#56. Dr. George Hu: The Message
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What's up, everybody? Welcome back to The Honest Drink. I'm Justin. You can always reach us at thehonestdrink at gmail.com. And if you've been enjoying this podcast, go ahead, rate, comment, and subscribe.

We got a treat today. We have a very special guest. He is a clinical psychologist and the chief of mental health at the Shanghai United Family Hospital. He is also the president of the Shanghai International Mental Health Association. Now, in many ways, this episode sums up what the show is all about. It was a really intimate and honest conversation, and my guest shares some deeply personal and painful experiences, and we get the benefit of learning from what he has to say.

Really, what this conversation boils down to is human psychology and why we think and feel the way we do, how our thoughts, emotions, and behaviors are all shaped by our environment. And while this might not be anything new, but in this modern jungle that we live in where we're constantly bombarded by information and messaging, both good and bad, what does that mean for our mental health? Because based on the research data, it's not trending in the right direction.

Now, we also talk about depression and suicide, but we approach it in a way that I think is very digestible. I had an absolutely amazing time talking to him. We shared several laughs during this episode, and he's just a remarkable person to talk to and truly wants to help. So without further ado, please give it up for Dr. George Hu.

I actually really like this one. I've never had this. Again, I'm an amateur.

So I have what they have at Costco. Whatever they have at Costco is what I have. Well, I think Costco has a fairly big selection, though. No, what I mean by Costco is like Kirkland. So what I mean amateur... You drink Kirkland whiskey? Okay. I didn't even know Kirkland made whiskey. They do. They do. It's not...

It's not bad. I have a bottle of it at home. You're welcome anytime. I got to try that. I got to have this on the show. No, now I'm embarrassed. Now I'm embarrassed. But you know, I didn't have any alcohol until I was 30. I'm a late comer to this. You're a late bloomer, huh? I'm a late bloomer for sure. So were you kind of like a goody two shoes growing up? You know, I was very much a goody two shoes. I had like, yeah, definitely. You were like a straight arrow? Definitely. Yeah.

I did everything by the book. By the book. I was like every Asian American. You never experimented with like substances, never drank, never done anything like that. Never drank till I was 30. Never even had so much as a puff on a cigarette. Really? To this day. Okay. Yeah. Anything I've inhaled has been secondhand smoke. I went to Berkeley too. So you know how hard that is. Yeah. You know? Well, cheers, George. Thank you for coming on the show. Thank you for having me. Appreciate it.

We are drinking the Mortlock 16. It's good, right? It's good. I like this. Please do not tell me this is not as good as the Kirkland brand. This is much better. Okay. Are you sure about that? I promise you. I mean, the Kirkland's not bad. You know, Kirkland does a good job, but it's nothing like this. That fine Kirkland whiskey. Oh, man. But I actually admire that about you because where I grew up,

Like, to not be a goody two-shoe was, like, the mainstream. So, it would take balls to be the goody two-shoe. You know what I'm saying? That's funny because that's the opposite of what? It's the opposite of what you would think because usually they think the social pressures try to make you... Right? But, like, the social pressures where I grew up really...

you know, lent itself to like kind of, you know, being like disobedient, you know, you know, rebelling and, you know, doing stupid things as a kid. Yeah. And so I actually admire that about you, that you kind of went your whole life without even like,

doing like even having a puff of a cigarette. It's interesting because, you know, yeah, I mean, I did everything kind of like by the book as it was handed to me. Were you ever curious though? Like, hey, what does the cigarette taste like? Or what is marijuana? What is marijuana like? No, honestly. It was never even curious. No, and if I were to be totally honest, I think maybe I'm just slightly more curious about marijuana than I am about tobacco. Like I have zero interest in tobacco. And that's not because I had a negative sort of like...

experience with it or anything like that or my parents, nothing. I just have zero interest in it.

Is that because marijuana actually might have some health uses? You know, because there's a lot of conversation. Yeah. Pain management, all sorts of things. Right. Yeah. Yeah. So there's a lot of conversation about it, especially in, you know, healthcare. Right. Which is the field that I'm in. And so now I'm just like slightly curious, but I've never, and I went to, I went through four years of going to Berkeley, even longer of living in Berkeley. Cause I lived in Berkeley for, for a little bit after I graduated and,

And I just never, never. But were people around you like going in or you just weren't in that crowd? I think it was both, right? I think the people that I hung around with were definitely more straight shooters for sure. Right. And then combined with the fact that I was just not curious. Like I just had no curiosity to it. Yeah. Yeah. But I'm definitely, I think I'm definitely an outlier. Even where I grew up, like I'm definitely more of a straight shooter than a lot of my other peers. Yeah.

Well, you mean straight shooter in the sense that you're just a straight arrow. Yeah. In the sense that I was the guy that, you know, that my friends, their parents wanted their kids to be friends with. Right. And even to this day, no, even to this day, when I go out, like some of our mutual friends, right? Some people that you and I both know, like, I think, you know, a lot of times I go out with these friends and they're like, hey, our wives only let us out because they heard you're coming. Right.

Right. Yeah, I know. I know exactly what you're talking about. Yeah, which means, all right, if George is going to be there, it's not going to be too crazy. There's going to be like somebody. Like he'll be the voice of reason. Yeah. I've never even been drunk. I've never been drunk. To this day? To this day, I've never been drunk.

