Don't You Know Who I Am?!

How the epidemic of narcissism is ruining modern society

Today we're talking about, "Don't You Know Who I Am?" by Dr. Ramini Durvasula.

There will be a paid-subscribers only Q&A for this on Tuesday at 7 PM Eastern.

This episode ran so long that I recorded two episodes - the first is free and the second is for paid subscribers. The second episode will drop early next week.

It might seem a little bit odd that I am talking about a book about narcissistic personality disorder. But it's really only come to make more and more sense for me as a clinician to talk about psychology in my practice, because I've realized that, because I'm a doctor, and not a surgeon, the only organ I actually work on is the mind. When I am counseling a patient, I'm telling them and recommending them to do things. And only when they do them, do we get results. In order to get someone to do something, I have to motivate them, I have to give them a good enough reason. And I've found that the number one reason that patients don't follow through on plans is a lack of self-love caused by toxic relationships. Second to this is a lack of trust in their doctor, which is usually because they're not comfortable with that doctor, or because the doctor and practitioner health coach or personal trainer, you know, therapist, whatever, whoever is trying to help them heal, recover, right, or to be healthy, they're already well, it's either because they don't trust or feel comfortable with, or they're not convinced that the therapy plan is going to happen. Or more commonly, because you don't seek out people who you don't trust and feel comfortable with.

I didn't realize what an enormous problem this was when I became a physician, I think in large part because I was so young. I've been practicing now for eight years, and particularly in the conventional medical model where you have very little time with patients, it's very hard to get to know them on an emotional level and have them open up to you. I've been blessed with colleagues who've explained to me and shown me that if you talk to patients, and you listen to them, they'll tell you about all the struggles that they have doing what they know is right for themselves, because of this lack of self love. By far the most severe psychological dysfunction I see in my patients is caused by exposure to narcissistic behavior. This makes narcissistic personality traits one of the most important things for me to teach you to avoid in our modern world.

Before I get into what narcissism is, let's talk about where bad, toxic, narcissistic behaviors come from. When people just have a lot of narcissistic behaviors, rather than having a full-blown personality disorder, they struggle to get through life having the kinds of healthy relationships that they desire, but they still have a sense of empathy and they are capable of loving other people. When narcissistic behavior becomes extreme, the narcissist creates more narcissists (and people who are borderline). So narcissism begets narcissism. You're seeing more and more narcissism in our world because (and Dr. Durvasula covers this in her book), because of the way that we're interacting because of social media, because of how people are now digitally connected, and not connected in real life.

Today, I want to talk about the things that I think are most important and impactful in this book. I think a lot of the psychobabble out there is well intentioned, but a lot of it is just empty cheerleading. It's the equivalent of saying, "go out there and do a good job." And that's the equivalent of just a pep talk when what people actually need is to learn tactics. The danger I see in our modern world, particularly in the health and wellness info space is that people end up getting sucked into the cheerleading because it feels good. And then they wind up showing up to so to speak to field without without any actual tactics, tools and information to understand how the game is being played level of how to play it, and then they don't understand why they're losing all the time.

The biggest problem and challenge in my practice now isn't actually figuring out what to do for most of my patients clinically. It's helping them get out of their own way, by getting them out of their toxic relationships and inter-personal dynamics.

The rest of this post is an unedited transcript, so you can search for different terms and topics that I touch on if you’re interested.

Enjoy this video and be sure to upgrade to a premium subscription to listen to part 2!

