times today, but attachment is so tricky, and I think the most vulnerable people are kiddos, and it just can be heartbreaking. When basic needs aren't met, there's abuse, and then, of course, that they're still not in a good place, and I don't know. But another totally agree, kind of just quick note about the Grinch is I thought it was funny someone it made me think of, like, what is it? Sad? Seasonal effective seasonal affective disorder. And it's like, it's always winter there. It's always holiday stress, right? So it's like, it's this perpetual can you imagine? Portia Pendleton, LCSW: Like, on the one hand, it's like, wow, it might be nice to live in Christmas time all the time, but then on the other, it's like such that's so much pressure, like, such high expectations. And we see that with the competition. Dr. Katrina Furey, MD: Between the neighbors, with how many lights. Portia Pendleton, LCSW: You get on your house. And then there's even the mayor's wife, who has, like, a Barbie body, right, who's using that light gun to get off. That's why loved this version of the movie, because it. Just speaks to that stress in such a comical way. Dr. Katrina Furey, MD: And it's also for adults with right seeing, like, doing the gun, it's shooting in that little bit, like, sensual way. It was funny. Yeah, it's funny. And it's definitely a part of the must watch list for me, at least for the holidays. Yeah, I love it. Portia Pendleton, LCSW: And I love this version. I just love Jim Carrey. Like, who doesn't? Yeah, but he's such a good Grinch. It's so good. Dr. Katrina Furey, MD: Yeah. Ten out of ten recommend. So thank you for listening today. I think we're going to wrap up. Portia Pendleton, LCSW: We'd love to hear your thoughts about this classic movie. What do you think about the Grinch's attachment style? Dr. Katrina Furey, MD: Yeah, so definitely let us know. You can reach us on many social media accounts like TikTok or Instagram at Analyze Scripts podcast. You can also leave a comment if you're watching this on YouTube. Or you can always email us at Analyze scriptspodcast at gmail. We'd like to hear your take. This was a little bit of new info. Portia Pendleton, LCSW: Yeah, let's talk about the giveaway. I believe this episode is going to come out before the giveaway. Let me double check. Dr. Katrina Furey, MD: Monday. I think it won't that Monday. Well, sorry. Portia Pendleton, LCSW: I mean, it could well, can we cut this out? Dr. Katrina Furey, MD: You should check our instagram. And if there is the still giveaway going on, we're giving away $200 of an Amazon gift card as a way to say thank you to our listeners. If it's not, we'll probably maybe do it again at some point. Portia Pendleton, LCSW: Maybe next do it again another time. Dr. Katrina Furey, MD: Make sure you're following us. You could see the opportunity to give us some feedback, and we'll definitely be taking some of the suggestions that have. Portia Pendleton, LCSW: Been on that post. Dr. Katrina Furey, MD: And again, please leave us some. We'd love to hear your feedback, but thanks for joining us. Portia Pendleton, LCSW: We're having a great time and we love all the interaction and catch us next week's. For our last episode of 2023, we will be covering Christmas Vacation, which is just such a classic. It's one of Portia's favorites. It will be released on Christmas Day. So if you need a little mental health break from all the festivities and you want to give it a listen, that's great. Dr. Katrina Furey, MD: Yeah, no, good note. All right, take care, guys. Portia Pendleton, LCSW: Bye. Dr. Katrina Furey, MD: This podcast and its contents are a copyright of analyzed scripts. All rights reserved. Any redistribution or reproduction of part or all of the contents in any form is prohibited. Unless you want to share it with your friends and rate review and subscribe, that's fine. All stories and characters discussed are fictional in nature. No identification with actual persons, living or deceased places, buildings, or products is intended or should be inferred. This podcast is for entertainment purposes only. The podcast and its contents do not constitute professional mental health or medical advice. Listeners might consider consulting a mental health provider if they need assistance with any mental health problems or concerns. As always, please call 911 or go directly to your nearest emergency room for any psychiatric emergencies. Thanks for listening, and see you next time.

According to research from Sales Enablement PRO's State of Sales Enablement Report 2023, when reps understand the winning behaviors that will help them improve performance, they are 74% more likely to effectively replicate them with buyers. So what role does effective training and coaching play in an overall enablement strategy? Shawnna Sumaoang: Hi and welcome to the Win Win Podcast. I'm your host, Shawnna Sumaoang. Join us as we dive into changing trends in the workplace and how to navigate them successfully. Here to discuss this topic is Malia Di Salvo, senior manager of training effectiveness at Upwork. Thanks for joining, Malia! I'd love for you to tell us about yourself, your background, and your role. Malia Di Salvo: I am super excited to be here. A little about myself, as you mentioned, I lead the training and effectiveness team here at Upwork. Under my purview, we have sales coaches, we have onboarding that is part of my scope, as well as a leader enablement program called lead up. A little bit about me, I am in Seattle, Washington so I am just getting in to enjoy the fall weather. I have a master’s in teaching. I’ve been a salesperson, a sales leader, in enablement, leading onboarding, coaching, and all those fun things. This has just been really the opportunity to marry a lot of my passions into one role and be able to play a part in the strategic vision and helping our sales teams and go-to-market teams really become effective. Marrying all my favorite things together now. SS: I love that. As you mentioned, you specialize in both training effectiveness and sales coaching at Upwork. Tell us about Upwork’s approach to training and coaching what are the key components of your enablement strategy and how do training and coaching both play a role in this? MD: One of the things that really drew me to Upwork was the fact that they had a sales coach team and we’re looking at expanding it and building it. Having been a sales coach in the past, I recognize the impact that coaches can really have when it comes to not just driving rep behavior and skill change, but ultimately revenue. One of the things that drew me was the fact that they had a portion on this team. Training and effectiveness to me, when it comes to our overall enablement strategy is really about effectiveness, like exactly what the team is. With enablement, we partner closely with our marketing team. We have a content enablement team that we really work closely with when they build playbooks or talk tracks, and then we launch the training and the pull-through. Training and effectiveness, to me, are one of the most paramount parts to pulling that enablement strategy forward and through all the way to application to competency to mastery. We’re integrally tied to our enablement as well as our overall strategy when it comes to driving revenue and impact. SS: I love that. We have this theme here at Highspot to help others understand what good looks like. What does good look like for sales training? In other words, what makes for an effective training program? MD: Sure, I think the overall best look for training is if it’s tied into larger strategic initiatives for the org. What are the overarching OKRs? Our OKRs should align back up into the go-to-market organizations and all the way up and through. Good looks like being able to tie your initiatives to those larger-scale initiatives and start showing the impact you’re having on those initiatives. I like to say that with enablement and with training and coaching, it’s really hard to say we’ve caused those success metrics, but have we correlated with them? What part of the equation were we when it came to attaining those overall strategic initiatives? Were we part of the equation? Anyone who’s in enablement knows it’s really hard. There’s a lot of squishiness in enablement when it’s like, did we make an impact or not? I think it’d be if you tie it into those larger initiatives, so you can show correlation to having achieved those, and that’s where it really shows the impact. I feel like when it comes to some of the programs that we’re doing to achieve these OKRs and these larger-scale programs, you start looking at progressive metrics along the way. For example, if we have a certain large-scale OKR from the CRO or Sales VP or whoever that might be. What are some of the programs we tie in place to tie back into them? If they’re looking to achieve X amount of revenue by the end of the year or by the end of the quarter, we can look at some programs to start increasing some of the leading indicators to tie into those ultimate goals. If we focus on setting more net new meetings or better qualifications or things like that, do we see an increase in some of these leading indicators knowing that they will impact the lagging indicators? That’s where the correlation starts to come in, and that’s where the enablement program happens. You need to be able to show that pull through that you were able to do, not just launching something, but the reinforcement, and then the ultimate indicator is like, oh, we saw an uplift in those new meetings and new opportunities I’m covering, knowing that that will ultimately lead to some of the larger scale programs and initiatives. SS: I love how you guys are able to draw that correlation. I have a similar question about sales coaching. What, from your perspective, does good look like for sales coaching, and what are maybe some of the core components of an effective coaching program? MD: I mean, there are anecdotal and empirical ways to say what good looks like with coaching. My coaches both come from sales, so they’re very empirical. They’re like, how do I know I’ve been successful? How do I know what I’m doing is making an impact on these teams? Since they come from very black-and-white situations where it’s like, you were successful today, you’re successful this month, or you weren’t, there’s that anecdotal and empirical type of way. Let’s start with the empirical. Do we see an uplift in any metrics? If you started coaching a rep and you’ve had them on your roster for X amount of time, did you see an uplift in some of the behavior and the indicators you were trying to impact? It’s really case by case because you might have one rep and this is very situational as well. You might have one rep who is really struggling with getting to the power in the deal. They’re having trouble gaining executive alignment. The coaching strategy is on that. We look at, did we get an increase in the VP plus opportunity or personas added onto these opportunities. Someone might have been struggling to close deals, so the coach comes in and really focuses on why aren’t you closing deals as strongly. Oh, well, they’re not creating urgency enough earlier in the sales process. We can start looking at the deal to move from stage one to stage two faster. On the empirical side, there are multiple ways you can look at that correlation. Again, I’m going to say correlation because the coaches are working tightly with the sales leadership as well. There are multiple things coming at them to help drive this particular behavior set. You can see the correlation on the empirical side. Anecdotally, it’s really like, do the reps get excited to meet with them? Are they like, hey, can I be on your roster this next month, or are the leaders like, hey, can so and so be on your roster this next month? They get a great Slack message at the end of the session like this was really great and impactful. You really helped me close this deal. When it comes to what good looks like, it really is twofold. There’s empirical and anecdotal, and you can look at it and I feel like you have to take both of them into account because. As a coach, people have to want to meet with you for you to be impactful. That’s where the anecdotal comes in before the empirical can even happen. SS: Absolutely. Now, I know, especially this year, a lot of organizations are hyper-focused on how they can improve productivity, especially amongst their revenue-generating teams. How can real-world coaching help to scale the productivity of a sales team? MD: That’s a great question. I think right now in this day and age, everyone is being asked to do more with less. We are off the teams that are impacted by rifts and layoffs. You have the sales teams that were cut drastically and are still having to drive revenue. How do you really focus on the most impactful part of your revenue team to do that? One of the things that I talk about and that we’re really looking to focus on as well here at Upwork is moving the middle. How do you identify the most robust group of people where the marginal benefit of them increasing their quota attainment by 1% will exponentially increase your revenue and productivity goals? The A players and the non-A players, we’ll say, the D and F players, that’s where the leaders can really lean into that. That’s where you’d be that the sales coach side of the house can really lean into the middle and focus on their productivity. How do we, again, get more with less, but not just necessarily more, but better conversations, better quality conversations, more power in the deal, and more effective ways to create urgency? We really try to focus on the middle portion, because again, that’s where we find if we see the increase in productivity, the increase in deals, the increase in quota attainment, that’s really going to drive our revenue goals in a whole, in a whole new direction. The coaching team can really help the leaders focus on and double down on that as well. To be able to help achieve some of that productivity and those revenue goals that we still have to hit. Every company still has to hit. SS: Absolutely. How do you guys leverage Highspot to help bring your coaching strategy to life? MD: Our company, our org is set up a little differently than other companies. Our enablement function and our sales enablement function focus on our content enablement. They live in our marketing department, and so my team lives in the ops department. We work really closely with our content enablement team to be able to develop playbooks, develop plays, develop talk tracks, and all these things to be able to double down and reinforce. We partner closely with them to build that content out, and then we launch the live training. We launch any e-learns you might need to have as well. It’s a double-down approach. We can use Highspot as well for reinforcement and to ensure we can get the insights we need. Anyone in enablement has heard of the Kirkpatrick model for measuring success. I think we use Highspot and recognize that Highspot is a great asset to us as we look to measure that impact. For level one for reaction, we can get the training survey and maybe do a quick pull to see if it was impactful, but for level two and level three, you start seeing the behavior, the learning, input, and impact. You can do the role plays and have them uploaded in Highspot. We have the reinforcement material. Who’s accessed it? Who’s been in the playbook that we created? Did it help drive a deal forward? It’s a real way to get that empirical data where it’s really hard to enablement, a way to continue that progressive measurement of success by utilizing the tool properly you can really start getting those insights. You can also see who hasn’t utilized it and get some feedback on why you aren’t there. Why haven’t you used it? We can pivot quickly as well to ensure that the material is as used as possible if you will. SS: Do you have any wins or best practices you can share about the outcomes of leveraging Highspot for sales coaching? MD: It’s all wins to me. Anytime we can utilize a tool to see what’s working, and what’s not. This is the beginning of the year we launched a program called Gaining Executive Alignment. As with every other company out there, as we’re all trying to get our people as equipped and enabled as possible, having power on the deal is really important. We partnered with our enablement team to build out the content and playbook for gaining executive alignment series. We were able to have a progressive series program where we did three different live sessions. We did some content and playbooks associated with it. We were able to not just use our live training, but also our content team to be able to measure who’s utilizing it. How is it working? We continue to still use it. We saw that when we focused on it, it really helped you, but we saw a pretty decent increase in actually getting power on deals and setting up new meetings with the right people as well. We’re able to back that into insights we use from it. If the person’s getting good, getting more deals or they’re getting more power on deals, of course, even in the Highspot, a lot utilizing some of the talk tracks and the playbooks that we have. There’s an easy correlation to make. If you use it it actually works. SS: Now, we’ve talked a lot about ongoing training and coaching, but I know that you guys are also using Highspot to help with your onboarding process. Tell us a little bit more about that and how you leverage Highspot in your onboarding program. MD: We’re actually in a revamp of it too right now, and I was just speaking with Nikki, who is our owner of Highspot over here at Upwork. Historically, we’ve used it for e-learnings and getting them on the path for that, but as we look to revamp our onboarding program and make it a more, I won’t say progressive, but for lack of a better word, progressive approach towards a true ramping experience versus this kind of like exponential curve and then fall off. We’re looking at how we’re going to be utilizing Highspot to have that experience be even more interactive with our new hires. Can we have a new hire landing page where every new hire goes to the page, they knows exactly what their journey is, where they are on the journey, what e-learnings are going on that week, what milestones we call them, and what assessments are coming down. We’re actually revamping it and going to be doubling down on our Highspot usage for our new hire training to really make it a much more singular source of truth for our new hires to come in. It’s not so, go to the search bar and find it, and here’s e-learning. It’s going to be a one-stop shop. I’m excited for what we’re going to be doing. I know that it’s going to be a lot more impactful to our new hires. It’s a new way that we’ll be utilizing Highspot. One of the other things we’re going to be looking at doing with our new hire experience is as we’re building out this content or revamping this content, what I think we’ve found is that governance is really hard as we like having people leaving the business or moving into new roles. We have to go in and update any e-learning or any videos where they were in. We’re also looking at making sure we have facilitator guides so that anyone who does come in can take over quickly. We’re going to start utilizing AI. You know, ding, ding, ding, the term of the quarter of the term of the year. How do we bring AI into some of our e-learnings and things too, to really make it a much more general approach versus a specific sales leader or person speaking to it? We’re also going to look at how we have a gated way within Highspot to have all of these facilitators, like kind of the backend, like with that leaders can access specifically where it holds all the facilitator guides, holds all the depth. If it’s like, oh shoot, this leader’s out this week, in the Highspot link, here’s the facilitator guide, here’s the deck you’re going to be presenting to the person who might be filling in for them. We’re going to be looking to expand over how we use Highspot for our new hire instance. We’re working on the plan this quarter with a potential launch in Q1, or Q2. I am excited to see how that turns out and how that’s going to impact our new hires coming in. SS: Amazing. Well, I’m excited about those plans as well. You guys are doing amazing already. You guys have incorporated Highspot training and coaching into day to day workflows of your reps, and you guys are already seeing an 83 percent recurring usage, which is amazing. I think adoption and usage are really critical in order to ensure that you’re seeing that intended behavior change. My last question for you, sales leaders obviously play a very critical role in reinforcing behavior from the top. How do you enable sales leaders to effectively support their teams and reinforce the value of training and coaching? MS: Great question. I got to give huge props again to Nikki, who is our manager over at Enablement. She owns, runs, and really drives that adoption for Highspot. She’s an incredible partner. I couldn’t do this without her. Reinforcement is the key when it comes to any enablement programs. I think we have all been at companies that had training rollouts, whatever that might be, new programs, new products, new pricing, new methodology, and it’s like, oh, great. We’re going to be sitting in this training and let’s check the box and get it done and then the next shiny thing happens and that’s all fizzled out and forgotten. Reinforcement is a huge part of success for any program or anything you’re trying to launch as we all know, but it’s also the hardest thing to do. What we’ve been looking to do, especially knowing that leaders have so much on their plate, is enablement teams are often a team of one or two. How do you scale that reinforcement? How do you enable and provide the leaders with the tools that they need to help you reinforce that? How we use Highspot is after we have training for some of our larger scale programs, we create what’s called a meeting in a box. It’s simple, but it’s a one-sheet that ties out just some decks that can provide some additional team huddle materials, and one-on-one questions to help continue that conversation. With leaders, we try to make it as simple as possible, knowing that their days are insane and slammed. I’ve said it before and I’ll say it again, I think frontline leaders have the hardest job in any organization. That middle manager, you’re really managing up, down, across in so many different ways. In enablement and training, our job, when it comes to making sure that we get behavior and skill change and that these training are impactful, is on that reinforcement and that sustained motion. While we depend on the leaders a lot, how do we make it as easy as possible? We create this meeting in the box, we share it with the leaders afterward, and then we can, using Highspot, look at who’s actually going in and utilizing that resource and that tool. It does a few things. It’s like, okay, they’re utilizing it, it’s being adopted like that’s that level two of Kirkpatrick, we’re starting to see it. We can see who’s not using it. Again, it’s a great way to go and see if someone’s not utilizing it, why not? Our goal is to get 100% of our leaders utilizing our content and at least getting in there to assess it and be able to pull through to the application. It’s a way to also get feedback and really identify the not, the non-adopters, which is to me the key. Who’s not utilizing it and why not? We can quickly iterate quickly, by seeing who’s not actually going in there and getting some insights from Highspot. We can go in really quickly and be like, Hey, Mr. Sales leader, let’s have a quick conversation, a couple of questions. My customers are the sales leaders, so I want to know what’s not working so that we can make it right so that they’re utilizing it and their teams are impacted as well. SS: I love what you guys are doing. It helped to enable your sales leader. You guys are doing a fantastic job there at Upwork. Thank you so much for joining us today. MD: This was awesome. Thanks for having me. Thanks for having such a great tool too. We are huge Highspot fans over here. SS: To our audience, thank you for listening to this episode of the Win Win podcast. Be sure to tune in next time for more insights on how you can maximize enablement success with Highspot.

Welcome back to Analyze Scripts, where a psychiatrist and a therapist analyze what Hollywood gets right and wrong about mental health. Today, we are thrilled to be joined by one of Dr. Furey's favorite teachers from residency, Dr. Zheala Qayyum. Dr. Qayyum is the Training Director for the Child and Adolescent Psychiatry Fellowship Program and the Medical Director of the Emergency Psychiatry Services at Boston Children’s Hospital. She has published on the use of fairy tales in teaching child psychiatry and joins us to discuss the first "Harry Potter" movie. In this episode, we discuss many interesting themes including the psychological effects of early childhood trauma and neglect, the attachment styles of the three main characters, and the importance of friendship in identity formation. We also reflect on the mirror of Erised and the importance of exploring dark feelings and themes in childhood from a safe space, such as through this magical film. We hope you enjoy as much as we enjoyed speaking with Dr. Qayyum! Instagram TikTok Website [00:10] Dr. Katrina Furey, MD: Hi, I'm Dr. Katrina Fieri, a psychiatrist. And I'm Portia Pendleton, a licensed clinical social worker. And this is Analyze Scripts, a podcast where two shrinks analyze the depiction of mental health in movies and TV shows. Our hope is that you learn some legit info about mental health while feeling like you're chatting with your girlfriends. There is so much misinformation out there. [00:30] Dr. Katrina Furey, MD: And it drives us nuts. [00:31] Dr. Katrina Furey, MD: And if someday we pay off our student loans or land a sponsorship, like with a lay flat airline or a major beauty brand, even better. So sit back, relax, grab some popcorn and your DSM Five and enjoy. [00:50] Dr. Zheala Qayyum: Don'T. [01:17] Dr. Katrina Furey, MD: For a very special episode of Analyze Scripts, because one of my favorite attendings for my residency training is joining us to talk about one of my favorite movies, harry Potter and the Sorcerer's Stone, or The Philosopher's Stone, depending on which country you're watching it in. So today we have Dr. Gila Kayum, the training director for the Child and Adolescent Psychiatry Fellowship program and the medical director of the emergency Psychiatry services at Boston Children's Hospital. She holds faculty appointments at Yale School of Medicine and Harvard Medical School, and she's the associate director of medical student education and Psychiatry. She's also serving as a lieutenant colonel in the United States Army Reserves Medical Corps and deployed to Afghanistan and was later mobilized in support of the COVID-19 response to New York. Dr. Kayoom has published on the topics of medical education, autism spectrum disorders, inpatient treatment of early psychosis, and LGBTQ, plus youth, the use of fairy tales in teaching child psychiatry, and the risk of youth suicide and firearms. She has a particular interest in the areas of supervision and mentorship, which she's so good at psycho oncology and palliative care. And I feel like we always called her Dr. Q. I guess I'm allowed to call her by her first name because I'm a grown up now, but I still feel kind of funny about it. But you were one of my favorite mentors, and I feel like you're really special because sometimes when you have a mentor, it kind of feels like they're trying to mold you in their image. But I always felt like you just wanted what was best for me, and you were so encouraging, and I just always loved working with you, and you hold a really special place in my heart. [02:58] Portia Pendleton, LCSW: So this is really fun to talk about. [03:00] Dr. Zheala Qayyum: Harry Potter no, this is, like, making me teary. This is just a lovely intro I have gotten. And it's just such a thrill that the people that you invest in grow up to be such amazing child or adult or psychiatrists, but more so, just people. And you're very dear to me as well. The best part of being an educator and a clinician is that not only are you trying to sort of transfer your skills or your wisdom, but you get to see your kids grow and become they're meant to be and their best versions. And if you think you're a part of that journey, I think that's just the most amazing privilege. [03:50] Dr. Katrina Furey, MD: Well, I know you were for me, and I know you were for a lot of my co residents, so it's so true. So I am dying to talk to you about this movie, given your interest in using fairy tales to explore development. So I just kind of want to jump right in and hear what you think about the first Harry Potter movie and kind of what jumps out at you. [04:13] Dr. Zheala Qayyum: So I think one of the loveliest things about Harry Potter was that it was a modern fairy tale, and we've had a lot of lovely fantasy series, but there was something very special about Harry Potter that just captured everyone, whether it was kids or adults. It's interesting, whenever I ask people what their favorite children's book is, inevitably, for a lot of them, it's Harry Potter. And I read it in med school. So I was much older, but I still stood in line at midnight yes, where I was standing next to like, ten year olds in their robes, and I was like, Am I in the right place? But you felt like you were in the right place. And I think that's what it communicated was it was or is a modern fairy tale for all ages. It just has that essence of a fairy tale, that it means something different to different people at whatever stage of development or life they're in. So a child can interpret it in their own way and have things that they resonate with. And as adults, we might find things that resonate to us, whether based on the hero's journey, these ordeals and call to action and your helpers that bring you along, but also the trepidations, the challenges, the times you doubt yourself when things are there. How do you overcome challenges and this power of transformation through a journey and a story that you're not the same person that you started off as, but with all of the things that you've had to experience? How does that evolve and transform you till you come full circle in some way? Not the same person that left, but so much more wiser grown. I think it's the transformative journey that we see from the first book that started, but there are these just themes that just feel like so relevant to today about loss and difficulty and when you're seeing this drive for power around you and how do you fit in the whole picture. And we usually have a reluctant protagonist in many stories that is not fully sure they want to take on the adventure and the call for action, and yet they do. But I think most importantly for me, the biggest thing was the importance of hope and friends. [07:04] Dr. Katrina Furey, MD: Yeah, I totally agree. And it's funny you mentioned hearkening back to standing in line at midnight at, like, Borders Books or wherever you were. I totally did the same thing. I think I was in middle school and then high school. But it is really fascinating how Harry Potter and other fairy tales like it. But I feel like especially Harry Potter, it is such a cultural, communal enjoyment and not just in American culture, but certainly worldwide. It's just such a really cool thing that it just really spans ages, genders, cultures, nationalities, languages. Everyone loves it, right? And I feel like this movie rewatching it now as an adult with my children was so meaningful and fun. So I have a seven year old and a four year old and they were just enraptured by it. They wouldn't stop talking the whole time. They wouldn't take their eyes off and this isn't like a cartoon, so they're still at the ages where really it's cartoons that catch their attention for two and a half hours. But this one did, and that was really interesting to me and really special. And I love some of their commentary. Like, with her, MayAny always raising her hand. My daughter, which I was so happy, said she's got a really big brain. And I was like, yes, she know. And then when Draco came on the scene very early on, my son was like, oh, he's a bully. And I was just you know, it's just really cool to kind of see kids watching it too. [08:40] Portia Pendleton, LCSW: Yeah. I think it's worth mentioning something interesting. When I was starting to read the books before the music, the movies had started kind of coming out. I remember very distinctly the religious organization that I was a part of at the time was very split with people thinking that you shouldn't be reading it. It's magic. It's witchcraft. Witchcraft. And then the other half being like, if you know the story, it's like this good versus evil. Good always triumphs. There's hope. There's, like you were saying, friendships. I mean, it's such a positive message. And there's so many interesting. [09:23] Dr. Zheala Qayyum: I don't. [09:23] Portia Pendleton, LCSW: Know, like, spiritual parallels and parallels throughout all of the books. But I think it was just an interesting time to be know, hearing this spoken series is bad or evil and then reading them. Know, in my family, we were very pro Harry Potter and loving the messages. And I think that was just like I don't know. I'm sure some other people might have had that experience. [09:45] Dr. Katrina Furey, MD: Oh, I totally remember. [09:48] Dr. Zheala Qayyum: Right. [09:48] Portia Pendleton, LCSW: Like, we come to see this boy in, I would say, a pretty abusive home with a lot of neglect. And I think it's funny watching it or thinking about it now versus in. Like, I'm curious what even your kids picked up of the scenes. The parents certainly seem mean and right dismissive. And you picked that up even as a child, like something not right. Why does Dudley receive all of these gifts and Harry not his clothing? [10:18] Dr. Katrina Furey, MD: Yeah, my kids were asking about that? [10:21] Portia Pendleton, LCSW: Like why are they so mean to? [10:22] Dr. Katrina Furey, MD: Why is he living under the stairs? They certainly were asking those questions. [10:29] Dr. Zheala Qayyum: Yeah, no, I think it's a really lovely depiction of how prevalent and difficult it is for kids that have neglect. And I think also it really sort of from starting from him being under the stairs and just watching Dudley get 36 presents and counting and him thinking about, like he has to get hand me downs to go to school and what that would be like. Just that differential that was created and that sense of otherness or I don't belong or I'm not good enough. It really, I think, beautifully highlights how a child will internalize that, because you see that then play out throughout, which partly keeps him humble when everybody thinks he's this amazing everybody knows him, but he's coming from where? Nobody. Knows anything about him. And he held on to that for a very long time and it really changed his I think we see him work through it, but his sense of belief and faith in his own abilities and his self because they told him he wasn't good enough for a good eleven years. And that sense of feeling like you're worth something that he didn't get initially. And how does one young child actually grow to develop that? Partly it kept him humble in the face of, I don't know, magician dumb or stardom or whatever that was that he got later on. But also, it really impeded his ability to rely on other people. And we see. This in the later books as well, but whenever he has to do something, he's very like the avoidant attachment style. I can't trust people to be there for me. And we know later in the books there are other losses that sort of reinforce that for him. But he embarks on everything on his own and working with others and trusting others comes very, very it's very challenging for him, comes much later. [12:52] Dr. Katrina Furey, MD: And I like that you brought up his attachment style. Can you explain a little bit what avoided attachment is or the kind of kids or adults we might see that in and how Harry either fits in or doesn't quite fit in. [13:09] Dr. Zheala Qayyum: So the avoidant attachment style is when a young child has inconsistent caregiving where their needs may not be consistently met. And so rather than clinging to their caregiver to get their needs met, they're like avoiding contact with them because they don't know are they coming, are they going, or are they going to be there. So the child starts to avoid that contact and doesn't get need or avoids contact with the caregiver to get soothed and self regulated. So we see the same thing, that since the Attachment is our template for forming relationships, that we carry on in life, we see Harry particularly later on as he's growing older, that even in adolescence, whenever there is a challenge, he goes off on his own rather than relying on anybody else because he doesn't know. Are people going to really be there for him or not? Are they going to leave? Are they going to neglect him? So he might as well do that for himself and just go off on his own. So that sense of avoiding closeness with people because they might leave or not be there for you, is that sense that avoidant children internalize and so they don't keep looking for closeness with people. It's good that we see Harry work through this over a great many books, which also tells you that it runs in parallel with the life experience of a young child who's had early life neglect and avoidant attachment style might need a lot of reinforcement of positive interactions to say, no, you can rely on other people. If you do get close to people, it'll be okay. And yet loss is a very, I think, integral part of our human experience and life. And for an avoidant child, there is that risk that it just might reinforce that belief that people are not going to be there for them. [15:18] Dr. Katrina Furey, MD: And in addition to Harry having that early childhood neglect and abuse, he also had early loss of his parents, who seem like lovely caregivers, who were likely very attuned to his needs, at least as far as we can tell, and that he was present for their murder. And so I was really curious about your take on that, given around the age they depict that and then what it must have been like for him at age eleven to start learning the truth about that loss at the same time as he's learning their loss is why he's famous or special. I just imagine that's got to be so confusing. [16:03] Dr. Zheala Qayyum: Absolutely. And I think that's such a lovely point of there's so much magic instilled in that power, of that parental love that he carried with him that it literally burned. Professor Squirrel. [16:22] Dr. Katrina Furey, MD: Right. [16:23] Dr. Zheala Qayyum: It was so powerful. I think it does show, though, however, that it was at a very sort of vulnerable time period in his life when that death occurred. He was still a baby, and we're thinking, like, till from infancy to toddlerhood, maybe the first part went well when his parents were attuned and taking care of him, but later on, and still in that very vulnerable time frame, he had a lot of neglect. And so as you're entering into your preteen years, your sense of, how do I relate with my peers? Who am I in relationship with them? Will they accept me as? We're thinking about later, latency age and early preteens going into your identity formation, who you are is so sort of determined by who are the people in your life? Who brought you here? What is your story? How did you start? And I remember as a child, my mom would tell me stories about, well, when you were little we did this things I wouldn't remember. But still you create these memories based on the things that your parents tell you as well when you're younger. But those things are so important in our development, and now he had to figure that out on his own. Who was he? What were his parents like? That question of when he goes and sees his father's name on the trophy room and he's like, I didn't know he was a Seeker. There's just so many knowns for him to figure out who he is because he doesn't know where he's coming from, and your legacy or your lineage or what are the wonderful stories about how amazing you are. Your parents tell you he never had that. And now he has to create his own narrative about who he is, which is the whole process through the book. [18:26] Portia Pendleton, LCSW: And speaking of like, identity formation, he went from being told that you're such a burden, you're unwanted. Your parents were horrible, they were weird or strange, to being praised or whoa, Ron's reaction to it's. You with the scar on the train, know, having all of this wealth suddenly and this importance in this world, it's just so interesting. You had written down with Hagrid, like him just going with that to this magical place that if somebody had told an eleven year old me, I think, and I'm hopefully that I'm securely attached, I would have been afraid to go with Hagrid. [19:08] Dr. Katrina Furey, MD: Right. [19:09] Portia Pendleton, LCSW: This big, burly, giant, half giant man who's telling me all these things that we're going to go to this magical place. I think for a securely attached child, they probably wouldn't have gone. But he didn't have any attachments. And then I think anything is better than living with the directly to finally. [19:29] Dr. Katrina Furey, MD: Take him out of that situation. [19:31] Dr. Zheala Qayyum: Right. [19:31] Dr. Katrina Furey, MD: It's like almost like this savior has come to rescue him. What were your thoughts about that, Dr. Q? The way he so know, latched onto Hagrid? [19:41] Dr. Zheala Qayyum: Yeah, I think just like Portia said, it's like that insecure attachment, there's nothing to hold him there. But he's also, I think, like you talked about at a point where he's thinking about things and his life. If he's going to go to the same school as Dudley, what is that going to be? He's getting into trouble constantly. And imagine the message you internalize after you're told that everything you do is wrong or you're a bad kid, and you get told that long enough, you start believing it. So maybe it wasn't such a far fetched thing to say, I'm going and I'm taking off. [20:19] Dr. Katrina Furey, MD: Right. [20:20] Dr. Zheala Qayyum: What's the worst thing that can happen whenever anything I do isn't good anyway? [20:27] Dr. Katrina Furey, MD: Right? And I think we see that in clinical work. And probably you see a lot more, given your line of work, in kids who maybe will go off with not safe people. That sort of increases their vulnerability for those very situations. [20:43] Dr. Zheala Qayyum: Because at the core of it, every kid just wants to belong. [20:48] Dr. Katrina Furey, MD: Yeah. [20:49] Dr. Zheala Qayyum: And so if it was what Hagrid said, is that's where you belong? He hasn't had that sense of belonging at the Dursleys. So he will try. And go and find if he belongs somewhere else and what other people. [21:09] Dr. Katrina Furey, MD: And he does find. [21:10] Dr. Zheala Qayyum: I feel like I'm going to cry. [21:11] Dr. Katrina Furey, MD: Talking about Harry Potter and also just thinking about Hagrid is like, I just love Hagrid. He's such a gentle giant, but I couldn't think of a better person to come scoop up Harry. Right. Like, even just imagining him sort of putting him in the little sidecar, he's, like, nice and cozy and secure and contained and I hope just feels safe next to this big old guy who. [21:40] Portia Pendleton, LCSW: Stood up to the dursleys, right? Chased found him. I remember my blood boiling even watching the movie again or rereading the book when they keep taking his know you know, it's such. [21:58] Dr. Katrina Furey, MD: His letter. [21:59] Portia Pendleton, LCSW: Yeah, that's the one thing he has. [22:02] Dr. Katrina Furey, MD: But then Hogwarts is like, well, we'll send you more. We're not going to give up. And I would imagine for, like, how wonderful. That must feel like, wow, they really. [22:12] Portia Pendleton, LCSW: Are trying to get to me. [22:13] Dr. Katrina Furey, MD: No one has wanted me like that before. And they're being like Hogwarts or whoever. Dumbledore's love for him is so transcendent and powerful that it wins. Out against the neglect of the know. [22:29] Dr. Zheala Qayyum: Just beautiful and sort of how teary Hagrid was when he was first dropping him off when he was a baby and dumbledore saying it's not goodbye for. [22:42] Dr. Katrina Furey, MD: Oh my gosh I feel like, that's how I am. Every year the new school year starts, you're just like, oh, my gosh, they're growing up. [22:51] Portia Pendleton, LCSW: And then hermione I think it's worth mentioning. So she has, it seems, securely attached, supportive parents. But is living as a muggle her whole life until receiving these letters and going to Hogwarts and then learning that she is like a mudblood and that she is not good enough. Her blood is like, dirty. And yet she is so brilliant, and I think that's such an interesting reversal of her and Harry's experience. She's still really smart, but it's like it's not good know are calling her names like Draco. And I don't think that she experienced that. Prior know the little bits that we get of her pre hogwarts. [23:40] Dr. Katrina Furey, MD: And interesting to think about her parents. Like getting this random letter and sending her. Right? [23:47] Portia Pendleton, LCSW: Yeah. [23:51] Dr. Zheala Qayyum: That's the wonderful thing about secure attachment and great parenting is know, we're all about you. So if this is who you are and this is your success and this is where you're going to thrive, sure. [24:03] Dr. Katrina Furey, MD: We don't know anything. Go for it. [24:06] Dr. Zheala Qayyum: And I think that is part of Hermione's own resilience as well is that that secure attachment, as difficult as those interactions with Draco are, allows her to stand up for Harry and Ron and build friendships and sort of extend that beyond the parental unit onto her friends, new people and say, because I have a good sense of attachment and security and I know people will be there for me, I can be there for other people, too. And then you can carry it forward. So I think Hermione is a really nice example of a secure attachment. And then I think you see that play out a little bit more. Not in the first book, but later on at the Yule ball, where she can put Ron in his place for not asking her out and sort of take ownership of her own. Know, next time you want to do this, pluck up the courage and ask, right? [25:10] Dr. Katrina Furey, MD: Boundaries. [25:11] Dr. Zheala Qayyum: I think that's a really nice illustration of how important attachment is as a child is growing and then into adolescence that the same things play out in your other relationships. [25:25] Dr. Katrina Furey, MD: And how amazing to have a girl character like Hermione, right? Like, I think all the things you just said, like her bravery, her intellect, her self confidence, her boundaries, I just think so lovely to have a girl character like this for girls and boys and adults to read about and identify with. And she can maintain that sense of herself in the face of draco and the slurs and the comments, even when people even know who she goes on to marry down the road. Spoiler alert. Even as he's kind of putting her down for being smart, she doesn't stop raising her, know? And I remember as a middle school girl who loved school, just loving that, just loving that. And I loved watching now my daughter, watch her, and I'm just like, soak this up, soak this. [26:20] Dr. Zheala Qayyum: Yeah, such a lovely little bottle for girls. And then since we're on the topic, like, you think about Ron, who is like this lost soul in this big family of redheads. And so you kind of see his sort of anxious style come through that, particularly when he was asked to relax and he couldn't. [26:44] Dr. Katrina Furey, MD: Yes, he's like, I don't know how. [26:49] Dr. Zheala Qayyum: Right? And all the hand me down. Not that he got, but also the same sweater that he gets every year, that there is love in that family, there is care, but also with so many kids, they're kind of lost until they get into trouble, that they get into parental they get parental attention and you hear about their concerns. And so even though there is not a lot of any mal intent anywhere within the Weasley family, but you can see where Ron's anxiety and anxious attachment style comes in and you see the same thing in the Eubolic. And the anxious attachment style is, you know, the child that doesn't know how to get through, they're like, all right, please pick me up. No, now put me down. No, pick me up again. I'm not sure. They're just taking time to self regulate and self soothe and sometimes they can get pretty irritable and upset too, and so they might lash out. And you see that in the U ball scene, too, where I know I'm jumping ahead, but rather than asking Hermione, he gets really sulky and irritable rather than owning up, but he wants it, but he doesn't know how to do it. So you kind of see that tension and that sort of clinginess but not sure what to do sort of thing. So I think the whole series really highlights these attachment styles really nicely. [28:19] Dr. Katrina Furey, MD: Isn't that amazing? How did JK. Rowling do that? And I thought the fact that they're all eleven, it was just perfect, right? Like at that age and kind of with all the books following them through is just really beautifully done, I think. [28:39] Dr. Zheala Qayyum: And you can kind of play out in the carriage scene when they're first on the Hogwarts Express together, where I think Hermione comes in looking for Neville's Frog frog. And you see how confident she is and she's you're and who are you and have you done this? And so self aware, self confident. And then you have Harry just sitting by himself, not sure he wants to talk to anybody. And poor Ron, who's trying to get his presence known again, just like a young child in a big family would feel lost, that I have to make my presence known, otherwise I won't get the attention I need. And poor Scabbers that he's trying to turn yellow and that's not working out. So you kind of see it play so nicely in a very simple scene. [29:36] Portia Pendleton, LCSW: Definitely something that I noticed, and I think it's just my interpretation of things, is that Ron seems to have the most obvious shame about his finances compared to the other siblings. I don't really notice or even Jenny's younger in this book, but being so visibly upset, I know that there's the interaction in the robes shop with Draco and then on the train, even with his little sandwich, right, he can't buy the treats. And then there's like whoa when Harry has those gold coins. And it really does seem to impact him even throughout the rest of the story. Just that intersectionality. He's a pure blood, but he is poor. And then how that really goes up against Draco and his Pure Blood and wealth family. [30:34] Dr. Katrina Furey, MD: I think that's an interesting thing to think about the intersectionality of all their identities in this sort of fantasy world, right? There's so many parallels. Like even if you think about different intersectional identities in our culture today, and it's just interesting to think about it's an older book. [30:55] Portia Pendleton, LCSW: I mean, again, it's so easy to talk about these more seemingly popular nuanced ideas. They've been around for a while, but everyone kind of talks about their intersectionality or different identities. And it's so clear in the book, right? [31:13] Dr. Katrina Furey, MD: It does seem like the type of series where you'll always get more from it. I reread the series I think, last year, and I loved it, and I feel like I got more from it as an adult than I did as a kid. And it's one of those things where I feel like every time you read it, you'll get more and more from it. [31:31] Dr. Zheala Qayyum: It just means something different. Yeah. [31:35] Dr. Katrina Furey, MD: So one thing I was hoping we could talk about is the mirror of Irisev, which is desire spelled backwards. I totally choked up watching this part again, as an adult, I was curious to hear about your experience. [31:52] Dr. Zheala Qayyum: Yeah, I had so many thoughts about that. I mean, it's such a powerful thing. And the fact that if you're truly content, then you can see yourself as you are, only the happiness, and if that is the measure of happiness. And it was like, wow, just the visual illustration of happiness, that you could see yourself and just see yourself as you are. Because I just felt like, yes, it is desire spelled backwards, but it is so prevalent throughout with starting with those 36 presents that you want more, and Voldemort wanting more, that defeated and needing to come back and needs to get more and more power and even kills a unicorn for it. [32:46] Dr. Katrina Furey, MD: Oh, my gosh, that was devastating for my four year old daughter. I regretted that part horribly. [32:51] Dr. Zheala Qayyum: Like, yes, moving but jarring scene. And then the fact that your heart's deepest desires that you're desperate for and you'll see that, but anything that's too much is going to consume you. And those people who sort of run after the things that they really, really want, I think it was a very powerful way of giving that message of too much consume you and there'll be nothing left. Like it does not do to dwell on dreams and forget to live. So I just thought it takes so much courage, though, to ask yourself what it is that you really want in life. I mean, a lot of us may want all these things, but what is it that you truly, truly want? I think that's a very powerful question to ask. And how many of us really can look at ourselves in the mirror and say, this is what I really, really want in life, and to be able to face that and own it. [33:59] Portia Pendleton, LCSW: It's a good question to ask a client, even, because I think you can always get to the feeling right under it. So if someone's they're saying that their deepest desire is financial gain, it's like, okay, but what does that mean? Does that mean you want to feel secure? Does it mean that you want to be powerful in a sense of authority? Do you want people to look up to you? It's always like a feeling. [34:26] Dr. Katrina Furey, MD: And why? Where does that come from? [34:28] Portia Pendleton, LCSW: Yeah, it's a good place to explore with yourself and maybe with a patient as well. [34:33] Dr. Katrina Furey, MD: Can you imagine, like, starting off a session, they come to see you. For the first time. And you're like, here is my mirror of IRISET. [34:39] Dr. Zheala Qayyum: Yeah. [34:40] Portia Pendleton, LCSW: Looking at what do you see and. [34:42] Dr. Katrina Furey, MD: What does that mean? [34:45] Dr. Zheala Qayyum: It'll make our job so much easier. [34:47] Dr. Katrina Furey, MD: I know, right quick, right real quick. [34:50] Portia Pendleton, LCSW: We'll get to the deep rooted issues in 10 seconds. [34:54] Dr. Katrina Furey, MD: Easy peasy. Managed care will love it. So we see what Harry wants, which is his parents. And again, I was so struck by him going back to that mirror repeatedly and I was just like, of course he is, right? Like his parents are moving. You see his mother, his father touch his shoulder. I was just like, oh, I so feel that for him. Then we see him drag ron so excited to share that experience of his parents with him. But Ron sees himself as head boy and winning the quidditch cup. And again, that totally makes sense based on everything we just talked about with Ron's family. We didn't see hermione. And I was curious what you guys thought. What would hermione see, if anything, or would she see herself? [35:46] Portia Pendleton, LCSW: I think maybe if anyone would be seeing themselves, it would be her. Especially like in book one. I think she does seem so content and excited and authentic that I think it might be her. Maybe it's her being top of the class. [36:04] Dr. Zheala Qayyum: I think she is. [36:05] Portia Pendleton, LCSW: She already kind of is. [36:08] Dr. Zheala Qayyum: I have a feeling that the one thing she grows to develop were friendships. That I wonder if she might see herself surrounded with friends. [36:17] Dr. Katrina Furey, MD: Yeah, I think at her age again, I agree. Portia of the Three know. Harry rod hermione. I feel like she would be the one closest to seeing just her true self. But I wonder if at that age of eleven, as a girl, if there's something deeper she's not able to articulate yet that we might see like friendship. [36:38] Portia Pendleton, LCSW: Yeah, I think that's accurate. I think sometimes you get the books confused or what's, like maybe a fan fiction thing online or something. But I am pretty sure that she does say that she did struggle with friends and so to have these deep friendships build at Hogwarts, I think that might be it. [37:00] Dr. Zheala Qayyum: Yeah. I'm just thinking know, she is very brilliant. So seeing herself as like the know, graduate or something of her class probably isn't far fetched. But if that intimidates other kids when she's correcting them over livio saw yes, that might rub kids the wrong way. That maybe that peer acceptance and those close friendships might be something that we see sort of develop over time as well. [37:33] Dr. Katrina Furey, MD: And so as we start wrapping up our wonderful episode today, let's talk a little bit about their friendships. Because I just feel like, gosh, I thought the movie did such a good job explaining the book, which has so many concepts, so much magic in it. It's had to do so much in just two and a half hours of just like background, like this is where we find ourselves. This is Hogwarts. This is Quidditch. This is Voldemort. Like here it is. And capturing all these complex concepts in such like a beautifully visually appealing way. The music is wonderful but we certainly see the triad between Harry, Ron and Hermione starting and forming and we know that just grows and grows and gets more complex over time. And I was really curious Dr. Q about your thoughts about first of all that it's a triad. There's three of them, two boys and a girl and what do you think of all that? [38:36] Dr. Zheala Qayyum: I just love the idea and particularly since you have the girl be somebody like hermione and I thought it's really nice to see their parallel processes. Each one of them is trying to sort of discovering that they're each really good at something but not good at everything. Like Hermione realizes she's not good at quit it. How humbling for someone who's really good and smart to know quidditch is not for, you know, Harry discovering that's what he's really good at and very early on know Ron playing chess and how it was reinforced with all the points even Neville's like standing up to your. So I felt that that was such a lovely way of saying that some of the reasons why friendships are important is that no one is whole in themselves and so much stronger when we all complement each other. But how do you explain that to an eleven year old? But if they saw the movie they would understand that we are so much more when we're all together and how those friendships last over years even for many of us. And I also felt like the complexity that you talked about. I think another movie that highlights it really nicely is Inside Out. [40:06] Dr. Katrina Furey, MD: Yes, we love that movie. [40:08] Dr. Zheala Qayyum: Our emotions are one color when they're younger and as you grow older they get more complex and those marbles are multicolored because emotions are more complex than just feeling sad, mad and glad. And similarly as we're thinking about I think this goes very nicely in a parallel of fairy tales and development that when children are younger they can only see good and bad. As long as you're giving me what I want you're the good parent. When you set limits you are not. [40:43] Dr. Katrina Furey, MD: Oh I feel this every day older. [40:46] Dr. Zheala Qayyum: You can hold the things together in the same person that there are things that are great about them and there are things that are some weaknesses. And when we're children we look at our parents as these idealized giants and as we grow older we see them for human beings that have wonderful strengths and flaws that we can still accept and love them still the same. So I think that is a big developmental challenge but I think the books highlight that really nicely with them being able to sit and tolerate that complexity. [41:29] Dr. Katrina Furey, MD: That nothing is so and again with them starting this journey at age eleven. I feel like that's the perfect timing for all of this to start. And I wonder if even the darkness of Harry Potter in watching the first movie, I was like, all right. I think it'll be several years before I show my kids the second movie because each one gets a little darker, a little grittier. But I think that maybe contributes to why it sort of captured all of us. And it is darker than the Disney version. Like, Inside Out is a great example, but I think that just speaks to the reality. [42:12] Portia Pendleton, LCSW: Like, the books get more complex, the books get darker, the characters get more complex, the characters get know. I think it was just such an interesting time to read it as a child as they came out, because it really kind of aligned perfectly with my own development. [42:28] Dr. Katrina Furey, MD: Yeah, exactly. [42:29] Portia Pendleton, LCSW: I remember my mom read me the first book, and then I remember the last one coming out, and I think my grandma said it to me. It was like raft in the Muggles, right? Like Muggles can receive on whatever date, and then I read it for myself. So I think it's so uniquely that way that led to so many people being a part of it for years and still feeling really connected to it now. [42:53] Dr. Katrina Furey, MD: And now getting to share it with your own children, like I'm starting to do, is so special. [42:59] Dr. Zheala Qayyum: Yeah. And that's the power of fairy tales, is that even if it may be really dark, it creates this metaphorical, imaginary, special place where you can still explore this darkness in a very safe way. [43:13] Dr. Katrina Furey, MD: Yes. [43:13] Dr. Zheala Qayyum: Go process it. Look what it's like to be angry. Oh, my gosh. Cruel people, mean people. And then you come back to the safety of reading this with your mom and everything's going to be okay. [43:27] Portia Pendleton, LCSW: Yeah. [43:27] Dr. Katrina Furey, MD: It's so beautiful. It is. It's very special. Very special. Well, Dr. Q, is there anything else you were hoping we could touch, know, talking about Harry Potter, the first it. [43:42] Dr. Zheala Qayyum: I think it's just a wonderful part of my life. I wish I was in Hogwarts, and that was the life I lived. Sometimes I'm looking forward to having a real Harry Potter birthday someday. But I think the thing that resonates most with me is this quote from Neil Gaiman that says, fiction is a lie that tells us true things over and over. And I think that's the power of Harry Potter is that the reason it spoke to so many of us is that we all connected at some level with something that was very true for each one of us. [44:18] Portia Pendleton, LCSW: I like that. [44:20] Dr. Katrina Furey, MD: That is a really beautiful place to leave it. Well, Dr. Q, thank you so much for joining us. We would love to have you back for the next seven movies over the course of time. It was so nice to personally reconnect with you again, thank you all for listening to this very special episode of Analyze Scripts. If you'd like to hear our take on Inside Out, we do have an episode about that from several months ago. I don't know. Dr. Q, did you know they're making a sequel? I think it's supposed to come out in the next couple of years, so that's really exciting. I hope it's about Riley's adolescence. Yes, and we really hope it also shows her living through COVID. Like, we could really use that for all the kids. We could, right? But you can find us at Analyze Scripts podcast on Instagram and TikTok and catch us next Monday for our next episode. Thanks so much. [45:24] Dr. Zheala Qayyum: See you next time. Thank you for having me. [45:32] Dr. Katrina Furey, MD: This podcast and its contents are a copyright of Analyzed Scripts. All rights reserved. Any redistribution or reproduction of part or all of the contents in any form is prohibited. Unless you want to share it with your friends and rate, review and subscribe, that's fine. All stories and characters discussed are fictional in nature. No identification with actual persons, living or deceased places, buildings, or products is intended or should be inferred. This podcast is for entertainment purposes only. The podcast and its contents do not constitute professional mental health or medical advice. Listeners might consider consulting a mental health provider if they need assistance with any mental health problems or concerns. As always, please call 911 or go directly to your nearest emergency room for any psychiatric emergencies. Thanks for listening and see you next time.