I don't know. You're like an alien right now. I'm an alien. I am. I know. I'm a 44-year-old Chinese-American guy in Shanghai, right? I mean, think about that. You're going to have to change that. Today. You got drunk? Yeah, today.

No, but yeah. So I'm, to this day, I'm still that guy that like a lot of my friends are like, Hey, yeah, my, our wives let us out. Cause you're here. Yeah. I need, I need more of those friends. Do you? Yeah. Which is like, this is what's so great about having a format like this is that me and you, and I was really excited to have you on the show. And you know, I've been looking forward to this conversation for a long time. And yeah,

You know, what's great about this is, like, we get to sit down and actually have a conversation and really get to know each other and share some ideas. Whereas, if not, like, when we were kids, I would, we would never have been friends. Yeah, probably not. You know, we kind of ran and completely do different types of, like, you know, crowds and circles. Now I'm curious. What was your childhood like? What did you...

What kind of kid were you? A lot of substance abuse. Yeah? Yeah, a lot of substance abuse when I was a kid. Okay. But that was like the norm, you know? Like alcohol? Sorry, you don't have to say it. No, no, no, no, no. I've said it before on this show. So, yeah, a lot of alcohol for sure. Yeah.

I had my first cigarette at a young age. But a lot of alcohol, a lot of weed. I've dabbled in some other psychedelics, things like that. But nothing truly hardcore. I've never tried crack cocaine or heroin. That was never even a thought. But the more recreational stuff, that is more typical, stereotypical, all that was...

Like, all the time. Just part of, yeah, part of the norm. Yeah, part of the norm. Especially in the circles I ran around. And, you know, I grew up in the suburbs in New Jersey. And in the suburbs, just like probably with any suburbs in the States, you know, kids get bored. And then they look for things to do. And usually it's not very productive or healthy things that they find to get themselves into. Well, now that I look back on it, you know, it's interesting because I think...

There's always the element of like, and it'd be interesting to get your take on this also as a Chinese American guy, right? Like, but there's always this element of what we should do. Right. I think especially as, as Asian folks growing up, like ABCs growing up in the States, right? I think there was this always like layer of our parents' expectations or, you know, the kind of story or narrative of what we should do. And that was always a big thing.

And I'm curious about whether maybe I just succumbed to that more. Maybe I was just like, man, I need to do this. I need to follow the book. I need to... That was your gospel. I wonder. I wonder.

- Well, you are, okay, what little I know about you, but it seems from the outside, it seems you are the shining successful example of that. - Oh, I'm not. - I mean, look at you now. I mean, you're the chief of mental health at United Family, right? You're also the president of the Shanghai International Mental Health Association. Did I say that correctly? - Yeah, that's right. - Yeah. I mean, that is like your shining success story of like what Asian parents would want from their child, right?

Maybe there's a veneer. Like, no, well, see, I'm not a physician. So there's also a... Okay, so you think that matters? I mean, you should have been a fly on the wall. I think it does, because you should have been a fly on the wall when I told my parents that I wanted to study psychology. What was their response? I think my mom's response was something like...

psychology, what does that mean? Like, you're gonna, you're gonna, I can tell who's crazy. Why do you need to study? I can, I can tell who's crazy. He's crazy. She's not. I can tell. Like, what do you have to go to school for? What is that about? What, what, what, what even does psychology mean? Right. And it was, I think the fear because, because my parents used to say, man, I hope they don't, I hope they don't listen to this. My parents, but my parents used to say, look, George, you have complete freedom to be anything you want to be.

As long as it's a doctor, lawyer, businessman. And I think to them, they really genuinely felt like they were giving me freedom. But obviously to me, that was a really narrowly defined definition of it.

But, you know, it was their fear, right? Their immigrant, like, I think, are your parents immigrants? Yeah. Yeah. Like many of us ABCs of a certain generation, I think, you know, we all come from immigrant families who spent a lot of their time in fear. And that fear was something like, am I going to make it in this new place? Because we probably left the old place kind of lost.

you know, under a complicated history, right? For complicated reasons, having to do with pain and, and stuff like that. And so now going to this new place, am I going to make it in a, in a place that does not look like me, that does not speak my language. And now I'm going to have children. Are they going to make it? And I'm really, really afraid. And that causes this, these immigrants to like clamp down and say, and to be pretty narrow, right?

Like there's no room for like trial and error. There's no room for experimentation. Yeah. You just got to go with like what you know. You got to go with what you know. It's like when I went to college, when I was preparing to go to college, right? The people around me, a lot of my peers were like, hey, we're going to do these college visitations. We're going to set up these visits and just kind of go see what they're like, see if I like it. And when I brought that idea up to my parents, they were like, what? It was like the most alien thing ever.

Because they're like, why do you need to go visit? What does that matter? You're going to go to the best college that you get into. And by best, we mean whatever U.S. News and World Report says. Right? Like the ranking. Not the best in terms of like the weather or the programs or like that. Like all those other variables don't matter. It's just whatever is ranked the highest. Do not matter. So what's the point of going to visit as if that's going to have any impact? Right? Wow. And it was almost like also this thing where like –

You know, I think college is the first time that a lot of us, at least for me, right, like I was going to spread my wings and sort of be my own person. Right. And, and I think my parents coming from a more traditional sort of Chinese or Asian background, we're kind of like, what?