So that they will take the steps necessary to heal so that they'll create the interpersonal relationships they need to have the emotional and psychological support to be well because if we can't get that to happen, it just Doesn't matter how technically competent I am, or how perfect the therapeutic protocol or plan is made, it won't happen. Okay, so without further ado, let's jump into the book. So what is narcissism? Narcissistic Personality Disorder is defined as a personality disorder or a mental illness. I'm not going to belabor the loyally way in which psychologists and scientists argue about this. But what are narcissistic people or someone with narcissistic personality disorder and let's get one thing straight from the beginning. This exists on a spectrum. Anyone can engage in narcissistic behavior. Most of the things that narcissists do are just bad behavior that everybody does. We're going to cover this in the second part of this web. When it comes to cystic personality disorder, has a pervasive pattern of grandiosity and fantasy or behavior, a need for admiration and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five or more of the following has a grandiose sense of self importance exaggerates achievements and talents expects to be recognized as superior without commensurate achievements, is preoccupied with fantasies of unlimited success, power, brilliance, beauty or ideal love, believes that he or she is special and unique and can only be understood by or should associate with other special or high status people or institutions, requires excessive admiration has a sense of entitlement, which is defined as unreasonable expectations, especially favorable treatment for automatic compliance with his or her expectations is interpersonally, exploitive, they take advantage of others to achieve their own ends. They lack empathy, they're unwilling to recognize or identify with the feelings and needs of others. They're often envious of others or believe that others are envious of themselves. They show arrogant, haughty behaviors or attitudes, okay, there's a little bit more to it than that. But for the sake of time, we're not going to we're not going to cover the rest of x, I want to jump into what this looks like. You know, I mentioned earlier that a lot of psycho, whatever ends up being sort of, let's just say, like a cheerleader cheerleading, right, I want to give you guys the tactics and the understanding of what this actually looks like in the real world so that you can recognize it. Because the best thing that you can do, in fact, perhaps the most important thing that I can teach you, as a doctor, isn't what magnesium does, or what vitamin B 12 does, or how to balance your sodium and potassium ratio, the kind of nitty gritty biochemical research things that give you it's actually how to recognize toxic people, and have the appropriate relationship with them, which is always at arm's length. And sometimes it means being on the other side of the world. If you don't do that, again, it doesn't matter what biochemical brilliance you have to bring to bear on a case or a medical problem, you're going to fail. So, alright, lack of empathy is the number one thing that people need to realize is part of this narcissistic kind of behavior. You will see these people running through life, asking superficial questions about other people, but never really listening, okay? And never validating the other person's feelings, never empathizing with them, which is not just a matter of asking and listening. It's a matter of providing reassurance, and sort of junus a qua as far as this good feeling you have when someone's doing it, okay, it's very hard to define, level of demonstrate right. So, lack of empathy is a lack of interest and or capacity for understanding the feelings and experiences of others. lack of empathy also reflects a lack of self awareness and indifference to the wants or needs of others. And little recognition of how the person's behavior impacts other people. My favorite litmus test for this is waiting to see how long someone it will take for them to ask me how I'm feeling and listen to the explanation and then provide some level of empathy. Really Emotionally Healthy People will do this actually, pretty soon after meeting you. People who are used to toxic patterns and relationships will never ask you whether they're a narcissist or not, because if they're, if they're not a narcissist, but they've been exposed to a lot of toxic behaviors and narcissistic patterns, they're probably not going to feel comfortable talking to other people about their emotions because they've been so damaged narcissists may be cognitively capable of empathy. They can understand why another person would be sad or upset, but they do not shape their behavior in accordance with that empathy.