Welcome back to Analyze Scripts, where a psychiatrist and a therapist analyze what Hollywood gets right and wrong about mental health. Today, we are analyzing the 2007 film "Awake." This movie stars Hayden Christensen, Jessica Alba and Terrence Howard. There is a nefarious plot to kill Clay who finds out during surgery. According to our guest, Dr. Gonzalez from the Yale Anesthesia Department, Clay experiences intraoperative awareness AKA "awareness" during surgery. The movie is filled with plot holes and some pretty inaccurate medical information. We learn so much from Dr. Gonzalez about anesthesia and patient pain. PTSD, medical factiods and financial stressors are topics in this episode. We hope you enjoy! Dr. Gonzalez Podcast Episode on Interoperative Awareness Website TikTok Instagram Dr. Katrina Furey, MD: Hi, I'm Dr. Katrina Fieri, a psychiatrist. And I'm Portia Pendleton, a licensed clinical social worker. And this is Analyze Scripts, a podcast where two shrinks analyze the depiction of mental health in movies and TV shows. Our hope is that you learn some legit info about mental health while feeling. Portia Pendleton, LCSW: Like you're chatting with your girlfriends. Dr. Katrina Furey, MD: There is so much misinformation out there, and it drives us nuts. And if someday we pay off our. Portia Pendleton, LCSW: Student loans or land a sponsorship, like. Dr. Katrina Furey, MD: With a lay flat airline or a major beauty brand, even better. So sit back, relax, grab some popcorn and your DSM Five, and enjoy. Welcome back for another very exciting episode of Analyze Scripts. As part of our Halloween month today, we are covering the 2007 thriller mystery movie called Awake with our wonderful guest, Dr. Antonio Gonzalez. And I cannot think of anything scarier than being awake during a surgery, so this is perfect for our Halloween month. But just as a quick bio, dr. Gonzalez is an associate professor of anesthesiology and the director of the Obstetrics anesthesia Fellowship at Yale New Haven Hospital. He completed his residency program at Rutgers in New Jersey and decided to pursue a fellowship in obstetric anesthesia at Columbia University in New York. And I will actually be joining one of his podcasts in the near future to talk about eternal mental health and anesthesia, which I'm really excited about. But thank you so much, Dr. Gonzalez, for joining us. Dr. Antonio Gonzalez, MD: Thank you so much for the invitation. I'm really happy to be here with you today. Dr. Katrina Furey, MD: So, Portia, where do we even get started with this movie? Have you seen it before? Portia Pendleton, LCSW: I have not seen the movie ever. I think that something like this would probably have been a little scary to watch. Yeah, I think a lot of people who are not in medicine and maybe people who are in medicine, I think it's a common fear to wake up during surgery. I think a lot of people going in get really calmed down once talking to the anesthesiologist or telling them that this is their process or this is. Dr. Katrina Furey, MD: How it's going to be. Portia Pendleton, LCSW: And all of the machines and monitors that they now have, you were saying a little bit before we got started today. So I think this is just like a pretty common fear that people have going into surgery. Dr. Katrina Furey, MD: What do you think, Dr. Gonzalez? Dr. Antonio Gonzalez, MD: Yes, I think that definitely introvertive awareness. It's definitely a fear of our patients. And unfortunately, this movie actually may have hyped that fear. But fortunately, the reality is that introvertive awareness is relatively rare, particularly these days. We have way better medications, way better monitors that help us to prevent intraperative awareness. The incidence has been documented to be somewhere around 0.1% to 0.2% in the United States. Dr. Katrina Furey, MD: So what is that, like, one to two out of 1000 cases? Something like that? Dr. Antonio Gonzalez, MD: That is correct, yeah. Because there are so many surgeries in the united States, that's about 20,000 to 40,000 cases a year, which still a lot. Right. The consequences of interoperative awareness can go from just having fear of future surgeries, even withholding surgeries for some of their relatives, particularly their kids, because they are so scared of what happened to them, they may actually be very fearful of letting their relatives go through surgery. Yeah. So that is one of the consequences. But, again, it's relatively rare these days. Dr. Katrina Furey, MD: Okay. Dr. Gonzalez. Portia Pendleton, LCSW: Is there anything in common. Dr. Katrina Furey, MD: That the people who this happens to. Portia Pendleton, LCSW: With each other, or is it just kind of like yeah. Dr. Katrina Furey, MD: Is there, like, a way to predict it that it could? Dr. Antonio Gonzalez, MD: So we don't have particularly great ways of predicting who will have operative awareness. We do know that there is a certain patient population or certain surgeries. So there are surgeries like trauma, cardiac surgery, and Obstetric. Anesthesia. Obstetric cases seem to be and when I mean Obstetric cases, Caesarean deliveries, particularly. These are cases that are very well known to have an increased risk of intraperative awareness. The reason behind it is because trauma patient and cardiac patients have a very delicate hemodynamics, meaning their blood pressure, it's low, tends to be on the lower side. They have a high risk of coronary vascular disease. So having their blood pressure too high or too low, it's at extreme risk. So in order to maintain that balance between the anesthesia that it's provided and the hemodynamics, those patients tend to be at a higher risk. And that implies for both trauma patients and cardiac patients. Now, the Obstetric patient population is at increased risk because of the risk that the anesthesiologist may perceive from the drugs transferring to the baby. So all the medications we give to mom will go to baby, and that increase in medications has been thought to be pretty dangerous to the baby. So anesthesiologists at some point, we're very scared of giving extra medications to mom nowadays. Again, I think that because our monitoring and the drugs that we have available and the awareness that introvertive awareness in this particular patient population, it's higher, we have improved the techniques that we have for providing general anesthesia. Now, that being said, we do a lot of our anesthesia under regional, and having pain during a surgery, even with epidural or a spinal, can be equally as scary, if not even more scary than having introvertive awareness while asleep. Dr. Katrina Furey, MD: I was wondering that. So, before we get into this a little further, I just want to give a quick recap of the plot of this movie. So, in the movie Awake, we see Hayden Christensen playing the main character, Clay Bearsford Jr. Who is, like a fancy pants financial person, super uber rich. He does something with stocks, probably, that I don't understand. And you see this interesting relationship with his mom early on, who's played her name's Lilith, and she's played by Lena Olin. And then we see Jessica Alba. This is one of her big roles, playing Sam Lockwood, who's his fiance. They get married very quickly because he is waiting for a cardiac transplant due to history of cardiomyopathy, which is something that happens. That seemed pretty accurate. And then we see Terrence Howard playing his friend and surgeon, Dr. Jack Harper. And spoiler alert, turns out all of the medical professionals on the team, including his fiance, were in on this plot to murder him during the transplant in order to inherit all his money and pay off some malpractice debt. Luckily, I think it was the anesthesiologist. The original one backed out. So this other guy was there, and somehow he figured out the plot, and he alerted authorities. And eventually, I think Dr. Harper injected the heart with adriamycin. I believe the Clay did, I guess, technically die on the table. When they delivered that news to his family, the mother committed suicide. I can't remember what she overdosed on. I'm assuming maybe Digoxin, which was in his bag. And then they wheeled the mom in and gave him her heart. And so he survived, and all the people got arrested. The end. That's basically the plot. Really quick. So getting back to what you were saying, Dr. Gonzalez, about the intraoperative awareness. So when you were saying that with these certain cases, trauma, cardiac, and OB with regional anesthesia, I'm thinking like an epidural, like for a C section or something like that. Like, if they give the epidural and it fails either in a C section or a regular delivery, vaginal delivery, would that be considered interoperative awareness? Dr. Antonio Gonzalez, MD: Well, if the patient is experiencing pain, yes, that can be as traumatic as experiencing intraperative awareness, because the patient mentally is completely there, but the patient is completely feeling the experience of the pain. And the definition of pain, actually, it's not only physical, but there is an emotional component to pain. Right. So what you describe as pain, you can only be the person that knows what pain is for you. So what we've learned through the years is that we are not the best judge of what pain is. The patient is the best judge of what pain is because pain is what the patient tells you pain is. Portia Pendleton, LCSW: I'm so glad you said that. Dr. Katrina Furey, MD: I think that's really important and to keep in mind the emotional side of it. Portia Pendleton, LCSW: I like that also, just as I don't know a similarity right. In mental health, like pain mental pain, emotional pain is, like, what the patient is describing versus my definition in the DSM. But I really like that. Or just validating their experience. Well, this is what they experienced. Maybe someone else's was different. Dr. Katrina Furey, MD: Right. Portia Pendleton, LCSW: I really like that. Dr. Antonio Gonzalez, MD: Yeah. I think that it's a great opportunity, because, as you mentioned, sometimes if, as physicians, we try to give an explanation to pain, right. We may actually minimize the patients. And at the end of the day, what ends up happening is that the patients feels that their feelings, they're being gaslighted. So the patient is telling you, this is what I feel, and you say, well, it's not that big of a deal. Right. But it is to the patient, it is. So pain is, again, what the patient tells you pain is. Dr. Katrina Furey, MD: No, I think that's great. And in my line of work, in private practice, I do end up seeing well, I see primarily women around pregnancy and postpartum. So I've heard many cases where the epidural failed, or it only took on half the side, or someone had a history of back surgery, so they met with the anesthesiologist ahead of time to talk about pain management options. And it is a super important aspect of prenatal care, especially delivery, and I'm sure that extends to other surgeries as well. So, Dr. Gonzalez, what are your thoughts about the way anesthesia was depicted in this movie? What they get right, what they get wrong? Dr. Antonio Gonzalez, MD: Well, there are so many things that they well, the one thing that they got right was to select the patient that was having a cardiac surgery. As we mentioned, patients with cardiac surgery have an increased risk of having introvertive awareness. So they got that one part right. Then the other thing is that it seems like they have a substitute anesthesiologist that's coming from another institution. It doesn't quite happen that way. You need to have privileges at that place. It's a little credentialed. Yeah. Unless he's a traveler. Sometimes we have anesthesiologists that are considered what is the term? Locums. That's correct, yes. So locums might have been a locums that they call in to substitute, but it's actually quite hard to find locums for very specific cardiac surgery. So I think that the other thing that I think was very wrongfully depicted was how easy he may look. The induction. The induction was basically he took this three CC syringe or four CC syringe. He gave it to the patient. He said, count back to ten. Cardiac inductions are very complicated. It requires a balance of many medications. Again, because there is this hemodynamic balance that you want to maintain. You don't want the patient's blood pressure to go too high. Do you want the patient's blood pressure to go too low? So that also it seems like it was completely off. And there is a point where the surgeons are discussing, like, well, we won't need you for a little bit, so go get a drink. We never leave the operating room. Dr. Katrina Furey, MD: Right. Dr. Antonio Gonzalez, MD: I know there is always somebody from anesthesia in the room that be like the anesthesiologist or anesthetist, but we just don't leave the patient in the or. Just because the surgeon tells us that they're not going to need us for a bit. So that was totally wrong. Dr. Katrina Furey, MD: Right. In my experience in medical school, rotating through that's exactly right. Even these long cases like cardiothoracic surgery, the anesthesiologist, maybe a resident, maybe the nurse, anesthetist. These words are hard to say. Someone's always there watching the monitor. They might be doing something else at the same time. I remember one time there was a resident practicing his golf swing, and I was like, this seems pretty unprofessional. But they're always watching the monitors. And I would imagine like this, especially watching the blood pressure, the heart rate, things like that. And they're always checking. They kept checking, at least in the cases I would be in, they would do things to check. The patient was still under enough. Not too far under. Not coming out of it either. Dr. Antonio Gonzalez, MD: Yes. And as you mentioned, sometimes the anesthesiologist, a lot of what we do, we may not be actually looking at the monitors, but because we're actually trained for so it's a three year program. By the sound of the machines, you actually know what is wrong. Like the pulse oximeter has a very typical sound. When the saturation drops, the alarms on the monitors are set off to go at X levels. Right. So you can set up your alarms. So even if we're like, let's say, fixing our medication drips or we're working on something that it's not necessarily looking at the monitor, just hearing the monitor, we are aware of what actually the vital signs are, and of course, the alarms are ever present. So we're always very aware of these alarms and everything that surrounds. We use pretty much all our senses when caring for patients. Dr. Katrina Furey, MD: That makes a lot of sense. Portia Pendleton, LCSW: It's interesting. I think there was an episode on Grey's Anatomy years ago about the anesthesiologist at the hospital was like, has a substance use disorder. And he was, like, falling asleep next to the patient. And of course, it's a drama, so the young resident had to do something and didn't want to get in trouble by the attending or something. But I feel like I've seen not a lot of medical dramas. I mean, that's not like my jam. But the couple that I have there seems to always be the anesthesiologist is like sometimes a villain. I don't know. Dr. Katrina Furey, MD: Is that a stereotype? Yeah. Is that a stereotype? Portia Pendleton, LCSW: Or like, maybe just in TV, the. Dr. Katrina Furey, MD: Psychopath is often the villain too, so we can empathize. Portia Pendleton, LCSW: Yeah, it seems like it's a lot of risk with that job. Dr. Antonio Gonzalez, MD: I think that psychiatrists, dentists, and anesthesiologist seems to be the highest the physicians with the highest incidence of substance use. Dr. Katrina Furey, MD: Disorder, I believe that's right, yeah. Dr. Antonio Gonzalez, MD: And suicide as well, I think. Yeah. Maybe media has picked up on that. Maybe. Dr. Katrina Furey, MD: Interesting. I think in my training, I was taught that in those specialties, you have the easiest access to controlled substances in terms of the risk of substance use disorders. So that's one reason the rates are higher. And then suicide. I didn't know anesthesiologists also had a high rate of suicide. Dr. Antonio Gonzalez, MD: Yeah. I haven't reviewed the statistics on this, but I think that it used to be that way. I think actually, dentists might be number one. For some strange reason, anesthesiologists are high up in there. Dr. Katrina Furey, MD: One big issue I had with this movie was the plot, because I feel like they went to great lengths to pay off a prior malpractice lawsuit. And I feel like they'd all have malpractice insurance, right? Even if I know there's certain specialties. Like, I think OB, for example, has a really high rate of malpractice insurance. Wouldn't they have malpractice to cover any claims? Dr. Antonio Gonzalez, MD: Yes, they would. Dr. Katrina Furey, MD: Think. And Portia, I think you were reading some criticisms of the movie. I think the general public also caught on to that, like, wow, this is like a really intricate plot to go through to pay off prior lawsuits. Portia Pendleton, LCSW: I don't know. Murdering someone, you have to be so backed into the corner hopeless, like no other options. And it's like, I mean, A, yeah, like, you're right about the malpractice. You should have an insurance through the hospital. You're not even in private practice paying for your own, and that maybe you cut corners with that. It just seems OD that they taking going to these lengths of murdering a patient that Dr. Jack Harper was, like, friend. And it's like, at what point did the friendship turn into this? Was it fake? The whole, like, I think that's know, I watched the movie, you know, taking. Dr. Katrina Furey, MD: Notes because we're professionals. Portia Pendleton, LCSW: We're professionals at watching TV here, and I was just lost with a lot of the line, so I'm glad to hear it know, I guess just me, but pretty gaping holes in some of it. Dr. Katrina Furey, MD: Yeah. And what did you think about that relationship of the friendship between Dr. Harper and Know? Because at least in psychiatry, we are big and not just psychiatry, but mental health in general, we are big boundary people. We really talk about boundaries and how to maintain them, especially in professional settings. I think in some other fields of medicine, I'm thinking more like primary care pediatrics in the old school days when you'd have the family doctor who took care of everyone in the town, I think the boundaries would have been a little different. But I always thought, especially when it came to things like surgery, it was really important not to operate or doing a seizure on people you're close to. Is that still the case? Dr. Antonio Gonzalez, MD: Well, I think it's probably the right thing to do because your feelings for your significant other or friend may actually interfere with your judgment. But again, I think it's more of a judgment call than a set rule. I do think that there are certain surgeries and certain procedures that we probably shouldn't be doing for our family members or for close friends, because, again, our judgment may be cloud by our feelings for that person. You may not necessarily take the best decision when you're put in that place. Dr. Katrina Furey, MD: Yeah, I think suturing up a superficial wound like your child cuts their knee. Oh, I can suture that up real quick. Feels very different to me than doing cardiac anesthesia or surgery on your buddy that you go fishing with. Yeah, right. Yeah, I would agree. Portia Pendleton, LCSW: I could see I was thinking just, like, what would I be comfortable with a friend doing? But maybe I don't know. I mean, I'm thinking of specialties, like, ortho I could see a friend doing but not OB. It's, like, all private, and then definitely not psychiatry, but I don't know. Cardiac surgery? I don't think cardiac no, it's like your heart opening my chest. I don't want you I think it's. Dr. Katrina Furey, MD: Important you feel like you trust the surgeon and the anesthesiology team, but to have it be like your buddy, that's risky. And what an ultimate betrayal. Portia Pendleton, LCSW: I mean, he trusted this person. He chose to have this procedure done by, I guess, at least rating wise, like a doctor with a lower success rate than right. The mom brought in this specialist who was operating on presidents and had all. Dr. Katrina Furey, MD: This prestige play picked Dr. Harper. Portia Pendleton, LCSW: And then right. To have this nefarious plot going on was just I was really shocked. I was also really shocked that Sam was in on it, his fiance, because at first, I think the movie kind of sets you up to not, like the mom. Right. Like, Lilith seems, you know, like, she doesn't have his best interests at heart. Dr. Katrina Furey, MD: It's controlling. Maybe they're enshring and not letting him. Portia Pendleton, LCSW: Live or be independent. Right. But then know, I was like, wow, really weaseled her way in. So I don't but she was a nurse, I think, so she had some info about his medications, which the mom, Lilith, was first, really surprised and pleased. Like, wow, like, you really have been taking care of him. I see all the medications in your bag. But then that's also ultimately how she found out that Sam was in on it. Right. Dr. Katrina Furey, MD: She saw, like, I think Sam left her purse behind, and the medications fell out. And when she went to go put everything back in the purse, she saw some mail where the name didn't match up, and then somehow she put it. Portia Pendleton, LCSW: Together, but that wasn't clear. Dr. Katrina Furey, MD: But again, also like, okay, so the names don't match up. That wouldn't automatically make me think, like. Portia Pendleton, LCSW: Oh, no, you're in on it to. Dr. Katrina Furey, MD: Murder my son while he's in this heart transplant. The plot was a little far fetched, but I did think it was entertaining, and I did know with Clay on the table, often the anesthesiologist is, like, the first person you meet when you're coming in for surgery that day and. Portia Pendleton, LCSW: The first person you see when you wake up. Dr. Katrina Furey, MD: So I think that's very important, as well, to your whole experience of surgery. And can you tell us a little bit, Dr. Gonzalez, about in your role, what that entails and how you sort of take care of the patient in broad strokes. And if this movie we've already talked about how the induction was totally off, but what the movie sort of got right and wrong. Dr. Antonio Gonzalez, MD: Yeah. So I think that the role of the anesthesiologist is very important. And I think that as anesthesiologist, we realize that, as you mentioned, unfortunately, the way our system is, we usually meet our patients just the day of surgery, right? So what that entails is that we actually need to create rapport with our patients very quickly. We know that the patients are coming in for a very stressful moment in their life. Sometimes it's very big surgery, sometimes it's very minor surgeries, right? But independently of what type of surgery the patients are coming for, we need to create that rapport and we need to bring the confidence to the patient. And as anesthesiologist, I think that we try to do that the moment we're talking to the patient. The first time we talk to the patients, it's all about creating rapport and creating a team experience in which you let me know what are your goals and we can try to meet those goals and expectations. What are your fears? Some patients tell you that their major fear is pain. Some patients tell you their major fear is throwing up because all the nausea, they've experienced so much nausea after. So then you can reassure the patient, okay, so this is our plan. This is going to be our plan to address the pain. This is going to be our plan to address the nausea. And again, we do this for all types of surgery. And I think that's very important as anesthesiologist to try to create that rapport and always be, when talking to the patient, basically addressing what are your major fears and how this is our plan to address those. Portia Pendleton, LCSW: That's such an important question. I think such an important part of the team. I think other people are just kind of part of the team, which makes sense. Like, okay, this is a surgery. They ask you a million questions like why are you here? What's your name? What's your birthday? Over and over again. So they're doing the right thing. But then for someone to ask, right, what are you scared of? Dr. Katrina Furey, MD: Right? Portia Pendleton, LCSW: What are you scared of today? How can we help you? Do you have any questions? Is really helpful. And I think just lets see the patient feel like they're a part of the team, like they're being validated, listened to, important, which of course they are. But I think in the system when you have maybe two to five, maybe surgeries that day, it's just like it becomes for everybody that's working, there just procedure. So I think those questions just stand out as really helpful and nice, good patient care. Dr. Katrina Furey, MD: And the anesthesiologist is the person who you really meet at the beginning, who asks you all these questions, checks on your allergies, looks in your mouth to see like, okay, how big are those tonsils? How are we going to sort of intubate? You most comfortably asks you what you're worried about, and then they walk with you in most of the time, and they're with you, getting you on the table, getting you positioned, making sure you're comfortable, saying, okay, it's going to be cold in here, let's put a blanket on. They do a lot of that caretaking right away. I think when people are really scared, even if it's a minor surgery, I don't know who's not scared when they're going into a surgery. And of course, the surgeon comes in and they're really focused on the surgery, and of course, they want to make the experience good, too. But you're usually, like with the anesthesiologist, I think, the longest as you're consciously awake and then coming out of the surgery, that's who's also waking you up and making sure you're okay. That's who's checking on you in post op and things like that. So it is interesting that such an important member of the team and you're right, you really meet them that day and then you don't see them again, right? Like at the follow up for the surgery and stuff, you never get to see them. Is that a part of the job? Do you mind that, or do you wish that you could check on these people again? Dr. Antonio Gonzalez, MD: Well, it's actually very interesting that you ask because one of the things that actually inspired me to become an obstetric anesthesiologist, particularly, was I sometimes felt that I was in these very long surgeries, and when I went to see the patients post op, they would not remember me. And there wasn't really a problem with the patient not remembering me. It wasn't really an ego thing. It was more like, I don't feel like he thinks I'm part of this team taking care of him. I didn't feel like I was part of the team again. But on the other hand, I just happened to see a patient in a hallway and he's like, oh, you did my epidural for labor. And I'm like, oh, I did. And that was like, oh, these patients do remember me. Do appreciate what we're doing. And although, again, it's not an ego thing, but it's just that feeling of being part of something more, like, you know, that you help somebody and they actually remember that you were part of that, alleviating the pain, and it just feels good. It makes you feel like you're really part of a team that addresses the patient's pain and all this. And that's what really brought me into obstetric anesthesia. Going back to what we were talking about, the patients, the pre op part. Again, because of my obstetric anesthesia background, most of the literature that I've reviewed is on that field. And there is a very interesting article that has changed the way I practice that basically addressed what we were just discussing, which was basically, you ask the patients would you rather have better analgesia or more side effects, depending on the dose? And the interesting thing it's a very interesting study, but the outcome of the study was that patients actually knew exactly what they wanted. The patients that were overly concerned about pain ended up consuming more pain medication. And the patients that were overly concerned with the side effects did not consume as many medications. So the patients always know. And that's why always asking your patients, what are your weigh the risk and benefits, or what are your main outcomes? What do you want to experience here? More pain, slightly less pain, slightly more side effects of the medications, or you're okay with pain knowing that your side effects are going to be less? Dr. Katrina Furey, MD: The patients know that's actually really interesting and really important to keep sort of their autonomy and their preferences. So, Dr. Gonzalez, I know you're not like a transplant surgeon, but I thought it was pretty unlikely that the mother would just be, like, wheeled in, especially after having overdosed on something and her heart would be given right to her son. Dr. Antonio Gonzalez, MD: Yeah, absolutely. Dr. Katrina Furey, MD: What do you think about that? Dr. Antonio Gonzalez, MD: Yeah, absolutely. I think you're absolutely right. And at some point, I was hoping to bring that up. First of all, as you mentioned, there is a battery of tests that the donor needs to go through before they can be a donor. Portia Pendleton, LCSW: That's number one blood type, right? Dr. Katrina Furey, MD: It's not just like, oh, it's a blood type match. There's like, so many more things they have to check. Dr. Antonio Gonzalez, MD: There's so many more tests. And it seems from the movie that the mom have actually taken the purse from Sam, right? So presumably she took medications that could have actually make her heart stop. Right, which means that the period of ischemia of the heart may not have make her a good donor for her heart. She might have been able to donate her cornea and other things that actually don't have a very specific ischemia time. But there are organs that have a very limited ischemia time, meaning that the time that the organ is without perfusion or without oxygenation, without blood flow. And that is very important. The heart is one of the organs that needs perfusion for very crucial timing. It's a very small window of ischemia for the heart yes. Dr. Katrina Furey, MD: That she'd take, again, cardiac medication that likely stopped her heart. It does seem like she called her surgeon of choice ahead of time and was like, get here now. We only have so much time. But still, it's just completely unlikely that that would have happened. It was kind of a beautiful, I guess, part of the story that they could both, in this other realm, connect with each other and she could talk to him and they got to say this goodbye. That was pretty beautiful. But in terms of accuracy, there's no way that would have happened. And so getting. Back to the title of the movie Awake, and the whole premise that he's awake in surgery and aware of everything that's going on. I think a fascinating question that comes to my mind is like, how do we define awake? Is it consciousness? Is it memory? Is it feeling? And then how do you assess it during and after something like a major surgery? Dr. Antonio Gonzalez, MD: Yeah, that's a very interesting question. And I was thinking myself the same thing throughout the movie. And at the end, I'm still not even clear that either he was awake. We probably will never know the answer, according to the movie. But interoperative awareness, it's basically the incidence of a failure to suppress arousal, experience and episodic memory. So for you to have recall, in order for you to have introoperative awareness, there has to be recall. There are some incidents of patients actually hearing things, but they may not have necessarily distress about it because hearing and depth of sedation, the depth of sedation goes anywhere from hearing to actually not even being able to have recall. So you're going to see the worst cases of interoperative awareness when there is recall, and the patient can actually tell you how stressed they were about the experience. So they've come up with some classification. It's called the Michigan Awareness Classification, and it goes from zero, class zero, which is basically no awareness, to class one, which is auditory perceptions, class two, which is tactile perception. So they feel the surgical manipulation, they feel the endotracheal tube. And then there is class three, which is they actually feel pain. Class four, they actually have paralysis. And this is what seems to actually be happening here. He's experiencing paralysis because he said, just move something, right? He's trying to move something. He can't move anything. So he probably is there at a class four. Later on, we know that he's definitely at class five, where he's probably experiencing pain and paralysis. And then you can actually assign a D if the patient tells you that it was very stressful. They have the fear, they had fear, they had anxiety, a sense of suffocation or doom. So basically all these classifications, you can actually add a D to them. And the higher they are, and especially if they have a D next to them, the more likely these patients will have sequela. As in your profession, you can probably talk about what happens to these patients that have interpreted awareness. Right? And you were talking about moms that have pain during surgery. So that could lead to post traumatic stress disorder. But I'm not the expert there. Dr. Katrina Furey, MD: I would imagine it would. Right. I would imagine when we think about post traumatic stress disorder, I like to think of that as a disorder of Stuckness. And I always tell my patients, like, it's normal after you've lived through something traumatic, to have the symptoms of PTSD, the hyperarousal, the hyper, vigilance, intrusive thoughts, altered avoidance, altered mood, altered line of thinking and things like that initially, because who wouldn't? We sort of call that an acute stress response. But then once it persists, usually after, like, a month or continues beyond that, then we start to think of it as something called PTSD or post traumatic stress disorder. And there's some really great treatments out there for that, including things like cognitive processing therapy or CPT, EMDR, different types of psychotherapies and medications, and patients can really get a lot better. I love treating PTSD for that reason. But I would imagine the first criterion to meet diagnostic criteria for PTSD is to have a life threatening situation happen to you or to be vicariously exposed to it, which I think is really important as a new addition to the DSM criteria. I think this will qualify. Portia Pendleton, LCSW: Yeah, I'm just even imagining a patient coming in and describing this. I would expect a person to develop PTSD from it, and then it's like. Dr. Katrina Furey, MD: Is that a disorder, or is that, like, a normal human response to being consciously awake but paralyzed during cardiac surgery? Right. Portia Pendleton, LCSW: That's where you're like, well, like, trouble sleeping following. I would imagine maybe some nightmares. Might be afraid to fall asleep 100%. Or obviously, like you were saying before, Dr. Gonzalez, afraid of returning for future medical care or surgeries or telling loved ones to not do it, or their experience. So it feels really serious. And obviously, many traumas can be, but also unique. I haven't worked with someone that this has occurred to, obviously, because it is rare, but I'm just imagining, like, poor Clay when he wakes up, and if he does recall at one of those levels that you described, then what? And also write the murder plot. I mean, that was like taking the cake, let alone feeling pain. Dr. Katrina Furey, MD: I know. Like, such intense pain, right. And being so paralyzed and helpless. I almost can't imagine anything worse. Portia Pendleton, LCSW: He's standing up. We talked a little bit about the dissociation. That being an interesting way to show it. So sometimes when somebody's experiencing a trauma, they might dissociate and kind of see. Dr. Katrina Furey, MD: Themselves from up above. And they did show that when he sort of zoomed out, then it took a turn where he's then solving the. Portia Pendleton, LCSW: Plot, like, walking around, figuring it out. Dr. Katrina Furey, MD: Like, I don't think yeah, that's not quite dissociation, but up until that point. Portia Pendleton, LCSW: It was a great depiction of. Dr. Antonio Gonzalez, MD: It. Portia Pendleton, LCSW: Just it was wild. Dr. Katrina Furey, MD: It was wild. What a wild movie. Dr. Gonzalez, as we wrap up, is there anything else you'd like to add or anything we haven't touched on that you think is important? Dr. Antonio Gonzalez, MD: What it's really important here is for the patients to really voice out their experience. Right. One of the things that we see as physicians, we're not necessarily, particularly not psychiatrists or psychologists, we are not necessarily very well versed in how to deal with the consequences of what happens interoperatively. And it's important for the patients to say, hey, this is what I felt. But equally as important is for physicians to actually avoid minimizing what the patient felt and actually acknowledge that something happened and say, hey, I'm really sorry that you went through this. Let's try to figure out what resources we have to help you to get better, to get through these. It's actually something that I've always wondered is when is the best time to reach out for the patients? When, for example, in our case, we do C sections, right? And the patients are telling us that they're feeling pain, so they actually quickly voice out their experience so we can quickly do something about it. And even then, it's hard to figure out if you should approach the patient, shouldn't approach the patient, because not every patient won't consider a short time of discomfort or pain as traumatic. So it's a thin line in which basically we rely on the patient telling us, this is what I felt, this is how I feel now, so that we can actually look for help again, because as anesthesiologist or, surgeons may not be the best person to deal with it, but we can look for the resources. Dr. Katrina Furey, MD: And I do think, actually, at least in my clinical experience, given what I do, it has been I can tell you without a shadow of a doubt, it has been so validating and healing for my patients who have experienced trauma within previous childbirth deliveries or IVF procedures or other things like that, who felt minimized by the team at the time when they go in for the next thing and their anesthesiologist is the one who asks them just the questions you're mentioning. Now, I'm wondering if it was you. Portia Pendleton, LCSW: Or if you've just trained, like, some. Dr. Katrina Furey, MD: Really good team members. But when they ask them about these things and they share their prior traumatic experience, which is very hard for them, right, like, to even share, period, but then, especially if they've felt minimized or invalidated in the past, when they share it this time, and it's met with compassion and validation, it goes so far in their healing. And so I think you're spot on, and I hope this can serve and your continuing education can serve to just keep reinforcing that to the anesthesiology team that that is really important and such a crucial time to give that validation to patients who might really need it. And I think that would go for any patient, but especially any patient with a history of PTSD prior to that. And that's a hard thing to ask about. Portia Pendleton, LCSW: Yeah, I could definitely see it in pregnancy traumas. I think it's a pretty common experience with just, like, whether or not it's their perspective of something happening. Everything moves fast sometimes, as both of you know, I'm sure if it's supposed to be a regular delivery and all of a sudden it's not like that can be scary. And sometimes you have to prioritize saving a patient so things aren't explained slowly. It's the after of, like, okay, I know. That was really scary. Dr. Katrina Furey, MD: Kind of debriefing. Portia Pendleton, LCSW: Yeah, the debrief I would imagine being really helpful. Dr. Katrina Furey, MD: And we always I think in mental health, we always assume our patients have a trauma history rather than assume they don't. And I don't think that's because there's like I mean, maybe there is a higher incidence given the patients we're seeing. But I think then if you can just sort of approach it in more of like a trauma informed framework and just assume, like, okay, let's just assume this person has had some experience in their life where they felt helpless or stuck or not heard. How do we approach them here so that they don't feel that you don't even have to ask, do you have a trauma history? You could just assume. And then I think that just goes a really far away. So I'm so glad, Dr. Gonzalez, to hear that you're just doing know that makes this psychiatrist very happy. Dr. Antonio Gonzalez, MD: Yeah, well, I think that a lot of it has to do with the fact that some time ago, we actually read this very nice article that came out that was titled Failure of Communication, and it was actually written by a patient who experienced interoperative pain. I actually had the pleasure to have a podcast with Susanna Stanford, who is a patient who experienced introvertive pain, and she shared with us through that paper that was a couple of years ago, her experience. And from the time I read that paper, I started realizing how important that communication part is and not minimizing their pain and actually trying to address the situation in the moment and offering alternatives. Right. The most important thing, as you mentioned, is the patient needs to feel that first of all, they're being heard and that their concerns will be addressed. The worst we can do is tell them that it's not that big of a deal. Baby is okay. That's usually what we hear. Oh, the baby's okay. So it's going to be fine. The means doesn't justify the end. Dr. Katrina Furey, MD: Well, that's wonderful. Thank you so much, Dr. Gonzalez, for joining us today. I think we will try to link to that paper in our show Notes. If anyone is interested in reading that. Portia Pendleton, LCSW: Further and maybe also your podcast, if you want to tell us, give us. Dr. Katrina Furey, MD: A little shout out yeah. Portia Pendleton, LCSW: Where they can find your podcast. Dr. Antonio Gonzalez, MD: Yes, the podcast is Yale Anesthesiology, and I will share the link as well. Dr. Katrina Furey, MD: Thank you. And we want to thank all of our listeners for joining us today. You can find us at Analyze Scripts podcast on Instagram and TikTok. We recently updated our Instagram handle, so now it's Analyze Scripts podcast across the board, and we hope that you will join us next week as we cover the Nightmare Before Christmas on our Halloween month. Portia Pendleton, LCSW: Yes. Dr. Katrina Furey, MD: So we'll see you next Monday. Portia Pendleton, LCSW: Thank you so much for joining us. Dr. Katrina Furey, MD: Bye. Dr. Antonio Gonzalez, MD: All right. Thank you so much for having me. This was great. Thank you. Dr. Katrina Furey, MD: This podcast and its contents are a copyright of analyzed scripts, all rights reserved. Any redistribution or reproduction of part or all of the contents in any form is prohibited. Unless you want to share it with your friends and rate review and subscribe, that's fine. All stories and characters discussed are fictional in nature. No identification with actual persons, living or deceased places, buildings, or products is intended or should be inferred. This podcast is for entertainment purposes only. The podcast and its contents do not constitute professional mental health or medical advice. Listeners might consider consulting a mental health provider if they need assistance with any mental health problems or concerns. As always, please call 911 or go directly to your nearest emergency room for any psychiatric emergencies. Thanks for listening and see you next time. Dr. Katrina Furey, MD: Our don't.