You know, the idea of where you want to go to college, like that's not the most important thing. The most important thing is where are we as a family going with this? Right. So the definition of the word, quote unquote, I was like different. Like I thought of I as in me, myself, George, like in my own skin and in my own body. And they thought of it very differently. They thought of the word George or I as being much more connected to this whole group.

Right. So the fact that you, George, would solely choose where you want to go to college is kind of like. Like that was an alien idea. Yeah. It was like a selfish idea. Selfish. Yeah. Or just like completely foreign.

But isn't that one of the biggest differences between Western and Asian culture, though? I feel like Asian culture in general is more of that community mentality, that group mentality. Yeah. Think about the mask stuff, right? Back in the US, right? You have all these people, or not everybody, thankfully, but a significant subsegment of the population just not wearing masks. Well, what do you chop that up to? You think that's just like individualism? Yeah.

like I'm my own person, don't tell me what to do kind of mentality or? Yeah. I mean, I think there's this ethos, right? For us as Americans, that's written into our, like Jefferson wrote it into our Declaration of Independence, right? The pursuit of life, liberty, and the pursuit of happiness. Like these are like tenets of our culture that are written into our very DNA and anything that would impinge upon our liberty, upon our individual pursuit of something called happiness, right?

Like, you cannot impinge upon that. Like, thou shalt not interfere with that, right? And here we are, I think not every culture historically has felt that way, has placed such a value on individual happiness, whatever that means, right? Or an individual's life or liberty.

The concept is different. So I think for a lot of Americans, the fact that even though they can cerebrally understand why wearing a mask might be important to public health or something like that, it is me as an individual, as a person, willingly accepting a limitation. And that feels anathema to a lot of people.

That feels like they prickle against that. Like, no, no, no, that's not right. Right. I, George should not be, should not have to sacrifice anything.

right? Yeah. For somebody else. Yeah. They should say, take care of them and me, I take care of me. So if you get sick, you get, you get sick. I'm sorry. I'm not wearing a mask. Do you know what I mean? Yeah, no, I know exactly what you mean. Um, but do you feel like it can go, it gets taken too far sometimes or it gets used as like kind of this atomic bomb in terms of any sort of like stopping any sort of discussion in its tracks, right? Like, like,

Like my freedoms, my personal liberties, boom. And once you say those words, it's like, oh, like hands up in the air. Can't talk any further. There's nothing else like you can do. Because once you bring up those terms about freedom and liberty, all of a sudden it's like, if you're like arguing or having a debate about these things, if you're debating on the other side of that, it's all of a sudden then it's, you're put in this, you're framed in this as like, you're against, you're against freedom. You're against liberty. You're against these things. Yeah.

And then all of a sudden it just stops any discussion in its tracks. Oh, you're so right. I totally agree with you. It's like these, I don't know what you call it, but it's like a card that you pull, right? And as soon as you pull that card, it stops any sort of intellectual discourse, right? And it's just not...

You know, I think COVID is bringing to light the fact that the world is operating on a whole different level, right? We have this virus. It's literally in the air. It spreads like wildfire. Yeah, you know, it may have started here in China, in Wuhan, but come on, we live in the 21st century, right? Nothing is so boundary to one place, right? It's gonna spread, right?

No matter how much you, and it's not because, and I do have issue perhaps with some of China's early efforts, right? And in terms of the way that the Chinese health authorities chose, for example, to silence some of the voices of the initial medical staff that found that this was a thing back in Wuhan, right? And then there's a lot of fear. But I think that after that, China's response to this has largely been appropriate, right?

And granted, I think China's in a unique space, right? We have a very particular type of governance here. We have a particular type of society. But I think it's really interesting because Chinese people in general have been much more accepting of the limitations. And part of that has been because they have to.

Right. Like, I remember being interviewed by the BBC once about, hey, like, how did you guys in China move so quickly to online education and working from home? And I'm like, well, part of the reason is because you showed up to work one day and there's a padlock on the front door. So you just got to suck it up and do it. There's no, like, conversation, quote unquote, about how we're going to do this. It's like...

You do it or you don't have a job. So let me know. Right. And, and it's part of it's that, but the other part I think too, is that there's much more of an understanding that, Hey, we're all going to have to do this. Right. If we, if we wish to come out of this like pandemic. Yeah. Right. We're all going to have to bite the bullet a little bit and suck it up. Yeah. And I think there's something in the American culture,

you know, our culture that we bristle against that. We don't think that's right that we as an individual have to suck it up. Yeah. Yeah. Because then, I mean, I think they always, Americans in general, um,

know, maybe they frame things in terms of like a slippery slope. Like, oh, well, if we, like, you know, if we kind of give this ground, even though it's like just a little bit, you know, what's going to happen later? What is that going to lead to? And then what is that going to lead to? First the mask, then the whatever. Yeah, then this and then that, you know, so they start hypothesizing or, you know, thinking about all these like worst case scenarios instead of addressing the issues, you

matter at a time and being like, okay, well, what do we need to do right now? What's immediate and what makes sense? Instead, they go on to like worst case scenarios, right? And these abstract ideas of like... Separate slopes. Yeah, separate slopes. Yeah. I totally agree with you. And I think that's sort of like...

the kind of fear that takes hold, right? Instead of going, hey, you know, this is a virus. We know how viruses operate. We know how they spread. And we know, I mean, it's not new that wearing masks contain the spread of viral epidemics. That's not new at all, right? Spanish flu, for example, but not just Spanish flu, SARS. Like part of the reason why I think masks took on here in China is because we went through SARS and masks were a thing already.