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They may cry at a movie, but when someone who's genuinely suffering in front of them they rarely show anything that resembles care, warmth or concern. This can leave you feeling unheard or uncared for. So if you feel that way in a relationship, that's a sign that it's not at all The relationship. And I also want to explain that I decided to make this webinar and do this as a book club. Because I see so much narcissism in modern medicine. Current Events aside, and I know that many of you as we go through this will think, wow, modern medicine and the last two years with COVID has been so toxic, so narcissistic. So evil, we're being run as a world by narcissists. I think that's absolutely true. But this was a problem in medicine before. And it has always been a problem in medicine, it will always be a problem. That's why because narcissists lack empathy, they're motivated by other things in life, superficial things, all of your wants, pleasures, sins, the things that we can do that make us feel good, but make normal Emotionally Healthy People feel bad, eventually, right? Cheating on a spouse drinking too much physically abusing someone, people who don't feel bad about these things are not emotionally healthy people. But narcissists don't feel this empathy and this, and the sadness for these people in front of them, who they may be abusing or who are suffering for other reasons, the abuse of others, right. They don't feel that. So they're constantly chasing something else, money, status, prestige, the things that can buy them the things that are pleasurable. Okay, so I like the way that Dr. Durvasa law breaks up this path, this part of the book, by the way, this is the anatomy of narcissism and interpersonal toxicity. And this is on page 29. She has these these little blocks blocks of text that at the end of these different characteristics of narcissistic personality disorder, and it starts with the normal, right manifestation of this because we all are guilty of love lacking empathy, sometimes, you may realize that someone else is hurting and you haven't we giving them empathy that they deserve, that you would have liked to have, give them given them. And hopefully you realize that right? But there's such a thing as a pathological lack lack of empathy. And when I say pathological, I mean it causes disease. She's a clinical psychologist, I'm a general internist. I can tell you that as surely as she thinks these things cause psychiatric and psychological illness. They also create physical illness. It is a frequent case in my office that the the physical problems of the patient are due to emotional and psychological abuse. Pathological lack of empathy is observed when the person rarely cares what anyone is experiencing or feeling never listens, often interrupts and always puts his or her needs ahead of others needs. If this person asks how people are feeling, he or she doesn't really want to hear the answer. People with a pathological lack of empathy consistently minimize the challenges that other people may be experiencing and are often emotionally cold. How does their map lack of empathy make you feel? You're going to feel unheard, misunderstood, invisible and hurt? The second key characteristics is manipulation. manipulation. This is the puppet master. Okay. And I've actually seen narcissists talk about themselves as the puppet master in kind of a disarming way talking about oh, I'm, I'm going in and this is really clever sales tactics, by the way, oh, well, you know, you know, I'm a salesperson, you know, of course, I want you to get into that car. But think about it, right? Why would I need this job? If I didn't, if I didn't really believe in what I was doing. If the people who are selling these cars to weren't genuinely happy with the kind of car they were driving away. I see this all the time. It happens in medicine, a lot. People selling procedures, selling the cosmetic procedures selling dermatological procedures, you name it from injections to surgical procedures, lifts, implants, whatever.

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The manipulator assesses the situation and manages the situation and other people in a way that achieves what they want with little regard for how this may affect others. You'll notice this in that they're constantly focusing on the outward manifestations of success, to move the conversation and really the sale in a way along without focusing on how it's going to make you feel at the end of the day. Right? So if you extend the car analogy, right, you're gonna feel good in this car, it's gonna put you up above the other people because it's a really, let's say, they've lifted truck. You know, your girlfriend's gonna think it's so cool. Your friends are gonna think it's so cool, right? But they're not going to focus on how it's gonna make you feel in the negative potentially, what if you can't afford the loan payment eventually? What if you spent that money on something else? Something more positive, constructive, helping someone in your life who needs it? Right. That's the kind of thing that a narcissist will never do. They'll be and they'll encourage you to be charitable in a way that advances your social standing increases your power. And your means. They'll do things like say, Oh, well, let's buy a charity table that dinner, it'll be a great networking opportunity. That's true. But that's not why you buy the charity table at the dinner, is it? These people tend to be calculating and cold. Other people are largely objects to them. You'll notice this because as they talk about people, they're constantly talking about those people and what they do and how they appear and how they fit into the world, and not about their emotional state, who they are what they find meaningful. So normal manipulation, frankly, normal manipulation, you have to in a certain way manipulate people, right? When you ask someone to pass me the salt, you're technically getting them to do something for you, that puts you first. Right. But and that's, that's normal. Right. So what's pathological manipulation? Because I think it's hard for people to see around this, it makes it almost sound like everything we do is grotesquely self serving. And it's not it doesn't have to be when manipulation is pathological. It entails getting what a person needs through interpersonal maneuvers with little regard for others. In other words, you're not worried about how this will affect the other person in the short term. And in the long term, specifically, their emotional well being. Okay, how they're going to feel about that goes back to that lack of empathy, which is why that's the first characteristic covered in the book. So this, this can include when people regularly use unpleasant details about other people's pasts, or partner's past to induce feelings of guilt or shame, and then capitalizing on that vulnerability to get what they need, chronically complaining about a situation in their lives, so that others will rescue them, and using lies to isolate a person from other advocates and then getting what they need from that person. So this would be like a doctor saying, Well, you know, I understand why your general internist doesn't want you to get this surgical procedure. But you know, he just doesn't understand how good of a surgeon I am. And what a wonderful procedure it is. That's, that's exactly why surgeons get referrals from General Insurance, we're supposed to be the brakes to their gas pedal, we're supposed to prevent them from sending patients who don't need surgery to surgery. And this is why I'm so frankly, disgusted by something like the spinal surgery industry. Because while the spinal surgery industry does yield some great results for people and many people do need spinal surgery, I'm thinking of one person in my life right now who had powerfully good results from spinal surgery this year, who genuinely needed thank God, she went and got an MRI, which I can get for discounts if you're curious. But most people couldn't get back surgery, the benefit they actually get as SIBO. And there's lots of books written about this. It's very clear from the medical literature, and surgeons will admit this, that the vast majority of spinal surgeries that have been done, maybe it's not the best, but let's say 50%. And maybe it's not 50%, but it's still a lot are largely the benefit is the placebo. Okay, so anyway, that isolating that diminishing or being negative about other people, I see that constantly in this right think about how our public health overlords have said things like, Don't do your own research. Don't trust those other people out there. You only need to listen to us. We're the font of truth and knowledge, right? You're seeing how this works. Manipulation makes you feel taken advantage of mistrustful foolish, stupid and violent. If you went through COVID, got vaccinated, locked down wore a mask and you didn't feel any of those