Show Notes Are you married to a problem solver? Does your husband like to fix things? Do you get perturbed when you look to him for sympathy, and he insists on offering answers instead? What's a wife to do in such a situation? That's what we're discussing today on The Loving Life at Home Podcast. Want to read the original post on which this episode is based? It's reprinted in its entirety below the show notes. RELATED SCRIPTURES: - "A wise man will hear, and will increase learning; and a man of understanding shall attain unto wise counsels..." - Proverbs 1:5 - "The way of a fool is right in his own eyes, But a wise man is he who listens to counsel." - Proverbs 12:15 - “Pride leads to conflict; those who take advice are wise.” - Proverbs 13:10 - "Hear counsel, and receive instruction, that thou mayest be wise in thy latter end." - Proverbs 19:20 RELATED LINKS: - The Male Brain - book by Louann Brizendine, MD - It's Not about the Nail - Jason Headly video - Are You Married to a Problem Solver? - my original blog post STAY CONNECTED: - Instagram: https://www.instagram.com/flanders_family/  - Marriage Blog: Loving Life at Home - Family Blog: Flanders Family Home Life (lots of printables!) - Subscribe: Flanders Family Freebies (weekly newsletter)  

Welcome back to Analyze Scripts, where a psychiatrist and a therapist analyze what Hollywood gets right and wrong about mental health. Today, we review "The Morning Show" season 2. This season is pretty heavy with themes of substance abuse, toxic relationships and Mitch Kessler's [SPOILER ALERT] death by suicide. We spend time discussing cancel culture and the complexities of the human experience. We also explore Cory's charcter, is he hypomanic? Or is it more of an ADHD presentation we are seeing? Who does Bradley choose? Is everyone in love with their mother? Listen now to your favorite TV loving shrinks for our full break down. We hope you enjoy! Instagram TikTok Website Dr. Katrina Furey, MD: Hi, I'm Dr. Katrina Fury, a psychiatrist. Portia Pendleton, LCSW: And I'm Portia Pendleton, a licensed clinical social worker. Dr. Katrina Furey, MD: And this is Analyze Scripts, a podcast where two shrinks analyze the depiction of mental health in movies and TV shows. Portia Pendleton, LCSW: Our hope is that you learn some legit info about mental health while feeling like you're chatting with your girlfriends. Dr. Katrina Furey, MD: There is so much misinformation out there, and it drives us nuts. Portia Pendleton, LCSW: And if someday we pay off our student loans or land a sponsorship, like. Dr. Katrina Furey, MD: With a lay flat airline or a major beauty brand, even better. Portia Pendleton, LCSW: So sit back, relax, grab some popcorn. Dr. Katrina Furey, MD: And your DSM Five and enjoy. We get started. We just wanted to include a trigger warning for this episode. This episode could include discussion about some themes and topics that might be upsetting, including, but not limited to things like substance abuse, suicide, self harm, disordered, eating, and harassment and assault. So if any of those topics are too upsetting, we totally get it. Please feel free to skip this episode and join us next week. Otherwise, we hope you enjoyed. Portia Pendleton, LCSW: Thanks for joining us today to cover the Morning Show season Two. If you have not listened to our take on season one, feel free to scroll back a couple episodes in our feed. Season two did come out in September of 2021, which was kind of in, like right. The throes still of COVID I mean, not like the Lockdown, which this show oh, my God. With that visual of New York City, which was eerie, to say the least. But did you watch this in real time? Dr. Katrina Furey, MD: No, I think I watched it last year, maybe, but rewatching it again. I had, like, a visceral reaction to all of the COVID stuff. What about you? Portia Pendleton, LCSW: It was weird. I really like and we talked about this about season one, how they show, right? Like, real time things. And it's so funny thinking back to hearing about, you know, it was like, in more of the Asian countries in Asia. It was kind of, like, sprinkling through. And I remember having some friends traveling internationally and being like, yeah, it was weird. Like, a lot of people are wearing masks, not domestically. And then all of a sudden, it was here, right? And it was like this very March white. I don't know, like, the grocery stores were full, and then they were empty. Schools were open and they were closed. It wasn't a smooth transition. Oh, this is coming. It was just like, okay, we're making this decision. Dr. Katrina Furey, MD: Oh, my gosh. I remember I'm so ashamed to admit this, but I was supposed to go on a bachelorette party to New Orleans, like, right in mid March, and it was for my very good friend, Dr. Kristen Heisel, an infectious disease physician at Mass General Hospital, so you can imagine what her March 2020 turned into. But as the news of COVID was, like, trickling in, I remember sitting in the psychiatrist talking to a colleague being like, this is just going to be like ebola where we all freaked out. And then it was fine. And I was like, trying to tell myself this because I really wanted to go on this Bachelorete trip and I feel so selfish saying that. Should we cut that? Like, does that make me look at. Portia Pendleton, LCSW: I can share a similar thing. Dr. Katrina Furey, MD: But then my friend kristen called me after they had this super secret meeting at MGH and was like, we're not like, you need to go to the grocery store immediately. This is like a really big deal. Harvard is preparing. They've talked to like, this is going to be a really serious thing. And I was like, oh, my god. And then two days later, yeah, everything shut down. Portia Pendleton, LCSW: It's funny because I was in DC. In February, like mid February, and there was still nothing. I don't know which speech I know that's not the right word for it was happening, but everyone in congress and the senate were there and it was really busy and it was fine. The airports were all good. But then I ended up having to come back from puerto Rico early. So I've told this story, obviously to my friends, but for my new friends out there listening. So we had been here and meeting family down in puerto Rico who had missed it by three days of what was kind of happening. And we were like, should we go? Should we not? And we're on the airplane, it's about to take off. They shut the door and everyone's like, phone alerts start to go off if you have news alerts. And it was that all international travel was stopped and we weren't going internationally. But I was immediately like, I need to get off this plane. Obviously I couldn't. So we went to Puerto Rico. We told our family that was down there and they just did not get it's. The like, this isn't a big deal. Why is everyone up there freaking out? Brian were like, my partner and I were like, how can you not understand? The grocery stores are empty. So we ended up flying home early and thank goodness we did because the island closed down. There was a ship in the port there from Italy that had some italian travelers that were sick and so it was just chaos. And then I remember coming back to work on Monday and we closed, right? So we had this meeting of how we were going to handle it. Everyone took their laptops and we went home. And then I never went back to that job. Dr. Katrina Furey, MD: Yeah, it was scary. I don't know, I feel like triggered watching this show and all the COVID stuff. It's like hard for me to watch. I notice kind of like not looking at the empty street. It's just like really hard for me to watch. I thought they did a magnificent job, though, covering it and how they had Daniel, the lone wolf, sort of like raising the alarm and seeing how Mia, who's now in Chip's old role, is kind know, not covering, know, choosing other stories to cover instead. And then they send him to China, right? Portia Pendleton, LCSW: And he is just like in the throes of it being like, this is serious. They keep giving him a short segment, they cut his segment, he's like but. Dr. Katrina Furey, MD: It'S so symbolic of how we were all thinking about it until it was really serious, right? And then we sort of see the COVID sprinkled in, I thought, even starting with New Year's Eve and how joyous it all was, like, woohoo. Portia Pendleton, LCSW: 2020. Dr. Katrina Furey, MD: And now as we watch it, you're just like, if we all knew what was coming. And then they still sort of sprinkle in COVID throughout the whole season as it builds. And I enjoyed how they kept reminding us of the date. Like, oh, Alex comes back February 20. And I was like, oh my God, that's like three weeks before it's going to start. And then her last day was like March, I don't know, like 14th or something, right? Like, it just kept building and building and building till we see Alex with COVID and we see Bradley, like, rushing into the Er to find her brother in the chaos of the emergency room with COVID cases. And it was just like, we see them all go home and trying to figure out contact tracing and Corey with. Portia Pendleton, LCSW: The and being silly with like, I don't know what that know? Dr. Katrina Furey, MD: Well, we didn't know what it meant. And Corey's like, can you stand can you step back? 6ft, right? Oh my God. Portia Pendleton, LCSW: It was such like an awkward time because I think everyone it was new social norms that we all had to just adopt and everyone had their own length of time for getting on board with specific social norms or not. And I think it was just like, there's a lot of awkward interactions with people. Dr. Katrina Furey, MD: I think what I found personally interesting as a physician and as a psychiatrist, as the time when it all hit, I was still doing some moonlighting at a local hospital and fortunately that was like extra work. And so as soon as I started to feel unsafe, I stopped. And I had a lot of guilt over that, but certainly I had a couple of shifts. I never will forget how scared I felt because I didn't have enough PPE. And I remember nurses coming in and smuggling in masks to each other and saying, don't tell the supervisor. And we were trying to figure out, as a psychiatrist, what do you do when there's a code and you don't know if the patient's COVID positive? Like a behavioral code, agitation, delirium, things like that, that you get called for in the middle of the night, like, how close do you get? How close do you not get? We didn't know yet how is it transmitted? How does it affect if you have history of asthma, how does it affect you? How does it affect kids? All of that stuff. I just will never forget being so scared. And I remember leaving one of those shifts and realizing, like, I can't do this right? Like, I'm terrified. And one of the nurses being like, Dr. Fury, are you okay? And I was like, no, I'm really not. And then I think as a physician, realizing this is really serious, during that time when everyone was trying to figure out, like, do we really need to stay home? Do we really need to stock up? And when people were like, oh, it's just 60 days lockdown. And I was like, this is going to be years, and it's just hard to watch. Portia Pendleton, LCSW: It was an interesting theme, like, you said that even I know one of the producers who went up to Mia with one of like it was a COVID story about a number going up, but there was also, like, three other things happening that day. And she was like, Nope. No, we're not running that story. And it's just right. Like, they didn't and then all of a sudden, it was the most important thing, right? Like, in mid March, everyone that's all anyone could talk about. And I remember, funnily enough, with the morning show being like, right, a news network. I'm just not, like, a news watcher. And I watched the news, right, for like, 72 hours when things had locked down. And then I was like, this isn't. Dr. Katrina Furey, MD: So great for my mental mental health. Portia Pendleton, LCSW: Yeah, but it was wild. Dr. Katrina Furey, MD: It was wild. Portia Pendleton, LCSW: Dr what was it? Fauci. And then that woman with the scar, Deborah. Dr. Katrina Furey, MD: And just watching them try to keep their composure. I'll never forget that. Meme going around with Dr. Fauci, like, touching his forehead in frustration and being like, you know, it's bad when the man telling you don't touch anything is like touching its head in frustration, right? And they showed clips of Dr. Fauci in this. So the season does culminate with COVID and I'm really interested to see now that we know season three is about to come out, like, how does that evolve? But there was a whole lot more in season two, and I have no idea how we're going to cover it. Portia Pendleton, LCSW: All in this know? So so we have some new characters. We have Stella, who's the new president of the news division. Dr. Katrina Furey, MD: I think she took Cory's job. Portia Pendleton, LCSW: Yep. Dr. Katrina Furey, MD: And then Corey took Fred's job, right, because they fired Fred. Portia Pendleton, LCSW: Yeah, that was a little I mean, it became clear, but right at the end of season one, it seemed like Corey was going to be let go, and then they ended up letting Fred go. And then Corey stepped into that role, which is what he wanted, right. And I think he kind of set some things up so that happened. Dr. Katrina Furey, MD: And I think also we come to find out he's kind of in cahoots with right? Like, it kind of sounded like I was a little confused by this, but it kind of seemed like Bradley thought she walked in and said, I'm not coming back if you don't rehire Corey. And then they did. But then we sort of found out later on that Fred was like, corey should be my successor and give me all this money. And then he's maybe pulling some strings in the background. So he's like gone but not really gone. That kind of confused me. Portia Pendleton, LCSW: Yeah. Corey is an interesting guy. Dr. Katrina Furey, MD: Do you think he's hypomanic? Portia Pendleton, LCSW: He is something. He is so animated and constantly hyper and activated. I just want to know his routine off when he's not at work. We saw some of his exercise routine. Dr. Katrina Furey, MD: When I saw that I was like, I think he's hypomanic constantly on the go. But explain that a little bit. Portia Pendleton, LCSW: Yeah. Dr. Katrina Furey, MD: So when we think about hypomania, what we mean by that clinically is when you think about depression, we think about people who have clinical symptoms of depression for two weeks or more. That's where your mood is lower than your average baseline. We all have mood fluctuations over the course of our life, but when you're feeling depressed, your mood is way too low. Now, the flip side of that is something we call mania. This is what we see when you have something called bipolar disorder where not only do you have the depressive episodes, but then you also have the manic episodes where your mood is way too high, right? Like, you don't need sleep. You're talking a mile a minute. You have all these big grandiose ideas. You're really impulsive. Portia Pendleton, LCSW: And people can tell. Dr. Katrina Furey, MD: People can tell when you are fully manic. That's a psychiatric emergency. You need to go to the emergency room. A lot of times people end up getting hurt either because they're doing something really risky like skateboarding down a highway or something or because they're using substances or sex, gambling, spending money, things like that. There's something in between what we call euthymia, which is like a typical normal baseline mood. You still have fluctuations because you're human, but it's all within a controlled range of feelings. It never dips too low or too high. Mania is like the highest you ever get. Hypomania is kind of like halfway in between. And some people with hypomania function really well in society. Like maybe corey, right. Like, maybe he only needs 4 hours of sleep. Cool. He can get a lot more work done. Maybe he has boundless energy, but he's not like, talking way too fast or having really big ideas that are people with mania might write their memoirs on postit notes and put them all over their room, for example. He's not really behaving like that outside the norm. But sometimes people with hypomania are really successful and productive because they just don't need as much sleep, and they have more energy than the average person. He also could be abusing stimulants or something. Portia Pendleton, LCSW: He could be and sometimes I think there's that little edge or overlapping, also, potentially, of ADHD, just like, really hyperactive. You know, what if you have ADHD? Some of the symptoms with mania are not presenting, though. But just that on the go. And we think about people who, in adulthood often find careers that do fit better if you have attention hyperactive or you're inattentive. It's hard when you're a child. I know I'm taking a little bit of a left turn here because school is pretty much the same. Right? We have expectations for everything. But when you get into adulthood, there's so many hands on careers. There's so many careers that you can be on the go that we see people typically be able to function a little bit better with that. So even I'm wondering for him, right. He's constantly being stimulated. He's constantly thinking of these things. So it's like that's a great point. He's got something, though. Dr. Katrina Furey, MD: Man, I'd love to evaluate him. He also has a history with his mom, which we won't get into all the details. Please watch the show. But which clearly influences his behavior and his love, it seems like, for Bradley. One thing I thought season two did a really interesting job of is, like, depicting how they're all falling in love with who I imagine their parents were. Right. I don't know. What did you think? Did you pick up on that at all? Portia Pendleton, LCSW: Yeah. Or, like, with Bradley. Right. It's like, for me, I felt like Laura was someone she never had. Right. Like, safe. She was really empathetic, really nurturing, really sweet, kind, really good advice, really validating, not dismissive. And then it's just, like, interesting now with, like, in the mix. It's like, who know in season three, I guess, where does and it's like it depends on, I think, where she is with herself and doing work or not. Because I would say and again, this is just like a guess if she hasn't done work on herself, I could see her picking Corey, and if she has, then it's like Laura. Dr. Katrina Furey, MD: So I think it's going to be Cory. Portia Pendleton, LCSW: Yeah. Dr. Katrina Furey, MD: What did you think about that scene with Laura and Bradley where Laura was encouraging Bradley to go to therapy? Portia Pendleton, LCSW: I thought it was excellent. Dr. Katrina Furey, MD: Right. I thought it was so gentle. Yeah. Portia Pendleton, LCSW: You're crazy. You need to go to therapy, or you need to get over this, so you should go to therapy. It was just, like, very like, it seems like you need to talk about this, or you need some support, you need someone to help you figure this out. Stuff with your brother. Dr. Katrina Furey, MD: Yes. After her brother Hal. And we'll get into this a little more later. That depiction of being the sibling of someone with an active addiction coming from a dysfunctional home life, we'll definitely get into all of that. But I thought the way Laura so, like, validated how hard all of that was for Bradley and said, I think you need some help figuring this out. Have you tried? Therapy was just such a nice way to bring it up. And then I thought it was so honest when Bradley was like, I think they're going to tell me I'm crazy, I'm scared. And I was like, girl, me too. I hear you. I think we all feel like that, right? Portia Pendleton, LCSW: And what a great Know line for her to say, right? Dr. Katrina Furey, MD: I thought that was such a beautiful depiction of sort of like a nice way to encourage someone you love to seek help and a really nice way to introduce a really tough concept of boundaries and when is it time to walk away? That's hard. Portia Pendleton, LCSW: That's hard. And I think in the spirit of therapy, everyone could use it on the Know. I think Mia certainly needs some support. I mean, what a complicated loss she is experiencing. Right. Dr. Katrina Furey, MD: It's like Mitch, you mean? Portia Pendleton, LCSW: Yeah. And even just of this distance, right, of just know, fall from grace as a loss, his loss of the show and then ultimately, right, like his death and then reporting on it and you can see her tearing up. But knowing that he also did all these horrible things and know had come out in this episode, these questions around, like, was he praying specifically on black mean? I just was like, Mia, I would love to I don't just I really like her character. I really empathize with her and I would love for her to get all the support she can. She seems like she's throwing herself into work, which is the job. I mean, I think it just is what it is. Dr. Katrina Furey, MD: At the end of season one, he looked so haggard and disheveled and exhausted. And I was like, you are like, going to collapse at the beginning of season two. He looks great. He's like well groomed. He's engaged. He's got this beautiful little house. Portia Pendleton, LCSW: He's driving a Subaru. Dr. Katrina Furey, MD: He's probably getting 8 hours of sleep a night. He's probably exercising. Maybe he's playing pickleball. Like, he looks so good. And it was fascinating to me how he so early on told Bradley, like, if I ever talk to Alex again, I got a lot to say to her. But then when she shows up and asks him to come back, he's like, okay, yeah. Why do you think he did that? Portia Pendleton, LCSW: I don't know if it was a selfish, not like, self seeking, self serving thing where it's like, I do want to be a bigger producer, right? Like, I'm this little smaller station and this is really my world. Or was it his connection with Alex? Does he think he owes her? Is there, like you had mentioned before, a trauma bond with like I don't know if it was for I mean, it could be all of those things at the same time. So what about you? Dr. Katrina Furey, MD: I think my theory is that I do think, like, near the end when they have that knockout fight in the car where they're really raging at each other and she mentions that she feels like he's in love with her and she doesn't love him like, that that got me thinking, like, is that true? Especially because then when he was making out with his fiance and was like, let's go do it in Alex's office, and that is kind of creepy. Portia Pendleton, LCSW: Yeah. Dr. Katrina Furey, MD: It got me thinking, like, was his mom, like Alex? Did he have a self centered, narcissistic mother who was constantly absent or critical? And is he seeking that validation unconsciously? Portia Pendleton, LCSW: Right. Dr. Katrina Furey, MD: But is he seeking that approval, that acceptance, that validation in a super unhealthy way? That's what I think. So I'd love him to get some therapy too. And I think what we were talking. Portia Pendleton, LCSW: About with who Bradley will choose based on her own internal path, I think same with like, if he is a well self, he's going to choose his current right like life, right. Working at the smaller station with his this this quiet, healthier, seemingly life, but maybe not so big and showy, right? Like you could see him kind of being pulled back and back and back into this abusive relationship. Dr. Katrina Furey, MD: Right. And we see that with how in that final scene or the final episode when Alex is on air with COVID which was weird that he lied and said he tested positive too. So he's like, totally around her. He could have just put a mask on if he could find one. I guess back then they were hard to find, but we see his fiance call and he declines it. Portia Pendleton, LCSW: He also then puts something on the prompter that Alex wasn't expecting, which is like, so are you getting back at her or you just like it was confusing of where they're going to land. Dr. Katrina Furey, MD: 100% because in so many ways, their relationship continued evolving in a very raw, honest way. But then we continued to see the power dynamic stay the same when she FaceTimes him. Portia Pendleton, LCSW: Right. Initially from bed and after, they are still not okay. They had just had that big fight in the car. And then she's like, very sick. He's being kind, but he gets sucked. Dr. Katrina Furey, MD: Into her again and again. And she keeps using him as a narcissist will do again and again. And I felt like at the very beginning of season two with Alex, she's in her little chalet. It looks so cozy. She has a dog now. She's writing her memoir. And you see when she comes back to the station, that dinner party at Corey's house, I felt like she put on such a good mask of like, I've really done a lot of self reflection. I want to be different. And then as the season progresses, under more and more stress and scrutiny, I just feel like she's the same old narcissist she's always been. And we see it in such a big way that she goes to Italy to get this letter from Mitch as if he's not again, she doesn't care what he's dealing with. She doesn't care that know, at that point, we knew COVID was spreading. She doesn't care. We see how much she doesn't care about other people. She kicks them off the private jet so she can get back. She goes back to work despite knowing she was in it. She doesn't answer chip's phone calls for like weeks. She's just so utterly selfish and it's. Portia Pendleton, LCSW: Just such a big and telling Mitch's wife, right. I think she thought that she was being so kind, like, I'm going to tell her, look at me. Dr. Katrina Furey, MD: I'm such a person. Look at me. But it's like, no. And I loved when Mitch's wife really put her in her, right? Portia Pendleton, LCSW: Well, because her whole world was shattering then. Because it's like other people know, right? She had been so desperate to protect that secret that her and Mitch had know consensual sex. And now it's like, well, actually, other people do know, or other people. There were whispers. And then when Bradley got the excerpts from the book and she's interviewing Maggie, it was just so fascinating to watch Alex unravel, right? Because her whole world had changed. She's no longer in the driver's seat. Her world is falling around her. People are starting to not like her. Dr. Katrina Furey, MD: Because people are seeing the real her. And the whole world was about to see the real her. Like, we saw Daniel's reaction to the real her. And I was really proud of him again, in that early scene at the dinner party, that he didn't just let her off the hook and like, because that's what he's supposed to do. He really held her accountable. And you see how much he does not like that. Portia Pendleton, LCSW: Daniel may be doing some work therapeutically. He is starting to stand up for himself more. He's setting is he is doing what feels authentic to him. You know what? Dr. Katrina Furey, MD: He has the it factor. Portia Pendleton, LCSW: Okay. Dr. Katrina Furey, MD: I agree with his grandpa. Portia Pendleton, LCSW: Yeah. Okay. Dr. Katrina Furey, MD: I didn't love the cringy song and dance for Alex, and I'm sure that was humiliating for him, but he's got the if factor. And I would be ****** if I were him that I almost got the job at the other network and I agreed to stay. And then Alex just like, stabbed. He just uses people. We really saw that in that scene with Laura when they talked about going to see Bring into Noise, bring Into ****, we see how even with like and I thought this was actually really smart of the writers because it shows that Alex has always been this way, that she was new on the scene. Laura was like know, she was like the lead anchor. She was closeted at the time, but she had some close friends who knew. And it sounds like we're accepting, but it wasn't the kind of thing you just shouted from the rooftops back then. And then soon after, Alex coming into the social circle, all of a sudden it leaks and all of a sudden she gets fired. And then Alex disappears but rises up the ranks. And it was just really interesting to see Alex try to get on Laura's good side and sort of remember that whole scenario so differently from how it actually happened. Portia Pendleton, LCSW: Do you think that there was malicious intent or do you think Alex just had no, no. It was either malicious intent or zero self awareness at that time. Dr. Katrina Furey, MD: Honestly, I feel like for someone with narcissistic personality disorder, how do you split the difference? I really feel like Alex meets criteria for that and she's always just it might not be conscious, but unconsciously thinking for herself and putting her own needs first. And the whole world revolves around her and quite literally it does. Being in such a powerful position in the media, we see again, people kick people off the private jet so she can get home. Chip comes in and exposes himself to COVID so she can go on the like, quite literally, people do revolve around her. So it's hard to like, was it malicious or was it just selfish? But where's the line? Portia Pendleton, LCSW: I saw a really interesting TikTok with Alison Stoner. So she was a child star and so she just made this video. It's from September 1, if you want to watch it. And she kind of speaks on how in the film industry, especially starting out with in childhood, how narcissists are kind of grown, even if it's not like rightly. You're born with the trait. And so I think what we've talked about also with Succession 100% is just like how do you have developed drive, right? This internal drive that maybe separates you or you have what do you call it? Like predestined predetermined. Pre, whatever that word is. I'm not saying it predisposed to something that maybe comes out in some people, not others. I don't really see it in Daniel. Dr. Katrina Furey, MD: Right. But maybe is that why he's not so as successful? Portia Pendleton, LCSW: Because he's not so brutal? Dr. Katrina Furey, MD: That's the thing, is you have more empathy and you think about others. Portia Pendleton, LCSW: Right. Dr. Katrina Furey, MD: And so that kind of holds him back. Portia Pendleton, LCSW: Exactly. Dr. Katrina Furey, MD: Whereas Alex was thinking for herself and wanted what she wanted and was going to get it at and then she. Portia Pendleton, LCSW: Did and then she did and then she did over and over and over again doing it. And then there are her expectations. I mean, even her family we saw in season one way more, but the facade with her partner, they did that because of her career, because she asked them to. It was expected. Dr. Katrina Furey, MD: And when you're on her good side, when you're on the good side of the split, she is so charming and funny and. You feel special being in her orbit, right? Like, we see that time and time again with Chip. And I feel like that's how she keeps sucking people in to help further her own agenda, though. That's the thing. Even Bradley again, I think because Bradley hasn't done the work, she's getting sucked in in a way that they I don't even think consciously realize. But Bradley's getting sucked in, too. And in many ways, we see that Bradley's mom, although very know in terms of not being successful, not being wealthy, but is still very critical, dismissive and invalidating. Much like Alex's, when you're on her bad side, like when you try to confront or criticize or point out that she's done something wrong, quickly flips on you. But I think that's why Bradley keeps getting sucked, why all these people get sucked into her orbit and she just uses them to get what she wants. Portia Pendleton, LCSW: So what do you think? Do you think it was Bradley being sucked in? What do you think about the interview with Bradley? And, like, what was Bradley's angle? I mean, I liked it. I know a question I'm saying to me. I liked it in the fact that I don't like Maggie, really. And I don't know if that's because I'm in Alex's. I just thought as a woman, instead of being about Mitch, which I'm not saying that in the way that it dismisses, because Alex is not like, a good person, really, but the fact that she kind of lied the whole time about what the book was. And it's like, I remember when Bradley was scrolling through the pages, gets in the back, right? She see her name twice. And then Alex, it's this huge thing. She's on the COVID And I thought that was a really I liked how she challenged her on some of like, why isn't this about Mitch? This was supposed to be about all of the guys and whatever. And yes, Alex is a part of that, which she doesn't want to admit. But I did appreciate kind of the pushback on, too. Dr. Katrina Furey, MD: I did too. And I think I would imagine Alex has really hurt Maggie. She must like I feel like this was Maggie's way of calling her to the carpet. Is that a saying? Maybe we'll go with know, like, holding her accountable and being, like, exposing who she really is to the world. But I think what Bradley was saying was, like, was that your right? Portia Pendleton, LCSW: Why'd? Dr. Katrina Furey, MD: You do know, why did you do this? Especially when she came to you and begged you not to. And that is true. She did. It was interesting. Yeah, I think it was really interesting. I don't think Alex expected it at all. I don't think anyone did. And then I'm wondering, why did Bradley do it? Portia Pendleton, LCSW: Right? Dr. Katrina Furey, MD: And again, is it like. Portia Pendleton, LCSW: Corey keeps putting her in these interesting, like, of, well, you should do it because you're fair. And it's like what does that mean? Remember when he's like, can you do the interview? And she's like, well, why? I don't know. This might be difficult. And he's like, I just know that you'll be really fair. But it was a drawn out it was intentionally that we heard that moment. What does that mean? Dr. Katrina Furey, MD: And I feel like especially in season two, we see that I hate this about professional settings, when people are saying one thing but really meaning something different and you have to learn the lingo and the undertones and what's being implied. I feel like we saw that a lot with season two. So just that when he's saying fair, does he mean, don't hurt the network. Let's keep us in a good light? Is that what he really means or does he mean, you'll be fair? Portia Pendleton, LCSW: I think it's almost both. But I'm only saying it's both because I think the fact that he likes her complicates things for him. I don't think he's used to that. I don't think he knows what to do with Bradley initially. He likes her. He keeps giving her all of these things. He keeps promoting her, promoting her, promoting her. Is it because he truly right, has this almost fantasy of how amazing she is as a career woman? Or is it that love piece? Is it infatuation? Dr. Katrina Furey, MD: But then he's the one who outs her. So he also loves her, but he's hurting her. And that makes me want to know more about Corey's mom. We learned just a little bit how he was taking care of her and he's kind of taking care of Bradley in terms of giving her the job, giving her a place to stay, rising through the ranks, giving her even Laura, like sending Laura into her life. Can you please help her? Portia Pendleton, LCSW: But with her in a really weird way? Permission. I think he made it in his head, okay, for him to do that when he outed them. Because Bradley he made Bradley say, right, he set her up to be like. Dr. Katrina Furey, MD: You have to do whatever it takes to protect. Portia Pendleton, LCSW: And, like, I think I don't know, maybe Bradley would at the end of the day, if it was super black and white or she knew the outcome later on, that she'd be like, maybe she would have given permission for that. I don't know. But in his head, I think he got permission from her. And that absolves him of the guilt. Yeah, guilt. Maybe it comes out in season three, maybe. Dr. Katrina Furey, MD: Because I don't think he ever told her that it was him. Portia Pendleton, LCSW: Right. Dr. Katrina Furey, MD: I thought he was going to at the end, but then he said, I love you. And then I was like, can he not sit with the guilt of telling her this? So he says he loves her instead, right? He's fascinating. I really hope we see a lot more of his development. I really hope we see Bradley in therapy in season like, I really, really hope we do. Portia Pendleton, LCSW: I think that would be a great line of whatever, to see Alex and. Dr. Katrina Furey, MD: Bradley in therapy together, almost like couple therapy or family therapy. Portia Pendleton, LCSW: And maybe she did she would go to therapy twice. Right. Dr. Katrina Furey, MD: And she's good. That's right. Portia Pendleton, LCSW: She talks some of the external problems, like the network or the cancellation. Right. But it's not about her. It's not deeply rooted in her Psych for interest. Dr. Katrina Furey, MD: And then she'd be good. She'd be like, I'm good. Or it would be like we saw in succession with the family therapy, right. Where you can't actually go anywhere substantial or honest. Portia Pendleton, LCSW: Yeah. Dr. Katrina Furey, MD: So rewatching those episodes with Alex and Mitch and watching Mitch's death by suicide was really emotional for me. But what about for you? What did you think of all that? Portia Pendleton, LCSW: It's interesting. Bringing then in paola paula. Paula because I feel like I was just feeling many different feelings towards Mitch. At the one hand, I obviously don't like his character. I think he's like, a crappy person. Dr. Katrina Furey, MD: Really hard to see Steve Carell like this. Portia Pendleton, LCSW: Yes. Right. But 100% such a good job. Dr. Katrina Furey, MD: And he's also such a good choice because I think it automatically makes you, like, ambivalent. Portia Pendleton, LCSW: Yep. Dr. Katrina Furey, MD: Right. Portia Pendleton, LCSW: And he is right from the office like this. Like everyone loves my favorite boss. But then, obviously, this is also another character. But it's like, oh, it's a perfect character based on his other fictional characters. Dr. Katrina Furey, MD: 100%. Portia Pendleton, LCSW: Right. Dr. Katrina Furey, MD: Because he's just, like, beloved. He's funny, rodeo virgin. There hasn't been bad press about Steve Carell, as far as I know. So him being in the role, it just automatically, I think, plants that seed of ambivalence in our minds. Portia Pendleton, LCSW: Yes. So when he was in Italy and that woman kind of came up to him right. And was, like, saying those things to him, and then we know her friend is filming it. Yeah. Paula come in and kind of interject. I didn't know how to so Mitch was like, right. He's excommunicated. He's living in Italy. He's by himself again. I think at that moment, he doesn't still have self awareness. I think he has more than his mentor. I think there's lines that Mitch won't cross that mentor did, but he still, I think, is lacking self awareness or really kind of understanding. He's still trying to, I think, come back or liked again. But I was again torn with that woman kind of saying those things to me. He's like, he's here minding his business. He's a hat on. Like, he's not right. Dr. Katrina Furey, MD: Exactly. Portia Pendleton, LCSW: Clear the restaurant for me. Dr. Katrina Furey, MD: And I thought it also brought up this idea of cancel culture and that exploration in a really smart way, how, like, yeah, he's done something many things that are awful and egregious. But, yeah, he's alone. He's not doing anything egregious right then. And we're just going to provoke him in hopes of filming it, that it'll go viral for that person's. Personal gain. That was. Portia Pendleton, LCSW: I i the one thing that I liked Paola said to them was kind of just the pointing out of, like, you're doing this to post it. And I was, yeah, like, this isn't you kind of coming up and having a conversation and being like, I just feel like I need to say you whatever. Like a small thing, which, again, still is unprovoked, but whatever. I think just like, people do that, right? People do that. She would have gone viral and had her moment and that feels just a little icky. So anyway, moving through that, I think, just because I always am. So I don't think it's naive, but, like, go lucky, optimistic, never ending. But I feel like Mitch, in his way, on his path, which is not mine or other people's, was kind of exploring what he did. Dr. Katrina Furey, MD: He was I thought so, too, way more than exactly. Portia Pendleton, LCSW: Like, I think he, with time was changing, maybe with more support. I think that documentary that he did with Paolo was powerful or learning of that survivor in Italy that she was talking about or trying to film or make the documentary about. I think he was learning. And so I'm wondering if because he was it was like all of a sudden there was this guilt or like he couldn't handle the fact that he was this person who did these terrible things because he wasn't suicidal before. It was on his journey almost to changing that he took his life. Dr. Katrina Furey, MD: It was so sad. Like that scene where he swerves and then you see his hand let go. I was like, oh, it really gets him. And he shuts his eyes like he's at peace. Portia Pendleton, LCSW: Oh, so sad, portia I mean, he's a children. I don't know. I feel like he had the capacity for change and you have to want it, and he didn't want it before. I don't think he wanted to be. Dr. Katrina Furey, MD: Alone, away from everyone. COVID, like, thinking about your life, I do think I was seeing more and more capacity for reflection and introspection and ability to change, and I wasn't seeing that from Alex. To me, it was a fascinating juxtaposition of her coming out to Italy, won her letter from him, really railing on him, saying anything she could to get what she wanted. Portia Pendleton, LCSW: And then them being good and then them not being good. Dr. Katrina Furey, MD: It was like this whiplash and then them dancing and having these really tender, loving moments and then parting ways, it seemed like, on good terms. And then that happens. But then in between, I guess, then he is intimate with Paola, who he's. Portia Pendleton, LCSW: Very upset by the allegations about it being like, preying on black women. Dr. Katrina Furey, MD: Yes. Portia Pendleton, LCSW: I don't know. It was sad. It was definitely sad and unexpected for me. I did not see that coming. Dr. Katrina Furey, MD: And one thing we've talked about in some previous episodes is that humans are complicated and flawed and complex and you can be a perpetrator and a victim. Like, we talk about this a lot with children who grow up in really abusive households and then, unfortunately, become abusive as adults, but I feel like we see that with Mitch here. And again, I'm not trying to be a Mitch Apologist or anything, but he did awful bad things, and now he's being treated so and, yes, he should be held accountable and be fired and maybe arrested or charged with things like all of that. And I think this show, we see what could happen to a human soul going through that and then being just, like, piled on, piled on, piled on top of it, as he does seem to be trying to figure it out or figure out how do you move forward? Right. Portia Pendleton, LCSW: I think it's also, like, the power of cancel culture, which is what I heard you kind of saying, but not saying those specific words just now. Because I think when some things are very clear, like taking absolutely social media or any kind of presence out, it's like, okay, you do something bad, maybe you do get convicted. Like, you actually are part of the criminal justice system, and you go to jail. It's like you are then treated poorly and in this terrible system. But it's clear then it's like the world, everyone hates you. They are death threats, making things about your kids. It's so interesting to hear people talk about cancel culture or being canceled because everybody says it's, like, the worst thing, because it's so unique. I don't know. It feels nuanced. I know it's not super new at this point, but it's just this weird thing. Dr. Katrina Furey, MD: And I think, too, with social media, I feel like that has to add to it. It's not just like you're being canceled at your place of work, in your immediate family, or even in America. He was canceled internationally, and again, in some ways, he deserves it. 100 million%. And then all the piling on at the same time. You just think about that is a human at the end of the day, too? And this is really tricky. I feel like this is really hard for everyone, humans, me to wrap my head around. The show just does such a good job portraying really difficult topics. And as we wrap up, I do want to make sure we talk about Bradley and Hal. What did you think of this? Portia Pendleton, LCSW: I thought it was was because I was so moved and I was so angry at him when he know, I'll make it really simple. He's describing how their mom has impacted him right. By being threatening, manipulative, all of these things. And he does it exactly to Bradley, like, within the same sentence. And it's just like I was speechless at how well they got it. Right. Dr. Katrina Furey, MD: I know. Portia Pendleton, LCSW: And then Bradley, the guilt tripping, the threatening, the putting it it's on you. My substance use is on you. Showing up and hurt me. Job horrible. Dr. Katrina Furey, MD: All of it. You can just see how much she is struggling with wanting to help and support him. Especially now that she has so much money, like more money than they ever had and she can't help him. But then being totally like, what are you doing? Like, why are you showing up here? Are you using? She looks through his bag and then he notices. But then it's like, of course she right. And it's just they perfectly demonstrated that dance. And that scene when she's dropping him off at rehab and trying to set those boundaries like Laura was encouraging her to, was heartbreaking. But I felt like if I was her therapist, I would say you have to set boundaries. Portia Pendleton, LCSW: I would have been very proud of her for how she was when she dropped him off. I can't do this for you. This is your decision. Go in or go out. I can't make you sober. And then sucked back in again later on. Dr. Katrina Furey, MD: But Manipulatively leaves all the money and disappears again. It's like just like Alex disappearing with her back and not answering anyone's calls. It is such a primitive way of getting someone's attention, right? By scaring them, being like, oh, you don't want anything to do with me? Well then look what's going to happen. And it totally worked. Portia Pendleton, LCSW: And it's so hard to not be impacted by that. People do it 1000 times over and over again. Sometimes they never stop and sometimes they do, but it just breaks you as a person and having to do that over and over and over again. Dr. Katrina Furey, MD: You really need help navigating that. And that's where support groups, even like Alanon, your own individual therapy can help with that. I don't think there was any way for Bradley to stick with her boundaries in that situation. I thought her reaction was really accurate and human and you just saw all the desperation and remorse and guilt and everything that she was feeling. And I feel like, unfortunately, people who love someone affected by substance use will totally relate to that. Portia Pendleton, LCSW: And the people who know in a relationship like Laura with Bradley, because I think that can oftentimes alienate the person like Bradley even more. Because as things are happening, as Hal is pushing Bradley and kind of like making her unwell, there's the people around Bradley like Laura, who then even more so will start to be know, you really can't do this anymore. You really need to set a boundary. And sometimes that know, break a relationship, right? And so then it's like, then you're more know, you're without more it's so it seems know, okay, it's just between Bradley and it just the spider web goes out so far with how substance abuse impacts families. Dr. Katrina Furey, MD: That's what we always say, right? It's a disease of the family. It affects everyone. Which I guess you could say about most mental health conditions. But we really see it with substance use. And it was just what a portrayal. And I mean, so expertly done and so heart wrenching. I was so glad she did finally find him, but I'm really worried they're both going to get COVID now. Or I was like, Bradley, what if you have COVID and you're running in exposing all these other people? And it's just like the chaos, right? Portia Pendleton, LCSW: And it's still so at the beginning. So they hadn't shut down, no visitors yet. It's within all the chaos of her own life. And then it's like you're seeing which we love, the parallels of all the chaos that now the world is being pushed into. Dr. Katrina Furey, MD: So where do you hope season three goes? Portia Pendleton, LCSW: I'm sure there'll be at least a couple episodes, right, with them working from home. And I'm curious how that is. But then I'm wondering where season three ends. I know I'm getting way ahead of myself, but because will Cobra be, quote unquote, over? Are they back into the office? Does anyone die? Are Corey and who does Bradley end up with? Is anyone fired? Is Alex ever able to gain anything? Does she keep doing her? Dr. Katrina Furey, MD: No, I don't have any hope for her. I'm sorry. Portia Pendleton, LCSW: I think it's interesting because the show, or maybe not the writers, but the producers or the directors in an interview had talked about how they really wanted to give Alex her redemption at the end of season two. And I feel like maybe a person without mental health background would think she did. Dr. Katrina Furey, MD: Were you watching, like, the stay tuned for the show? I did watch that for a couple of episodes, including the last one, and I think they touched on, like they were trying to say, like, Alex is human. And I'm like, yeah, and really far on the narcissistic spectrum, like, really lacking empathy and ability to appreciate how our actions affect others. So I just don't think that's going to magically develop. Portia Pendleton, LCSW: Yeah. And if it does, I don't know. I think the writers, like we've talked about a million times, are wonderful and have they must have mental health experts they have to, helping them develop these characters. Dr. Katrina Furey, MD: If you want some more, you can find us at Analyze Scripts podcast. Portia Pendleton, LCSW: Exactly. So please reach out to us anywhere. You can find us on Instagram or TikTok at Analyze Groups podcast or check out our website. You can also email us if you'd like to get in touch with us on a more of a professional level. But stay tuned for more of our episodes and check out the ones that we have back in the feed. There's a lot. Dr. Katrina Furey, MD: There's a lot. All right, thanks for listening and we'll see you again next Monday. Portia Pendleton, LCSW: Bye bye. Dr. Katrina Furey, MD: This podcast and its contents are a copyright of analyzed scripts, all rights reserved. Any redistribution or reproduction of part or all of the contents in any form is prohibited. Dr. Katrina Furey, MD: Unless you want to share it with your friends and rate review and subscribe, that's fine. Dr. Katrina Furey, MD: All stories and characters discussed are fictional in nature. No identification with actual persons, living or deceased places, buildings or products is intended or should be inferred. This podcast is for entertainment purposes only. The podcast and its contents do not constitute professional mental health or medical advice. Listeners might consider consulting a mental health provider if they need assistance with any mental health problems or concerns. As always, please call 911 or go directly to your nearest emergency room for any psychiatric emergencies. Thanks for listening and see you next time.