Masks were a thing because of the pollution. Well, even before COVID, people were wearing masks. Because the air is bad. Yeah, wearing masks already. Yeah, I mean, I spent three years, me and my family in Beijing, where we wore masks most days. Yeah, it's like bringing an umbrella if you think it's going to rain. Exactly, exactly. And so we didn't see it as so much of an impingement upon us.

individual liberty. We saw it only as, well, you know, it's up to you whether or not you want to breathe something in that you don't want to, you know? But like, where do you draw the line, right? Like in this, like, I think these ideas, these like things that would you would think would be like just self-evident become these abstract ideas of like impingement on liberties. Like if wearing a mask is impinging on liberties, then isn't wearing a seatbelt in a car a

Sure. Or clothing in general. Yeah. Like you can't walk out naked. You'll be arrested, right? You will. Yeah. And it's not necessarily about decency. It's also about, well, I don't want to sit where your bare butt has sat either. Yeah. Right? Because I don't know how you're – But no one talks about that. Yeah. No one puts up a fuss the fact that there is laws that you have to wear clothing in public. Yeah. Yeah.

And I think- And that's your body, right? Exactly. That's your very body. That's what everyone says. Like, this is my body, my choice, right? Yeah. Well, like, that has other connotations. Sure. But my body, my choice. Well, wearing clothing, wearing a seatbelt, and there's probably a ton of other things. And you're right. I think this is a perfect example of something that most people are not thinking of in a logical way, right? They're only reacting out of fear, right?

The fear of the slippery slope, like you said, the fear that or the unwillingness to give, right? To be, to appear weak. And I think that's a very interesting kind of concept too, is that I don't want to appear weak by wearing this mask. And that's what makes the mask different from pants, is that somehow I no longer, you know, connect the wearing of pants to weakness, right?

but I'm connecting the wearing of a mask to some sort of weakness or fear that I just don't like. And so I'm going to just like push away the concept of wearing a mask, even though it makes no sense. And even though I may not be a dumb person, I might be a perfectly reasonably intelligent guy, but I'm going to push that away. Oh, did you hear just a few hours ago, the news broke out Donald Trump and Melania, they have, they're positive for COVID. Yeah. Yeah. I can't say I'm surprised.

It's just a matter of time. - Do you think it's real though? Or do you think it's like a stunt he's pulling? And if there's a little bit of me in the back of my mind, that's like, he's doing this on purpose just so that he can come out, like he's healthy. And just so he can come out and be like, I recovered, it's no big deal. See, I told you COVID is no big deal. I recovered, I'm 70 something years old. There's a bit of me that feels like he wants to do that. - Maybe there's a little bit of that. I mean, you know, I will not pretend that I know his mind.

I do think that, though, if anything about Donald Trump is that he has been eminently readable from the beginning. Do you know what I mean? Yeah, so I wanted to kind of get you—we don't need to get political if you don't want to. But I really was curious about your take as a mental health expert, a doctor, and when you see someone like him.

Or did you watch the debates, the first debate, or see the highlights or hear about it at least? I saw highlights. I could not bring myself to watch the whole thing. Yeah. I must admit to you. So what's your take on what's going on mentally? You think it's just a game, it's tactics, or do you think it's some other deeper kind of...

something about his personality or I don't know, like what's your take on it? I mean, I hesitate to say, I hesitate to say on many levels, number one, like I I'm a clinician, right? And so we are really not supposed to be diagnosing or like sort of like going too far in terms of, um, you know, clinical commentary on a person that we don't have that kind of relationship with that having been said, like I said before, I think he's eminently readable.

Like he's not that complex of a person. It appears, right? He's not so nuanced or layered. He puts it out there. Unless he's doing these things on purpose. Unless this is a character that he's portraying on purpose. On purpose. But I think that the purpose is clear. He wants to win. Yeah. Right? At all costs. At all costs. And to him, win is defined in a certain way.

My win is defined by me being in a certain position and my family being in that position, right? So hiring in my daughter and my son-in-law and whoever, right? My friends and my tribe into those positions, right? And I think that because that is the primary goal, the ends justify the means, right? So I'm going to say whatever, I'm going to do whatever as long as that final goal is achieved. And I think that that's been...

it appears to be the kind of person that he's been from the beginning, you know? And so I can't fault him necessarily for like obfuscating himself or playing the political game and this overly sophisticated and nuanced way. I don't think he's that, it does not appear at least that he's that sophisticated or nuanced. He's quite clear. Now I don't know myself, I don't support him politically, right? I sort of, you know, from the beginning have bristled, I think against his style and,

I tell a lot of people like he may have, he may have policies that maybe I agree with. I don't even know because it's been hard for me to get past the packaging.