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things. You might still be asleep. So anyway. Next characteristic is projection. This is a primitive defense that people engage in without thinking about where what they're doing is what they'll project on somebody else. And so a classic to extend the example I just gave you a surgeon saying that a general internist might not know what he's talking about, and the patient shouldn't trust him. to dissuade them from surgery. They might say that, Oh, well, that general surgeon he just thinks he can manage everything with medication because he really just has an inflated sense of self right? narcissists will do this constantly. It's why I'm very careful about not just saying, Oh, that person's in our says that person's in our system. So really, it's a bad move psychologically for yourself. And I've seen too many people fall into this trap. And when someone's talking about this and labeling other people and really denigrating other people, I immediately my hackles go up and I'm wary of that person, maybe engaging in those very same toxic behaviors. Here's example a person who is lying will accuse another person applying a person's unfaithful will accuse a partner of being distant. This is also by the way in Really pathological examples. It's used as a, as a way of manipulating the other person into giving up what what should be a normal healthy part of the relationship. So to extend that example of an unfaithful partner accusing another partner of being distant, right that that by accusing them of that that person says, Oh, well, maybe I haven't been affectionate enough, I'm giving them enough space. But lo and behold, they're giving them affection, and then they're giving them the space that they want, but the person is then abusing that trust and that space in order to go out and be unfaithful. This could happen in a business relationship, a personal relationship, friendship, you name it. Toxic and narcissistic people are also fragile, they are always monitoring their world for threats. Projection becomes a way of punishing other people for their own deficits, because they lack the insight or maturity to understand that these are their issues, pointing this out to one of these people. A healthy well adjusted person with a positive sense of self and positive self esteem, and have the humility to understand that they make mistakes that all people make mistakes. If you point this out to them, say, hey, you know, do you think you might be projecting a little bit on them? That's pretty bold, right? But if somebody said that to me and say, Well, you know, I'm gonna think about, because it's really worth thinking about that. Because even if they're wrong, well, you know, that's good. But if they're right, you really need to know, a really toxic person who's got a fragile ego will get hypersensitive and they will freak out on you. And that's one of the characteristics that you'll you'll see in these people is they're very fragile. You challenge their authority, you challenge their ego, and they will lose it. Okay? That goes back to how these people are made. They're made in toxic environments, with people who aren't positive, who don't love them, don't treat them well. They're, they're early childhood environments are chaotic, insane, unpredictable. They're frequently victims of childhood abuse. And that's really important to appreciate. Because otherwise, it's frankly very hard to have empathy for these people in the moment because they can be so mean toxic, annoying, difficult, and sometimes outright dangerous. All right. So normal production projection is it's, we all engage in it to some degree, okay. Pathological projection is pathological. And it becomes a pattern a primary way of dealing with feelings and other people. When a person is regularly accusing other people of his or her own shortcomings or attributing patterns or moods to people that are simply not true on a regular basis. This is considered pathological. projection will make you feel confused, misunderstood, self doubting on her and angry pay particularly close attention to these parts of these boxes. How does this make you feel? Because this is probably the best litmus test for whether or not you're actually involved with people like this on a daily basis in your life, and helps you understand which of the things they're doing that are making you feel this way. Okay, lying. I don't think lying. That's the third thing we're talking about today. I don't think lying needs any introduction. Normal line is about saving face because you're embarrassed because you feel guilt, shame, whatever, okay? And that's really because you're afraid that the other person who you're lying to is going to punish you for being honest with them. And it's frankly, it's this is one of the things that people struggle with most in life is accepting and providing unconditional love to the people around them to the point that no matter what they think, what they want, how they feel, you can still accept them in love. Everyone struggles with that, even you.