Welcome back to Analyze Scripts, where a psychiatrist and a therapist analyze what Hollywood gets right and wrong about mental health. Today, we're analyzing one of Dr. Furey's favorite movies - the 2008 comedy "Step Brothers" starring Will Ferrell and John C. Reilly. In this lighthearted episode, we use the comedic depiction of two 40-something year-old men living with their parents to discuss failure to launch syndrome and common difficulties encountered when blending families. We also explore the depiction of an enabling vs dismissive parent, the thrapist-patient dynamics between Brennan and Denise, and the classic narcissistic traits embodied by evil older brother Derek. We hope you enjoy! Instagram TikTok Website [00:10] Dr. Katrina Furey: Hi, I'm Dr. Katrina Fury, a psychiatrist. [00:12] Portia Pendleton, LCSW: And I'm Portia Pendleton, a licensed clinical social worker. [00:16] Dr. Katrina Furey: And this is Analyze Scripts, a podcast where two shrinks analyze the depiction of mental health in movies and TV shows. [00:23] Portia Pendleton, LCSW: Our hope is that you learn some legit info about mental health while feeling like you're chatting with your girlfriends. [00:28] Dr. Katrina Furey: There is so much misinformation out there, and it drives us nuts. [00:32] Portia Pendleton, LCSW: And if someday we pay off our student loans or land a sponsorship, like. [00:36] Dr. Katrina Furey: With a lay flat airline or a major beauty brand, even better. [00:39] Portia Pendleton, LCSW: So sit back, relax, grab some popcorn. [00:42] Dr. Katrina Furey: And your DSM Five and enjoy. Welcome back for another episode. I am personally thrilled to be talking about one of my favorite movies of all time, the 2008 smash hit Step Brothers. I feel like in rewatching it for this podcast, I didn't even need to. I know every single line of dialogue, but I still love it so much. [01:20] Portia Pendleton, LCSW: I think my husband's favorite movie of all time. [01:23] Dr. Katrina Furey: Yes. This movie also happens to always be on every time I'm in a hotel on TBS or where they're censoring a lot of the dialogue. It's still funny. [01:34] Portia Pendleton, LCSW: Yeah. This movie is just, like, iconic. The cast is ridiculous. Will Ferrell, John C. Reilly, Adam Scott. We have Mary Steenbergen, who's also the mom and elf. [01:46] Dr. Katrina Furey, MD: Yes. [01:46] Portia Pendleton, LCSW: Which we're going to be will Ferrell. So it's just like I think he likes working with her. She likes working with him. It's just they're great. [01:53] Dr. Katrina Furey: I love it. Yeah. [01:54] Portia Pendleton, LCSW: Her voice and her mannerisms, I just love. [01:57] Dr. Katrina Furey: She was so good in this role. Like, all the times when her and Richard Jenkins, who plays Jobak, like, when you can tell he's trying to lay down the law, and she's like, Robert thinks we agree. It's time for you to move, know. Or like, when he's so mad they destroyed his boat with the boats and host thing. And she's like, I am so upset that you two destroyed his boat. That being said, I thought you showed a lot of enthusiasm and inventiveness. And I was like, in some ways, you're so enabling them, but in other ways, that's so loving. [02:33] Portia Pendleton, LCSW: She reminds me a lot of the actress herself and the roles that she's playing reminds me of the wife in What About Bob? [02:43] Dr. Katrina Furey: Yes. [02:44] Portia Pendleton, LCSW: She plays similar roles. She has a very similar cadence. [02:48] Dr. Katrina Furey: The way she sort of like light, airy voice. I totally agree. Totally agree. And then we have Catherine Hahn as Alice, who is Adam Scott's wife. What do you think about the scene with them in the car with their children singing? [03:04] Portia Pendleton, LCSW: I sing along every time. It is so funny. I think I sing this in the car sometimes with know, I'm not a great like, I can tell that I'm not good, so I have an ear. [03:17] Dr. Katrina Furey: And I know you're not the little boy's role. [03:20] Dr. Katrina Furey, MD: No. [03:20] Dr. Katrina Furey: You might be Catherine. I think I'm her. [03:22] Portia Pendleton, LCSW: And someone can yell, flat. [03:24] Dr. Katrina Furey, MD: Flat. [03:25] Portia Pendleton, LCSW: One $200 voice lessons a week. Offer this. And I was like, wow, that is so mean. So mean. [03:32] Dr. Katrina Furey: He is so mean to everyone. Right? [03:35] Portia Pendleton, LCSW: Like, brutal, slurs aside. Like, mean. [03:44] Dr. Katrina Furey: Do you think he is a narcissist? [03:47] Portia Pendleton, LCSW: I think that he is a not human person. I don't know. Yeah, I guess I'm trying to think of something else. I was even thinking of animals to compare him to. He's just so gross and obsessed with putting other people down and himself. And sometimes I think, too, I wonder if he is, because he's so homophobic. [04:11] Dr. Katrina Furey, MD: Maybe he. [04:14] Portia Pendleton, LCSW: Pushing something down. [04:15] Dr. Katrina Furey: Repressed energy. [04:16] Dr. Katrina Furey, MD: Yeah. [04:16] Dr. Katrina Furey: To be clear, we are talking about Adam Scott's character, Derek, not Scott himself. [04:22] Dr. Katrina Furey, MD: Right? [04:23] Dr. Katrina Furey: Right. Who I don't think is, like, this character at I thought, you know, again, this movie is so funny. It is a comedy, clearly. [04:32] Portia Pendleton, LCSW: So they're pushing they're pushing every character to the max. [04:36] Dr. Katrina Furey, MD: Right. [04:36] Portia Pendleton, LCSW: So it's so ridiculous over the top. [04:39] Dr. Katrina Furey: And yet I still think displays some really interesting topics in a really accurate right. Like, I really think Derek meets a lot of criteria for narcissistic traits. [04:53] Dr. Katrina Furey, MD: Right. [04:53] Dr. Katrina Furey: Like, he's constantly putting other people down to make himself feel better. I loved all the family dinners where he's, like, bragging about going fishing with Jay Z or whatever he's doing. And then by the end, they have to be like, okay, Derek, that's enough. They have to cue him, let other people know. [05:10] Portia Pendleton, LCSW: But then Robert is so enamored with. [05:15] Dr. Katrina Furey: Derek, which people can be, and his. [05:18] Portia Pendleton, LCSW: Own son, Dale down in such a mean way that the stepmom Nancy has to tell him to stop. [05:28] Dr. Katrina Furey: But then also, Nancy also chimes in with Brendan has a mangina. [05:33] Portia Pendleton, LCSW: I know, right? [05:35] Dr. Katrina Furey: But this is what these sorts of people can do. They can pull this out of you. [05:39] Dr. Katrina Furey, MD: Right. [05:39] Dr. Katrina Furey: They can make you feel. [05:42] Portia Pendleton, LCSW: When she's yeah, like and then I joined in. [05:45] Dr. Katrina Furey: It's just like what? But the whole scene with Will Ferrell dressed like a pirate doing his dancing on the stage is just and the. [05:54] Portia Pendleton, LCSW: Fact that he is so clearly like, a middle aged man, even. [05:58] Dr. Katrina Furey, MD: Yeah. [05:58] Portia Pendleton, LCSW: They're playing, right? Like, you know, in real time. But, like, the flashback, it's, like, still. [06:04] Dr. Katrina Furey: This middle aged so funny. But that's what mean. Like, these sorts of little things. I'm like you're kind of hitting the nail on the head, though. You see Derek splitting the family, right. Even his new stepdad. It's really interesting. He's so mean to his wife and kids. You can tell they all have to be perfect. They're all there to play a role and fill his own need. Of course. He's a real estate agent on the side, right? I just have my license on the side. I had one supervisor once say that. I don't know if there's any data to back this up, and I don't want to offend our listeners who are real estate agents. But she said in her clinical experience. And she's been doing this for decades and decades. There's a lot of narcissism in real estate. And I was like, that's interesting. And she's like, yeah, if you think about it, part of their job is to form relationships quickly, often superficially, and to sell things. And I was like, that's interesting. Yeah, so I just thought for him, it tracked. And I just thought, even though this is so over the top, they did depict this. I don't even know if back in 2008 this was as much of a thing, but this whole notion of failure to launch. [07:18] Portia Pendleton, LCSW: Right. Because that's a movie too, right? [07:21] Dr. Katrina Furey, MD: It is. [07:22] Dr. Katrina Furey: And even though there's like that new Jennifer Lawrence movie, it's kind of about it. Maybe I haven't seen it yet, or maybe it's just they want to prep their son for. [07:33] Portia Pendleton, LCSW: Mean. Failure to Launch, I think is an interesting phenomenon that there's a lot of books out now and yes, like comedic movies as well, but it's really like. [07:44] Dr. Katrina Furey: This interesting cultural, societal thing that's happening. [07:48] Portia Pendleton, LCSW: It seems to be happening more to males than females with just like a anecdotally movies, books. It seems to be more about males that's true. Launch than females. [07:59] Dr. Katrina Furey: Actually, in every single movie we just mentioned, the quote unquote identified patient is a male. [08:05] Dr. Katrina Furey, MD: Right. [08:05] Dr. Katrina Furey: And in this movie, they're both men. [08:08] Portia Pendleton, LCSW: Yeah. And I'm just curious what that's about. I wish I had read one of the books that I'm referencing now. [08:14] Dr. Katrina Furey: Well, we have full time jobs and we're watching a lot of content to do this. So again, if anyone wants to sponsor us, dear Media, feel free and we could really dive into the research. [08:25] Portia Pendleton, LCSW: So it happens when the term has been coined, when your adult children are not kind of leaving the home, having independence, able to support themselves financially, emotionally. And you see a lot of I think this is kind of just like the funny end of it. Like basement dwellers who are just kind of living at home. I'd say there also is a difference in my kind of opinion, in practice with today's current housing market and so many people returning home after college or just for whatever reason, after a couple of years, because they just cannot afford to live outside the home. So I'd say, like, if you're living at home and you are working however you are, whatever that looks like, whatever field you are in and contributing to the household in any way that your family is asking you to, and maybe they're not, and that's okay, but that feels different, really. Failure to launch. [09:21] Dr. Katrina Furey, MD: Yeah. [09:21] Dr. Katrina Furey: I think that's a really important distinction to make. And I feel like you're right that there's just so much economic stress for young adults these days in terms of student loans and then housing market and wages and how do you get on your feet? So that, I feel like, is a difference, right? Like sort of living at home until you can launch, but like prepping for the launch and fostering independence along the way. Very different from what we see going on with Dale Brennan. Dale, yeah. Very different. Right? [09:57] Portia Pendleton, LCSW: So childlike. Right? Like so childlike. [10:00] Dr. Katrina Furey: Toddlers. [10:00] Portia Pendleton, LCSW: Toddlers. [10:01] Dr. Katrina Furey, MD: Toddlers. [10:01] Portia Pendleton, LCSW: I was laughing with what they're eating. So, like chicken nuggets and French fries. A lot of ketchup, which is like a kid meal, right? Kids eat chicken nuggets and they really like ketchup. [10:11] Huff & Doback: Yes. [10:11] Dr. Katrina Furey: They just freaking love ketchup. [10:13] Portia Pendleton, LCSW: It's like the best condiment ever. It's how kids start learning about condiments. Then we move to a balsamic vinegar. [10:21] Dr. Katrina Furey: It's the gateway condiment. You got to be careful. It's a slippery slope getting started with that ketchup. [10:27] Portia Pendleton, LCSW: Yeah. So that was just funny, like in all ways, right? The movie is highlighting them as really just like children. [10:34] Dr. Katrina Furey: They're like into Shark Week. Like just every single thing dealing this drum know, just like being like, you can't come over here because this is like my area. Just like so childlike. And the way that Nancy talks to them is just like how I imagine or do talk to know where she's just you just couldn't hold the fart in or what happened there. I heard you interviewed together for that job. Or maybe take the long way home. Just too much. [11:08] Dr. Katrina Furey, MD: Right? [11:08] Portia Pendleton, LCSW: And I just imagine her being like that in real, you know, in this kind of bad way that we're going to get to with enabling. But I just think that she's so soft and kind and open that I just feel like that's her in real life. [11:24] Dr. Katrina Furey: Just like how everyone thinks Jennifer Aniston is who we think she is in real life. But then I'm like, what if they're like raging jerks, right? Could you imagine? What if there were all these blind items that turns out were all about Mary Steenberg? That would be shocking, right? She would tell you to F off, but in a really nice, weird way. [11:48] Portia Pendleton, LCSW: Toned. Right? [11:49] Dr. Katrina Furey: Which is like worse, right? Like maybe even more dangerous than the people who are really in your face. [11:56] Portia Pendleton, LCSW: Right? And it's funny because Robert seems to be irritated with Dale, but it's like you still made him this way, right? And so he gets mad more easily or frustrated with them more. And it's like but you both still have 40 year old sons living with you who are not doing anything. And they both only eat chicken nuggets. They both have their own space. They both are childlike. [12:22] Dr. Katrina Furey: They both wear chewbacca masks. [12:24] Portia Pendleton, LCSW: Why are you now getting mad? I get you're probably been frustrated for years, but it's funny, like his response. [12:30] Dr. Katrina Furey: All of a sudden I get the sense that he checked out, right? Like that he's frustrated and he just threw his hands up and was like, I give up. Whereas she is just taking care of Brennan for her own needs, wants to be a mom, right. And is really struggling with letting him go. [12:51] Portia Pendleton, LCSW: So more like codependence there. She needs him. [12:54] Dr. Katrina Furey: Even though right. We do see in this movie a lot of very quick and heavy romantic connections, right? Like Robert and Nancy, like, right away lock eyes at that cochlear implement conference. [13:11] Portia Pendleton, LCSW: I love to know what she's doing there. [13:13] Dr. Katrina Furey: I was like, I wonder if she's like a rep, like a sales rep of some kind. That's the vibe. [13:19] Portia Pendleton, LCSW: I was she's not called Doctor and he is. [13:23] Dr. Katrina Furey: He's the doctor. [13:24] Dr. Katrina Furey, MD: Right. [13:24] Portia Pendleton, LCSW: That's like, the point. [13:25] Dr. Katrina Furey: I love Dale wanting to go into family business. [13:29] Portia Pendleton, LCSW: Yeah. [13:30] Dr. Katrina Furey: And he's like, Trust me, I've tried to tell him that's not how it works, but it's just so funny. Like, at the beginning, they're being intimate and then she tells him, she's like, I have to get this off my chest. And then he's like, Me too. And then that's it. That seals it's like a trauma bond, right? They're like, quickly bonded. And then we see Alice, Derek's wife, fall hot and heavy for Dale very quickly. What did you think of that? [14:00] Portia Pendleton, LCSW: Well, besides feeling gross about it and just write the, like, gross open mouth, like, lapping of each other's faces was just like, making me one of them. [14:14] Dr. Katrina Furey: Can you imagine if that's like, your job as an actor? Like, all these people around you, and they're like, okay, do it again. [14:19] Portia Pendleton, LCSW: And do it in a way that will disgust people. [14:22] Dr. Katrina Furey: Do it more. Do it like more slobbery. Like, okay, we got to get it from this angle. [14:29] Portia Pendleton, LCSW: The scene where they're like, in the forest, right? And she's like, running after him. She sees him, and then it's just so cringy and funny. [14:38] Dr. Katrina Furey: But if the roles were reversed, like, if it was Dale coming onto her with that intensity, don't you think it. [14:43] Portia Pendleton, LCSW: Would feel more I also just think because of their body stature, right? She's like, small, he's really tall. And so when she kind of assaults him in the bathroom and climbs on top of him with zero foreplay and zero consent right. Asking any questions. And then they finish together after 4 seconds, it just feels like right? Like she's the girl, she's small, he could get off her, he could leave if he wanted. [15:13] Dr. Katrina Furey, MD: Right. [15:14] Portia Pendleton, LCSW: But yes, 100% the other way. If the roles were reversed, even just for body structure, I think it would be more like assaultive. [15:22] Dr. Katrina Furey: Yeah, it would feel more I mean, it is uncomfortable to watch, but it's also a comedy. But you're like, well, Dale's kind of speaking like Attack. [15:30] Portia Pendleton, LCSW: And Dale is also like a child, right? So I don't think he knows what's going on, really, what you do in those situations. Besides, there's a lot of masturbation. They have a lot of the nudie mags. And he has this collection that's from like seventy s, eighty s and ninety s and Brennan's crinkling a page because there's three lower body parts with hair on that page. And it's like a classic and it's. [15:54] Dr. Katrina Furey: Just like so funny. I know. [15:56] Dr. Katrina Furey, MD: Oh my God. [15:57] Portia Pendleton, LCSW: And their favorite magazine to ********** to. That's not a nudie. Good Housekeeping. When they're like, aligning finally and have all of these things in common. [16:05] Dr. Katrina Furey: Oh, my God. [16:06] Portia Pendleton, LCSW: Combining families is hard. [16:08] Dr. Katrina Furey: It is portia. [16:10] Portia Pendleton, LCSW: It is typically less hard for very obvious reasons. And it doesn't make it not hard, but it's less hard when your children are older. [16:19] Dr. Katrina Furey, MD: Right. [16:20] Portia Pendleton, LCSW: So it's like harder to combine families. I'd say the hardest time I find is when you're in teenhood. So I'd say like ten, I don't know, eight to 18 feels because life is so hard those years. [16:38] Dr. Katrina Furey, MD: Yeah. [16:38] Dr. Katrina Furey: I do just want to point out, like eight to 18 is like a good chunk of childhood. So just to point out, most of the time it's hard. [16:45] Dr. Katrina Furey, MD: Right. [16:45] Portia Pendleton, LCSW: So, like, babies, I would say, don't really know anything different till like three. [16:51] Dr. Katrina Furey: That's it. [16:53] Portia Pendleton, LCSW: Three to 18. All of childhood. It's really sounding when you're aware. [17:01] Huff & Doback: Once. [17:02] Dr. Katrina Furey: You have awareness, it's really hard because. [17:05] Portia Pendleton, LCSW: It is so different. [17:06] Dr. Katrina Furey, MD: Right. [17:06] Portia Pendleton, LCSW: And I think one of the hardest things is really not always the siblings, but the parents. Like this guy or this girl who's an adult is coming into your house and you could have the most self aware stepparent who's doing their own work, who's so kind, who's communicative, who's asking questions, and it's still hard. There's boundaries that are supposed to be kind of coming together, but it doesn't feel good at first, and they can't tell me what to do and it feels weird. And what are the other parents? Are they around? It's very challenging, even in the best of circumstances with the best kind of adults. [17:43] Dr. Katrina Furey: And the adults, I feel like, have. [17:44] Portia Pendleton, LCSW: To be able to tolerate the pushback. [17:47] Dr. Katrina Furey: From the kids and not take it personally and just be like, this is to be expected and you have to weather the storm. But I think you do have to have a degree of psychological mindedness and total awareness to be able to do that. [18:00] Portia Pendleton, LCSW: Yeah. So I think when you have adult children who are 40 plus, who a shouldn't be living in the home real. [18:10] Dr. Katrina Furey: It shouldn't even matter. [18:11] Portia Pendleton, LCSW: It really shouldn't matter. That's why it's so unless right. The partner, your dad is dating this woman and she's horrible. [18:18] Dr. Katrina Furey: Take advantage of him. [18:19] Dr. Katrina Furey, MD: Yeah. [18:20] Dr. Katrina Furey: But I think that's what makes this movie so funny. And it's like if this movie were done with children between the ages of three and 18, you could still do it. [18:31] Portia Pendleton, LCSW: Exactly. [18:32] Dr. Katrina Furey: What would happen? [18:33] Portia Pendleton, LCSW: Maybe testing, maybe splitting. [18:36] Dr. Katrina Furey, MD: Right. [18:36] Portia Pendleton, LCSW: Like I'm going to ask now, Stepdad, because he's probably going to say yes. I think it's just like it's interesting when Dale is testing Nancy about know, I like to have a lot of fresh fruit around and I like, whatever in my pancakes or something. [18:50] Dr. Katrina Furey: And she's like, okay, that sounds great. [18:54] Portia Pendleton, LCSW: Great stepmom, if anyone's going to be a stepmom. Nancy is the way to go. So supportive. [19:00] Dr. Katrina Furey: I know, but again, where does it tip over from support to enabling, right? And I thought it's crossed. Where do you think it got crossed? [19:12] Portia Pendleton, LCSW: Maybe at the mangina moment. [19:14] Dr. Katrina Furey: Maybe she just feels so guilty that now from then on, whatever. [19:19] Portia Pendleton, LCSW: Maybe I don't know Dale and Robert. But I'm also curious, just as a side note, and we have no information like what happened to the other parents. [19:28] Dr. Katrina Furey: So are they deceased? [19:29] Portia Pendleton, LCSW: And did that have anything to do right. With kind of enabling or not parenting kids anymore? Maybe, but we don't like I thought. [19:39] Dr. Katrina Furey: They said that Nancy and her husband got divorced and she said what's harder on Brennan? I'm blanking on what happened. Know Mrs. Doback number one, or who knows if there was more than one before Nancy. Maybe she didn't, I don't know. [19:55] Portia Pendleton, LCSW: I feel like she did and I don't know why. Maybe they said that really quickly, but. [20:00] Dr. Katrina Furey: I think she did. But again, I get the sense Brennan's younger, like Derek's doing okay and then Brennan is stuck at home. But again, I think isn't that what we see in family structures like this? That usually it is the youngest with the parent if there is some codependency. [20:18] Dr. Katrina Furey, MD: Right. [20:18] Dr. Katrina Furey: At least in my experience. That's what I've seen. Again, I'm not like a family structure expert by any means. [20:25] Portia Pendleton, LCSW: No. I think it's hard to be in any family system who is merging with another family system. [20:34] Dr. Katrina Furey: Yeah, and it's just like they just really touched on some of the, I would say, like common roadblocks in a really humorous way. And I think you could do it because they're like full on adults and they're hilarious. [20:48] Portia Pendleton, LCSW: Like space. [20:49] Dr. Katrina Furey, MD: Right. [20:49] Portia Pendleton, LCSW: So having your own space or having conversations about space is so difficult if you're merging a family. And what if everyone can't? What if you don't have the money for a 5000 square foot home where one has their own bathroom and bedroom? It's like sometimes people do have to share and that feels there's not always. [21:06] Dr. Katrina Furey: Enough room for activities. [21:07] Portia Pendleton, LCSW: Really difficult. And Dale's drum set should have been moved. It needed to be. [21:15] Dr. Katrina Furey, MD: Right. [21:15] Dr. Katrina Furey: And that's another place where they're enabling him and they're not helping the families merge by being like, okay, fine, you can keep your drum set. You do have to make but then again, it's like but it's also hard on Dale. [21:28] Portia Pendleton, LCSW: This is his space. It's so delicate. And you just said but it's a comedic way of pointing out really challenging things that this happens all the time, right? Like family. Unfortunately, the divorce rate is high. And as we know, evidence says that it's better to have an amicable divorce than to stay in a bad relationship for your children. So a lot of people will stay married because they think that's what's best. Even though they're constantly fighting. It's tense, it's bad, it's like it's actually better to have. Not everyone can do this. Like an okay divorce where the parents. [22:08] Dr. Katrina Furey: Can co parent supportively. [22:11] Portia Pendleton, LCSW: That is great. Kids turn out great. But it's like these really messy things where there's a lot of **** talking. The other parental alienation. That's when things go really go south. [22:26] Dr. Katrina Furey: Yeah. So then in terms of other common roadblocks, when people are merging families, what are some other things that you noticed this film depicted? And again, like a hugely ironic, funny way, but pretty accurately. [22:45] Portia Pendleton, LCSW: It felt like Brennan and Dale hadn't met before. They just got married really quick and they both had this big reaction at the wedding. And again, because it happened really fast, which again, they should be able to do because you have two, three. But like very adult children, that should be fine. [23:06] Dr. Katrina Furey: But for younger kids, it is nice to have a transition period where you. [23:11] Portia Pendleton, LCSW: Slow process, get to know each other. [23:13] Dr. Katrina Furey: You don't just move right in, right? [23:15] Portia Pendleton, LCSW: This is like mom's special friend who's coming for dinner a lot. And then there's these nice moments where there's like play and you're not in a parent role. You move slowly. Sometimes the snails pace, sometimes backwards. But it should be like friend and fun into kind of both into then like the caregiver role, right. [23:38] Dr. Katrina Furey: But you don't just jump in and. [23:40] Portia Pendleton, LCSW: Expect and then make demand. Listen, right? Exactly. Never going to work. [23:44] Dr. Katrina Furey: Right. [23:46] Portia Pendleton, LCSW: But they should meet many times and do some fun things, right? Like go to the movies, go see a show. It's easier. And even this in general is good advice for people who are a little uncomfortable. Maybe like if you have some social anxiety, it's good to do things that you can talk about, right? Like go for a hike, go to see a movie, go get a pedicure. And don't just stare at each other and all hang out in your living room. [24:09] Dr. Katrina Furey: Go for a walk, play with something. [24:12] Portia Pendleton, LCSW: That'S so much easier to do than just having to talk to each other. So they should have done some events. [24:17] Dr. Katrina Furey: And it's hard, too, right, when two parents are falling in love and creating a relationship and they have children of their own, then you're like, well, the kids, you want the kids to get along. And what if they just don't? Right? That's got to be really challenging. [24:31] Portia Pendleton, LCSW: And I think it's difficult and there's not really anything you can do about this. But when kids are really the same age so if your mom starts dating your dad and you guys are in the same grade at school and then you move in together eventually, even if it's like the grade process and it was slow, it's like all of a sudden your step brothers in your class. That's hard. I think. Again, maybe not none of this is easy, but if you're like 15 and your new stepsister is seven, it's like that feels a little bit easier because the roles are so clear. You have your own identity. You're not having to mix friend groups or these expectations. [25:17] Dr. Katrina Furey: Right. Or like, what if you were attracted to your new stepsibling or something? Like, if you're both teenagers, I mean, that is a I feel like that happens. [25:35] Portia Pendleton, LCSW: Do we also see a therapist patient depiction in this movie? [25:41] Dr. Katrina Furey: Which I forgot about, but then I was like, oh, this is perfect. [25:44] Dr. Katrina Furey, MD: Right? [25:44] Dr. Katrina Furey: So we see that when Nancy and Robert are trying to push them out of the nest. They're like, we signed you I loved when they're talking to them and they're like, we put enough money in your account for security deposit, and we're going to give you another kind of support. We signed you up for therapy. And I was like, that was a really thoughtful way of introducing this idea. So we see Brennan in therapy with his therapist named Denise. What did you think of this, Portia? [26:14] Portia Pendleton, LCSW: So also, just like right? Playing on this other trope of right, you you have sexual relations with your therapist. They end up falling in love with you. They come on to you. They're obsessed with you. I think it happens with other providers, too. I don't know. [26:30] Dr. Katrina Furey: It's always a female therapist, though. I mean, this is just like such a Nick Rope or Nick with you. But I'm just thinking, like, in suits, this happened. It's just in The Sopranos, we see this. I'm like, is this like a fantasy? I think it is, because it's teacher, too. [26:48] Portia Pendleton, LCSW: You see a lot. [26:49] Dr. Katrina Furey, MD: Yes. [26:49] Dr. Katrina Furey: You see that like a woman in power. But I just thought it was so funny. Again, looking at her office pretty good. That was pretty good. She's not wearing suggestive clothing. She's in, like, a business suit. And it's just so funny that she reflects something back to him. So basic. I think she's like, that must be hard. And you see Brennan go. Yeah. Yeah. And then that's it. [27:16] Portia Pendleton, LCSW: He loves know. He feels so seen. She's the only one who can understand him. Like, wow. [27:23] Dr. Katrina Furey: He's like, oh my God, we're in love. And then throughout the rest of the movie, remember when Nancy's like, oh, Denise called and she said she's not your like, stop asking her. And he's like, did she say that? [27:36] Portia Pendleton, LCSW: That rascal. And he's like, no, she's not your girlfriend. [27:40] Dr. Katrina Furey: But then she shows up at the end. [27:42] Portia Pendleton, LCSW: Of course she does, right? And is so moved by his singing. She's like and everyone is right. I mean, his singing is excellent. And also the song choice is just so funny. Perfect. Like it had to be Italian, right? He can sing in Italian. Like, he knows all the words. Of course it had to be and Dale is an excellent know it's like, you guys are great. You're actually very talented. [28:06] Dr. Katrina Furey: And when finally pushed lovingly or hopefully lovingly, they can rise to the occasion. They're both working on their feet. [28:15] Dr. Katrina Furey, MD: Yeah. [28:15] Portia Pendleton, LCSW: It seems like Brennan had planned the Catalina Wine Mixer, and Dale is working as a chef. [28:22] Dr. Katrina Furey: Oh, my God. Mark my words. Portia, remind me when I turn 40, I want to have a Catalina wine. [28:28] Portia Pendleton, LCSW: I think that's an excellent party theme for a 40th birthday. Right. I feel like this should be normal. [28:35] Dr. Katrina Furey, MD: Yeah. [28:35] Dr. Katrina Furey: So just remind me in a couple of years. [28:38] Portia Pendleton, LCSW: I'll put in my calendar. [28:39] Dr. Katrina Furey, MD: Thank you. [28:39] Dr. Katrina Furey: Yeah, but oh, my gosh. I mean, it was so funny, though, when she's showing up and Nancy's like, oh, hey. And again, it's like, oh, my God, these are such inappropriate boundaries. You're all calling her by her first name. Some therapists are fine with that, but I just feel like in this situation, probably not. And she's like, I had to come. I had a legal obligation because he threatened to harm himself. Back up. That doesn't mean you as therapist, show up. [29:04] Dr. Katrina Furey, MD: Right. [29:04] Dr. Katrina Furey: Which again, this is a comedy. It's funny, but you call the police or things like that. But again, it is just depicting that Brennan has some problematic behaviors and boundary problems. [29:18] Portia Pendleton, LCSW: And then Denise gets really angry and just starts calling all out the parents. [29:22] Dr. Katrina Furey: You're enabling. [29:23] Portia Pendleton, LCSW: And she has this moment, and you're like, wow. But yeah, guess. But maybe we could have said this in a way where everyone could have heard it in a session where you're being paid and it's like real then there's boundaries around that. Not at where I'm assuming people have had a couple wine mixers and then we see. [29:46] Dr. Katrina Furey, MD: Right. [29:47] Portia Pendleton, LCSW: Derek try to be emotional with Brennan. And he can't. They're trying to hug and they're just like, leaning on each other, and it's so then, you know, Derek has this outburst, again, because he can't be nice to just it's funny, but it's so ridiculous. [30:06] Dr. Katrina Furey, MD: Yeah. [30:06] Dr. Katrina Furey: And it's also like derek probably does have a lot of repressed emotion, like you're talking about. He does use the F word slur a lot, which is hard to watch nowadays. Looking back at some of these old movies, we're just like, oh, gosh. [30:21] Portia Pendleton, LCSW: Because it's like the go to slur for any guy. [30:25] Dr. Katrina Furey, MD: Right. [30:25] Portia Pendleton, LCSW: It's like such a put down with. [30:27] Dr. Katrina Furey: Like, oh, you're being this or you're being that. [30:29] Portia Pendleton, LCSW: And it's like, we don't have any. [30:30] Dr. Katrina Furey: Other creative ways to being like you're. [30:33] Portia Pendleton, LCSW: Like a girl or you're gay. And all people said and I do think it's interesting because I think the F word is so much more shocking than like, oh, that's so gay. Right. I think that was really common. And everybody I'm not going to throw everyone under the bus, but that was something that I think most people said in the early two thousand s and. [30:53] Dr. Katrina Furey: Ninety s too much. [30:54] Dr. Katrina Furey, MD: Yeah. [30:55] Portia Pendleton, LCSW: But really, I think still, the F slur was still reserved for more. [31:01] Dr. Katrina Furey: It feels a little more aggressive. It does. It feels like more aggressive. [31:06] Dr. Katrina Furey, MD: It does. [31:06] Portia Pendleton, LCSW: And so now it feels really. Horrible, and I just think it was, like, a little bit of the times. But also, I do know that with my young adolescent clients, people still do say this. I think we're just also removed from it. I think it has changed a little bit, but I think it's still happening, and I would just love it to not. [31:27] Dr. Katrina Furey: Yeah. No, I totally agree. All right, well, so as we start wrapping up this episode again of one of the greatest movies of all, know, slurs aside, which, again, I don't want to minimize how awful it is to. [31:40] Portia Pendleton, LCSW: Use language like some just putting this out, there like, a little bit of racism thrown in there. When Derek is showing that couple the house, and he's, like, talking to them, and they're like, Why are you saying it like that? [31:53] Dr. Katrina Furey, MD: Yes. [31:53] Portia Pendleton, LCSW: Just call just call us, like, mean, I just think that's not funny know? [32:01] Dr. Katrina Furey: I don't know. [32:02] Dr. Katrina Furey, MD: Yeah. [32:02] Dr. Katrina Furey: No, I hear you. [32:03] Portia Pendleton, LCSW: I don't think it ever should have been, but it feels so much more. [32:05] Dr. Katrina Furey: Like it feels dated. [32:07] Dr. Katrina Furey, MD: Yeah. [32:09] Portia Pendleton, LCSW: Let's be more creative. [32:10] Dr. Katrina Furey: Yeah. Do you think they were doing that to point out this kind of behaviors from Derek? [32:18] Portia Pendleton, LCSW: Yeah, I think it was to point out that he would be like, um. [32:24] Dr. Katrina Furey: And that it's, like, not um. Okay, but as we wrap up, I do think as budding entrepreneurs, I'm really curious to hear what you thought about their pitch to everyone at Derek's birthday party about Prestige Worldwide, because we keep talking about what can we do to get the word out about our podcast. [32:45] Dr. Katrina Furey, MD: Right? [32:45] Dr. Katrina Furey: And I was like, well, this is a creative idea. [32:47] Dr. Katrina Furey, MD: Yeah. [32:48] Portia Pendleton, LCSW: Maybe we should make a slide music video combined with a music video of a boat and show it at a party. Right. Can we do it really fast? I'm having one this weekend, and we could just show it. [33:02] Dr. Katrina Furey: I think, though, the thing is that they showed it at a party with new people. Like, these weren't people they knew. Right. I think all of the people we know are already supporting us, which is great. So I'm like, okay, so what entrepreneur tips can I take from this video presentation? A music videos with a catchy song stick in your head. Like, I know all the words. The Santa, the Zena Maria do in the back while I'm drinking sangria. Like, we all know the words. Okay, so maybe that's an interesting tactic. Again, like, you keep saying we got to go viral. It's kind of similar. Right. And then pitching it to strangers with money, I guess, and wanting investments. [33:44] Portia Pendleton, LCSW: And I think that they just do such a good job of being bold. They are unashamed of who they are and what they're promoting. And at the end of their Know serenade at the Catalina Wine Mixer, I love how Dale in the background is saying potent hose, and then it's like Prestige Worldwide. So we have to do things like that. [34:06] Dr. Katrina Furey, MD: Yeah, we do. [34:07] Portia Pendleton, LCSW: Maybe we should do it at the end. This is a joke for people listening. At the end of our sessions, I'm just going to start saying, analyze Group. [34:15] Dr. Katrina Furey: I'll see you next week. Because people are leaving, like, their hands on the door. You know how in our field there's always like the doorknob comment we talk about when people are leaving therapy and they're like, by the way, you're never going to make me cry. [34:28] Dr. Katrina Furey, MD: Right? [34:29] Portia Pendleton, LCSW: By the way, I'm getting divorced. [34:30] Dr. Katrina Furey, MD: Yeah. [34:30] Portia Pendleton, LCSW: By the way, this by the way. [34:32] Dr. Katrina Furey: I had this repressed memory. Come back and then, bye, see you in two weeks. I hope you enjoy your vacation. But this could be ours where people leave my script. [34:40] Dr. Katrina Furey, MD: What? [34:40] Dr. Katrina Furey: And you're like, oh, nothing. [34:41] Portia Pendleton, LCSW: Yeah, psychologically, which is not ethical. I'm going to implant these little whispers. [34:48] Dr. Katrina Furey: Of the podcast, like subliminal messaging. [34:50] Portia Pendleton, LCSW: Like you're going to play in the. [34:51] Dr. Katrina Furey: Waiting room, but like, backwards somehow. [34:55] Dr. Katrina Furey, MD: Right. [34:55] Dr. Katrina Furey: So it just gets in your head. Our theme song. Oh, my God. I just love it. [35:03] Portia Pendleton, LCSW: Speaking of being supportive, because we are entrepreneurs, we would love for you to follow us on Instagram at Analyze Scripts, on TikTok, at Analyze Scripts podcast and just follow along. Give us some recommendations like this. Rate us subscribe. Thank you for subscribing. We do have a lot of subscribers. It's awesome and we are so thankful for you. It's going up every week and we're reaching for the ride. [35:24] Dr. Katrina Furey: I think we've reached every continent, which is like, wild. We have at least one fan in Kazakhstan, like, who knew? What's up, Kazakhstan? So, yeah, we love the interaction. Let us know what you want to hear. Let us know what you think about this movie. Let us know. Do you enjoy throwback movies like this? Or current stuff? Just let us know. [35:44] Portia Pendleton, LCSW: Yeah, we'd love to hear from you. [35:46] Dr. Katrina Furey: And hopefully if we can find it, we'll send you out with some boats and hose. See you next time. [35:52] Huff & Doback: Boats and hose I got to have me my boats and holes boats and hose boats and holes I gotta have me my boats and hose boats and hose boats and hose I gotta have me my boats and holes I'll do you in the bottom while you're drinking sangria Nachos lemon heads my dad's boat. You won't go down cause my **** can float. We sail around the world and go port to port? Every time I come I produce a quad put on your life best lunch jump anchor there's a nice lady who I like to swank boats and holes boats and holes I got to have me my boats and hose boats and hose boats and holes I gotta have. [36:35] Dr. Katrina Furey: Me my boats and HODcast and its. [36:45] Speaker E: Contents are a copyright of analyzed scripts all rights reserved. Any redistribution or reproduction of part or all of the contents in any form is prohibited unless you want to share it. [36:56] Dr. Katrina Furey: With your friends and rate review and subscribe, that's fine. [36:59] Speaker E: All stories and characters discussed are fictional in nature. No identification with actual persons, living or deceased places, buildings or products is intended or should be inferred. This podcast is for entertainment purposes only. The podcast and its contents do not constitute professional mental health or medical advice. Listeners might consider consulting a mental health provider if they need assistance with any mental health problems or concerns. As always, please call 911 or go directly to your nearest emergency room for any psychiatric emergencies. Thanks for listening and see you next time. Don't.