Well, his actual policies are actually not even that much- That revolutionary. In the news even. And probably nothing even new. All the headlines are always about like his antics or his tweets or whatever. It's hardly ever about his actual policy. It's about his style and the way that he engages. And I think a lot of people would call my sort of approach to this as like sort of non-substantive, but I can't get past his outer-

Right. Like, I don't even know if what you're saying makes sense because I just don't like you. Right. So I don't know that we can even get to that other conversation, you know, but, um,

But yeah, I mean, for him getting COVID, like I'm not surprised, right? I mean, he... Well, it's like about time, right? He's been doing all these rallies. It's going to be a matter of time. He's a human being breathing air and really has not really been into masks or the people around him view masks as a weakness or are worried about the quote unquote optics of people in the West Wing wearing masks, right? So obviously it's just going to be a matter of time. And I think that that is really, really...

shameful in the 21st century and much too bad, right? That in the 21st century, with all that we know about viruses, about coronaviruses, which are a very understood class of viruses, right? I mean, with all that we know, the most advanced, economically advanced, scientifically advanced country in the world could not protect itself.

Sorry, I say could not protect itself. Was unwilling to protect itself. Yeah. Right? It could. It could have. It has the means to. It's not rocket science, right? A surgical mask is not rocket science. Well, you know, we did it here in China. I mean, we did it, right? And we are over here very much a developing society, right? But, I mean, and around the world. Yeah. Right? I mean, we are at over 200,000 American deaths worldwide.

From this virus? 7 million contracted. Embarrassing, you know? Well, talking about the 21st century. Yeah. I want to take it back a little bit to something you mentioned when you were talking about like when you first kind of, you know, confronted your parents about wanting to go into psychology. Because, you know, obviously you're a mental health expert, chief of mental health at United Family Health.

So I want to talk about kind of like modern day threats to that, I guess. And also maybe just the idea of stigma. Because when you said like your mother's response to me,

automatically what came to my head as you were saying that was, well, that's the very definition of the stigma, right? Like the fact that when you said mentioned psychology, your, your mother was like, what psychology? That's not like a real thing. Like, why are you going into that? Like,

But that's the very kind of, I guess, one of the roots of like why a lot of these mental health issues are a stigma is because people don't feel like it's a real thing. They feel like it's a character flaw or something. Yeah. Rather than an actual illness, which it is. A lot of these things are. I love the way you put that because that's exactly the way that I describe it. When people talk about mental health difficulties, right? Yeah.

The stigma exactly comes from the fact that a lot of people say, you know, there's something wrong with you and your character. Like you're weak. You're weak. Yeah. That's why you have that. And we would never say that, or that's why you have that difficulty. We would never say that as somebody suffering from liver cancer or like skin cancer or whatever, right? Or diabetes or any sort of, you know, other difficulty. Yeah. Right. But when it comes to,

something that we don't understand, right? There's something that's not so direct. Is it the mind? Is it the brain? Is it the person? What is it? Is it the environment around them? What is it that has caused this disorder or this difficulty, right? I don't know that I love the term disorder, but I think that a lot of mental health difficulties just actually, just like a lot of physical difficulties arise, not just from one factor, but are actually multifactorial, but we don't understand it.

And so it's easy for us to say, oh, you're like that because you're weak. If you were just stronger, if you would just suck it up, if you had better character, then you wouldn't have that problem. And that's just so, that's too bad. And I'm very, very, I'm quite open when I give talks and seminars. But I recently wrote an article for Suicide Awareness Month, which is just September, right? So just this past month.

And I wrote an article sharing my own experience with suicidal ideation. Right. I was very, I was very open in the article, but I've always been, you know, as I spoke that I have, I started this field and by field, I mean mental health field. I started this field as a patient first, really before I became a clinician. Oh yeah. Yeah. And that's because of a lot of things. Like I went through a lot of, you know, difficult traumatic kind of, um,

I struggled with difficulties in my mood and depression, but I also have been suicidal in the past, you know, and, and, and I talk about it openly because I want, I want to de-stigmatize this phenomena, right? I even want to de-stigmatize these phenomena away from the concept of like diagnostic categories and mental illness, right?

These are just difficulties and experiences that people go through, even suicidal ideation. And just because somebody feels suicidal, yeah, sometimes it means they have a mental disorder. Sometimes it doesn't, especially in this part of the world. Suicide here is a complex thing. If you think about the kamikaze pilots of World War II who chose to end their life, not because they were depressed, right?

or had a disorder, but because of some purpose that they felt required that, necessitated that. Here in China, we have Duang Wujie, a whole holiday celebrated in commemoration of a poet who killed himself to make an expression about where he felt his country was going and the sorrow and the angst that he felt about that.

And he chose to end his life as a statement of that because he was a well-known figure. And now the zongzi, the things that we throw into the river because he drowned himself in a river.

Right. And so the rice, the glutinous rice balls that are wrapped in leaves are done so because the people would throw them into the river so that he could actually eat them before the fish did. Right. Because the leaves protected against the fish. So, I mean, we have here in this part of the world, I think, a much more layered and nuanced view of like suicide, for example. Right. That's hardly ever talked about here. It's hardly ever talked about. Because I think and I wonder because...

Because I think that there's an idea from the West, right, that suicide means you're mentally ill, that you have a psychiatric problem, that if you think about it, you have a psychiatric problem. And by psychiatric problem, I mean institutionalized, like some sort of like, even in the way that we even talk about these issues here in China now, you know, as like, 心理疾病 versus 精神疾病, like it's a very...