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It tends to be less of a pattern as as well. Just an occasional quick fix and one that normal liars often feel guilty about. Okay? Most people healthy people try to avoid putting themselves in situations where they have to lie all the time. It's unpleasant, it makes you feel bad. So you don't want to do it. Topical pathological lying. These are people who live in lies as much as truth. At the core of it, they are deceitful people. The healthcare system is full of these people, which means that there's a lot of lying going on. It's very difficult. It's very tough. I know because I had to deal with it as a provider. Watching other providers lie or tell half truths are not being fully open and honest with patients. Because what you will find is that patients who are narcissists will then take advantage of the system. This is why a very am this, by the way is a fascinating little tidbit. This woman got interested in researching narcissistic personality disorder because she was fighting immense levels of burnout and health care providers. And she found that the burnout was due to something like 3% of the patients when she studied the behavior of these patients in the ER population. She found that they were all narcissists. They were engaging these in these behaviors. So when you find your health care providers are difficult to deal with, guess what? It's because they're all victims of narcissistic abuse at the hands of hospital administrators, various employers, health insurance companies, the government and patients. That's why The only really happy doctors I know, are in private practice and they work for their patients, and they're very picky and choosey about their patients and they don't just agree to take care of anybody, because that's a recipe for burning out and being taken advantage of. So, okay, that's like pathological lying is done in ways that can hurt others. Right? Lying about expectations of service or clinical results. Lying about expectations of availability, right. You think the surgeons gonna be there with you every step of the way? Right. Then you're calling the office at midnight, you've got terrible pain postoperatively they're not calling you back. The nurses and helpful answers just take more time. All right, like you didn't already think of that. Sad, it's happening. And I'm trying to give you guys the tools to see this before your victims are. Okay, how does their line make you feel deceived, unsafe, suspiciousness, trustful, angry and duped. Next up poor boundaries. In many ways, toxic people. And narcissists are what we call impervious, rather formal word that implies being rude and disrespectful or asking a person inappropriate or intrusive questions. Because of their high levels of entitlement. narcissists will offer unsolicited advice or inappropriate or unkind feedback or foist themselves into situations and events into which they may not have been invited. These people aren't the definition of social climbers, they want to climb into situations to advance themselves personally and professionally. have empathy for the fact that this is because they've learned that the world is a scarce place with not enough resources for everyone, they're going to get hurt at every possible opportunity. And so they have to, you know, find a way to get ahead and find more clients or find more donors or find more patients or whatever, or they'll go hungry. Or even if they don't go hungry, they won't feel safe. Okay. They'll have no filter, they'll be brutally honest, they use these as disingenuous excuses that allow them or enable them to continue hurting people's feelings. Far beyond what is reasonable. I noticed this, in the sense that and what I ask patients about is, do you feel like this person's feedback or health or brutal honesty is helping you become a better person or resolve the problems that you've got? And if the answer is anything, but a resounding yes, definitely. Then I assume that this is toxic feedback, because people like to make excuses for their narcissistic abusers because of the trauma bonding that goes on. That's a story for another day. But I see this all the time. Okay, toxic partners, narcissists tend to be unfaithful in relationships. And that often starts with poor boundaries. They don't have good boundaries with their spouses, they don't have good boundaries with their kids, they don't have good boundaries with their parents, they don't have good boundaries with their patients, they don't have good boundaries with their clients, they don't have good boundaries with other colleagues or co workers and have good boundaries with any. Right. And you know what it's like to get good positive, constructive feedback. That doesn't, you know, brutalize your ego, it may bruise it, because it's kind of hard to take any kind of feedback without feeling a pang of guilt, shame, sorrow, whatever you want to call it. But it doesn't have to be this sort of slap in the face. Right? The narcissist will slap you in the face, and then tell you to say thank you. Don't alright. anthological poor boundaries happen when everyone blurts things out, right, that's normal. The pathological poor boundaries is where there's just an immense amount of enmeshment these are the people who, you know, say, oh, man, I'm, you know, I'm down or now can come sleep on your couch for a week, and then they're three weeks later. It's the people who are saying, oh, man, you know, I just need a small loan to help get my business off the ground, you know, you know, remember that time I helped you with this or that other thing? Can you just spot me 1500