Welcome back to Analyze Scripts, where a psychiatrist and a therapist analyze what Hollywood gets right and wrong about mental health. Today, we are analyzing "The Bear" season 1. We meet the chefs and other restaurant staff this season and WOW, was anyone else's heart racing? We root for Carmy and the restaurant to be successful but see poor interpersonal skills, trauma, grief and trust issues impact everyone. Mikey's story line is tragic and unfortunately a common reality when mental health issues combine with substance abuse and financial troubles. Be sure to watch this show with some snacks, we hope you enjoy! Instagram TikTok Website Dr. Katrina Furey, MD: Hi, I'm Dr. Katrina Fieri, a psychiatrist. Portia Pendleton, LCSW: And I'm Portia Pendleton, a licensed clinical social worker. Dr. Katrina Furey, MD: And this is Analyze Scripts, a podcast where two shrinks analyze the depiction of mental health in movies and TV shows. Portia Pendleton, LCSW: Our hope is that you learn some legit info about mental health while feeling like you're chatting with your girlfriends. Dr. Katrina Furey, MD: There is so much misinformation out there, and it drives us nuts. Portia Pendleton, LCSW: And if someday we pay off our student loans or land a sponsorship, like. Dr. Katrina Furey, MD: With a lay flat airline or a major beauty brand, even better. Portia Pendleton, LCSW: So sit back, relax, grab some popcorn. Dr. Katrina Furey, MD: And your DSM Five and enjoy. We get started. We just wanted to include a trigger warning for this episode. This episode could include discussion about some themes and topics that might be upsetting, including, but not limited to things like substance abuse, suicide, self harm, disordered, eating, and harassment and assault. So if any of those topics are too upsetting, we totally get it. Please feel free to skip this episode and join us next week. Otherwise, we hope you enjoyed. Portia Pendleton, LCSW: Hi. So we are back again with another episode, and we are going to refer to each other today as, like, yes. Dr. Katrina Furey, MD: Drink, yes shrink, yes, chef, cousin, cousin. Portia Pendleton, LCSW: Whatever kind of comes to mind. We're not going to be swearing and putting each other down. Dr. Katrina Furey, MD: Hopefully not kind of abusive, which we. Portia Pendleton, LCSW: See a lot in the show. The Bear, which you're coming today. Season one, kind of blew up recently over the summer. I definitely had not heard about it last year. Dr. Katrina Furey, MD: I hadn't really either. Portia Pendleton, LCSW: It was all over, like, TikTok. A couple months ago, Jeremy Allen White. Dr. Katrina Furey, MD: Is all in the news because he got a divorce. And I don't know all the details about it, but it seems to be, like a hot. Portia Pendleton, LCSW: Yeah, yeah. People really like. So what how do you want to start talking about this? First, I would like to say that my blood pressure was so high, I'm making this up. Dr. Katrina Furey, MD: Okay. You weren't, like, checking it? Portia Pendleton, LCSW: No. Watching some of these episodes, this level of stress that I was feeling, and my heart was racing, I was like, I feel like I'm back in a restaurant, and I'm not. Okay. Dr. Katrina Furey, MD: Yeah, you worked in a restaurant too at some point, right? Yeah, I did too. Only for, like, six months. Like, in between college and med school, I took a year off to apply, and it was really stressful. I worked in a Mexican restaurant. It's closed now, unfortunately, one of the owners embezzled money and went to federal prison. Fortunately. But I was trying to get out of this other job, and so when I applied, I said I was available for all shifts. So I got all the lunch shifts and made, like, no money, and I would have to come in early and clean, like, literally move the heavy tables, clean the windows. It was, like, a lot of hard work. Portia Pendleton, LCSW: It's like, labor, labor, physical labor. Dr. Katrina Furey, MD: I lost a lot of weight because you're, like, running around all day. And I'll never forget my last day was Cinco de Mayo. I was like, I have to work Cinco de Mayo. Right? I'll never forget. The floor was, like, so sticky with tequila. It was a good restaurant. The food was really good. But at the pre shift meeting, one of my coworkers was like, hey, guys, I got Adderalls. Does anyone want one? And all these people took Adderall. And I was like, I'm good. I'll be okay. I don't know. It really shocked me. But then I guess in watching this show, and I don't know if in your training, you learned that there's a lot of mental health issues in the restaurant industry. Because I learned that. Portia Pendleton, LCSW: Yeah. I mean, I think it seems like and of course, we're generalizing here, but in my experience, and even hearing from clients who work in the restaurant industry, there is so much substance use. Dr. Katrina Furey, MD: Yes. Portia Pendleton, LCSW: And with that often comes mental health issues. I'm just curious about who ends up in the restaurant industry. Right. I think you have to be really personable. You're really friendly, energetic. Energetic, I would say. And I think this is like, a little bit of just like anecdotal information. I feel like it's often kind of you have a little bit of ADHD. You're good, right? You can BOP brunch the 100% environment for you because it's so stimulating and. Dr. Katrina Furey, MD: It'S so quick, fast moving. I totally agree. And I think a lot of young people, I think, work in restaurants or bars or things like that when you're younger. But then I think you're right that there is a lot of substance use. I think there's, like, erratic hours does. Portia Pendleton, LCSW: Not help mental health, sleep. And then I think people often might, in that example that you provided, will take something to help stay up. Dr. Katrina Furey, MD: And then oftentimes, once the restaurant closes, shifts over, I think people go out for drinks. Or then there's, like, substance use with downers, kind of. I think, like we said, it is really hard work. Like, physically demanding. I think the pay can be good, right? Portia Pendleton, LCSW: Depends. Dr. Katrina Furey, MD: Depends. It fluctuates, and you don't really get benefits, so there's a lot of stress. It's certainly like, when we think about what are, like, risk factors, I guess, for mental health conditions, there's a lot of environmental risk factors just right there. And then you're also dealing with people who are hard to deal with. Right? Like, you have demanding customers, people complaining you're not doing it fast enough. There's a mistake. I can't imagine, right? Like, just all the complaints you have to deal with in a personable, happy way. Portia Pendleton, LCSW: And now I always think about everyone having sensitivities or allergies right to foods and how many requests we're making. I do make one request, but I'm just thinking about how complicated things are now. Everyone at a table could be like, okay. And I've been at a table before where it's like, every single person has a something, and I'm just like, oh, man, it's just so much more work. Dr. Katrina Furey, MD: Than just accommodating like, a regular taco salad. Portia Pendleton, LCSW: It's like, no cheese on this one, no meat on this one. We have to leave out the taco because it's corn based so much. It's a lot, and I think the pressure for certain people gets to them, and I think that's why we see. Dr. Katrina Furey, MD: Also just, like, a lot of abuse yes. Portia Pendleton, LCSW: With the hierarchy within the kitchen, and it can get really ugly. Dr. Katrina Furey, MD: Yeah. So when I started watching the Bear preparing for this, unfortunately, Hulu just, like, auto played the last episode of season two. I didn't get through the whole thing. We got through maybe the, like, ten or 15. No, I know. And then we're watching it, and I'm like, am I supposed to understand who these characters are and how they relate? And then all of a sudden, my husband noticed, and I was like it. Portia Pendleton, LCSW: Was like, s two, like, episode ten or something. Dr. Katrina Furey, MD: I was like, oh. So I felt like I had, like, a preview. Not in a great way, but then it's like, I don't think it's going to spoil all that much. So then we restarted it. But even in season one, we sort of see these flashbacks of Carme right. Played by Jeremy Allen White, the main character who worked in a really fancy like, they kept saying, the best restaurant in the world, and we saw Joel McHale. I was surprised to see in, like, a dramatic role. Do you know who Joel McHale is? Did you ever watch The Soup? No. Okay. Again, I'm older than you, but I. Portia Pendleton, LCSW: Know I didn't like. Dr. Katrina Furey, MD: It. Portia Pendleton, LCSW: I don't love him. No offense. That's okay to him. If you're listening, that's okay. Dr. Katrina Furey, MD: Does he have any weird outcomes? Portia Pendleton, LCSW: I just don't think he's funny. No. To me. And maybe he is now, but I remembering watching The Soup and being like, not your thing. Dr. Katrina Furey, MD: That's fine, but yeah, dark, like, abusive. And it was very hierarchical, like, almost like the military. It kind of reminded me of and you have to go up the chain and sort of that kind of thing. In prepping for this episode, I did some quick research, and it does seem like the restaurant industry hospitality has very high rates of depression, anxiety, substance abuse, and harassment, which I think makes sense, like, if you've ever worked in one. And then I think this show really accurately portrays that. Like, you were saying in watching it, your heart rate is high, your blood pressure is high, you feel stressed, and you're like, God, it is a lot. It's a lot. Portia Pendleton, LCSW: I mean, when they had finally implemented the to go, oh, my gosh, and they didn't notice that they had done, like, preorder selection, and it was just, like, coming out of the machine. I was just I felt like, I mean, a good acting, good storyline sucked me in. I don't know if it's because I can, like, I have some restaurant experience, but I was just like it's like a trauma response. So some people freeze, some people flee, and other people freak out and fight. Whoa. Dr. Katrina Furey, MD: Interesting to see everyone's individual response. And carmi just freaked. Like, it was almost I felt like his explosion of pent up emotion. Right. I feel like his sister Sugar had been saying, you're not expressing things. And he wasn't really he was really holding it in, and then it just all exploded. Like, he couldn't take it anymore. I was really proud of Sydney and Marcus for walking away and being like, we don't tolerate know I didn't see that coming, but I was really proud of them for doing that. Portia Pendleton, LCSW: And I think what I thought was interesting was when we see Carme working at that Michelin star restaurant, and he's being right, like, verbally berated saying all these horrible things to him. I thought it was so interesting because Sydney and, like, have a similar experience with working at higher end places. They know, yes, chef. Behind you, chef, all that stuff. So Sydney, in one of the later episodes when she is accidentally a stabs richie in the behind. But also, you see her absolutely berating him. Right. She's like, you're a loser, your kid, your partner. And I think for her, that almost felt like she was so horrified, almost, that that's how she had become in this place. Right. Because her and Carmen talked about how horrible that was, and then she did it, and it's like, place brought it out of her. Right. Dr. Katrina Furey, MD: It's like the abuse becomes the abuser, which we see. I'm thinking more along the lines of children who grew up in abusive environments and then sort of take on those behaviors in adulthood. It's reminding me of that. Yeah. And I feel like she couldn't it was really sad. And when she was sitting there at the lockers, and he was like, are you okay, chef? And she's just like, no. And it's like, no, you're not. You're right. And she has to walk away. And I think you're right. I think it was a combo of Carmen berating her, but then her doing that too. Portia Pendleton, LCSW: Right. And losing it, and right. They are these experts, and she's holding the knife right out. No intention right. Dr. Katrina Furey, MD: Of like yeah. Portia Pendleton, LCSW: First she's waving around, but then she's pointing it out, and he just, like, turns like, you don't ever walk with a knife pointing out. That stuff can happen. Dr. Katrina Furey, MD: Exactly. Right. Portia Pendleton, LCSW: And you can stab someone in the a fatty tissue place where it's, like, less right, right. Whoa. Dr. Katrina Furey, MD: I know. Portia Pendleton, LCSW: Yeah. Dr. Katrina Furey, MD: And so, again, it's just like, how did all that come to be? Was it, like, stress? Was it trauma? Probably a mix of everything. Also, like, Richie I don't like him. There have been very few characters so far in all the shows and movies we've watched, which is quite a bit by now, where I really don't like them. Like, the whole time I'm watching it, I'm trying to find something redeeming. And since I did see the first. Portia Pendleton, LCSW: Ten minutes of the final episode of. Dr. Katrina Furey, MD: Season two, and I see what role he assumes and he's behaving a little differently, spoiler alert. It's not much of a spoiler, but still, I kept trying to find something redeeming about him, and I had a really hard time. What about you? Portia Pendleton, LCSW: I think that I really did not like him until the last episode, and I wouldn't even say I like him. I feel like I just have empathy for him. I feel sorry for him. Dr. Katrina Furey, MD: Why? That's where I struggled. Portia Pendleton, LCSW: I feel like he is so broken. Dr. Katrina Furey, MD: Yeah. Portia Pendleton, LCSW: And I want to know nothing story. Maybe we learn it because they said in season two read an article that was like, season two gets right with the only thing that season one got wrong, which is like, there was no backstories for anyone. We didn't know anything about anyone. And so I'm wondering if we get his because I'd be so curious. Dr. Katrina Furey, MD: It just seems like he's. Portia Pendleton, LCSW: And why he was really hearing what Sydney was saying when she's calling him a loser. Dr. Katrina Furey, MD: I feel like he feels like he's. Portia Pendleton, LCSW: A loser, and he's a loser in every way. And then he talks about his daughter saying to his ex or her mom, right. Like, he's bad news, Richie or something. Dr. Katrina Furey, MD: I just feel like that's more. Portia Pendleton, LCSW: I feel bad. I don't like him. I don't want to be his friend by any means. I don't want him to be around him. But I just feel sorry for yeah. Yeah. Dr. Katrina Furey, MD: I kept wanting to feel sorry for him and trying to access that empathy, but I had a really hard time. And again, I hear what you're like. It seems like before Mikey died by suicide, richie was, like, the head guy, like, maybe the manager, or like, he was, like, running the show. And then I think to have Carme and Sydney come in, like, out of Sydney, a younger girl, a younger black girl, which, again, maybe that's not intentionally getting under Richie's skin, but maybe it is. We don't really know yet. But again, I could see how that would threaten his ego, because this is. Portia Pendleton, LCSW: All that he has. And then he kind of says that at the end, right when Carmen picks him up from the jail, which I thought was really interesting. And this is a little bit of a sidebar, but I think it's so risky, little PSA, to ever be in a fight with someone that's physical, because we all talk. Oh, someone says something to you. Everyone's drunk in a bar. A bar fight, right? Someone gets punched in the face. It doesn't seem crazy, but it's like the wrong hit you could fall. You hit your head, you can die. And it's like now it's literally manslaughter. And it's like things can escalate so quickly where it's like it's not just like right, a punch in the schnaws or getting pushed. Dr. Katrina Furey, MD: It's like hitting your head wrong on the curb. Portia Pendleton, LCSW: Yes. I'll never forget and I'm going to talk very loose circumstances here, but witnessing someone hit someone and they fell and they hit their head on the curb, that's scary. They got up. But I know another instance that I did not witness but happened at my college. Dr. Katrina Furey, MD: Even like if you're super intoxicated and you fall the wrong way right. You could die. Portia Pendleton, LCSW: Yeah, it's really know. And I don't know if it's just like I respected and this is such a stretch. I respected Richie for completely owning that he was the one that did he there was, you know, because it was messy. Right. Everyone's pushing, pushing. And there was no question he was going to take the and I think that's also when he comes out, he's like, no, this is all I have. I would do anything for you. It seems like they connect. I'm curious to see in season two how that plays out. I'm hoping that that's like a change then for Richie. Dr. Katrina Furey, MD: Yeah. Portia Pendleton, LCSW: But up until that episode, I was so irritated with him. He just kept messing everything over and over. Dr. Katrina Furey, MD: That's what I mean. And I do think that's like the perfect depiction. And I'm like I am really curious. And I hope we do learn more about his backstory because I wouldn't be surprised if he had, like if I'm making it up. Really critical parents, like one parent who's really critical, one who's absent, whether it's because of substance abuse or like a father left or something like that, that's setting him up to never feel good enough. So he's going to keep trying, keep trying. And then he just gets to the point where it's still never good enough and he starts getting in his own way. Portia Pendleton, LCSW: Right? Dr. Katrina Furey, MD: Like he just kept messing up. Yes. Like when they did the kid's birthday party and he doesn't bring the ketchup. Right. His Xanax. Portia Pendleton, LCSW: Oh my God. Dr. Katrina Furey, MD: And the drink and all the kids pass out and no one calls the ambulance. Portia Pendleton, LCSW: I was like, waiting for your take on that. I was just like, dying. Dr. Katrina Furey, MD: When they just show, all the kids. Portia Pendleton, LCSW: Pass and the guy right? They're like mobster uncle is like, well, this is preferable, to be honest. Because he's like annoyed, right? Kids suck. Kids are annoyed. Dr. Katrina Furey, MD: Kids are annoyed. At least they're quiet. Portia Pendleton, LCSW: But I was like, are they breathing? Dr. Katrina Furey, MD: Has anyone put their fingers under their nose to see? Portia Pendleton, LCSW: Is their breath? Dr. Katrina Furey, MD: Oh my God, I can't believe no one called the police or the is. Portia Pendleton, LCSW: Such a bare minimum, and you're going to be like, you're crazy. But I was kind of pleasantly surprised that Carmen told him. Right? I feel like, it could have been like, oh, because you could literally go to jail for that. Again, not intentionally, but you could go to jail. Dr. Katrina Furey, MD: Maybe you should. Right? Portia Pendleton, LCSW: So the fact that he told him. Dr. Katrina Furey, MD: I was like, okay, at least have. Portia Pendleton, LCSW: A moral compass in there. Dr. Katrina Furey, MD: Get somewhere in there, I guess. Yeah, but then no one does anything. Portia Pendleton, LCSW: But I was thinking would have been in there, right? Let's talk about that. Because it looks like it was one bottle. So were they like, bars? Dr. Katrina Furey, MD: That's how Xanax comes, right? I don't remember what the dose was. So Xanax is the trade name for Elprazolam, which is a very short acting benzodiazepine. Incredibly addictive, right? That's why most people don't prescribe it, hopefully, except in very specific circumstances, like flight phobia or something like that, where you only need a little relief for a little bit of time. Portia Pendleton, LCSW: You're not getting prescriptions every month for it. It's like you're getting ideally, right? Like, once a year should be enough. I think providers feel comfortable with that. Dr. Katrina Furey, MD: Depending on the situation. I think, unfortunately, it is really abusable. And the reason it's so abusable is because it is so short acting. So it hits your system really quickly, like, within 30 minutes or so, you feel so good, you feel a lot calmer, but then it's out of your system really quickly, too. So then you're like, oh, I need more, I need more. And thus starts the cycle of dependency and addiction. And again, I specifically use those words because there's a difference, right? You can become physically dependent on a medication like this. Like, your brain gets used to it. If you don't have it, you develop withdrawal symptoms. You need more. You can have that without perhaps being addicted. But again, they kind of go hand in hand, I guess. But with addiction, you also think of it as like, okay, then you start doing riskier things to obtain it, right? Like, you might start stealing, or you might start obtaining it illicitly, like, on the street, or you might be spending a whole lot of time trying to find it at the expense of work or spending time with your family. There's a lot of criteria that go into addiction, but you can also be physically dependent on I mean, that is like, one of the main criteria, too. Portia Pendleton, LCSW: And I believe right. You can die from the withdrawals from. Dr. Katrina Furey, MD: A benzo 100% class. Yes. Benzos act on the GABA receptors in the brain, very similar to alcohol. So it's also incredibly dangerous to mix benzos with alcohol. When you're intoxicated with both, what can be fatal is the respiratory depression. Basically, you start breathing so slowly that you could stop breathing. And that's what I was worried about with these kids, just, like, sleeping. I was like, is anyone making sure they're breathing and they're getting enough oxygen to their brains? Like, these little kids getting whatever the adult dose is. I mean, it looks like the whole bottle got in there somehow. Who knows how much is in there was so dangerous. And then if you are addicted or physically dependent on alcohol or benzos and you just try to quit cold turkey, that's also potentially fatal because you can develop seizures and cardiac instability. So, like, really high blood pressure, really high heart rates, you could have a stroke, you could die. So it's really dangerous. I was very uncomfortable with that whole. Portia Pendleton, LCSW: Like, you need a medical detox, right, versus, like opiates. It's a horrible detox, but you can stop. You won't be very sick, you won't die. But a couple of kids, and I say kids because they were under 18, who I worked with in a residential program, if they were abusing benzos, they would still be on them, right? So they would come in and they'd receive a lower and a lower dose versus some of the kids who were on opiates, they would be very sick or they would have been in a very fast detox like in the hospital. Dr. Katrina Furey, MD: Yeah, I did a lot of detoxing when I worked at the VA in residency, and I did a lot of time in the emergency room there. So that was like one of the main things we saw. And you're totally right that alcohol or benzodiazepine detox is medically necessary. Like you could die. And that was like one of the hardest conversations to have with patients when they would get to day two. And of course they're waiting for a bed because we don't have enough access to treatment in the whole country. We've already talked about this. But by day two, they're starting to feel cravings. They want to get out of there and we have to have the discussion like you're just starting the detox. We still don't know which way it's going to go. There's like risk factors and algorithms we can keep in mind to help predict it, but we just don't really know. You could get delirium tremons, which is potentially fatal. I mean, it's really scary and a lot of times they would leave against medical advice and probably start drinking again, which is very sad. But then in other ways you're like, well, I guess it mitigates the risk of death from an unsupervised detox, but it's really risky. But you're right. With opiate withdrawal, that's where the phrase cold turkey comes from. It feels like the worst flu of your life. It's incredibly painful to go through, but it's not medically dangerous. So in either way, like with benzo or alcohol withdrawal, we do taper using the benzos. And then you can also give other medications to help with other symptoms to help make people more comfortable. And then with opiate withdrawal, some places will start, like Suboxone once you're a couple of days out to make sure there's enough out of your system where it doesn't plunge you into a worse type of withdrawal. But then you also give other agents to help make people feel more comfortable. So that too, it's like ideal if you can do a medical detox, but not medically dangerous if you're just trying to quit, like, on your own. Portia Pendleton, LCSW: Yeah. Circling back now to restaurant employees right. Often not having insurance. Dr. Katrina Furey, MD: Yes. Portia Pendleton, LCSW: And being or I think, too, what's interesting now is with a lot of credit card tips right. That is on the books versus cash tips. So it's like they pay taxes on right. So you could be, I think, right on the line with, like, you don't make a ton, but you also don't qualify for Medicaid or full Medicaid. So I just think there's a lot of people that are underinsured or not insured who specifically work in this field of know with with sometimes raging substance use issues and mental health issues. It's just like a perfect storm. Dr. Katrina Furey, MD: Yeah. And I mean, most detoxes would be at least five days. So when you're imagining, like, in restaurants, you often do, I think, live day to day in terms of your income. It's not predictable. You're not going to have short term leave or things like that. It's really hard to think, like, I'm going to take five days away and somehow pay for this treatment and make up for not and then come back. The same environment. Portia Pendleton, LCSW: Right. Dr. Katrina Furey, MD: It's really tough. Portia Pendleton, LCSW: Yeah. I was just thinking about Mikey in that and just like, it seemed like he was struggling for a while with opiate abuse, and some people knew, some people didn't. And that was kind of really eating at Carme for not knowing. Dr. Katrina Furey, MD: Yeah. So what did you think about Mikey's story and then this show's depiction of addiction and grief and people reacting to someone's suicide. Portia Pendleton, LCSW: I thought it was good. I thought it did a good job of showing multiple reactions and responses, which I think hits the nail on the head with everyone will respond differently. I think if we look at it in kind of a black and white way, like, some people shut down, other people have really big reactions immediately. So it's like right. Someone if you're picturing at a funeral, which is kind of morbid, there's people who are, like, wailing and visibly upset for weeks. Tanya from Lettuce. Yes. And then there's people who are just totally shut down right. Haven't cried at all. And that doesn't mean that they're not processing it or grieving, but I'd say because they might be doing it at home. But if you're not doing it at all, I think then sometimes there's a bigger reaction that comes out later, which we see with Carmen kind of starting to lose it or some of his other symptoms, which I was curious to get your take on with some of the nightmare being sleepwalking. Right. And in his apartment earlier on, it seems like he's having a horrible time sleeping, which isn't helping any of his symptoms. And then at the end, we see, right. Him kind of what appears to be maybe he's, like, dissociating when he tries to light a cigarette and then the whole stove catches on fire. Two different things, I feel, like, all around fire, too. Dr. Katrina Furey, MD: Yeah, I mean, I think you're totally right. Portia this show, I thought, again, another expert portrayal of grief, and I think the complicated grief that comes from losing someone to suicide, of all things. Like, just how many questions are know Carmen? No one saw a note until the very end, and it's still in my mind. It's like, Was that a suicide note? I think so. Portia Pendleton, LCSW: I think it was meant to be, but it wasn't, like, by the know, maybe not by Mikey, but it just. Dr. Katrina Furey, MD: Wasn'T it wasn't clear. And I think in the know, it sounds like Mikey and Carmee, they were brothers, right? They sort of bonded over cooking. And then Mikey goes on to open the Bear, but then won't let him. Portia Pendleton, LCSW: Eat the beef store. Dr. Katrina Furey, MD: Sorry, the beef, but then won't let Carmen work in it. And that created a really big rift in them. And I think we still don't really understand why he wouldn't let him in. I started wondering, was there some connection to organized crime? It seemed like Richie maybe had a connection. And those feuding groups on the corner that Sydney placated with the sandwiches and even, like, the Uncle Jimmy, I was like, Is he a like, is that why Carmen wasn't he was trying to keep him away? Or was there something like, is that how Mikey got introduced to Opiates? There were a lot of questions for me, but then that was, like, a real wedge in their relationship. And it sounds like in the very last episode with Carmen's Monologue at Al Anon, first of all, how moving was. But then we finally start learning some of this backstory, and it sounds like that almost, like, fueled Carmen's desire to show, like, just achieve know, really escalate to the best of the best, to be like, you're lost, dude, and then gosh, how complicated and confusing for carme to lose your brother in that way. And then learn that he left the restaurant, that he'd never let you work into you, and you have to leave your position at this best restaurant in the world to come here. Like, Whoa. Portia Pendleton, LCSW: And also was and maybe it didn't feel like a choice, but that was his choice, that a lot of people were like, what are you like, you didn't need to come back. I think Richie was upset that he was coming back and taking over. I think the staff initially were all. Dr. Katrina Furey, MD: Upset that he was, because it seemed like the like, Tina Ibrahim, like, all the staff, it seems like, had been there for that. They forever, right? And then all of a sudden, you have Carme coming in out of nowhere again, this white guy. A lot of the staff. Were people of color. And then he hires Sydney, this young girl, and they're like cleaning everything up, operationalizing things. And I could imagine and we see how the old crew reacted and we're like about it. Yeah, exactly. But then eventually they do warm up to it. And I did think at the beginning, Carme was really respectful in terms of saying, we call each other chef. We have high standards. This is what you need to do well. And at first, they weren't really believing it. Like the family dinners I thought were so I never had that at the. Portia Pendleton, LCSW: Restaurant I worked at. Right. I was like, Where did this come from? Dr. Katrina Furey, MD: This is really nice. We all have dinner before it's. Like, that's really nice. I think eventually it did help them sort of get on board. Portia Pendleton, LCSW: Right. Dr. Katrina Furey, MD: But it took a while, especially with Tina. Portia Pendleton, LCSW: And know, it seemed like Tina kind of bought know after a little bit with Carmee, but then it was really like an interesting dynamic watching her and Sydney, and then Tina pretending not to speak English, like, here and there. And Sydney's like, I know you can you just were doing it and calling. Dr. Katrina Furey, MD: Carme Jeff instead of Chef. Just all these slight jabs. I can't remember what it was that finally got her to come around, but eventually she did with Sydney. Portia Pendleton, LCSW: It was something with the potatoes, right? So, like, Tina didn't burned something or something and then Sydney already had it going, but didn't criticize. Tina was like, just get it over with, do it. And Sydney was like, no, it's fine. And then she complimented her later. And then I think Tina was like, okay, we're good. Dr. Katrina Furey, MD: Yeah. Sydney kind of like, helped her out instead of rubbing her nose in it. But getting back to, I think what you originally asked me about grief, I also thought it was interesting that I was like, is there a gender dynamic here? Because his sister seems to be more openly grieving or at least talking about the death. She's like, trying to get him to go to Al Anon, which to me suggests she's going to Al Anon and then Carmi is really closed. And I I think you could say that might be a more stereotypical man reaction. Portia Pendleton, LCSW: I'm sure it depends on generalizing, super. Dr. Katrina Furey, MD: Generalizing, like, depends on different families structures and dynamics and stuff like that. But I think what is that old phrase? What is it we talk about a lot with trauma? Like what you won't remember eventually comes out or something. What you try to avoid thinking about eventually comes out, whether you like it or not. Death of anyone can be very traumatic, but I think a suicide in particular is very traumatic for all the people involved. And it sounds like in Mikey's case, it's like, was it planned or was it impulsive? Right? Like, was he intoxicated and had a mean it's not really clear until we find the note, right? Portia Pendleton, LCSW: I don't know. Dr. Katrina Furey, MD: What did you think? Portia Pendleton, LCSW: I think it was unclear. I mean, I think I could go on the one hand with him stashing the money for so long. Was he planning on ending his life for that time, or was that just like a side project of him? Just like, stashing all this money away to avoid taxes? To avoid taxes or in the end to give to Carme? I don't know. Was his plan like, okay, Carme is going to be this amazing chef, and then we're ready for him, we're going to have all this money? Or was it like, I know I'm going to die? I don't know. Dr. Katrina Furey, MD: It's a weird spot to leave a suicide note, right? Usually I feel like if someone does leave a note, it's with the body, like it's nearby. Portia Pendleton, LCSW: Do you think it was maybe, though, supposed to be in a locker and fell out? Like, maybe, like, Carmen's locker from years ago? Because that was my question. Why was it behind lockers, the lockers on the floor? Had it fallen somewhere? Was it supposed to not be there? I don't know. Did he mean to bring it with? Dr. Katrina Furey, MD: That's what I mean. Portia Pendleton, LCSW: How could anyone find that? Someone could have easily thrown it away, could have easily gotten damaged by water or something. It just was so risky. And also right. If you're leaving someone, like, $300,000, you want that to get to them. So that was just strange. Dr. Katrina Furey, MD: It was strange. Portia Pendleton, LCSW: Why do you think Richie put it back? Dr. Katrina Furey, MD: I think at that time, when he first found it, he was still really mad at Carmen for coming in. In this season, we really see how the landscape of Chicago, the landscape of their neighborhood, the landscape of the restaurant itself is changing. Portia Pendleton, LCSW: Gentrified. Dr. Katrina Furey, MD: Yes, exactly. And I think Richie's like having an identity cris and not on board, and I think he was just at that time, really mad at Carmen, didn't want to help him along. Portia Pendleton, LCSW: I guess this is where my little thread of empathy comes out. It's like he could have thrown it out. Dr. Katrina Furey, MD: That's very true. Why did he put it back? Portia Pendleton, LCSW: Put it back. Dr. Katrina Furey, MD: That's actually a nice point, Portia. Portia Pendleton, LCSW: I don't and there's million different reasons why, but I'm thinking maybe it was because not right for Carmen. But he couldn't do that to not. He's he wasn't just being this huge. Ahole. Dr. Katrina Furey, MD: Right. Portia Pendleton, LCSW: There was just something in there. I don't think it was he was looking out for Carmen. He didn't think Carmen was ready. Dr. Katrina Furey, MD: I don't know. Portia Pendleton, LCSW: Maybe. But there was something. Dr. Katrina Furey, MD: You're so right. He could have thrown it. Oh, okay. Now I'm feeling something for him. Portia Pendleton, LCSW: You're right. Dr. Katrina Furey, MD: Like, he definitely could have, and he didn't. Portia Pendleton, LCSW: Just interesting. Dr. Katrina Furey, MD: Yeah. That's really making me think. Really making me think. Portia Pendleton, LCSW: So we know from past episodes how important sleep is, right. And how the lack of sleep can literally bring someone right to have some psychosis. Dr. Katrina Furey, MD: Yeah, and mania like sleep is the biggest trigger of a manic episode. Psychotic episodes, for sure. I've seen a lot of first breaks in college. Students who were flying internationally didn't sleep on the plane. That's what brought it out, finally, which. Portia Pendleton, LCSW: Is what you said, that I am good because I went to Europe and I was up for like 48 hours and I'm fine. I was like, that's a really good sign. You don't bipolar disorder in Portia winning in some ways here, but also in. Dr. Katrina Furey, MD: The restaurant industry, like other industries, too, like if you're working third shift or other things like that, it is so disruptive to your sleep. And I think the high energy, fast paced environment of restaurants makes it really hard, even when you get home to fall asleep. I think that is why so many have a drink after work or take another substance like Xanax to try to calm their brain down. Portia Pendleton, LCSW: It's also so bright in the kitchen. You know what I mean? It has to be, but the lights are so fluorescent. It's so bright and shiny in a cleaner restaurant. I was impressed at how much they were cleaning. Dr. Katrina Furey, MD: I was very happy. I think, again, that's, like, where Carme comes in and is like, this is unacceptable, even if we're like a sandwich, like, let's have high standards for ourself. And I thought, that's a nice way to live as long as the standards aren't impossibly high. But I think it does. And we saw that it did lead to feelings of self efficacy and pride in your work. But yeah, certainly you hope all the restaurants are that clean. I sort of doubt they all are. Portia Pendleton, LCSW: I think it's so funny, like, being kind of near New York and going and right. And seeing the know, just kind of how they showed in Chicago, because they don't do that in the like I'm sure there's, like, a public health infected, but they don't have that in the. Dr. Katrina Furey, MD: Window, which I just think is so, like and it was interesting, like, when they didn't get a good grade, and he's, like, blaming Richie, but then it turns out it was his fault. That's like another time where he was sort of like kind of I did, I think at least in the initial time where he was setting his apartment on fire, they both felt dissociative to me. And I think that's part of his trauma response. Portia Pendleton, LCSW: Right? Dr. Katrina Furey, MD: Just like trying to keep putting 1ft in front of the other, but you're not processing what you're feeling, and it will inevitably come out and sort of that's how it was coming out at the end with the fire in the kitchen. At first I thought, is he going to intentionally let the restaurant burn down and be like, okay, now it takes care of it. But then everyone sort of grabbed the fire extinguisher and took care of it. Portia Pendleton, LCSW: Yeah, that was an intense scene. So, like with Mikey's suicide, I think we kind of talked a little bit around the edges here. But suicide, I would consider is like a complicated loss, right? So there's some losses that are really uncomplicated. Like losing a grandparent in a natural way, right? It's like it's sad and can be really life shattering, but it's expected. It's like the natural way of life. And those losses are typically more easy to process, just like as a human. But then these complicated losses, like losing a child as a parent or losing a parent when you really suicide exactly. Or really unexpected deaths are complicated. And it doesn't mean that this is way harder or it's a much bigger loss, but it's just a different loss. And I think it can make it harder to process. And I would really say specifically with suicide, because there are so many times that people somebody does die by suicide, the people who are left right, are often like, what did we miss? How did I not see this? How could I have stopped it? And there's so many of those lingering questions that we don't ask ourselves when again, it's like a grandparent has an attribute loss. Dr. Katrina Furey, MD: And sometimes you ask yourself those questions right. In the grieving. Like, when we think about grief, that is a common, universal human experience right. Portia Pendleton, LCSW: There'S the what stage would that be like? Bargaining. Yeah. Dr. Katrina Furey, MD: So there's Elizabeth Kubler Roth has her five stages of grief theory shock, denial, bargaining, anger, acceptance. We don't think of people as moving through those stages linearly. Like, you can feel things at the same time. You can go back and forth. But those are like, the universal emotions all humans feel. When you're grieving in the field of mental health, then we sort of think about, okay, what's like a typical grief reaction versus, like, a complicated grief reaction? And again, it's not because we're trying to have grief Olympics where one person is worse than the other. It's just grieving. A suicide is very complicated, and I think it is traumatic. I think a lot of people develop trauma reactions or even post traumatic stress disorder when these things happen. And I think you hit the nail on the head portia that it leaves so many questions and people when you're faced with an unimaginable trauma, you try to make sense of it. And a lot of times that leads you to blaming yourself. And that's where really good therapy is important. And sometimes you can find that, like in Alanon, which is the sort of what would you call it? Portia Pendleton, LCSW: It's for people who have been impacted by people with substance use. So someone who is struggling themselves currently or in the past, who goes to know that's typically for them, and then maybe their brother, their sister, their parents would go to Al Anon, right? Dr. Katrina Furey, MD: Exactly. And it can be a really healing, helpful place. And finally carme started. I was I remember, like, midway through the season when things were really stressful. He's like, I have to go. I have to go to a meeting. And then Sydney was like, you just left us here. And they finally sort of connected over it, remember? And then she was like, Chef, that's too much. Portia Pendleton, LCSW: Yeah. Dr. Katrina Furey, MD: And he's like she's like, I'm just kidding. But yeah. I think to lose anyone by suicide has got to be devastating and traumatizing and so hard to cope with. So there are resources out there. I mean, in terms, of course, your own individual therapy, but Nami, the National Alliance on Mental Illness, certainly has a lot of resources available to people who have lost loved ones by suicide. I would imagine that feels lonely, right. Hard for someone to talk to their friends about, or their family about, if they haven't gone through it. Portia Pendleton, LCSW: I think there's a lot of perceived and it might not be real or not, but like, perceived judgment from others. I know that a lot of parents who have lost teens to suicide really feel like there's a lot of judgment on them for they should have known, they should have stopped it. So I think it's really hard to reach talk to people who haven't experienced it, and what a wonderful way for a very horrible thing to occur. But if you can find a group with other shared experience, it can be so helpful and such a safe space. Right? Dr. Katrina Furey, MD: And I think it's really scary to start attending a group. Whether it's group therapy or a support group, I think it can be really scary. And that's totally normal if you're feeling like that. I always try to encourage my patients, just go sit in the back and just see, test it out. You don't have to say anything, just see what it's like. And I always say not everything's going to stick. Especially things like AA. There's a lot of resistance to it from different people. And some people don't identify with the religious aspect. There are non religious AA groups out there these days. But I always try to tell people, like, go take what works and leave the rest. You don't have to accept everything to find some healing or benefit from some of the things. But there are, I think, nami, and I'm sure, other groups out there with support groups or people who've lost loved ones to suicide. I think that's a uniquely terrible way to lose someone you love. And especially when there's substance abuse, too. It's just even murkier, right? And you could see these characters really be like, how did we not see it? Should I have done more? And it's just I think a lot of the healing and therapy comes from just exploring that with people and trying to help people not blame themselves. But it's really it is really hard. Portia Pendleton, LCSW: It's heartbreaking and it's hard. And not to deter anyone from going to see a therapist, but it's hard as a therapist to sit in that. I think grief is hard because there's no really clear treatment plan based on time, right? It's like, okay, well, we should be processing this better now. Sometimes it's shorter and other times it's so long and grief is challenging. And I know even additionally to that, a lot of clients who are a support for someone who is going through grief, it's so hard just to sit and be there because we want to make people feel better, right? We want to get people okay and feeling happy and positive and sometimes it's just not we can't do that yet and we just have to wait. Dr. Katrina Furey, MD: And that's hard. Portia Pendleton, LCSW: It is hard as a provider and it's hard as obviously a person who's not a provider. Dr. Katrina Furey, MD: And sometimes when people do die in very tragic ways, it is hard to bear witness and sit with someone in that suffering. But it's so important. And again, I think that's where it's really important for therapists to also know their own limits or have their own support system, right? We're all supporting each other. But you're right, it is really hard to bear witness to grief, I think, as we wrap up. Isn't it interesting that thus far in our podcasting journey, there have been some common themes of shows that are big hits in society and a lot of them are about like, we talked about shrinking, we talked about succession season four with Logan's death. Now we have the like I think, again, that just speaks to how grief is such a universal experience and we all can connect to that. Yeah, that's a good know. Portia Pendleton, LCSW: I think a lot of people resonate with tough topics and whether it's we're seeing it done in a comedic way or really dramatic and intense way, it's like everyone knows someone who knows someone or themselves who struggled with substance use. Everyone knows someone is someone who struggled with grief. And it's just like, again, these universal experiences that I think it can be really helpful to have a media or write some content out there that helps you cope, whether you're crying through a show or laughing through a show 100%, right? Dr. Katrina Furey, MD: It's like a way of connecting and experiencing it or feeling less alone, right. I think we're all wanting to feel like someone out there understands what we're going through. And even if it's not, or most of the time it's not the exact same experience, but these shows really let you know, like, okay, the writers, the creators, the actors, they're all doing such a good job because they know in some intimate way and then whoever's watching it can also feel understood. Even like the whale, everything, everywhere, all at once. Like everything. These themes are coming up again and again and I think these expert portrayals of it are just so great to have. Portia Pendleton, LCSW: And that's why they're nominated, right? That's why also these are successful. Dr. Katrina Furey, MD: So it's really interesting. I'm excited to see where season two. Portia Pendleton, LCSW: Leads now that you have maybe a little window into some things. I'm excited to watch it too. I'm looking forward to it. I was laughing because I started episode one, season one, and I was like, trying to get my husband to come watch it. And he was like, oh my gosh. And he has restaurant experience too. And he was just like, I don't know if I can watch this. And I was like, it's really intense. I don't know. Anyway, but thanks for listening to our episode today on The Bear, season one. We will be covering season two at some point, so stay tuned. Dr. Katrina Furey, MD: I think next month. Portia Pendleton, LCSW: Yeah, so we're excited. Make sure you follow us on Instagram for some more content at Analyze Scripts and on TikTok at Analyze Scripts podcast, and we will see you next time. Dr. Katrina Furey, MD: Bye bye. This podcast and its contents are a copyright of analyzed scripts. All rights reserved. Any redistribution or reproduction of part or all of the contents in any form is prohibited. Unless you want to share it with your friends and rate review and subscribe, that's fine. All stories and characters discussed are fictional in nature. No identification with actual persons, living or deceased places, buildings or products is intended or should be inferred. This podcast is for entertainment purposes only. The podcast and its contents do not constitute professional mental health or medical advice. Listeners might consider consulting a mental health provider if they need assistance with any mental health problems or concerns. As always, please call 911 or go directly to your nearest emergency room for any psychiatric emergencies. Thanks for listening and see you next time. Portia Pendleton, LCSW: Sam our channel.