It's a very stigmatizing way to talk about it. And when we think about suicide, people immediately jump to like jingshen, psychiatric illness, right? Jingshen jibi. And I don't know that it's always like that, right? And I think that many of my peers in mental health will probably like, I'll probably get a lot of calls and complaints about this. But I say, because you know,

I do think that suicide, obviously suicide is something that needs to be addressed. And that more and more now, thinking about ending one's life is because it is a marker of the fact that we need to change and we need to address something around this person's life. But I want to destigmatize it. Somebody feeling suicidal does not necessarily mean that they have

a serious psychiatric illness, but it does mean that we need to pay attention to what's happening. But a lot of the time, what's happening with somebody suicidal is not so much a problem with them, but it's sort of also an issue with the environment around them. The society, the community, the environment around them also needs to be changed.

And I think I want to take the conversation there, right? Like how could we talk about the communities and the families and the societies around people to care for people more so that they don't have to feel this way. So they don't have to feel alone. They don't have to feel like their only option is to kill themselves. A lot of people here in China and a lot of Asians in general who feel suicidal feel this way because, um,

they perceive themselves to be more of a burden to their communities, right? Then, then, then they are a benefit, right? And we see this, you know, here in China, there's kind of two like times of life in which we see suicide, suicide attempts spike. One is late adolescence. So 15, 16, 17, that, that sort of period. And the other is in the older population, like post 70, right? And a lot of times, and, and for the post 70 folks, it's,

It's really because a lot of times they perceive themselves to be much more of a burden to their families than they are a benefit. They're older. They may have limited mobility. They're not working anymore. Maybe there's some health problems that are presenting a financial burden to the family. There's a concept here that you have to take care of your older generation. The nursing homes are not as much of a thing here. They kind of see themselves a burden sometimes.

And thankfully, that's becoming less and less the case as China urbanizes more and more. But I think, you know, there still is this sort of like, I, you know, a lot of folks choose to attempt to end their life, not so much because they're depressed classically, but because they feel like I just don't want to be that burden anymore, you know, and yeah, it'll be an emotional burden.

Because I died. But that would have happened anyway. Yeah. And at least that will be temporary. Yeah. And that'll be temporary. That'll go away. But like the financial burden, what if I'm such a financial burden for X or Y number of years that like, you know, now my kid has a hard time sending his own kid to school or like, you know, like giving their own children the opportunities that they would have given because they're spending money on me. I would have to imagine like, you know, for people who are

or have health problems, I would have to imagine the last thing they would want is to leave their loved ones in this state of financial bankruptcy or financial trouble, whatever it is. I mean, that's the last way you want to go, right? Yeah, that's the last way you want to go.

you're in a way where you feel like you've really helped, right. That you've really helped to elevate your family, you know, to, to a different style or standard of living, you know? Now, now the other end though, the late adolescence, I think it's, you know, there's a lot of reasons why obviously adolescence is a emotionally too much was, you know, period of life for anybody. But, you know, the,

the children here are under so much more pressure, I feel like, than we were in, right? Oh, for sure. For sure. For sure. Like the educational system here is just so competitive. It's very competitive. There's just so many people, so many kids. Yeah, if you think about the sheer number, yeah. I think there's something like, I mean, there's millions, like probably something like millions and millions of students taking the Gaokao every year, vying for...

a very limited amount of college spaces. And basically, right, you have the best colleges here. There's really only two.

right there's really only two like those are the and everybody in and their mothers are shooting for that like the whole country of the whole country is shooting for that i mean these are just crazy standards and the competition and the fact that you throw in there the one child policy too right for each family it's easy for a child to feel like i'm the hope of the family that my achievements educationally are the um

it's the representation it's the viable representation of my family's success this is the way to show for my family to show the world that they have succeeded all the burdens on me yeah is for me to show them that i got into this school that's a lot but the one child policy is not really a thing anymore right no no but it only changed what like two years ago

Was it two years ago? Yeah, just a few years. I mean, I think that it was relaxed a little bit for people living in the countries, in the rural areas, right? Like if you're, it's kind of sexist, but in the rural areas, if your first child was a girl, you were allowed to quote unquote try again for a boy, right? Because the boy could carry on, you know, do work and all of that, right? Yeah.

So I think that was the case. And also in certain urban areas too, you were allowed to go for two. But generally speaking, it was a one child policy until pretty recently. Do you know what the suicide rates are here in China? In America, I've heard it's as high as one out of 10 people.

10% of deaths are suicides. I don't know about that. In America, it is one of the leading causes of death for adolescents. There are more people die from... This is what I heard. More people in the United States, more people die of suicide than murder. I think that that is probably true. Right? But like in the news, you'll hear about murders, but you won't really hear about suicides. No. Yeah. And again, I think because people...

You know, look at suicide as an individual problem. Like that person was sick, right? It's not like, it's kind of like you don't even hear about cancer. Like you kind of do, but cancer is also like a public health concern. Like how can we change things about the environment and things about our system to better take care of people with cancer? But you don't hear about that with suicide because there is, again, like you said, the stigma that, you know,

Part of the problem at least is because that person was kind of like not able to just like bear the burden, right? That there was just something, you know, individually placed on that person. And, you know, I don't, while maybe, obviously there's always individual factors that impact what's going on. What we're missing is what's happening in the family, right?

What's happening in society? What's happening in the community around that child where that person felt like their only option was to die? Why didn't that person see? Why couldn't we, as a society around that person, show that there were some other options that were viable? Well, you bring up... I think that's a really good point. And you bring up society. Have you ever...