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bucks, right? That's okay, to an extent. But this is where you've got to be really clear yourself with setting boundaries when people ask things of you. Like saying, Hey, listen, I understand that you're starting a business but and you did help me that time. And I really appreciate that out of gratitude. I'm gonna give you 500 bucks, but I want you to understand that I can't do that again. So this is it. Right? That we are giving yourself permission to say no later. One of the things I find and that's very clear about people who have enmeshed with these narcissists is that they're very nice people, they want to please and they want to help, okay? And so what will happen is, you'll wind up in a situation where you're not creating an out for yourself, and then you're chronically people pleasing and you're chronically sending them money, giving them thanks. helping them out with daily tasks, not you know, deferring a paycheck or something like that. I mean, it's just the list goes on and on and on. sob stories that I've heard from patients since I became aware of this are just tragic. Poor boundaries make you feel violated, threatened uncomfortable, guilty. They may make you feel special, because that person is being inappropriately forward with you. And not necessarily in a romantic way. But in a way that is where they're coming into your life in more boldly and aggressively than other people. And you think, wow, this person must really care about me, that happens to you, you've got upset, well wait a minute, or is this a front for them getting what they need? Right? That's the nice surgical suite, an office where everything is perfectly laid out and everyone greets you by your first name, there are no ID and the doctor comes in, they look good, they smell good, they sound good, they're perfectly styled and whatever, but then your post operative experience is terrible. A lot of elective surgery that's not being referred by a general internist like me. That's exactly how they're selling the procedure. Okay, next up is jealousy. And I realized that I'm actually running on on these way longer than I thought I would, and there's like another 50 pages I want to cover. So what we're going to do is have that behind the paywall. So if you want to get access to my commentary on this amazing, powerful information, go ahead, pull the trigger on your subscription to the premium version. Before, before we end, let's get into jealousy. Jealousy reflects a pattern of envy and fierce protectiveness over the things a person values. Jealousy is a normal emotion that can grow out of multiple spaces, competitive childhood, having experienced betrayal, and past hypersensitivity, paranoia, insecurity or fear of banding. If you go back to these people's pasts, the rife of this stuff, it's when you really get to know these people, as I have. Because I've worked with so many of them healthcare space, it'll just break your heart what they've been through, but it's not an excuse for their continued bad behavior. And a healthy person Jealousy is a transient state. And hopefully you recognize when you say, oh, man, that guy's you know, spouse is prettier than mine, man, woman. Third options that didn't exist 20 years ago. But you say, Yeah, but, you know, that's, it's not healthy for me to feel that way. It's not healthy for me to have that feeling of jealousy. Right? That's, that's, it's appropriate for you to recognize that. It's, it's, it's inevitable that you're going to have those feelings, right. That's just being human. But recognizing that it's jealousy and covetousness, and envious nests, or whatever else you want to call it. That's really important for your emotional well being and for you to check yourself and stop yourself from allowing that to then color your day. Right. There's many different forms of, of jealousy, what jealousy will do in the narcissist and people who are behaving narcissistically is it will lead them to try to get that which they are jealous of. You know, they'll see the other doctor getting more patients for doing more procedures, whatever, and they'll start to engage in the same behavior, even if it's not necessarily the best thing for them for their family. There will be in moderation here. Right? They will sacrifice, say, time at home cherishing, loving, nurturing their families in order to go out and do the things in business, make the money, have the get the bonus hit the sales numbers, in order to be able to afford the more expensive car, the bigger house, whatever,