Welcome back to Analyze Scripts, where a psychiatrist and a therapist analyze what Hollywood gets right and wrong about mental health. Today, we are discussing "She's the Man," a 2006 film starring Amanda Bynes and Channing Tatum. Did you know this movie is based on the Shakespeare's play "Twelfth Night?" This is arguably one of Amanda Bynes' best performances. She is hilarious, captivating and witty. We discuss gender identity and sexuality at great lengths in this episode. Dr. Furey provides us with some medical facts about sex organs and we talk about where a person can fall on the gender expression spectrum. You don't want to miss this one, we hope you enjoy! Instagram Tik Tok Website Dr. Katrina Furey, MD: Hi, I'm Dr. Katrina Fieri, a psychiatrist. Portia Pendleton, LCSW: And I'm Portia Pendleton, a licensed clinical social worker. Dr. Katrina Furey, MD: And this is Analyze Scripts, a podcast where two shrinks analyze the depiction of mental health in movies and TV shows. Portia Pendleton, LCSW: Our hope is that you learn some legit info about mental health while feeling like you're chatting with your girlfriends. Dr. Katrina Furey, MD: There is so much misinformation out there, and it drives us nuts. Portia Pendleton, LCSW: And if someday we pay off our student loans or land a sponsorship, like. Dr. Katrina Furey, MD: With a lay flat airline or a major beauty brand, even better. Portia Pendleton, LCSW: So sit back, relax, grab some popcorn. Dr. Katrina Furey, MD: And your DSM five, and enjoy. Portia Pendleton, LCSW: Welcome back to another episode of Analyze Scripts. We are so excited to be covering the movie she's the man, which came out in 2006 and starred Amanda Bynes and Channing Tatum. Dr. Katrina Furey, MD: Whoa. I'd never seen this movie before. It's almost 20 years old. Isn't that crazy to think about? Portia Pendleton, LCSW: I've seen it many times. Dr. Katrina Furey, MD: That's interesting. Yeah. Portia Pendleton, LCSW: Like, loved it. One of my favorite movies from, like, teenhood. Dr. Katrina Furey, MD: Nice. I think this is, again, where I feel really old, but that's okay. So, this movie was based on a play by Shakespeare the 12th night. Right. Portia Pendleton, LCSW: So I didn't know that until I did research for this podcast episode. Dr. Katrina Furey, MD: Because we're professional. Portia Pendleton, LCSW: Yeah. Because we want to plan things out. But apparently it's based on the Shakespeare's play, and it's about even by name. Viola and her twin brother Sebastian, they're shipwrecked. They believe that each other drowned. So Viola disguises herself as a young man in order to get a job as a servant for Duke, the Duke of what is it? Or Sino. And it's, like, funny because Duke is played by Tatum. So I had no idea that there were all these references to this. Dr. Katrina Furey, MD: Right, right. And I think it's just interesting. Right. Like, a girl dressing up as a boy, how that has been in culture and society forever. Right. Really interesting to talk about this movie now, just, again, in the political climate of today and everything going on in terms of gender identity. Portia Pendleton, LCSW: Yeah. So we see. Amanda Bynes did a lot of work at this time in some other movies that I absolutely loved. One of them, she goes to, I think, like, England or something to find her long last dad, and then she's absolutely a gem. So she was 20 when this was filmed. Channing Tatum was 26, which I think. Dr. Katrina Furey, MD: Is we always kind of laugh at. Portia Pendleton, LCSW: People who play high school role. Dr. Katrina Furey, MD: Right. They were totally in high school. Yeah. And he was 26. Yeah. It was funny to see Channing Tatum as, like, a youngster and just be like, he really bulked up for magic Mike. Yeah. Portia Pendleton, LCSW: This was even pre, like, the dance movies, not magic. Step up. Step. Dr. Katrina Furey, MD: Yep. And I did find it hard to watch. I'll be Amanda Bynes, like, in her quote unquote prime, given what we sort of have seen happen to her. And again, we're not here to offer any thoughts about someone's personal mental health issues, but I think, Portia, you were pointing out that she's 20 years old in this movie, and around age 24, things started to change for her, which we do see in terms of when women tend to develop significant mental health issues. Portia Pendleton, LCSW: Yeah. And something that I learned more recently as well is that Amanda Bynes actually really lobbied to have Channing Tatum in this role. And it was his first role where he was like a main character. Dr. Katrina Furey, MD: I think I did read that somewhere. I think you recently said that or was giving an interview about that, how we really appreciated that. Portia Pendleton, LCSW: Yeah, so that was sweet. And then we have some other cast members who I thought most notably Daphne, who plays Viola, and Sebastian's mom, played by Julie Hagerty, was also the mom and wife in what about Bob? Dr. Katrina Furey, MD: And she kind of played the same kind of like a loop, stitzy, disconnected character. I thought it was really funny. The whole thread of the debutante ball is that something that happens up here in the Northeast. So growing up in the south, this is like a thing. And it seemed know, I believe, like, debutante balls back in the day were for maybe even still presently. Like, I remember a couple years ago, reese Witherspoon's daughter was like, in a debutante ball, it's supposed to be like the way high society girls are introduced to society and maybe meet a suitor. Interestingly. Just yesterday I saw a New York Times article about debutante balls or like, debutante societies, but in an African American community, I believe in Detroit or somewhere in Michigan, and how those women really appreciate the balls because it helps them find mentors. So it's interesting because I always thought it was like to find a husband, but it sounds like at least in this community, it shifted a bit to find mentors, which I thought was really positive growing up in the south. I did go to something called Catillion. Portia Pendleton, LCSW: Okay. Dr. Katrina Furey, MD: Have you heard of what that is? Which they sort of depicted, like, when Amanda Bynes'character is coming in and they're all eating on china and stuff like that. I just remember I had to wear these white gloves and learn how to handshake and how to curtsy. And we had homework assignments in between the sessions where you'd have to shake certain people's hands and they'd have to sign off and you had to learn all these fancy dances like the foxtrot. Portia Pendleton, LCSW: I mean, that's exactly what I envisioned it being. Dr. Katrina Furey, MD: Yeah, I hated it. I remember I used to pretend to have stomach aches so I wouldn't have to go. And then the final dance, you're supposed to dance with all these boys and it was like in 6th grade or something. I just hated it. So sorry. Mom, if you're listening, I just really didn't love it. But that's sort of spot on depicted, I think, in see. Portia Pendleton, LCSW: So it's kind of just the plot is that Amanda, bynes Viola's character, learns that her high school women's soccer team is being cut, but due to low. Dr. Katrina Furey, MD: Participation numbers and she is really into soccer. Portia Pendleton, LCSW: Right. We see the opening scene. They're playing on the beach. She seems like she has a good relationship with her boyfriend and her friend. He seems supportive in the moment. So they are really upset and they kind of go up to the boys soccer team and they want to play, and the coach is kind of like, laughing. Like, that's absurd. You can't do that. Dr. Katrina Furey, MD: Can't play with the boys. Portia Pendleton, LCSW: Exactly. And so girls aren't fat. Initially, it seems like they're not even going to let them try out, which, per Title IX, if there is not an alternative sport, then they have to be allowed to try out. Dr. Katrina Furey, MD: Can you explain portia for our listeners what Title IX is? Portia Pendleton, LCSW: So Title IX basically is for education systems and kind of guarantees equal treatment. And what we're seeing now is a lot of Title Nine being brought up with gender identification in sports. So basically it guarantees an equal amount of so I'll just speak to it with sports. I know that it's bigger, but it guarantees an equal amount of sports per school. So, for example, if there's six boys sports teams, there has to be six girls sport teams. If there is a 7th sports team, it has to be coed. So, for example, a lot of I'm thinking about in my high school team, like, golf was coed, and then there was like, boys and girls tennis, football, field hockey. So that's the kind of counterpart. But there has to be an equal number. Dr. Katrina Furey, MD: Okay. And I think aren't there also, like, I think at colleges and stuff now, they have like, Title IX offices, title Nine coordinators. And I think that's also maybe where you go if you've experienced like a sexual assault or there's some concern about harassment or things like that. Portia Pendleton, LCSW: Right, yeah. So it prohibited sex based discrimination in any school or education program that receives any funding from the federal government. And it started in 1972. Dr. Katrina Furey, MD: Oh, I thought it was like, recent. Portia Pendleton, LCSW: So they've made amendments to it, I'm sure, over and over since then. But that's when it started. Dr. Katrina Furey, MD: So this initial school would have been in violation of Title Nine then. Okay, good to know. I thought maybe that came about after in the past 20 years, but I guess not. Portia Pendleton, LCSW: No. Dr. Katrina Furey, MD: Okay, good to know. But so they won't let her sort of try out or play. Her boyfriend is really icky and dismissive about her feelings, so she breaks up with him. Good. And then she has this idea that she's going to dress up like her brother and impersonate him at his school for two weeks so that she can make that male soccer team and kind of beat her boyfriend's team. Yeah, it's Cornwall and Illyria Illyria, which was a funny name, but I bet those stem back to the Shakespeare play, right? Portia Pendleton, LCSW: That makes sense, I think. Dr. Katrina Furey, MD: So that makes a lot more sense. Portia Pendleton, LCSW: Because they're kind of OD. Dr. Katrina Furey, MD: So basically, that's the premise of the movie. And we see Amanda Bynes portray stereotypical gender roles and mannerisms in a comedic way. And she's always been known for her comedic timing and the slapstick nature and the physical comedy. She's always been known for that. So you definitely see that here. But what were your thoughts, Portia, about the way she sort of portrayed masculinity versus femininity? Portia Pendleton, LCSW: So I think she also let's first remind ourselves that this film was probably made in 2004, right? Came out in 2006. So some of the things that they were even just saying when she's in the shower room with Duke and she's just like, calling Brosif broski G money, a lot of those things are also just like from then. And people did say, you know, it's not that outrageous, but I thought she first of all, which we already said, she is just phenomenal at that kind of humor. And so I think ironically now, looking back, though, she in this role is bringing a lot of gender issues and questions up onto the surface in a really big way. Again, that we did not see. Dr. Katrina Furey, MD: Yeah, and again, using humor, which we think of as a mature defense mechanism to explore really complex, difficult topics, much like we talked about with our Barbie episode, but in a different way. And I'm like, was that intentional or was that like, it just happened. Portia Pendleton, LCSW: And they take it even further with you see her because they could have easily just thrown a wig and write the sideburns on and just had her wearing like a tightly fitted sports bra. But you see them like, they take the espinage and they're like binding, which is a pretty common practice if someone's trans and they are trying to have like a flat chest. You see her kind of packing like a filled sock to look like a ***** to use in her pants. And again, that's something that is used. So I thought even that could have easily been left out and I don't think anyone would have noticed. Dr. Katrina Furey, MD: Right, I totally agree. And I thought before we continue, I did just want to give a couple of definitions for our listeners because I think as we start talking about gender dynamics, sexual dynamics, trans, cisgender, like, things like that, it can be really confusing. So, again, I want to just give a couple of standard definitions. So when we use the word sex, like in the medical field, the definition of sex is a biological category based on reproductive, anatomical and genetic characteristics, generally defined as male, female and intersex. So something I hear a lot in the popular press and media is like, you're born a boy or a girl that's it. And actually, that's just not true of the human species and a lot of other species if you look into different animals and things like that. So there are several medical conditions where a child isn't born at birth with what we consider male genitalia or female genitalia. Those things can include things like Kleinfelter syndrome, turner's syndrome, and androgen Insensitivity syndrome. And these are complicated things, and we won't get into all the details, but in those different know, the anatomical chromosomal or gonadal, sex varies in some way from what we would typically call male or female genitalia. So for people who are constantly shouting, like, you're either a boy or a girl, that's just not true. Like, there are humans again, it's rare, but there are humans born who, for example, like their internal organs don't match the external genitalia or vice versa. And so, again, usually at birth, parents are kind of advised, like, you can pick the gender. Now, it might change for some of these conditions. Other times, maybe the parents just maybe especially today, like, don't pick and sort of see what the child chooses. But that can change over the course of a child's life. And sometimes people with these conditions prefer to be called intersex. I think back in the day, we used to call people with these conditions hermaphrodites. And that, I think, can have a really negative connotation attached to it. But I think that is important to just point out that not everyone is just born a boy or a girl. So that is sex. That's medical based on these factors, gender is different from that, right? So when we say gender, that refers to socially constructed roles, behaviors, activities, and attributes that a given society associates with being a woman, man, girl, or boy, as well as relationships with each other as a social construct. Gender varies from society to society and can change over time. I think that's really important that we understand that that's what gender it is. I think we see Amanda bynes'character Viola sort of display that right? And so someone's gender identity is an individual sense of being a man, woman, boy, girl, genderqueer non binary, et cetera. And this doesn't have to be visible to other people. What you see from the outside is what we call gender expression. That's how someone chooses to convey their gender identity through their behavior, clothing, or other external characteristics. And not everyone feels safe to do that. And so I just thought it was important to sort of bring up those topics and give those legitimate definitions to help us as we conceptualize this movie and the effects it's had. Portia Pendleton, LCSW: So if we also think about gender kind of being on a spectrum, I think we have either end where you are highly feminine appearing or highly masculine appearing, and then we see kind of people forever, right? Like, kind of being in the middle. Like, that would be a tom boy. So a girl who feels more masculine, maybe plays more with masculine toys. They might be more like, I'm just envisioning a little girl who has braids and overalls and is like playing in the dirt with a monster truck, like. Dr. Katrina Furey, MD: Roberta from now and then. I don't know if you saw that movie. Oh, my. Again, I'm it's so good. Portia Pendleton, LCSW: Portia but I will also add that I think it's always been way more. Dr. Katrina Furey, MD: Acceptable to be a tomboy than a. Portia Pendleton, LCSW: Girl to be more masculine presenting than for a boy to be more feminine presenting. Dr. Katrina Furey, MD: Yeah. Portia Pendleton, LCSW: So, again, we just see there's this really long range of how you present yourself. And I think what's interesting that you just kind of spoke to, though, is it's different in culture to culture, right. So if I'm thinking of, like, we also covered the movie Barbie. If we think about that Barbie feminism, it's like I'm thinking of someone who might be all the way on one of the spectrum who's wearing, like, all pink, driving a pink car and is, like, in this pink role and likes everything that's feminine. Dr. Katrina Furey, MD: But that's what that culture calls feminine. Portia Pendleton, LCSW: Exactly. And another one might be entirely different of they're all the way at that end. Femininity right. Dr. Katrina Furey, MD: And again, their inner gender identity might not be the same as what they're expressing outside their gender expression. And I think that is where, as people grow up and you start to figure out who are you, really, things can change. And speaking to that in different cultures, again, how gender is such a social construct, I was really interested to learn recently about the concept of two spirit in the Indigenous culture. So Indigenous people I didn't know this before doing a little research before this episode, have kind of always had this concept of two spirit which they sort of define as a person who identifies as having both a masculine and a feminine spirit. And this term is used by some Indigenous people to describe their sexual, gender and or spiritual identity. I thought that was just really interesting. Like, other cultures sort of have lingo to talk about these difficult concepts. And I'm sure it varies from culture to culture, too. Right. Portia Pendleton, LCSW: And even, I think as simply as like in, I don't know, I guess American culture, it's like there's some women we could think of it just as this, who don't ever want to wear a dress or a skirt, and they just feel more comfortable always wearing pants or shorts or something like that. And that's such not a big deal. But again, I'd say that is someone who's on a different place of the gender spectrum than someone else who does feel more comfortable or wants to do that because they think of it in a feminine way. So I just think it doesn't have to be that huge. Right. Which I think that's the big kind of conflicts going on. It's like we all land somewhere on it. And I think everyone would be surprised that they're probably not on the end. Dr. Katrina Furey, MD: Right, exactly. Right. Yeah, exactly. And I think like you're saying, how you define masculinity or femininity is really determined by the culture you're growing up in and how you're reacting to that. Right? Yeah. And sometimes I like that example about the dresses or the pants. Just because you like to wear pants, that doesn't mean your gender identity is male. It could not always. Like a lot of women like wearing pants too. It's different. Again, exactly. I think the way you're expressing yourself is different from your gender identity for some people. So given that example, why don't we also define what transgender means? Because that is a term that we use a lot in our American society. It is hot in politics right now. Portia Pendleton, LCSW: Also a lot with title nine, specifically in sports. Dr. Katrina Furey, MD: Yeah. That has been everywhere these past few years. So the official definition of transgender is someone who identifies with the gender other than the one that was assigned to them at birth, period. Okay, guys, that's it. It has nothing to do with your genitalia. It has nothing to do with your anatomic, chromosomal, gonadal, sex organs. That is it. It means that the gender you identify with differs from the one you were assigned at birth. There is a lot of discussion, I think, about this term because in some ways it feels outdated or there's some criticisms about it because it sort of implies that there was a point at which someone was cisgendered, which means that your inner gender identity matches the gender you assumed at birth. The word trans in some ways, some people, some critics of that word will say like, implies that you were cisgendered than you became transgendered, I think, which can be really harmful. But it does give us a language to use. So often when someone identifies as a trans man, that would be someone who perhaps or who at birth was assigned a female gender or identified female gender and finds that they identify more with being a man, a trans woman would be the opposite. And a lot of people don't like those terms. And so they might use something more broad like gender non conforming or non binary. Portia Pendleton, LCSW: So in the know, we're seeing viola by definition cross dressing. Right. So it's like she is putting on male clothes. She hasn't said anything that she's feeling like she is thinking of having an identity as a man or anything like that. So by a definition, using just like language, that's what she's doing. But in it, it expands this whole question of like well, and again, we're pretending to know her inner thoughts as viola. It's like, is she does she have some thoughts of maybe wanting to identify more with a male persona or does she feel more comfortable that way? Where does this go in the, like I think it's just really interesting because she can still know attracted to Duke, right. That has nothing to do with how you express your gender, but is know kind of throughout the end of the film exploring this, and does it feel good for her and is that something that then she might choose to do? Dr. Katrina Furey, MD: Right? And I personally don't think so. I don't think Viola is trans. I think that she had a goal in mind. She wanted to play soccer, and that is why she's doing this. It didn't seem like she was having confusion or what we might call gender dysphoria, which is a lot of distress about the gender you feel like you have to express. I didn't get that from her. I got that she just wanted to play soccer, but the whole time felt female. I think you could see that, like when she would slip back into her girl voice or these girl mannerisms and things like that. But I do agree that this film does open that up and it does show someone in adolescence exploring their gender. Now, again, what we know about people who identify as trans or non binary is that this starts really early, just like someone else walking around who identifies as cisgender and they say, like, I've always known I was a girl. These people have always known that this is where they fall. And it's even normal in toddlerhood, right, for boys to wear dresses or girls to pretend to be boys. This is normal as you're trying to figure it out. But then, typically, people who identify as trans keep wanting to if you're born of boy gender, you might want to play with dolls, you might want to dress up. That starts really early and tomboys start. Portia Pendleton, LCSW: To not be enough. Right. This is why it's a spectrum experience. Exactly. So it's like you're kind of portraying a little bit more of a masculine expression and then that's not enough. Right. And you still are having kind of this gender dysphoria. You still feel distress, and then you kind of keep following along the spectrum until you land somewhere that feels good. Sometimes that is with surgery, and other times it's not. Dr. Katrina Furey, MD: Right? And I think it's really important that we also talk about that. These are real things, right? And this type of dysphoria that stems from a mismatch between your inner gender identity and the outer gender expression you've sort of been raised to abide by or is socially acceptable, is really significant. And it's been around forever. Like, this is just a thing. This is real. This has happened. And what we know is that trans youth and trans adults have significantly higher rates of mental health conditions, substance abuse conditions, and suicide compared to people who identify as cisgender. And I think that's really important that we talk about that because studies have shown that 40% 40%, that's almost half of transgender adults have attempted suicide in their lifetime, not just thought about it, but tried it, and that 30% of transgender youth have attempted suicide in the past year, that's huge. Those rates are so significantly higher for any other mental health condition that I can think of. And add to that if these transgender youth, for example, also, I mean, being transgender, you already are facing a lot of stress from being a minority, like in that way. But if you add other intersectional identities to this in terms of race, socioeconomic status, religion, family structure, poverty, like things like that, your rates just go up and up and up and up. And what we have found is that by providing gender affirming care, which again is a spectrum, right, it runs all the way from gender affirming psychotherapy to explore your feelings, to hormonal treatment and puberty, which again can be reversed. There's this big fear like, oh no, we're going to do something that is permanent and we can never fix it. The hormonal therapies basically stop puberty from happening. And so it gives a child who's experiencing this the chance to sit with it and really figure it out. And there are so many guidelines that you have to wait a certain amount of time. Someone has to live in their well, I think that's actually for surgery, but there's a lot of guidelines before you just do that, before you stop puberty. But then if this person sort of changes their mind down the road, which is incredibly rare, but does happen, it is easy to reverse and then sort of start puberty in the gender you were assigned at birth anyway, all the way to gender confirming surgeries, which, again, a lot of rules around qualifying for surgeries like that, at least in our state. You have to live in your gender identity for at least a year. You have to express that outwardly. And then you also have to have psychiatric evaluations and be cleared from a psychiatric standpoint by more than one physician. There's a lot of hoops you have to jump through. And what are your thoughts about that, Portia? Do you think that's helpful or do you think that is kind of further stigmatizing or a barrier? Portia Pendleton, LCSW: I think it really depends on the like I think it can be, I think I guess I'd say as a whole, I don't know. I think it can go either way. I think there's positive experiences where it's just like it is catching people, making a secure choice in something that they've always known. But surgery has risks and I think it's just to really prepare you for that. I guess we're kind of going, I'm going to bring up something totally different. But it's like if an 18 year old female would want to have their tubes tied, right? It's like if a 30 year old is coming to you and want to have their tubes tied, sure be done. But it's like, okay, we need to give you information. Do you know, because I'm actually unsure of permanent for the most part. Dr. Katrina Furey, MD: I think there's some that you can. Portia Pendleton, LCSW: Reverse, but yeah, some more permanent options. I think it's just important to educate, write the risks, if this is something that you really want to. So it's thoughtful and I think most of the time, again, it is like it's been years and decades of wanting or not feeling comfortable in the gender you were assigned at birth. So I guess, I don't know. I think in some cases it can be useful just to prepare yourself for a very significant surgery. Dr. Katrina Furey, MD: Just like any surgery, huge change. Portia Pendleton, LCSW: Right. But I also do think there's absolutely aspects of it that can be super harmful. Like really navigating it with insurance, which I think if you are paying privately, I think it's a much quicker process. Right, so I think that's true. That's always just like something to throw in there, right? Dr. Katrina Furey, MD: True, very true. And also, I think we know that people who identify as trans face so much stigma and violence. Like trans youth, trans adults are so much more likely to be victims of physical violence, assault, murder, things like that, than cisgender people. Portia Pendleton, LCSW: Especially when they are presenting a gender and they're not passing. Right. That's the highest risk time for them. So you're asking them to stay in the year. Right. Dr. Katrina Furey, MD: That's the part where I'm like, oh, on the one hand, I get it. It's like you want to make sure you're sure. On the other hand, it really increases I think I don't know this for sure. I don't have the data to back it up, but I worry that it increases their risk of harm coming to them. And there is something just so stigmatizing about the system being like, well, you. Portia Pendleton, LCSW: Have to really make sure that you're sure before we help you and offer. Dr. Katrina Furey, MD: You this care that's been shown to significantly decrease your risk of suicide. Again, I don't pretend to know all the answers or have a better system option in my mind, but I just think these are really complicated issues. And coming back to the movie, she's the man, we see her kind of dealing with that as she's trying to pass. Portia, can you define what passing means for our listeners? Portia Pendleton, LCSW: Sure. So if somebody's passing, that means they appear, I'd say, I don't know, to 99% of people the gender that they're intending to pass as. So if somebody is making a transition from male to female, they look like a female. Like, you would never question it. And I also would just ask people to know that there's a lot of people that you don't know who are 100% passing and you're feeling safe with them. So it's like the people who are not passing yet who are coming in. And I'm thinking this is the big issue to a bathroom where you're still kind of looking like a guy, but you're dressed as. A female. That's where people get really scared and it feels but again, that's where the danger comes for them. Dr. Katrina Furey, MD: Not 100% you. Portia Pendleton, LCSW: That's just what the data says. Dr. Katrina Furey, MD: And again, the data says that people who identify as trans are not sexual deviants or aggressors or pedophiles or things like that. That's just not true. That's like an really unfortunate stigma and bias that just keeps getting perpetuated and. Portia Pendleton, LCSW: All the way know. I think we've seen we see this date back centuries is like people performing, right? Like drag queens are going to shows where people are cross dressing like Shakespeare around forever. The idea that it is this harmful, right? Sexual deviant going to corrupt children is. Dr. Katrina Furey, MD: Like this new thing ridiculous, right? And again, we see this in other animals too. I can't think of anything off the top of my head, but I do remember in college, in my animal behavior class with Professor Wasserman, learning about different species where the women would pretend to be men to protect their young and vice versa. So we see this in other species. We've seen this in humanity dating back centuries, like forever. This is just a thing. Portia Pendleton, LCSW: Yes. So you brought up you before, right? Or was that in another so so getting back to she's the man worth noting that we see Malcolm, who's just kind of like this annoying guy, right, who's trying to figure out what's happening with Viola and Sebastian, like expose her. He is stalking Olivia. Like, he has pillows with her face. Dr. Katrina Furey, MD: Creepy. Portia Pendleton, LCSW: He's always trying to talk to her. And I was just just just also keeping in mind, like, yeah, that seems silly in the movie, but it's not. Right. Stalking is the opposite of funny. It's the most terrifying experience. Per again, all the data to go through. So it's just like Malcolm is you're. Gross. Yeah, we don't like you. Dr. Katrina Furey, MD: Yeah. Portia Pendleton, LCSW: But a little bit of stalking we see in this movie and then we see right. Dr. Katrina Furey, MD: Olivia too. Portia Pendleton, LCSW: So Olivia, initially we're introduced to her because Duke really likes her. And then she develops feelings for Sebastian. Sebastian played by Viola. Right. I thought that is so interesting for Olivia. Like, how does she feel knowing that she wanted to kiss and was really into a girl playing a guy, right. And then she ends up being with the real Sebastian. Dr. Katrina Furey, MD: I know. Portia Pendleton, LCSW: So I'm just curious about like that was just interesting. Dr. Katrina Furey, MD: And I think that brings up a great point, again, Portia, that there is a difference between your gender identity and your sexual identity. Right? So we've talked about gender identity. Your sexual identity is who you feel attracted to. And that is under the umbrella of things like heterosexual, homosexual, bisexual, asexual and again, I was like, is this movie a little homophobic? Like Amanda or Viola when she's playing Sebastian, wouldn't kiss the girls and stuff. Maybe she doesn't want to. Right. But I also thought it sort of did play off of that like you're saying. And it was interesting that it seemed like Olivia was attracted to the feminine aspects of Viola playing Sebastian's character, right. Portia Pendleton, LCSW: And not Duke, who presenting to outside people, is not that sensitive guy, but he is closed doors to other guys, right. Dr. Katrina Furey, MD: So, again, it explores these themes of gender, sexuality, and just how you kind of express yourself and move through the world in a really interesting way. But again, if you are a trans person, that doesn't mean you are homosexual or bisexual. And so that is something important to keep in mind that you can be a trans man and still be attracted. Portia Pendleton, LCSW: To whoever you are attracted to. Dr. Katrina Furey, MD: They're not like mutually exclusive, one doesn't lead to the other or anything like that. Portia Pendleton, LCSW: And we see Amanda Bynes really come to life when she is at the carnival and performing the rapid gender changes, code switching in how she's talking and how she's walking. And it's just a being a good actor. And also I think it's part of the humor that they pulled from the play. Yes, the play. I think it's like carnivally. It's silly. It's again, it's supposed to give that gender ambiguity which I think is just interesting. Dr. Katrina Furey, MD: Right. Portia Pendleton, LCSW: Shakespeare's from a long time ago. Dr. Katrina Furey, MD: And can you again define code switching for our listeners? Portia Pendleton, LCSW: So we also talk about code switching with people. Describe it as going to different groups of people. Right? So you might have a way that you speak at home and then when you're in a certain environment, like maybe work or like a classroom, you become kind of different. And you say words differently, you use different words, you carry yourself differently. I think I was more thinking of it or I've been aware of it more from black Americans kind of identifying their experience with being home and then being in a colleges are historically white places. So kind of having to adopt a white code when going to them to appear, right. Like the norm, which is like professional. You can be an educated black person in your home code, but in order to be perceived as educated in some of these other environments, you need to adopt the bigger code all the way. Dr. Katrina Furey, MD: From what you wear to the way you do your hair to do you have tattoos or not, like all of those things. Portia Pendleton, LCSW: So we see in the movie where I don't want to say it necessarily gets wrong. I just think it's like the times and it's not them continuing to educate the masses, but right when they identify their gender by showing their body parts at the end. So it's like we see Sebastian pull his pants down. Which also that's I feel like we don't get arrested. Dr. Katrina Furey, MD: It's indecent exposure. Portia Pendleton, LCSW: And everyone's like, oh. And then they're all kind of joking because seemingly he has a large *****. Right? Dr. Katrina Furey, MD: It seems like. Portia Pendleton, LCSW: And then we see Viola later on lift up her shirt to prove she's a girl. Dr. Katrina Furey, MD: So, again, even in the movie, they're mixing know, anatomical sex parts and your gender. I also thought the principal just like, calling out this issue in front of everyone. Weird stopping the game. There's title nine violations all over the place here, and that's just like, not the way you do it. Portia Pendleton, LCSW: He's also just like a weirdo. Dr. Katrina Furey, MD: Remember when he's like, over identifying and assuming that Viola as Sebastian's experience is the same as his? Yeah, kind of crazy. Portia Pendleton, LCSW: Did you recognize him? Dr. Katrina Furey, MD: No, I did. Portia Pendleton, LCSW: He's in a lot of things, actually, when I clicked on his name. But I think I recognized him from Men in Black. He's in the first movie, I believe. And I used to really like that movie and I watched it a lot. Dr. Katrina Furey, MD: But I was like, how do I know this guy? Probably from then. Portia Pendleton, LCSW: Yeah. Dr. Katrina Furey, MD: So, yeah, in general, I thought I wasn't expecting all of this. Like, when you said we should cover this movie, I was, huh. Okay, amanda bynes cool. It's a throwback. All right. But it really did bring up a lot of big themes about gender identity, sexual identity, girl versus boy. Why do we divide sports all the time? Just like all of these sort of gender archetypes really brought it out. And again, thinking that this movie is 20 years old, it's really interesting, again, that so many of these themes are still something we're trying to sort through in our culture today. Portia Pendleton, LCSW: And really, I think it was just kind of dismissed probably as like a teen movie. But I think The Band of Buys, she was excellent in it, I think, based on the Shakespeare, twelveTH Night was excellent. I think I'm almost comparing it. And we're laughing because we also recorded Barbie on this day. And I think it's very similar to Barbie in some ways, right? Where I think, yes, of course the movie could have been better. It's also almost 20 years old. But I think that she didn't get the credit that she was owed for playing this role and for the writing. And again, I just think it's a really clever idea for a movie and people like me loved it. Dr. Katrina Furey, MD: And you were saying there's been a lot of discussion about it, even in the present day, where they're really sort of analyzing the gender roles and the way she portrays it, the way she's code switching, people are still talking about it. And so I think that is what makes art beautiful, is that it can provoke these feelings. These thoughts give you a means to discuss these bigger issues, especially when you might not agree with the person you're talking about it with. But it's like a maybe safe, neutral place to talk about it. And we're still talking about this stuff. So it was interesting. Portia Pendleton, LCSW: Yeah. So of know, I think it's worth saying we wish Amanda finds well. She's iconic and I selfishly would love to see her back in theater, but I don't know if that's good for her or know, who am I to say? But I love her. She was through my childhood and stay tuned. Maybe we'll do another one of her things, but thank you for listening today to our podcast. If you would like to follow us, you can follow us on Instagram at Analyze Scripts or TikTok at Analyze Scripts podcast threads at Analyze scripts podcast, and you can check us out on our website to get more information or continue to search through some of our older episodes. They're great. Dr. Katrina Furey, MD: Yeah. All right, we'll see you next Monday. Portia Pendleton, LCSW: Bye bye. Dr. Katrina Furey, MD: This podcast and its contents are a copyright of analyzed scripts. All rights reserved. Any redistribution or reproduction of part or all of the contents in any form is prohibited. Dr. Katrina Furey, MD: Unless you want to share it with your friends and rate review and subscribe, that's fine. Dr. Katrina Furey, MD: All stories and characters discussed are fictional in nature. No identification with actual persons, living or deceased places, buildings or products is intended or should be inferred. This podcast is for entertainment purposes only. The podcast and its contents do not constitute professional mental health or medical advice. Listeners might consider consulting a mental health provider if they need assistance with any mental health problems or concerns. As always, please call 911 or go directly to your nearest emergency room for any psychiatric emergencies. Thanks for listening and see you next time.