There's this term called a radical environmental mutation. Do you know anything about that? It's basically, it's the idea, right? If, okay, this is going to be kind of a long explanation, but bear with me. No, I'm interested. So, so,

So as humans, right, individuals, we look at time as very short segments of time within our own lifetime. Yeah. Right? Yeah. Decades, years, right? Very short. Yeah. But when we're able to step back and look at the greater kind of span of time that goes beyond our lifetime, we get to see like...

bigger patterns. Yeah. Right. And more like changes over a long course of time to human evolution, human genetics, behavior, the way our bodies and brains are wired to interact with the environment around us. Yeah. So there's this idea called a radical environmental mutation, which basically from the beginning, basically it's like from the Pleistocene era, which is like,

Basically, humans and pre-humans have 99% of all human experience has been hunter-gatherer experience. Over 99%, actually, has been living as hunter-gatherers. And relatively recently, there was the agricultural revolution with the advent of agriculture and settlements and cities and things like that.

Industrial Revolution. Yeah, well, so I'm going to get to that. But the Agricultural Revolution, very little thing, like, you know, like there are some kind of evolutionary changes, a little bit that happened during then. But then when you talk about the biggest change, one of the biggest changes of recent time is really the Industrial Revolution. And that dates back only 200 years ago.

So that's really only, well, that's like four or five generations of people. It's like nothing. It's literally nothing. - Yeah, it's a blink of an eye. - Yeah, so obviously during that time, there has been no human real evolution or changes to the way we're wired or our genetics or anything like that. Yet our environments have completely, completely changed. - Totally.

So what this idea is, is that we're actually still wired genetically, physiologically, neurally,

We're still wired. For a different environment. For a completely different environment. We're wired to be still to be hunter gatherers because 99% of our human experience has been that way. And we don't evolve that quickly. We don't evolve. We evolve very slowly. Yeah, very slowly relative to the way the information. So now all of a sudden, just a few generations ago, you go through industrial revolution where now we're living in this holocaust.

whole different modern society. So that's the radical environmental mutation where all of a sudden we're not ready for this. Our bodies and minds are not built for this, are not built to be sedentary, are not built to be indoors, are not built to be sleep deprived and stressed at work and all these things.

Or so digitally connected, which is another... Or digitally... The technology is a whole different can of worms, right? Where now, in the recent years, you see that spike. Generation after generation, the rates of mental illness, depression, these things are going up. They're not going down. And...

So it's like this idea of like, we're just not built for this. And if you look at like modern day, like Aboriginal tribes, and there have been a lot of deep studies that go back decades where they're focused on like studying a lot of these tribes that live like secluded and their lives and the way they live are a lot more similar to like

hunter-gatherer lifestyles. And you basically see none of obesity. You see none of diabetes. You don't see asthma. You don't see cancer. Depression. Depression. You don't see these things. Anxiety. Yeah, anxiety, suicide. These are basically non-existent in these societies. Yeah.

So, I mean, that's not end all and be all, but it's interesting to look at that body of research and evidence and think about this whole idea and being like, well, we're kind of like a fish out of water right now. Oh, definitely. Yeah, definitely. And I see that as we flail in sort of the internet age, right? And sort of our relationship a lot of times to technology and social media use and social media particularly. And I...

you know, I will admit that I have a certain type of relationship, right, with this and that I'm a clinician, right? And so I see people having a maladaptive relationship to technology and maybe addicted to social media and seeing the effects of social media use and on things like anxiety in adolescence or even in myself, right? So I admit that it's a very particular kind of a

a perspective, but you're right. I don't think we have evolved or developed, however you want to put it, in a way that we can handle these things responsibly and that we can understand its impact. And I think that this is a conversation that we have to talk about as a society because you're getting at something. We have to acknowledge our weakness before we can appropriately decide what we're going to do.

we have to acknowledge that we don't have the tools, right? And we don't have that evolution or that development or however you want to put it. And until we can admit that first and to admit that we don't know what we're doing and that we're out of control and ill-equipped, we can't, as a society, have a conversation on how to handle it, right? And I think that has a lot to do with mental health because I think that one of the primary issues

sort of roadblocks to people, one of the primary things that prevent people from accessing support, right? Emotionally, accessing support socially is an inability or unwillingness to admit their own need, right? Admit that I don't know. I don't have what it takes. You know, I don't know what I'm doing. And I think that as Americans, we have, you know, something else that's written into our ethos that

it's sort of this lone ranger, desperado kind of like mentality, right? Like the lone ranger riding off into the sunset. Tough guy, hero. Tough guy. I don't need nobody. Yeah. Right. I'm my own man. I don't need anything. Nobody's, I'm going to, you know, all I need, you know, all I have is my horse and my gun and I'm, I'm out, you know, I'm fending for myself. Me against the world. Me against the world. And, and I love it. The Marlboro man, Marlboro man, kind of like mentality. I,

you know, I, I see it, but I think it is profoundly unhealthy because it's not true. Right. It's like the Disney-fied version of the ending for boys. Right. It's just not, it's just not reality in reality. The reality is unless we, you know, learn to be well adjusted to our own weakness, we're not going to function well, you know, we're going to become like,