Unknown Speaker 33:41

I cannot tell you the dysfunction, the sadness, the the disease I see in society today, because so many people are stuck chasing the other stuff, and not being present in the home with their loved ones focusing on loving who they have, rather than chasing what or who they don't have. Normal jealousy. Like I said, it's normal. And it's hard not to an age of social media where everyone's constantly advertising on the amazing things that they have on social media. That's largely what social media is. It's like an engine for jealousy, which is why I'm so bearish on it. If I could make it all go away and shake everyone back in person. I would do it with any. The best way to beat back normal jealousy is to cop to it. Acknowledge it, like I said before, it often can help to let it go and always recognize that a little is normal and someone else is always going to have some things that you don't. And that's okay. Pathological jealousy occurs when jealousy is the prevailing state of affairs when someone else's good news raises mean spirited rants on kind emails or insults. That means to publicly impugn another person's good fortune, one of the things to look for in folks who are really emo What's really unhealthy is that you say, oh, man, you know, I just, you know, had a new client sign up and wow, you know, they're really excited to work with me. And then they agreed to like a really expensive program with me, or whatever or, or they just sign on a new car, a new car with a huge payment or whatever, I'm gonna get lots of money from it, right? That person will say, Oh, wow, that's great, you know, and it's sort of a cold way. And then they'll immediately move on to something else, or they'll somehow make it about them. Or they'll somehow make it make you feel bad about your success. You'll if you notice that feeling of wow, I don't even feel like sharing my successes with this person. It's a red flag. It can also manifest as frequent accusations about betrayal, or telling the object of jealousy that he or she does not deserve good fortune, or happy life or ruminating about the lives of others, people who are constantly out there saying so and so successful, but they've built it online or so and so is, you know, is is wealthy, but they've built it on, you know, greed and lies and deceit and, or they or they've stolen something, right? That's a really toxic mindset in that person, even if it's true, emotionally healthy, people will talk about this quietly, calmly, and then they'll leave alone. They won't dwell, they won't ruminate on, people do get betrayed, people do get let down, people do have things stolen from them. I mean, I can't tell you how many times I've seen that happen, you know, providers getting abused, manipulated, and collected by hospital administrators, you know, they're driving to work and they're beat up rav4 and worrying about paying off their student loans and the administrative rules in in a Mercedes Benz and you know, flies and desk comes in at night and leaves a for and doesn't worry about whether or not anyone's going to die on his watch that day. And somehow he makes more than the doctors. This is an example right, that I think a lot of you will relate to in your industry, from your personal life, some sort of jealousy will make you feel attacked, uncomfortable, hyper vigilant and disrespected. You're going to feel like these people are coming at you, you're gonna feel uncomfortable around them, the more success you have, you're going to be very, very nervous around because you're going to feel like you can't tell them about how good things are going unless it's like their fault. Like unless the doctor or the therapist or whatever, did a great job and they're directly responsible for you, you're getting better, you're gonna feel like you can't tell them anything that's going wrong, or anything that you did outside of their device, that work that made you feel better or got you results. And you're gonna feel like they don't respect you. Be aware that that's a sign of this is a that relationship. So there's tons more in here that I'm going to share with the premium subscribers if you want access to that, like I said, upgrade your subscription today as long as everyone. Thanks for watching. Take care. Have a great day.

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Leland Stillman, MD