Welcome back to Analyze Scripts, where a psychiatrist and a therapist analyze what Hollywood gets right and wrong about mental health. Today, we are analyzing "White Lotus" Season 2. In this season we follow Tanya and Greg to beautiful Sicily where the water is a dreamy blue and the passion red hot. This season has received 23 Emmy nominations and we think they deserve them all! We continue to analyze Tanya for a personality disorder, discuss the power and currency of sex, and talk all things complicated relationships. If you are missing this season come along with us to admire the clothing, food and of course their mental health. We hope you enjoy! Instagram Tik Tok Website Dr. Katrina Furey, MD: Hi, I'm Dr. Katrina Fury, a psychiatrist. Portia Pendleton, LCSW: And I'm Portia Pendleton, a licensed clinical social worker. Dr. Katrina Furey, MD: And this is Analyze Scripts, a podcast where two shrinks analyze the depiction of mental health in movies and TV shows. Portia Pendleton, LCSW: Our hope is that you learn some legit info about mental health while feeling like you're chatting with your girlfriends. Dr. Katrina Furey, MD: There is so much misinformation out there, and it drives us nuts. Portia Pendleton, LCSW: And if someday we pay off our student loans or land a sponsorship, like. Dr. Katrina Furey, MD: With a lay flat airline or a major beauty brand, even better. Portia Pendleton, LCSW: So sit back, relax, grab some popcorn. Dr. Katrina Furey, MD: And your DSM Five, and enjoy. Portia Pendleton, LCSW: Welcome back to another episode of Analyze Scripts. Today we are covering White Lotus, season two. I'm so excited. The scenery is beautiful. They're in Italy. Dr. Katrina Furey, MD: Oh, my gosh. Portia Pendleton, LCSW: I just want to be there. Dr. Katrina Furey, MD: You've been to Italy? Portia Pendleton, LCSW: I have that part or a different no. So I think this is in Sicily. Dr. Katrina Furey, MD: Yes. Portia Pendleton, LCSW: So I visited Naples and then Positano and Capri. Dr. Katrina Furey, MD: Oh, wow. Oh. Was it like this? Portia Pendleton, LCSW: It was literally everything of the sort. Like, stunning, beautiful, incredible. The food I could write home about every day. Just the most beautiful, stunning place ever I've been. Dr. Katrina Furey, MD: I mean, that reads true in this series. It looks so beautiful. Portia Pendleton, LCSW: I definitely want to go there. I noticed, too, in season one of White Lotus, right, there's a lot of cuts of the water, the waves crashing, that the water scene often either comes out of or into another scene of a person. It kind of fades into the scene of underwater or something. So I think that's like an interesting. Dr. Katrina Furey, MD: And sometimes it would be like the waves are slowly, gently crashing. Other times, there's a big crash. And I feel like that was purposeful and sort of played into the scene or what's going on with the then, you know, spoiler alert. Tanya eventually dies in the water. Portia Pendleton, LCSW: The water takes her. Dr. Katrina Furey, MD: The water takes her. She almost made it. Like, I thought she was going to make it, and then she slips. Portia Pendleton, LCSW: I think that was they said the writer director was commenting on how it was so important for him that Tanya did not die at the hands of someone else, that she still was kind of able like, she still was in charge even though she slipped and died, but he didn't want her being killed. Know the quote unquote gaze? Dr. Katrina Furey, MD: Yes. Portia Pendleton, LCSW: Oh, my gosh. Dr. Katrina Furey, MD: So let's just jump right in, I think, with Tanya. Yes. So we talked a little bit about our feelings toward her last time we recapped season one. We talked a lot about how she displays some traits and characteristics of borderline personality disorder and how the character talks about how her mother actually also had borderline personality disorder. Did you feel, Portia, like that was consistent in season two or I think so, yeah. What did you notice? Portia Pendleton, LCSW: So I think, again, her interpersonal experiences with both Greg with know, fun to see my name in the light, for one. She just seems to really be only thinking about. Right. So, like can't hear Portia. They were having a conversation. We were talking about this before the podcast. And it's like she almost like tunes her. It's kind of is talking over her. Just goes back to her. Right, right. She can't even hear Portia. I think she's asking for a day off to Albie. Dr. Katrina Furey, MD: Yeah, there was that scene where Portia was like, I know I'm kind of on the clock, but could I take the day and hang out with Albie? And she sort of tries to make a case for it, and there's like a pause. And then Tanya just keeps talking about her own issues. Like doesn't even acknowledge that Portia said anything. Almost like Portia didn't say anything. And I think that actually so tracks with people with cluster b traits, whether it's borderline narcissistic histrionic that the way they relate to other people is almost like other people in their lives are objects that are only there. To serve a purpose in relation to really? They can't see these people as their own independent humans who have their own wants and needs, who are both good and bad. Right, exactly. And so Tanya couldn't even hear it, didn't even register in her consciousness that Portia was asking for some distance from her. And I think that probably played into her intense fear of abandonment. And she just didn't even acknowledge it. I thought that was such a smartly written scene. And I wonder if the writers were really going for that, if they knew, or if that just happened, if that's just the way I'm interpreting it. Portia Pendleton, LCSW: I feel like it's got to be intentional just because it's so perfect, you know? And Greg also says to her at one point, I think at the beginning when he sees that Portia is there, they get into a fight and he says, you discard people. You drop people on a dime, you fire people. And then she calls him a full of ****, man. And then she says, I hate so. Like, I think that even their dynamic you see over the couple of episodes that he's there in Italy with her for, she's really easily know. She's really emotive. Which again, if someone was on vacation with me, like my partner, and all of a sudden they were like, oh yeah, I'm going to leave you for two days, I might have a reaction to that as well. Dr. Katrina Furey, MD: It was unknown. So again, maybe that's why she brought Portia, because she had a feeling he was going to leave and she didn't want to be. Portia Pendleton, LCSW: So my question is the ultimate kind of problem or issue, I guess I would say with Bpd is right, the fear of abandonment. And so is Tanya picking up on Greg's right like other relationship, his obviously very nefarious plan to have her murdered know, I think this is hard talking with clients. It's like, are you picking up on something that's real or not? Dr. Katrina Furey, MD: Or are you projecting such a difficult question? Portia Pendleton, LCSW: Exactly. Dr. Katrina Furey, MD: That is such a hard question. I also think as a therapist, it's really hard when you only have your patient's perspective. I wonder if that's easier to pick up in couples or family work. But I think that's part of the therapy is learning where your own baggage ends and where the person you're interacting with begins. And that is almost like the definition of an interpersonal boundary which people with these personality disorders really struggle with. And we see that displayed so know throughout this series with Tanya. And I think you're totally like, at first when I was watching this, I thought Greg was upset Portia was there because he wanted to just be on vacation with her. Then I realized it's because he was planning to murder her and didn't want a witness. But yeah, why did she bring Portia? Like a why does she have an why? Um, but I wonder if she was picking up on, like, pulling like, we easily see that. We also easily saw that in season, like, from the yeah. And we talked about how, like, isn't a safe attachment figure for her, but that's probably what she's used to. So for her, that feels like it's, you know, and we just see how mean he is to her, like, with the macaroons. Right? Portia Pendleton, LCSW: Yeah, totally. Dr. Katrina Furey, MD: So mean. He's just always putting her down, always criticizing her. It's just mean. Portia Pendleton, LCSW: And in some points, I was like, it's interesting, Tanya's interpretation of that. Right. Dr. Katrina Furey, MD: She said to herself, like, oh, he. Portia Pendleton, LCSW: Cares so much about me. That's why he's saying that. And it's like, no, he just said something mean to you. But then, on the other hand, she has a quote unquote inappropriate reaction to something that isn't that bad. So it's just like her it's skewed where and again, I'm a third party. I'm also a therapist. It's also a show, but I'm watching. I'm like, Tanya, you should have had a bigger reaction to him, like food shaming you and a lesser reaction over here, right. Dr. Katrina Furey, MD: And a bigger reaction when you overhear him in the bathroom saying, like, I love you. I'll be there soon. And I know, right? Portia Pendleton, LCSW: That's what was just, like, interesting, confusing, and I think maybe difficult for someone who doesn't know or isn't thinking about her in terms of Bpd. Dr. Katrina Furey, MD: Yeah. But I also wonder if that is just, like, a really accurate portrayal of the inner world of someone with Bpd. She was saying at one point to Portia later on in the season, basically saying, like, Portia, you remind me a lot of me when I was younger, and you could see Portia, like, recoil inside, like, no, no, I don't want to be like you. But then she said to Portia, when you're empty inside and you have no direction, you'll end up in some crazy places, but you'll still be lost. I think she said that to her after Portia and Jack sort of, like, dined and ditched, and Portia was, like, sort of high off the thrill of that. And Tanya was like, Aaron, teeny balls are like a like, what are you doing with this guy? And I just thought that spoke to another core feature of borderline personality disorder, which is this pervasive inner sense of emptiness. And I think that's exactly what Tanya was speaking to. And I thought that was just, like, a really beautiful way to put words to a really difficult experience. And I just thought in general, we've really got a feel for the chaotic inner world of, like, in all of her big reactions, her small reactions, where you think they should have been bigger, and just kind of all of it. Like, her whole character, I thought, really just portrayed the inner emotional chaos people with Bpd often feel and how, again, that's in such discrepancy to also their inner emptiness. And that goes right back to that old sort of, like, splitting defense mechanism. Right. It's just fascinating and just really well written, really well portrayed. Portia Pendleton, LCSW: Yeah. I think Tanya I wish that she could go on to season three. I know I'm definitely disappointed that she's not going to be, but also, I think that was intentional. This was the end of her story, and we'll see if there's some talks that maybe Portia is in season three. Dr. Katrina Furey, MD: I would love that. Portia Pendleton, LCSW: That was a cliffhanger. Like, what does she do with this? You know, is in this weird position of being scared and not sure if it was Tanya. Right. She learns from Albie that a guest was found dead in the water, and then there was this ship with all these gunshot weddings, and that's kind of all she knows. Dr. Katrina Furey, MD: And I just think I hate I. Portia Pendleton, LCSW: Just how dare you? Dr. Katrina Furey, MD: How dare you? Greg and I just feel like he's going to get off, like, he's going to inherit all the money. He just used everyone he used. Right. Like, we come to find that Greg was like, the cowboy from the past that Quinton was in love with. And it sounds like I didn't quite understand why Quentin felt such loyalty to Greg, but he's, like, doing his dirty work, I think for financial reasons, too. Like, Greg's like, I'll give you some of the money. It sounds like Quentin really needed it. He's kind of spent all his money, but he used that love from Quentin to get rid of his wife so he could get the money. And he also knew that Quentin and his friends could suck Tanya in, and she would quickly idealize them, which she does with everyone, and she did. And they knew how to make her feel exactly how to manipulate. I was like, is he trying to give her make the last week of her life the best ever. Like, even when they play out her fantasy in Italy on the Vespa, which I thought was hilarious, I was like, on the one hand, you're like, is that kind of nice? But then you know you're going to kill her, or is it just like you're getting even more over on her? Portia Pendleton, LCSW: Well, and how do you do that as a person, right? Like, if we try to diagnose Greg, what does that even look like? I mean, you come into someone's life and have the gall to take their family money after being married to them for a year. It's just so gross. How do you think you can do that? Dr. Katrina Furey, MD: I think he's, like a know, and I think he just is so and again, like, is looking and relating to Tanya as just like a means to an end for like, she's an object to him, and now he's ready to discard her and kill her. And I was just so sad that it took her so long to figure it out. And even as she is shooting the gays, as she calls them, she asks, is Greg having an affair? And again, it just speaks to that is the core fear of abandonment. Like her life is in danger, and she still wants that answer. Right. Portia Pendleton, LCSW: Because that's more heartbreaking. Dr. Katrina Furey, MD: Right? It's just so heartbreaking because it's almost. Portia Pendleton, LCSW: Like the money isn't about her, but him cheating on her is about her. Dr. Katrina Furey, MD: Right. And her just being so rejected and unimportant, and yet he treats her as unimportant, and he rejects her all the time, and she's constantly coming back, wanting to feel good enough, and she's just not. Like, she'll never get that with him, but she doesn't have a secure sense of self enough to be able to walk away. Portia Pendleton, LCSW: No, totally. I think, too, there was some question of were we seeing more borderline traits with her or more histrionic traits, right, yeah. So histrionic just a little bit of background is in the same cluster as borderline. You experience discomfort when you're not the center of attention. You might engage in provocative or dramatic behavior. There's, like, mood swings, over the top, displays of emotion. So some of these sound, like, pretty in line with Bpd, seeking reassurance or validation. Extreme sensitivity to criticism. Impulsive behavior, easily influenced, but also, like, a lack of concern for others, which I think in some ways, Bpd, it's not a lack of concern of others due to being how do I say this? Because you want to. It's almost like you have deep concern for others. You are often just so stuck in your head about you because your emotions are so intense. A lot of people with Bpd have care. Loved ones do have great relationships, are often used or often vulnerable. So I think that was just, like, a little bit of a difference. Dr. Katrina Furey, MD: Where do you think Tanya falls? Portia Pendleton, LCSW: I think more in Bpd, especially just primarily because we know of her trauma history, and we know we think of her mom's diagnosis. There's less research with histrionic personality disorder, so maybe they also have strong connections to childhood attachment trauma, but the research is more so currently with Bpd. Dr. Katrina Furey, MD: And like you're saying, Portia, there's so much overlap. And that is why we sort of lump or think about personality development when we're trying to organize such a complicated, convoluted topic into more concrete ways of understanding it. We've sort of come up with these clusters, like these buckets of, like well, people with these types of personality traits tend to have one of these personality disorders, but often there's some overlap. So she very well could have traits of both. And sometimes some traits might be louder, others are softer. And it can go back and forth. Yeah. Portia Pendleton, LCSW: No, someone I saw online, the main difference between histrionic and Bpd is that Bpd with I'm sorry, that histrionic personality disorder are motivated more by receiving and their desire for attention, while people with Bpd are more motivated by fear of abandonment and rejection. But I would ask, like, okay, but why do people with HPD need this desire for attention and different from narcissism? Exactly. So I think there's some questions that I have with HPD. Dr. Katrina Furey, MD: Yeah, I feel like HPD we don't talk about as much. It doesn't get as much airtime, I guess, in the media or even clinically. Maybe we kind of leave it at like, oh, those are histrionic behaviors. Yeah, I would say. And then what. Portia Pendleton, LCSW: Do we come from? Dr. Katrina Furey, MD: Right. And how is that different from someone with narcissistic traits also needing to be the center of attention? Or else they feel like nothing. Portia Pendleton, LCSW: Right. Dr. Katrina Furey, MD: Is that what's similar? And people with histrionic personality disorder just really act out in a more behavioral, attention seeking way? Portia Pendleton, LCSW: It just feels unclear to me. Dr. Katrina Furey, MD: It does feel unclear, and it's murky. And again, I think it is unclear because personality development is so complicated, and sometimes this is just us trying to put words to such a complicated topic. Portia Pendleton, LCSW: No, I agree. And some of the parts of thinking back to attachment trauma, childhood trauma, maybe, is when Tanya is having sex with Greg, right. And she says that she is disassociating. Dr. Katrina Furey, MD: Disassociating. I just want to put this out there. The word is dissociate. Dissociate. I hear so many dissociating. It is a tricky word with all the S's and C's, but I don't think it's disassociate. But I hear a lot of people say it that way. I don't know why. Maybe this is just splitting hairs, and I'm just being a snob, but I thought that was hilarious. Right. And again, so well written and perfect. Right. Like, her and Greg are finally having sex. She had come in in her beautiful lingerie, beautiful. Trying to get his attention after he'd really shamed her for all the macaroons. He's so mean to her and so dismissive. Like he's just constantly rejecting her. But finally he's like, okay, let's do it. And then as they're having sex, she freaks out, right, and pushes him away. Pushes him off of her. And he gets offended and annoyed. And she's like, I'm sorry. I was just disassociating. Do you remember what she was imagining in that moment? Portia Pendleton, LCSW: Well, it kept, I thought, showing, like, one of those statues or those heads. Dr. Katrina Furey, MD: Yeah. Portia Pendleton, LCSW: And then she tells him she's like, this head was on you and then you were gone and you were right in my face. And he's just, like, looking at her like, she has three heads. And then he's I didn't I didn't get off. And she's like, okay. I was proud of her for know, getting him off. Dr. Katrina Furey, MD: Me too, Portia, because it was so interesting. Right. They're finally connected in a very physical, intimate, sexual way. And then she dissociates and pushes him away. And I wanted to be like that. Is your gut instinct telling you, Get away from him. He is dangerous, but she can't stay there too long. But she did stay there enough where she didn't just get right back to having sex. Which, again, I was proud of her for, but only further pushed him away. Portia Pendleton, LCSW: Yeah. Dr. Katrina Furey, MD: What a fascinating scene. I would love to interview Mike White and just pick his brain and figure out how did he get these complex interpersonal dynamics depicted just so perfectly. I'm just now realizing also, his name is in the title White Lotus. Portia Pendleton, LCSW: That's funny. Dr. Katrina Furey, MD: Interesting. Portia Pendleton, LCSW: So then we know around Tanya, Greg and Portia's kind of dynamic, we see. Dr. Katrina Furey, MD: Portia and Jack develop who's the alleged nephew of Quentin. And then we find them having sex. So we sort of come to find out he's not actually the nephew. He's also being used. That was sad to me. That was really sad. And to see that actor really portray the heartbreak when he was really drunk and talking to Portia near the end. Portia Pendleton, LCSW: How did you feel with all that? I thought it was really sad. My guesses are maybe that he was struggling either with contemplating suicide when Quentin came about him. Maybe some substance use, maybe being unhoused. Dr. Katrina Furey, MD: He probably had his own trauma history. Portia Pendleton, LCSW: Seems like he was in a really dark place. I mean, he says, then he cries. Which is so different from this character that Jack, the character, is portraying as this macho man who's very appealing to Portia after she has been having some fun with Albie, who we will cover. You know, Albie seems more like kind, soft spoken, very aware of using consent. And Portia is then all of a sudden very taken by Jack who kind of comes in and kisses her. And it's more like a little bit aggressive and hot and sexy to her. But we see this downside to it, which, again, is not typical. Typically, if someone's kind of like taking swept off your feet in that way, you don't end up in a murder plot. But know, I think just Jack's story was like it made me sad. Dr. Katrina Furey, MD: It made me sad too. I found him really obnoxious, and as soon as he came into the show, I was like, oh, no, Portia, you've been talking about how you want to make better decisions. Albie's right here. He seems really sweet, but you're noticing, like, he's not chaotic enough or bad enough. And then here comes this guy. And I was like, oh, no, she's totally going to go for him, and he's going to be such a bad choice. But I still feel like she's, like, young and learning these things and making these choices and mistakes, and it all. Portia Pendleton, LCSW: Feels very appropriate, to be honest. Dr. Katrina Furey, MD: Yeah, this feels like kind of like appropriate development. I did find her costumes really interesting. I felt like she was such a great character that just embodies the early 20s person of today. I actually thought her dialogue with Albie on the pool chairs just about how struggling through COVID and how it affected her mental health. And now she's feeling lost. She doesn't know what to do for a job. She has this awful boss. I was like, this is all so accurate, and she's really putting good words to it. But then she's opening up a lot to him and dumping a lot on him, and he's, like, just listening. That didn't feel like a really equal relationship right away. Portia Pendleton, LCSW: Well, maybe that was part of her discomfort, maybe after a while with Albie and then why Jack felt so good because he didn't know anything about her. Right? It was just purely physical. She hadn't shared anything emotional with him. It was just like, based off having sex and being hot and sexy and doing these wild things, and there was no nothing deeper emotional vulnerability. Dr. Katrina Furey, MD: And in that way, I kind of did find myself wondering, is Portia like, a younger version of Tanya? Is this sort of the development of something like Bpd or attachment? Like, she's opening up to Albie so quickly, but then pulls away so quickly? Is that more in line with a personality disorder brewing, or is this also just like, normal development and she's figuring it out and just like, what an interesting character. I felt like she some of her clothes I loved, and then some of them reminded me of limited two. And I think, again, that was probably intentional to just play up, like, how she's so childish and immature in some ways. But again, she's like a young person. Portia Pendleton, LCSW: And they did intentionally include her talking right about COVID being alone. And I think we've seen both littles adults and really specifically, at least for me, adolescents, and how COVID and the social isolation and not being around your peers has impacted them. I see a lot of more immature behaviors that shouldn't be, quote, unquote, happening. So I think even so, if we picture her more as maybe like she's a little stunted 18 instead of maybe 22. I'm thinking, right when you get out of college, she feels more appropriate. Dr. Katrina Furey, MD: And again, like we talked about last time, we've talked about before, you can get psychologically stunted when a trauma has occurred and COVID is a trauma. We have all lived through this collective trauma, but it affects us all in different ways. And we are seeing just skyrocketing rates of youth and adolescent mental health issues also in adults, but I think especially in that population, it's huge. And that social isolation was a really big deal and it was a really scary time for people and for the youth. So I totally agree. I was really glad that they touched on that. I also thought it was interesting that I guess the first season of White Lotus was filmed in 2020, and that was partly why they were restricted to the resort. Remember? I was always like, why doesn't anyone go explore Hawai? And I'm like, oh. And then season two was still in COVID y times, but things were loosening up so they could film elsewhere and leave the resort a little more. And I was like, oh, that makes a lot of yeah, but that scene when Portia's like, starting to put together that something really bad is going on and then I couldn't tell if she was supposed to be killed too, and then Jack spares her or if he was just supposed to keep her away. What did you think of that? Portia Pendleton, LCSW: I think it's left intentionally kind of like, unclear. There was some talk of why didn't he kill her? And it was just more people were talking about it's not because he loves her at all. They developed this connection. It's just because of his character. He's not a murderer. Yes, he's capable of other things, but we saw how it feels like all this world that he's in is so destructive for him. And he's kind of holding the line at like, and I'm not a killer. He seemed torn for that know, he was angry, which I think, you know, coming off to Portia, which again is so like, he seemed scary. Yeah, he might kill, but like, I don't know, maybe there's some inner conflict at that, like, what to do? And then he drops her off right kind of near the airport and just go to the I thought, you know, that to me was like, he's a victim of his circumstances, but still has like a moral compass. Dr. Katrina Furey, MD: Right? Yeah. And I thought, did he end up having sex with Quentin to spare know? Was that happening all along? I bet it was happening all along, but he really seemed so distraught. And I really didn't know until he drove away if Portia was going to be okay until we saw her in the airport again. And I don't know if he knew. I don't know if he was supposed to bring her back or not, or if he was going to then get hurt because he didn't follow through with the plan, or I just really felt for him by the end. I found him really obnoxious at first, and then learning about his whole backstory, he's just so vulnerable and was just taken advantage of. It's so sad. Portia Pendleton, LCSW: Yeah. I mean, I think Portia's character, people like, I wouldn't say maybe loved, but some people had really big reactions to her. Didn't like her at all. Thought she was, like, the main villain. Dr. Katrina Furey, MD: Of the that I find shocking. Yeah. The main villain. Right. Like, whoa. Portia Pendleton, LCSW: I think that's more and this know, my opinion. I would imagine that's probably coming from a little bit of an older commentator who's watching, because I think if you are a working with Gen Z or if you are in Gen Z, she feels really normal, feels so relatable. And I think she's actually not the villain. She's trying to find herself. She's, like, in Italy with her boss. She doesn't know what to do with. Like, it all makes sense. So she actually had come out with a quote, which I thought was interesting yeah. About commenting on people not liking her. And she said it. The one thing that I thought was actually kind of unfair and warped was the people who were saying that she was awful or that she was the real villain of the season. There's no way that you can look at that young woman and be like, she is the most awful one on this show. People who think that way should go to therapy. And I was like, or maybe just spend some time around the yeah, yeah. Dr. Katrina Furey, MD: I totally so, you know, expanding out from know, we talked a little bit about Albie and just the stark difference between Albie versus Jack and how they were so different and how you sort of saw both cute. Portia Pendleton, LCSW: Yeah, of course. Dr. Katrina Furey, MD: Both, like, physically know. But yeah, albie went to Stanford. He seems really modest. He humble, he's really sweet, sensitive, and it's like, you can tell she kind of wants to be attracted to that guy, but there's something missing for her, like that spark and that sexiness. And I think all people maybe can relate to that or I think a lot of people have felt that at different points in their life. Probably in their early 20s. Yeah. And then here comes Jack, and she's just, like, totally taken by him. What did you think of Albie's character? Portia Pendleton, LCSW: I thought that he was so interesting in how season or episode one portrayed him. And then the final episode, episode seven, did. So it's like we learn that he is kind of stuck in the middle of this family dynamic, where he's often the moderator. He often, it seems like, also has power in the family. He can kind of go to mom or dad and make changes or make. Dr. Katrina Furey, MD: Them move things over. Portia Pendleton, LCSW: Yeah, exactly. So he seems initially really sensitive, and I think he still is, but he's sensitive. He does not like what his dad, Dominic, is doing to his mom. It sounds like Dominic has chronic issues with cheating. Maybe some kind of sexual addiction. I don't know. Dr. Katrina Furey, MD: And the kids know at this point, it sounds like he has a sister who's not on the trip. The mom refused to come because of his dad's actions, but he came. And his grandfather oh, my God, what a character and what a stereotypical caricature of older man. Portia Pendleton, LCSW: And it seems like so Dominic has contacted Lucia prior to going, that was my interpretation. And then she meets up with them there know, Lucia is like a sex worker. And then we kind of go through all the stages of Lucia and Mia being with or a part of the evening for Albie, Dominic, and Burr, all in different ways. And then at the end right. So his arc from episode one to seven with Albie, it's like, we see Albie, Dominic, and Burr all kind of their heads turn as this attractive Italian woman is walking by in the airport. And I don't know. Would that have happened at episode one with Albie? I don't know for sure. For Burt and Dominic, burt is like this flirt ladies man. Dr. Katrina Furey, MD: The scene where they're arriving, and the young receptionist walks him to the room, and he's flirting with her, and then he farts. Portia Pendleton, LCSW: Ever. Dr. Katrina Furey, MD: Just the look on his face, like, pretending it didn't. Portia Pendleton, LCSW: And the employee is so professional, she's just, like, ignoring it. Dr. Katrina Furey, MD: But he's so trying to hold on to his suaveness and his ladies man vibe, but then he's, like, farting and falling, and he's older. It's too much. Portia Pendleton, LCSW: Yeah. So I thought what I really liked hearing about this family was when Dominic challenges Bert about Bert's relationship with his wife, who is deceased, Dominic's mother, where Dominic knew that Bert was cheating on his mother. It seemed like she knew. And he kind of talked about her as like, she's either a martyr or she's like, I forget what. It like really resentful, like a bitter woman. And Bert seems so taken aback. Dr. Katrina Furey, MD: That his son. Yeah. And that's new. Portia Pendleton, LCSW: All his experience or that he sees Bert's love of his life. Dr. Katrina Furey, MD: Right. Portia Pendleton, LCSW: So Bert has this image of his wife, his deceased wife, who's like, that's everything to him. And then we learn of these actions that kind of say differently. It's interesting him being challenged on that. Dr. Katrina Furey, MD: And it's almost like speaks to Bert's own defensive reactions to keep all of that out of his consciousness and just think, like, wow, we have a great life, and, you know, my girlfriend's on the side, and no one's the wiser. And then Dominic's, like, really in his face, like, we all knew, and this was really hard. And then Dominic, though, is repeating it. Portia Pendleton, LCSW: Right. Dr. Katrina Furey, MD: And then in that generation, it's like everyone in the family still knows, but in an even more open way, know the earlier generation. And then we at first think Albie's not going to repeat it, and then the question for me is, does he or was he sort of taken advantage of by Lucia, right? Like, was he really developing strong feelings for her or not? What do you think? Portia Pendleton, LCSW: I don't know. I think it could go either way, and I think the writers and they do that intentionally. They totally do that intentionally, because I think it could go 100% either way. I think also I'll be learning that Lucia is a sex worker. I think that then was where I see his path to go either way. He was either, okay, this is something that we do, and I care about. Dr. Katrina Furey, MD: You and accept that about you and sort of kind of love you, want to move forward with you, or then he's like, okay, I can use that to my advantage. Portia Pendleton, LCSW: Right? Is that what you're so I think, you know, albie still feels like the better choice than Jack, but I think that I don't know. I guess what happens in Italy stays, or does the question yeah. Dr. Katrina Furey, MD: And I think, like, asking his dad for all that money and phrasing it as how did he phrase it, it's. Portia Pendleton, LCSW: The least you could do, or think. Dr. Katrina Furey, MD: Of it as, like, retribution for all your prior actions. And they were both so manipulating each other that I found it really interesting, and that's when I thought albie really did care about Lucia, and they had that whole scene where her pimp is, like, following them, and she has to go with him, but then that's fake. Oh, was it? Yeah. Portia Pendleton, LCSW: So then at the end, when it's showing, her and Mia, like, last five minutes of the movie, and they're walking down the street, they stop, and they kiss and hug her pimp who's working at some other place I think it was a friend. Dr. Katrina Furey, MD: Maybe that's her boyfriend. Portia Pendleton, LCSW: I think it was a way to get more money. That's what I interpret it, because we saw him, and they were cheek to cheek, kissing, smiling. Dr. Katrina Furey, MD: Yeah. Oh, I didn't know that was the same person. Wow. Whoa. My mind is whoa, whoa because I kept wanting Lucia to, like she was fascinating. She was a fascinating character to me, too. If we want to move on to know the, like, the depiction of a sex worker, is that the politically correct way to sort of refer to her? Not it's not clear to me if that's legal or illegal in Italy, but you certainly saw all the shame coming from Valentina, the manager of the White Lotus. At first, you see Lucia talking to Mia about it in terms of sort of the way they both view money and sex. I just thought it was really fascinating. What was your take? Portia Pendleton, LCSW: Yeah, it seemed also like Lucia at times, though, was really ashamed of what she was doing. She didn't want Mia to be a part of it. And then there were times where she's like, I don't like this feels not okay. And other times where she felt like, really manipulated and also in charge, right? Like, she was manipulating these men to make a lot of money. I was like, wow, get your bag, girl. Dr. Katrina Furey, MD: That's a lot. But then I thought she just wanted to make enough money to get out and open her own store. But then by the end, I wasn't sure if that's really true or if she's just happy and fine doing this job right. Portia Pendleton, LCSW: I would have liked to know. And again, it seems up for interpretation. Like, as her and Mia, I thought that after I saw that that was not her pimp, I thought that she was going to show. Like, this is the store I bought with the money from Albie because they didn't I was this is this something that she does frequently. And it wasn't this one time opportunity with Albie to get this huge amount of money. So then I was like, I don't know. Again, I think it's ambiguous on purpose. Dr. Katrina Furey, MD: Exactly, and I think they do that on purpose, ending with them strolling down the street, looking in the windows, but not being like, okay, this is the store I bought, and now I can have this new life. And again, I think that speaks to just the strong feelings. The whole concept of sex work, I think, stirs up in everyone, and it's so different for everyone. And I think it perhaps is also different culturally. Like, I'd imagine there's some cultures where it's more accepted than it is in our American culture. And I thought Lucia's influence over Mia was also really interesting. Right. On the one hand, she's, like, bringing Mia along at the beginning, and Mia's, like, not really wanting to, and she's pushing her she's kind of pushing her to like, let's go have a threesome. Like, come on, come on. And then when Mia starts to participate with the original pianist, and then eventually with Valentina and sees like, oh, I can know sex as currency, know, use that power to my advantage to get what I want in the world. I feel like Lucia has mixed feelings about it, kind of. Portia Pendleton, LCSW: Yeah, no, I thought that was an interesting dynamic, the two of them, because as I thought initially, like, Lucia seems like she's getting out, mia's getting in. Yeah, but then I think they both were. Dr. Katrina Furey, MD: But it seems like kind of they want to be. I think it was sort of like thinking, like, oh, poor Lucia. She has this pimp. She can't get out no matter how much she wants to, but maybe not. Like, maybe she is fine with it. Portia Pendleton, LCSW: And is that the intent, right, to have this question in your mind when you finish of, like, this isn't a clear cut visual of sex work in a really vulnerable way. It's more like they're in charge of it, and they actually got some nice things. Mia, her music career. She gets to sing here, it seems like, too. At least they showed besides the pianist. And I think that was also just like Mia's discomfort, maybe because it was like the first time she was doing something like that. But all of the experiences seemed consensual. Dr. Katrina Furey, MD: Right? Yeah. Portia Pendleton, LCSW: And like, gross or where they're feeling or being portrayed as like a victim. They seem very much in charge. And I think that's even more clear when I think you learn that that's not her pimp. Dr. Katrina Furey, MD: Yes, I agree. I totally agree. And I'm sure all of that was intentional. And it does stir up important, I think, questions. And then also with Mia and Valentina. I loved the character of Valentina. I loved how quick witted and strong she was. I loved her initial commentary when everyone's getting off the boat and she's saying to Bert, like, well, you're so old, right, but you're like just some of the things she would say was so funny. But wow, it really turned it on its head. Right. Because you really saw how she was shaming Lucia and Mia at the beginning, throwing them out, like just being so derogatory toward them, treating them like they're subhuman, which, again, I think a lot of people in the sex work industry, that's probably how they're treated. Right. But then by the end, it's like Valentina's a willing participant. And Mia is it's like, in some ways was that kind of beautiful that Mia was finally helping, like, explore her sexuality, which had been so repressed and unsafe for her to explore? That actually seems like take the sex work out. That seems like a beautiful way for someone to explore their sexuality, finally righteous. I don't know. It stirs up a lot of mixed feelings for me. It does. Portia Pendleton, LCSW: And I think also interestingly, just her character being gay, I know historically and I don't know, like anecdotally that Italy. There's a lot of gay men in Italy. You have been allowed to have a homosexual relationship there since the 18 hundreds. Dr. Katrina Furey, MD: Wow. Portia Pendleton, LCSW: In parts. So they've been historically progressive in that way, especially with men. And there's like parts of Italy where there's like a lot of gay beaches. Dr. Katrina Furey, MD: I mean, look at the gay posse around which is sidebar. I feel like part of that posse was like Borat and Albert Einstein. Like, I couldn't stop thinking that when I was watching. Portia Pendleton, LCSW: That's so funny. Dr. Katrina Furey, MD: But then yeah, compare that to Valentina's experience as a gay woman, and she certainly seems like it was not safe at all to know give any ounce of it was so repressed. Portia Pendleton, LCSW: She also seems to really not like men. Dr. Katrina Furey, MD: Yes. Like in that coffee shop. Portia Pendleton, LCSW: Yeah, the coffee shop. And then she's really like it's so funny. Dr. Katrina Furey, MD: Rocco. Rocco. Portia Pendleton, LCSW: Yeah, she makes Rocco go and work down at the beach. And then she's so, I think, trying to almost use her not 100% fluent in english to challenge and shame Dominic when he's asking for lucia and Mia to be added to his room. And she's like, I don't understand. So they'll also be sleeping with your dad? Dr. Katrina Furey, MD: And he's like, no, you'll all be. Portia Pendleton, LCSW: In the same bed. Yes. That was funny. And I think, like, her doing that purposely. Dr. Katrina Furey, MD: Yes. Portia Pendleton, LCSW: Oh, I think so. Dr. Katrina Furey, MD: I think she has, like, contempt for men, and that makes me wonder why. I'm sure there's a lot of background there we didn't get to learn about, but watching her evolution, I also thought was really fascinating. I kind of just wonder how she felt at the end of the like, did she feel, like that relationship with mia, if that was, like, did it end there, or did it continue? Did it feel okay to, like, how is she doing? Portia Pendleton, LCSW: I and I think that's another right. Like, because she ends up after her and mia had spent the night together, kind of unmia. Didn't ask her, but obviously she made it known that she wanted to sing there. But valentina dismisses the other guy, the other pianist, and he's very upset by it, and she's just like, no, we're moving forward with this. And then she kind of, like, smiles at mia and then goes about her day. So it's like, again, right. Dr. Katrina Furey, MD: Like, sex is passed. Portia Pendleton, LCSW: What happens next? Do they have another night together, or is Valentina now, like, this confident woman? Dr. Katrina Furey, MD: I think she's going to go meet someone else to have another night. I think she had said, like, if you're not busy, but how long does that continue? Right. I loved mia. She did have this sort of naive innocence, in a way. All she wants to do is sing, and then she's finally singing, and she's so happy, and I was so happy for her. I did think she was a lot better than the guy. Yeah. The scenes with her and the guy trying to have sex in the chapel, I did feel grossed out by oh. Portia Pendleton, LCSW: And she kept turning her head, and there's, like, right, jesus, there's mother mary. Dr. Katrina Furey, MD: And I was just like, oh, my god. And I thought it was humorous when she gave him the wrong pill, and that can happen, so you have to be really careful. As I put my doctor's hat on, be really careful what kind of pills you're taking. Don't take your friends pills. They can interact. Portia Pendleton, LCSW: Yeah. Dr. Katrina Furey, MD: ****** can interact with blood pressure medications and lead to really serious problems, which I think is maybe what happened with him. But just be careful. We do see in this season a lot of talk about prescriptions, like, there, and then we see harper and her ambient and kind of sharing it around. Ambien is also not something you should just be sharing around. Yeah. Portia Pendleton, LCSW: And she seems to think like it's so normal for everyone to take. And I'm like, Ambien is often, like, a last resort. Dr. Katrina Furey, MD: It should be, I think. Unfortunately, it can be quickly prescribed, but it's really powerful. Do not mix it with alcohol. Do not mix it with other drugs. Please don't. You could get really hurt or stop breathing. It's really serious. But yeah, maybe that's a nice segue to our last crop of characters, who I found perhaps the most fascinating of know we have Ethan and Harper, who seem to be married, no kids yet, maybe I think they're thinking about starting to have a family, but they haven't really yet. And it seems like Ethan has come into this. Portia Pendleton, LCSW: Right? Right. It seems like he's in tech. Maybe he just sold some that he created. Dr. Katrina Furey, MD: Yeah, harper's a lawyer, right? She's a lawyer, so she has her own career too. But they were, like, all of a sudden, like, uber wealthy. And they're on vacation with Cameron and Daphne, who are also uber wealthy, but it seems like he's in finance. I think they live in Connecticut, and she's, like, sort of a stay at home mom. And we come to find out that Cameron and Ethan were roomies at Yale. Right. And then it seems like their dynamic was always like, Cameron always had to be, like, the big guy on campus and was threatened by, like, quiet power. And so I think Ethan was saying whenever he expressed interest in a girl, cameron would swoop in. Which reminded me of Olivia. Yes. Right. From season one. It's just like, in, like, Olivia and yes, yes, kind of fast forward, and now let's switch up the gender roles. So what were your first impressions of these folks? And I can't wait to pick your brain about Daphne. Portia Pendleton, LCSW: Well, I think intentionally, right. Like, Harper is made to appear as, like, oh, I know she's fabulous as, like right. Like, I'd say, like, really liberal woke and not in an icky way. Dr. Katrina Furey, MD: Like Olivia from season one. Portia Pendleton, LCSW: Right. Like, in a really smart way. Dr. Katrina Furey, MD: Yeah, like, she's a lawyer and she's, like, fighting for the employees and all that stuff. Yep. Portia Pendleton, LCSW: It sounds like she's either fully or, like, half Puerto Rican, so she has that kind of experience and knowledge base. Dr. Katrina Furey, MD: But, like, white passing. Portia Pendleton, LCSW: Ethan seems like he's Asian to some degree. So again, not white, but also, I'd say, like, what do they call what's the phrase? Dr. Katrina Furey, MD: Model minority. Portia Pendleton, LCSW: Yeah. So so Ethan might also be considered right. Like, part of the model minority and also very stereotypical in tech. Made a lot of money, very smart. Right. So just interesting that dynamic then kind of pushed against Cameron and Daphne, who seem opposite in some ways. Right. Like, more clear gender roles with, like, Cameron makes the money, daphne stays at home with the kids, and then the conflict or how, like, tolerates that comes. Dr. Katrina Furey, MD: Out that I thought was I I sort of, from the jump, had this feeling like, okay, so Cameron and Ethan were friends. Our friends, I don't know. And they're like, on this vacation together, harper was spot on to say, like, he invited you because he wants your money, so just be ready for it. And like, yep, that's what happens, right? It totally blindsided me. I knew Cameron was cheating and stuff. I didn't think Daphne was also getting back at him, but in major ways, like, almost like she has the power. And again, it's like she is using Cameron's fear of abandonment to her advantage. What did you think of that? Yeah. Portia Pendleton, LCSW: And also I was just wondering, like, chicken or the egg, right? Like, who pushed who first? Dr. Katrina Furey, MD: And they get off on pushing each other. Right. It's like, real toxic, but, like, hot. Portia Pendleton, LCSW: And we're going to spend some time talking about them, but I think, again, where we're left to wonder, right, is it's not entirely confirmed, but, like, did Harper and Cameron have sex? And did Ethan and Daphne have sex? Dr. Katrina Furey, MD: Yes. And the final scene of them waiting at the airport where Cameron and Daphne feel kind of distant, but then Harper and Ethan are way more connected, and. Portia Pendleton, LCSW: They know sex back in the hotel room. Dr. Katrina Furey, MD: Finally, it's like, finally that spark is reignited. Right. It seems like they were married and maybe going through, like, a dry spell. And they were so openly talking about how well, Ethan watches **** all the time. He wants to have sex in the morning, I want to do it at night, all this stuff. And you could see how when Harper's trying to seduce him, he's, like, pushing her away, and then it's like the flames rekindle. Portia Pendleton, LCSW: Right. And so right. The question is why. Is it because they both had sex with others and now they're in this relationship similar to Cameron and Daphne, or did they not? And they are now feeling really close and connected to each other because of that? I don't know. Dr. Katrina Furey, MD: I know. I don't know either. And I could see it go both ways. Did they redefine the terms of their relationship and they're both on board with it, or did they resist and that made them realize how much they really care about each other, and that's what reignited the flame? It's so ambiguous. It is clear. I don't know either. I don't know either. Portia Pendleton, LCSW: So we see them have so Daphne and Daphne tricks Harper to go spend. Dr. Katrina Furey, MD: The night somewhere, some palazzo or some fancy thing. I was like, who wants to do that? It seemed kind of boring, right? Portia Pendleton, LCSW: They were, like, in this know, beautiful. Dr. Katrina Furey, MD: Space, but, like, by yeah, like, where do you get dinner? I don't know. I don't like she could find one strand. Portia Pendleton, LCSW: They took an edible yeah. To relax. Dr. Katrina Furey, MD: But I would feel like yeah. Like Harper felt like she was trapped. Portia Pendleton, LCSW: And she was and then Daphne's like, well, don't call Ethan. I want to call Cameron first. Right. Like, she needed to call Cameron first to let them know that they just got so swept up and are just going to stay here now. Dr. Katrina Furey, MD: But that wasn't true. She knew the whole time that she was going to stick it to him in this way. Is it because she knew he was bound to cheat on her, or he has before and she's spending his money. Portia Pendleton, LCSW: And this is her okaying. It because if they had never left, they never would have had the opportunity to do that. Dr. Katrina Furey, MD: Never crossed. Portia Pendleton, LCSW: She left intentionally, like, giving him this, which, again, he obviously didn't need to do it, but she gave him this space to have this day that could have just been jet skiing. Dr. Katrina Furey, MD: Oh, that never crossed my mind. I always thought she was mad at him and getting him back, but this is also like she's giving him an invitation. Yeah, but it's also like this is where their toxicity plays off each other because she knows it's going to hurt him. And she says that to Harper, like, oh, he has this fear of abandonment. I think she even calls it that. Portia Pendleton, LCSW: And fear of missing out, having this phone experience. Dr. Katrina Furey, MD: Right. And she was like, yeah, they're going to stick it to him and spend his money to rent this place, but then maybe she knows that's going to make him mad enough to be unfaithful to her, but then maybe somehow that justifies her. And the scenes between Harper and Daphne where Harper's trying to bring it to her attention, what did you think of Daphne's responses and the actress's responses? Portia Pendleton, LCSW: I would say first, not typical. Not what know, I guess the knee jerk. Dr. Katrina Furey, MD: Not what I was expecting at all. Portia Pendleton, LCSW: And she kind of initially gets pretty severe with Harper insisting that she is not the victim. Dr. Katrina Furey, MD: Yes. She gets very hard and defensive very quickly, like when they're still in that palazzo or something, and she's like, I think something happened with them. Right. And when Harper's like, do you think he cheats on you? And she's like, once or twice, like. Portia Pendleton, LCSW: A year, a month. Dr. Katrina Furey, MD: And I think at first you're left to think like, he does that, and she accepts it. And then it hit me out of left field when she's talking about her personal trainer. Right. Did you pick up on the kid that it's like his kid? Yes. Right. Yes. And that's like the ultimate sucker punch, I feel like, to Cameron. Right. Portia Pendleton, LCSW: Because she describes and this was very, in my opinion, intentional. She describes the trainer as like he looks this blonde haired, blue eyed guy. And then she shows them a picture of her two kids and the one that I zoomed in on, which again, it was probably edited, so I would do that was this blonde haired, blue eyed boy. And Cameron has brown eyes and Daphne has blue. That's possible. But I just thought it was like. Dr. Katrina Furey, MD: No, she's trying yeah, and she was allegedly trying to show Harper a picture of the trainer, and then Harper's like, oh, this is a picture of your kids. And she's like, oh, is it? And that's like, Daphne leaves so much she says so much by saying so. Portia Pendleton, LCSW: Yep. Dr. Katrina Furey, MD: And I feel like that is her power and just like, what a thing to hold on to. And does Cameron know, or like, I. Portia Pendleton, LCSW: Think no, I think he thinks that he is the one who's getting away or being hot shot, but I think it's like, Daphne is the one, ultimately, and she knows it, and that's how I think she can tolerate and that's. Dr. Katrina Furey, MD: How she gets, I think oof, icky. Yeah. Portia Pendleton, LCSW: And not expected. Dr. Katrina Furey, MD: Right. Portia Pendleton, LCSW: When we meet her, she's like, oh, hi. Dr. Katrina Furey, MD: She's always so fun. I think I voted last year. When I get drunk, I donate to know. I didn't see that coming. Like, what a fascinating character. I kind of want Daphne to be in season three. I want to see where Daphne goes. I never liked Cameron. He gives me the like right away. Portia Pendleton, LCSW: Well, in her comments, daphne's of not having a lot of female friends or having a hard time with that. I was like, well, is it because Cameron's, like, touching them? Is it because he's trying to have sex with all your friends? Or are they picking up on just, like, your toxic relationship and don't want anything to do with it? Dr. Katrina Furey, MD: Just icky. Yeah. And then it's like, look how she relates to right. Like, at first, she's really complimentary and seems kind of sweet, and one of those like, at first I was like, you're just one of know, people who can just see the good and block out the bad news and stuff like that, whereas Harper and Ethan are more based in reality. But then this whole other nefarious side to Daphne came out, and I'm just left wondering, is this who Daphne is? Or has she turned into this in relation to Cameron? Portia Pendleton, LCSW: Right. Dr. Katrina Furey, MD: And this toxicity. I don't know. It's fascinating. Portia Pendleton, LCSW: It is. It's so fascinating. I mean, I thought the four of them were a really interesting storyline to follow. I think also, just, like, it seems to be that if there's something that you're trying to get away with, it's, like, the truth seems to always come out right. Of course, Harper finds the condom, and then she starts pulling all this other information out of Ethan, which I was like, ethan, come clean earlier. It's like you kept adding things in over time, over and over, and it's like, I understand that you still, by sharing what happened, are going to make Harper uncomfortable or upset, but she thinks that you had sex with someone. Dr. Katrina Furey, MD: And on the flip side, Harper didn't bring it up right away. Like, she found it. She kind of kept it. They went to dinner as if everything's okay. Portia Pendleton, LCSW: She kept asking him questions about last night, and he was really evasive. Dr. Katrina Furey, MD: I know. I was just like, you guys communicate directly, right? Like, come on. But I don't think they really know how to and then they really start to mistrust each other. Portia Pendleton, LCSW: And it seems like it's all because of cameron and right. Dr. Katrina Furey, MD: Like I blame for yeah, for sure. Portia Pendleton, LCSW: It's like he's the one who's stirring the pot. Dr. Katrina Furey, MD: And I think ethan touching her leg is right. Portia Pendleton, LCSW: Flashing back to college, where it seems like he actually really doesn't like cameron, and cameron took a lot from him, and that's why then he becomes really paranoid, which may be rightly. So about cameron and harper. And then he beats him up in the water, which I loved. And then they're all, like, dining together. Dr. Katrina Furey, MD: Oh, my know, I don't even know I know. And then it's like, I felt like harper was seeing ethan maybe like, is this why we're on the trip? Because you want to show him? Like, you finally win it's like, again, them on the jet skis was so perfect. They're just having, like, a man contest, like, who wins? And he want to rub it in his face. But then it's like you see cameron for who he is, and he's always been that way. Right? Oh. It's just really, you know, and we. Portia Pendleton, LCSW: Saw power dynamics as well in season one, but it's like the power of yeah. The power of relationships manipulating each other. It just was a really interesting season in that way. Dr. Katrina Furey, MD: It was really interesting. I mean, I totally see why it swept the emmy nominations right. Under succession. All of the characters in that forsome were nominated for emmys. So was just it was such a good show. Portia Pendleton, LCSW: And lucia and mia, which I loved, the fact that they were I think. Dr. Katrina Furey, MD: It was actually lucia and valentina. Portia Pendleton, LCSW: Valentina, yeah. Dr. Katrina Furey, MD: But just really remarkable. And I thought, again, right up there for me with succession and you and just getting it so right in terms of the dialogue. But even more than that, everything else besides the dialogue when they're acting and staging and their body language and what's not said and the silences and the facial expression, all of it is so good, so compelling and so accurate. Portia Pendleton, LCSW: And even the more quieter characters on this show, like jack, like know, maybe he's a little bit of a bigger character than but, like, I think they're also such good actors. We felt so many different emotions towards all of the characters, all at different times, and I feel like that to me, really speaks about someone's ability to be an actor. Yes. And we also have coming out next month, one flew over the cuckoo's nest, and we talked, too, about jack nicholson's performance in that where it's like his character is set up so that you automatically should not like him. And then there's this weird dynamic in the show where you're rooting for him. And again, I feel. Like, I see that with Jack, right? Like he's participating in this horrible scheme, but I feel really sorry for him and know, have empathy and I think, well, most people can feel empathy. Empathy. Dr. Katrina Furey, MD: Sociopath. It's confirmed. Portia Pendleton, LCSW: Yeah, confirmed today. But I just think all of their characters are so well written and so well acted. I know we just said that, but I'm repeating it because I'm just such a fan. Dr. Katrina Furey, MD: Yes. Mike White, please come on our show. Portia Pendleton, LCSW: I'd love to pick your brain. It must be an amazing place to be in your brain. Dr. Katrina Furey, MD: I know, right? Portia Pendleton, LCSW: So what is your prediction for season three? So we saw an emphasis on money. There's an emphasis on sex. Dr. Katrina Furey, MD: What could be greed? Portia Pendleton, LCSW: I mean, I'm thinking maybe of like the seven deadly seven deadly sins. Dr. Katrina Furey, MD: Like gluttony, like sex. I'm fascinated by like I would actually love it if Portia's the one who we sort of follow next. I think that'd be really interesting. I found Daphne really fascinating. I don't know Portia. I have no idea what to expect. I bet all the writer strike and the SAG strikes, which I fully support, but I think that will sort of delay. Portia Pendleton, LCSW: Yeah, that's such an interesting thing to think about. I was watching a rerun of a show that I like, I watch Big Bang Theory sometimes at night because I've. Dr. Katrina Furey, MD: Seen all the episodes fun, silly, soothing. Portia Pendleton, LCSW: And I was like, this is what we're going to have to do, like watch all these reruns because everything is going to be delayed, right? Dr. Katrina Furey, MD: Yes. Portia Pendleton, LCSW: I'm sure they can throw out some Hallmark movies because they're really good at producing and getting those ones out fast once this is over. But some of these shows we know yellow Jackets, White Lotus, you. Dr. Katrina Furey, MD: Know, like. Portia Pendleton, LCSW: You said, I'm supportive, but I just want the content. I know. Dr. Katrina Furey, MD: So if these corporations could just get it together, that'd be great. But in the meantime, if you're enjoying this content, please rate, review and subscribe. Our show is doing better than we expected, but if you're listening and you haven't subscribed yet, please do follow us on Instagram at Analyze Scripts. Follow us on TikTok at Analyze scripts, podcast. Follow us on Threads at Analyze scripts. Podcast. Let us know what you want to hear us analyze next and we'll see you next Monday. Portia Pendleton, LCSW: Yeah, thanks for listening. Dr. Katrina Furey, MD: Bye bye. This podcast and its contents are a copyright of Analyzed Scripts. All rights reserved. Any redistribution or reproduction of part or all of the contents in any form is prohibited unless you want to share it with your friends and rate, review and subscribe, that's fine. All stories and characters discussed are fictional in nature. No identification with actual persons, living or deceased places, buildings or products is intended or should be inferred. This podcast is for entertainment purposes only. The podcast and its contents do not constitute professional mental health or medical advice. Listeners might consider consulting a mental health provider. If they need assistance with any mental health problems or concerns. As always, please call 911 or go directly to your nearest emergency room for any psychiatric emergencies. Thanks for listening and see you next time.

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and how to be in solo practice with no debt. I'm your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients, more profits and stellar reputations. Now, today's episode is called "Solo Practice, No Debt — with Philip Robb, Jr., MD". People develop different money mindsets based on their upbringing, beliefs, attitudes and behavior.  And there are many money mindsets to choose from: Scarcity, abundance, thrifty, growth, generosity, materialistic, and entrepreneurial mindsets.  Knowing yours helps you make decisions that you are comfortable with and that align with your goals, values and aspirations for a healthy relationship with money. This week's Beauty and the Biz Podcast guest is Philip Robb, MD, a facial plastic surgeon in private practice for the past 7 years located in Alpharetta, GA where he was raised. Dr. Robb embraces the thrifty mindset which has paid off for him (pun intended). He sleeps better being debt free, so he stretched his resources and made prudent choices. That has allowed him to build out his own surgical center while doing surgery 5 days/week on his terms…No Debt! That didn't happen by luck. It was mindset.  Visit Dr. Robb's website P.S. Earlier this week, I talked about following up on leads and that starts with your receptionist. Get 87% OFF front desk training with this one-time offer….

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and how to perform 3k lip lifts plus 300 facelifts per year. I'm your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients, more profits and stellar reputations. Now, today's episode is called "3k Lip Lifts Plus 300 Facelifts Per Year — with Benjamin Talei, MD". One way to differentiate yourself in the marketplace is to work harder than everyone else, which is what enables Dr. Talei to perform 3k lip lifts plus 300 facelifts per year. That doesn't guarantee your success, but it certainly gives you a leg up over your competitors. That's what my next Beauty and the Biz Podcast guest did. Ben Talei, MD, facial plastic surgeon set up shop in Beverly Hills and went to work. For 6 years, Dr. Talei worked 16-hour days, 7 days per week honing his surgical skills and making a name for himself…. …until he had a medial scare and had to slow down. Now Dr. Talei “only” works 12-hour days, 4 days per week providing some of the best results seldom seen. He continues to perfect his techniques and do what others don't, won't or can't. And he uses social media and his before/after photos to set himself apart from everyone else and build a demand he struggles to keep up with. Here are some things we talked about: How he gets photo approval from his private patients How he gets results that others don't Tips for marketing to build up a huge demand and much more Visit Dr. Talei's website P.S. Please review!

Limited by our expertise and knowledge, we become trapped in the confines of our comfort zone, unable to break free and reach our true potential. But what if there was a way to crack open the barriers that hold us back and unlock success in areas beyond what we can do?    In this episode of The Moonlight Real Estate Side Hustles and Syndications Show, Eric couldn't agree more when Felecia shared her realizations about her mission-driven investment journey,  how she tirelessly worked to become a real estate syndicator while balancing a demanding full-time urology practice.   “The Moonlight Real Estate Side Hustles and Syndications Show With Eric Lindsey”  focuses on achieving financial security through real estate.   Felecia Froe, MD is a licensed urological surgeon with over 20 years of experience. She is the owner of Money With Mission, an investment company focused on empowering professional women to build wealth and achieve financial freedom through social impact investing.   00:00 - Introduction of the Inspiring Journey 02:23 - From Medicine to Real Estate Success 05:50 - Unintentional Asset Building 10:22 - Mission-Driven Investing 13:30 - Thrive Without Burning Out 22:00 - The Power of Association 23:00 - Balance Resources for Success 25:01 - Beyond Transactional Relationships 27:17 - Recap The Moonlight Real Estate Side Hustles and Syndications Show With Eric Lindsey  Showing Busy Professionals and People How to Acquire Real Estate Website: https://ericlindseyml.com/the-moonlight-real-estate-side-hustles-and-syndications-show/   Be the Boss of Your Own Money and Own Your Future. Connect with us and Discover Investment Strategies Designed to make a Difference. Website: https://moneywithmission.com/  Linkedin: https://www.linkedin.com/in/moneywithmission/  Quotes:   “You do not do well when you learn real estate investing by yourself.” - Felecia Froe, MD   “It's not [about] what you can do for me. It's [about] how I can serve and see where you go.” - Felecia Froe, MD  

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and selling but staying in your practice. I'm your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients, more profits and stellar reputations. Now, today's episode is called "Selling but Staying in Your Practice — with Andrew Kaufman, MD". This week's Beauty and the Biz Podcast is an interview with Dr. Andrew Kaufman, a board-certified dermatologist specializing in Mohs, dermatologic and cosmetic surgery in Thousand Oaks, CA for over 28 years. He built a nice size practice with several doctors under him plus 40 staff and a lot of accounts receivable. And, like others who have put decades into building their practices, he was searching for an exit plan that made financial and emotional sense to him. Dr. Kaufman recently sold his practice to a big private equity derm group known as Forefront Dermatology so we talked about the specifics of that transaction. We discussed: Why he was ready to sell What made his practice attractive to buy  How his associates and staff reacted What it's like to sell yet stay in the practice as an employee He offered great advice on how to set yourself up to sell, how much time it takes to prepare and who to get help from to negotiate the best scenario for you.  Visit Dr. Kaufman's website P.S. Please review!

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and buying land & building a practice from scratch. I'm your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients, more profits and stellar reputations. Now, today's episode is called "Buying Land & Building Practice from Scratch — with Edward D. Buckingham, MD". Deciding WHERE you do surgery is a big decision that affects your time, resources, profits and sanity.  And the answer to that question changes as you change. For example: You have a killer deal with a friend of yours to use his OR; however, it's a 30-60 commute depending on traffic  You use another surgeon's OR in your building, but they continue to raise the fees and you're feeling exploited  Your surgical coordinator is struggling to get you blocked times at the hospital and so on. That's usually when you start dreaming of taking back your life and enjoying autonomy to do surgery wherever and whenever you please, while even adding more surgeons to help pay for it if you choose. This week's Beauty of the Biz Podcast episode is an interview I did with Dr. Edward Buckingham. He's a facial plastic surgeon with a BA degree in accounting and in private practice, in a gorgeous new office in Austin, TX. He decided it was time to upscale and play a bigger game, so we talked about: The myriad of construction and permit issues of buying land and building a practice from scratch The timing challenge between the end of your lease and the start date of your new office being “move-in ready”  Bringing on other surgeons to buy in to his practice so he can enjoy life/work balance Visit Dr. Buckingham's website P.S. Give us a review please!

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and being in a solo practice within a group practice. I'm your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients, more profits and stellar reputations. Now, today's episode is called "Solo Practice Within Group Practice — with Sam Jejurikar, MD". Some surgeons dream of complete autonomy. They want to do whatever they feel like doing without having to answer to executive boards or other surgeons they work under.  They want to set their own hours, hire and fire staff and buy equipment if they feel like it.  They also want to make more money and assume they will in solo practice since they keep all of the profits and not just a percentage.  However, the flip side of that autonomy means they also get to handle their own books and inventory, while also marketing to attract cosmetic patients.  The business and marketing side of plastic surgery can be fun, daunting, uncertain and confusing.  So, is Solo or Group practice better? Here's a unique business model that allows you to run your solo practice as you want, but also enjoy the perks of being under the umbrella of a much bigger practice. Very interesting! This week's Beauty and the Biz Podcast was an interview I did with Sam Jejurikar, MD, a board-certified plastic surgeon and a member of the Dallas Plastic Surgery Institute that includes 10 surgeons, 4 ORs, 40 staff in a 45,000 square foot facility. We talked about their unique business model to buy into the practice but run as a solo practitioner and how they make decisions with so many surgeons involved. Visit Dr. Jejurikar's website P.S. Want Catherine's book for free? Just leave us a review, text (415) 851-0172 and her book is on the way!

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and how Dr. Kontis is the 2nd female president of AAFPRS. I'm your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients, more profits and stellar reputations. Now, today's episode is called "2nd Female President of AAFPRS — with Theda C. Kontis, MD". I had the privilege to interview Dr. Theda Kontis, a facial plastic & reconstructive surgeon in a private, multi-surgeon practice in Baltimore, MD. Dr. Kontis has been very active in the American Academy of Facial Plastic and Reconstructive Surgery for the past 30 years and was recently elected to serve as the AAFPRS president, making her the 2nd women to hold that title.  We talked about her vision for the Academy under her presidency and the challenge of juggling her duties there, while also managing a big practice with multiple surgeons and lots of staff.  She also shared her opinions on private equity, the change she has noticed in cosmetic patients' attitudes, as well as staff tips to keep turnover at bay. Visit Dr. Kontis' website P.S. Please review!

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery and how to Dr. Chernoff performs 700 – 1000 surgeries per year. I'm your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients, more profits and stellar reputations. Now, today's episode is called "700 – 1000 Surgeries Per Year — with Gregory Chernoff, MD". Some surgeons have two locations usually about an hour apart. They do that to capture a bigger market share than they can with only one office.  However, this week's podcast guest performs 700 – 1000 surgeries per year in his two practices located in two different states that are 2,200 miles apart. My latest Beauty and the Biz podcast guest was Dr. Greg Chernoff. He's a cosmetic surgeon in private practice in Santa Rosa, CA AND Indianapolis, IN.  We talked about how he manages his time so he can do surgery every day in 2 different parts of the country AND sit on several medical, scientific, and editorial advisory boards, while maintaining his health and marriage. (Hint: He loves what he does and he invests in outside counsel). Dr. Chernoff also talked about the latest technologies to watch for that will revolutionize the aesthetic industry (Hint:  Regenerative innovations). Visit Dr. Chernoff's website P.S. Please review!

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery and insights from Grant Stevens, MD. I'm your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients, more profits and stellar reputations. Now, today's episode is called "Insights From Grant Stevens, MD". Dr. Grant Stevens is the who's-who of plastic surgeons and one of the most trusted voices in beauty, and will have lots of insights to share. He's a board-certified plastic surgeon who is the founder and medical director of Marina Plastic Surgery by Athenix and Marina Med Spa in Marina Del Rey, California. Not only is he the past president of The Aesthetic Society, Dr. Grant Stevens also actively speaks, writes, researches, teaches, consults and participates with national and international medical societies, journals, hospitals, universities, industry, pharma, PR outlets and even government.  This week's Beauty and Biz Podcast is my interview with Grant Stevens, MD where we talked about: Insights on new business models available to those who want to simplify Insights on equity deals to invest in to shore up your financial future Insights on how to differentiate from everyone else  Insights on how cosmetic patients have changed  You may need to listen to this Beauty and the Biz episode several times since it's packed with pearls on how to market, scale and exit a cosmetic practice.  You'll hear how differently Dr. Grant Stevens thinks about business, marketing and the plastic surgery industry. Visit Dr. Steven's website P.S. Please review!

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery and blending plastic surgery with wellness. I'm your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients and more profits. Now, today's episode is called "Blending Plastic Surgery with Wellness — with Emily Hartmann, MD". The healthier your patients are, both physically and mentally, the better their outcomes and the less grief you have to deal with. So, you can either hope your patients are fit or you can proactively help them get to sound body and mind, so they have a smooth journey before, during and after surgery. This week's Beauty and the Biz episode is an interview I did with Dr. Emily Hartmann, a board-certified plastic & reconstructive surgeon in private practice in Chico, CA, where she was born and raised. She takes the sound mind and body philosophy to a new level. After suffering from her own health issues trying to juggle being a wife, mother, surgeon and business owner, she needed a new approach for herself and her patients. Here's what we talked about: The downside of tackling medical school, marriage and babies all at once How the COVID lock down helped her prioritize How her approach to addressing ALL of her patient's mind, body and wellness issues has grown her practice kingdom quickly through word of mouth. Visit Dr. Hartmann's Website P.S. If you want to attract more cosmetic patients, check out my latest resource to help:

Episode 137. Following on from a workshop titled “JEDI Journey: This is the Way,” our diverse panel discusses the importance of processes such as integrating the social determinants of health (SDOH) into information systems via Z codes to advance Justice, Equity, Diversity & Inclusion (JEDI) & anti-racism. With episode host Charla Johnson, DNP, and guests Tonya Jagneaux, MD, Holly Pilson, MD, and Daytheon Sturges, PhD. The group also explores achieving workforce diversity in general and orthopedic surgery specifically, which is the least diverse specialty of all. With current trends it will take 217 years to reach parity in terms of race and gender representation, and the group shares strategies for accelerating the pace. We hear how part of the challenge is getting diverse students into schools, but once this is achieved the environment must be set up for success. Otherwise, tokenism can lead to isolation and burnout. With pointers towards actionable steps and resources, this episode takes DEI up a notch. © Copyright Movement is Life 2022-2023 Host: Charla Johnson, DNP, RN-BC, ONC Secretary, Board of Directors, Movement is Life System Director, Nursing Informatics Franciscan Missionaries of Our Lady Health System Baton Rouge, LA Featuring: Tonya Jagneaux, MD, MSHI, FCCP Chief Medical Information Officer – OLOL Associate Professor of Clinical Medicine, Pulmonary/Critical Care, Louisiana State University Health Sciences Center, Baton Rouge Campus Holly Pilson, MD, FAAOS, FAOA Associate Professor of Orthopaedic Trauma, Vice Chair of Social Impact, Co-Director of Diversity and Inclusion, Co-Director of Clinical Research, Department of Orthopaedic Surgery and Rehabilitation, Affiliate Faculty of Maya Angelou Center for Health Equity, Atrium Health Wake Forest Baptist, Wake Forest University School of Medicine Daytheon Sturges, PhD, MPAS, PA-C, DFAAPA, CHES® Assistant Professor of Family Medicine, Vice Chair for JEDI, Associate Program Director for Regional Affairs and Academic Affairs, JEDI, MEDEX Northwest Physician Assistant Program, University of Washington School of Medicine Physician, University of Washington Primary Care – Northgate Producer/Editor/Writer: Rolf Taylor  Resources:  USING Z CODES: The Social Determinants of Health (SDOH) Data Journey to Better Outcomes: https://www.cms.gov/files/document/zcodes-infographic.pdf Advancing excellence in PA education through leadership, scholarship, equity, and inclusion. DEI Toolkit & Best Practices Guide: https://paeaonline.org/diversity-equity-inclusion Fewer Words, More Action: Cultivating an Anti-Racist Environment Strategies/Solutions (CARES) Framework for Physician Assistant Education. Carl Frizell et al: https://pubmed.ncbi.nlm.nih.gov/34817435/ Excerpts:  We need to do a rebranding and a paradigm shift, so that we don't view diversity as a risk, but we view it as a strength, and we view it as beautiful. I use that term because this is not only hard work it is heart work, and there is some emotional exhaustion that comes with that.” ~ Daytheon Sturges PA-C “It's voluntary in 2023 then mandatory in 2024 to be screening for social determinants of health for Medicare and Medicaid for reimbursement. So, people really need to understand the importance of this, and it can't be just another check the box. At Our Lady of the Lake we have a marketing slogan, “we listen, we heal,” – which is perfect alignment with integrating social determinants of health.” ~ Charla Johnson, DNP “Just like we look at things like A1C, I'd like to see Z codes be reviewed routinely so we ask the questions, have we resolved food insecurity, have we resolved homelessness, and we can report on that and close that loop. And I really appreciate a provider wanting to use Z codes.” ~ Tonya Jagneaux, MD “From the vantage point of the good, the bad, and the ugly, the good is that the trend for gender and race diversity is that orthopedic surgery has got better. But the bad is that we remain, year after the year, the least gender, race and ethnically diverse specialty in all of medicine, recruitment efforts alone have not reversed that. To get to parity at the present rate would take 217 years.” ~ Holly Pilson, MD “I liked how you laid it bear that your zip code is more of a social determinant than your genetic code, and speaking of codes, I really like that you introduced the Z codes as well because that introduces a level of accountability. When you document it, you then have to have a plan about it.” ~ Daytheon Sturges PA-C “We had two great talks from Cara McLellan and Frank McLellan, and I am going to start using that term: The power of the purse. Until you incentivize it, it does not become a priority. When people see a target then they see this is the journey we are taking.” Tonya Jagneaux, MD “My part of the session was about workforce diversity, particularly in orthopedic surgery, and what better specialty to talk about in terms of workforce diversity than the one that struggles the most with it.” ~ Holly Pilson, MD “When you fix policy at the system level then you are able to see more results. We need to look at policy with a JEDI lens, so Justice, Equity, Diversity, and Inclusion, but I also add in anti-racism, to become anti-racist we have to center and discuss race. We are looking at our policies using an equity impact tool, and we are looking as possible harm as well as alternative approaches.” ~ Daytheon Sturges PA-C “One of the quotes I heard recently is “Nothing about us without us,” it takes bringing those stakeholders to the table, working alongside them and with them, to figure out how we get to more equity in this space.”  ~ Holly Pilson, MD “It's important that the minority people who are leading these efforts are doing it alongside and with the majority members of our departments and institutions, because it takes both together. “It's important to equip the champions and provide education. I have my lived experience as a gender and racial ethnic minority, but I'm not a (DEI) expert.” ~ Holly Pilson, MD “Medical students have consistently said that orthopedics as a specialty is less welcoming. I don't know if it's the surgical culture, some the other specialties mentioned as being less welcoming were also surgical.” ~ Holly Pilson, MD “I like to offer a DEI toolkit that the Physician Assistant Education Association (Diversity and Inclusion Advancement Commission) has developed.  It's 6 steps of a quality improvement loop.” ~ Daytheon Sturges PA-C “Target the leadership structure: what is the racial composition? What voices are there? Do you have buy-in? These are the people who are yielding and wielding power. We need to look at admissions and ask how can we kick the door open and look at our applicants holistically, because this is where the gatekeeping is. We will never have a diverse medical workforce if the schools are not admitting these students.” ~ Daytheon Sturges PA-C      

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and 6k B&A Photos and Just for Men. I'm your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients and more profits. Now, today's episode is called "6k B&A Photos, plus Just for Men — with Sam Lam, MD". One of the biggest complaints I hear is the reluctance of patients to share their B/A photos.  I used to believe that too. Until I met surgeons who have thousands of B/A photos of their patients on their website, on their social media and on Ipads in their office. How is that possible? Why can one practice collect thousands and others can't? In this week's Beauty and the Biz Podcast, I let Dr. Sam Lam answer that question for us.  Dr. Lam is a facial plastic surgeon with 20 years of experience in private practice in Plano, TX. He focuses on face and hair transplantation, and still manages to collect lots of social proof from his happy patients, willing to share.  Here are other topics we talked about: How to grow a “Just for Men” component to your cosmetic practice How he grew his own 600-video library and use it to market his services How his building differentiates him from his competitors (gorgeous) Visit Dr. Lam's Website P.S. If you haven't already, please subscribe to Beauty and the Biz and I would appreciate a 5-star review to grow the audience. Thank you!

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and transforming patients and yourself. I'm your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients and more profits. Now, today's episode is called "Transforming Patients and Yourself — with Nicholas K. Howland, MD". When you've spent years training to become a surgeon, your fortitude and character were tested big time.  But that's just the beginning. Then you had to have enough left over to go into practice and grow a sustainable business that takes good care of you and your family.  That is no easy feat. This week's Beauty and the Biz Podcast guest is Dr. Nicholas Howland, a young board-certified plastic and reconstructive surgeon practicing in Draper, UT for the past 5 years. Dr. Howland looks at plastic surgery not as vanity, but as transformation and self-empowerment for his cosmetic patients and by extension, he learned about "transforming patients and yourself". He's walking his talk since Dr. Howland also went through his own transformation this past year by divorcing, being a single Dad, losing 60 pounds and working on his mental game to become his most authentic self.  We also talked about: Dr. Howland growing up in Salt Lake City as a Mormon and the values he gleaned, even though he has since left the church; How he entered the crowded Utah marketplace and found a unique hybrid practice situation to join that works with his personality; and  How he's an independent contractor with freedom to build his own brand, while also growing equity for his future and not having to worry about the day-to-day HR and office issues. He really does have a nice set up! Visit Dr. Howland's Website P.S. Can you please take a minute to review Beauty and the Biz? I would appreciate it.

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and how to charge a lot / give a lot. I'm your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients and more profits. Now, today's episode is called "Charge a Lot, Give a Lot — with Ryan Neinstein, MD". How do you charge up to $75K for a tummy tuck? That's what I asked this week's Beauty and the Biz Podcast (link) guest Dr. Ryan Neinstein. He's a plastic surgeon in private practice in NYC, in a gorgeous 6K square foot office above the iconic Bergdorf Goodman store with views overlooking Central Park. Dr. Neinstein's answer….”We charge a lot. We give a lot.” He went on to explain his hyper focus on the patient experience and aftercare that his patients gladly pay extra for. He walks his talk by employing 30 full-time staff who assist him in surgery, offer concierge services, drop off garments, pick up prescriptions, visit post-op patients and anything else that makes patients feel special and cared for. His entire team thinks “relational” vs “transactional” and he gave lots of great tips for developing a practice culture that is fun, inspiring and profitable. We also talked about HOW: His marketing efforts keep 3 plastic surgeons busy What he focuses on that allows him to charge more How he “rules but not reigns” Dr. Neinstein shared his pearls and philosophy with good take-a-ways. Visit Dr. Neinstein's Website P.S. If you are NOT getting the consultation conversions you want, there's something your coordinator doesn't know. I'll train her to be a converting rock-star within weeks.

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and how Burke Robinson, MD went from a 40-surgeon practice to solo. I'm your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients and more profits. Now, today's episode is called "40-Surgeon Practice to Solo — with Burke Robinson, MD". I am fascinated by surgeons' stories that relay their jagged paths from fellowship to where they are today. Nobody's path was a smooth one and nothing went scheduled as planned.  That's life. It's full of surprises, twists and turns and the secret is to adapt to these challenges and grow (or give up and settle for less). This week's special guest Dr. Burke Robinson knows this well and decided to grow. He is a board-certified facial plastic & reconstructive surgeon with 30 years of experience in private practice in Alpharetta GA. Dr. Robinson had a tough childhood start but managed to become a surgeon in spite of it, and then he ended up in a 40-surgeon ENT practice for years.  Like others who had the calling for “more”, he finally spread his wings and went out on his own.  We talked about the challenges he faced, what it took for him to finally make the move to private practice and pearls learned along the way.  He also gives a really good tip for buying a laser ;-) Visit Dr Robinson's Website P.S. Get my hard copy book for free when you leave a review at Beauty and the Biz Podcast. Just follow the instructions below:

Burnout is becoming increasingly common among physicians of all levels of training and practice. But as healers, oftentimes, they are the last people to address the issue and seek help. Here to share her burnout experience and how breaking the box can beat burnout is Dr. Sapna Shah-Haque, MD.   Dr. Sapna is a board-certified Internal Medicine physician. She was born and raised in Kansas and attended medical school at the University of Kansas [KU] School of Medicine. She completed her Internal Medicine residency at KU-Wichita as well. After experiencing burnout herself, and watching other physician colleagues burn out, it became a passion of hers to look into different aspects of burnout. While the system does need to change, as it is broken, she started her podcast, The Worthy Physician, as a way to reach physicians and possibly shed light on what is not an isolated situation. [00:01 - 03:35] Opening Segment Dr. V welcomes Dr. Sapna Shout out to Dr. Sapna's podcast: The Worthy Physician   [03:36 - 18:10] I Define Who I Am Dr. Sapna talks about her backgroundFrom an engineering student, she shifted to medicine and became fascinated with the engineering of the human body She discusses her residency experienceWhat makes a toxic environment and how to deal with difficult attending physicians Medicine culture is deeply rooted in tradition but to Dr. Sapna, rules are meant to be broken and she always tries to do things differently She recognizes her grandmother's influence on her way of thinking  After medical school, she decided to go to an underserved area and work for a non-profit   [18:11 - 30:05] Realities of Physician Burnout Her first run with burnout was within her first three years when she was adjusting to the work structure in rural Kansas and when a family member had a health issue Part of the problem was also when people that were non-physicians were telling her how to do her job The wakeup call was her best friend's untimely passingA lot of physicians struggle with debt and sometimes even legal issues Physicians usually put others above themselves and they don't ask for help Some people who have burnout are not outwardly sad, look for other signs (ex. loss of weight, lack of appetite, etc.) Dr. Sapna's burnout manifested as irritability and impatience even with small things   [30:06 - 36:29] The Road to Recovery Dr. Sapna addressed that she needed a changeShe cut back on her hours, doing outpatient only, having enough sleep, and working out  It's important to sit down, process the situation, and start drawing boundaries between work-lifeAfter the loss of her colleague, she created her podcast to focus on physician suicide and burnout   [36:29 - 37:35] When You Take Care of Patients, Who Takes Care of You? Dr. V takes care of the healthcare provider that takes care of everybody elseGo to  https://officevisitswithdrv.com and click on the coaching tab to schedule a free discovery interview   [37:36 - 41:03] Closing Segment Dr. Sapna's final words: Push the pause button and make sure you are taking care of yourself. Get comfortable saying no. Reach out to Dr. Sapna! Tweetable Quotes   “When people try to define physicians or try to define me as a person, no, I'm going to define who I am. I'm not going to be labeled by these stereotypes that society has. That's just me.” - Dr. Sapna Shah-Haque, MD   “There's no reason put somebody else in the corner just because that was done to you, which, unfortunately, seems to be the culture in medicine. And again, that's why I say rules are meant to be broken because they're not always right.” - Dr. Sapna Shah-Haque, MD   “Self-care is not selfish. It's the way to replenish your cup.” - Dr. Sapna Shah-Haque, MD   “It is okay to not try to fit into a box that somebody else has set for you. Create that box for yourself or, sweetheart, break out of the box.” - Dr. Sapna Shah-Haque, MD   -----------------------------------------------------------------------------   Connect with Dr. Sapna Shah-Haque, MD Website: https://www.theworthyphysician.com/ Instagram: https://www.instagram.com/theworthyphysician/ Facebook: http://www.facebook.com/theworthyphysician Twitter: https://twitter.com/SapnaShahHaque YouTube: https://www.youtube.com/channel/UCKeTspKZmx8Isbq9rYlucMA LinkedIn: https://www.linkedin.com/in/sshahhaque/  Thank you for listening, please like and share this episode with a friend!   If you would like to stay connected and get your questions answered by Dr. V, feel free to reach out!   Facebook: Office Visits with Dr. V Instagram: office_visits_with_dr_V. Website: https://officevisitswithdrv.com Email: officevisitswithdrv@gmail.com    Links and Resources: https://officevisitswithdrv.com/resources 

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery and secrets to long-term staff. I'm your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients and more profits. Now, today's episode is called "Secrets to Long-Term Staff — with Giancarlo Zuliani, MD." Some surgeons look at staff as an overhead expense that must be “dealt with” to run their practice. They wish they could forgo staff altogether and skip the hassle of hiring, training and managing people. They have had enough of bad hires who: come in late, leave early and do mediocre work in between. They can't understand why staff can't just do the job they are getting paid to do. What's the big deal? It can't be that hard and so on…. Other surgeons think much differently about staff. They know they can't do it alone and good staff can make them look good and make their life easier. They like working with staff who have their back, who support them and who move the practice forward. They see staff as their practice secret weapon who is an asset to their success. Dr. Giancarlo Zuliani is of this later mindset. In this week's Beauty and the Biz Podcast, I interviewed Dr. Giancarlo Zuliani. He is a facial plastic surgeon in private practice in Bloomfield Hills, MI and focuses on rejuvenating, restoring and reconstructing the face through surgical and non-surgical procedures. We talked about how he finds good staff (even with today's staffing challenges) and keeps them engaged for the long run. Also, how they help him grow the practice using their own unique talents. His attitude about staff being as asset has paid off, to the point where he is busy and now looking for more space. His approach is refreshing (and he has run with the bulls!) Visit Dr Zuliani's Website  

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery and Park Avenue prestige. I'm your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients and more profits. Now, today's episode is called "Park Avenue Prestige — with Thomas P. Sterry, MD." We all heard its location, location, location, but is that enough to grow a successful practice?  That's what Dr. Thomas Sterry, a board-certified plastic surgeon with 20+ years of experience in private practice in Manhattan, NY asked himself when he had to decide if he would rather have a large, 2-floor office near Mt. Sinai or ½ that space on Park Avenue in Manhattan? My guess was there is so much prestige with being on Park Avenue that can attract patients from all over the world, since the address alone gives him status. That's what Dr. Sterry thought that as well, so he set up shop on Park Avenue years ago, at his wife's request to live and work in the City.  While he enjoyed some out-of-town patients, he found most of his patients were locals coming in from Brooklyn, Queens, CT, New Jersey, Long Island and Staten Island. This week's Beauty and the Biz Podcast is an interview I did with Dr. Sterry where we talked about the moment he quit insurance and went to cosmetic medicine, his advice for residents soon graduating, as well as his love for vintage cars. There is no right answer to where you should set up shop, but there is the right answer for YOU so choose carefully. Visit Dr Sterry's Website  

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery and how Dr. Zakhary is practicing in Canada. I'm your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients and more profits. Now, today's episode is called "Practicing in Canada — with Kristina Zakhary, MD." Canada has restrictions on advertising cosmetic surgery that we don't have here in America. For example, plastic surgeons cannot use testimonials and a facial plastic surgeon must call themselves Otolaryngology-Head and Neck Surgeons. This week's Beauty and the Biz Podcast is an interview I did with Dr. Kristina Zakhary, a facial plastic & reconstructive surgeon in private practice in Alberta, Canada. Dr. Zakhary splits her time between cosmetic and reconstructive facial surgery as an associate staff member of the Faculty of Medicine at the University of Calgary. We talked about the challenges of staffing, how to avoid embezzlement and how she markets herself in a country that limits her options. Dr. Zakhary also uses an interesting consultation process that yields above average conversion rates in her practicing in Canada. Visit Dr. Zakhary's Website  

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery and how Dr. camp went from recon to solo practice buildout. I'm your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients and more profits. Now, today's episode is called "Recon to Solo Practice Buildout — with Steven Camp, MD." As a new surgeon entering the marketplace, it's nice to join a hospital or practice that takes care of the business side so you can focus on what you enjoy most and that is surgery.  But oftentimes, you ended up wanting more. Today's special guest is Dr. Steven Camp. He is a Board-Certified Plastic & Reconstructive Surgeon in private practice in Fort Worth, TX. But he didn't start out in private practice. Dr. Camp went into a multi-surgeon insurance-based practice performing reconstructive surgery.  The risk was minimal since he joined a thriving practice that was already set up and working.  He didn't have to deal with the business or marketing side and that was fine by him. However, after several years, Dr. Camp got restless so he made some moves and is now in his own brand new building with 2 OR suites that he will share with other surgeons in the area.  Listen in to this week's Beauty and the Biz podcast as he explains his journey of how he got there.  As usual, it's never an easy or straight path (but what fun would it be if it were?) Visit Dr. Camp's Website