We were just talking about Donald Trump getting COVID finally, and we all saw it was going to happen because, you know, he doesn't wear a mask, right? And he's sort of anti-mask. And he's like, I'm not, you know, it's weak and I'm not doing that. Well, all right, but you're going to get infected. So what are some like possible solutions to that? You know, I think us as society have to change the messaging that we're sending. You know, I think us as society... It's like machismo kind of message. Yeah, this thing where like...

you know, I don't, that strength is equated with not needing any help or support, right? That's a false connection. Like if, like I work for a healthcare company, United Family, right? We are a healthcare company. We are not a technology company. We are not a whatever company, right? And so if I, as a healthcare, you know, healthcare company, and maybe a quite a mature and like respected one, right? But if I have an IT problem,

I'm going to have to admit that I have an IT problem. And because I'm a healthcare company, I don't know what to do about that beyond the basics. Like I have an IT department, but we are not an IT company. So I'm going to have to do something called, you know, get a consultant, right? Hire a third party. I mean, that's why God made consultants, right? Because you're not expected and it would be folly for you to say, no, I'm a mature company, damn it.

I'm not getting a consultant. You're in denial. You're in denial. And yeah, I guess that's your choice. Don't get a consultant, but you're going to flail and you're going to suffer the consequences of that. And then you're going to look foolish instead of going, you know what? I need that. Because maybe I do know what I'm doing in healthcare, maybe, but I don't know this other stuff. I have to hire a third party advertising firm.

I have to hire an IT consultant. I have to hire a management, whatever else it is. I have to partner with these other companies. And until I do, unless I do, I'm going to fail. And I think, you know, it's a false equivalency personally and on a personal level to say, to connect strength with not needing any support. Yeah. Right? I think we have to send a whole different message. And I think this was like...

Yeah, I mean, I think we have to really, really change the messaging that we send to kids, to society. I think we have to change the messaging we send to boys in particular. So like the stigma is more intense with boys? I think a little bit. I mean, all of us suffer from messaging and narratives and socialization, right? And traditionally speaking, yes, definitely women have suffered more from that for sure than men, right? But...

One of the particular ways in which men suffer, I think, is because we are pushed this narrative that we cannot ask for help. That as soon as you do, you are weak or worse, girly. That is something, right, that especially as American men, I think we just...

Well, like when we were growing up, it's like, oh, don't be a girl. Don't be a pussy. Yeah, exactly. It's all these things that are like demeaning you, but also demeaning the women at the same time. Yeah, I know. Because what are you trying to say, right? But obviously, it makes no sense whatsoever. But we are trained to fear that. Yeah. Oh, as men? Yeah. It's like your manhood. Your manhood. Yeah. Like your cojones or whatever we say. Yeah, your balls are being taken away. Yeah. Yeah.

The harshest thing you can say to your friend is like, oh, stop being a pussy. Because then they change their behavior right away. Right away. That's motivated because nobody wants that. Yeah, you can call him an asshole. You can call him a jerk. Whatever. Nothing's going to change him. Once you call him a pussy, all of a sudden he's like, oh, shit. I better change. Yeah, I better change. Because you don't want that. And that's, I mean, there's just so much wrong with that. So there is the, you know, not only is it sexist, but it creates...

It's this environment where if somebody does go, oh, shoot, I am feeling something right now that's scary and I don't know what to do with it. It prevents that person from talking to anybody else around him. They stay silent. They stay silent. And maybe that has something to do with what causes people to say, you know what? I'm going to jump or I'm going to, right? Like take a gun and I'm going to, you know what? I can't.

Because there's no one else that can help me with this. I can't reach out to people. And it seems like everybody else is fine. So I'm the weak one. It seems like everybody else is just fine. And I'm the one feeling this inside my heart when actually you're probably not at all.

So that's why I speak kind of openly about my own struggles and my own sort of journey as sort of like on the other end of the couch, quote unquote, as it were. Because I really want to put out there that, hey, no, I want to send a different narrative. That it is strong. It is strength for you to admit your weakness. Unless you admit it, unless you admit it, there's no help.

So you don't have to answer this if you don't want to, I'm getting personal, but like, what was your experience with suicide? Like how, how did you find that light at the end of the tunnel and get out of it? Well, my experience in college was the first, but not the last. So, you know, it is a journey continually to get out of it. Right. And it's a journey continually to understand that whatever I'm feeling and going through emotionally is,

I'm not the only one, right? That there are other people who have felt that, that also that there is hope, right? And there's a connection to hope that for me is very powerful and a connection that, you know what, with the right resources, with the right support, the circumstances of my life can change, right? And unless I am willing to admit that I'm feeling this way,

I can't, I won't be able to change it. I won't have the support to change it. And I need that support because I don't know how to do it myself or else I would have done it. Right. So I think it's the connection to hope. And it's a good thing for me. I think too, that I grew up a little bit less buying into this desperado or Lone Ranger kind of thing. I think I just grew up in a place and with a person, you know, with a,

you know, with a structure that I had to kind of seek support from other people. I kind of had to, maybe because I didn't grow up in like the traditionally, like I wasn't like your sporty guy. Like I wasn't the guy that played basketball really well or like, you know, kind of was any of those things. So I think I grew up pretty profoundly insecure and knowing that I had to lean on other people. Was that like your saving grace in a way?

Maybe one of them. But also, you know, I'm a religious person, right? And so I connect hope kind of on a spiritual level, right? And I think that also helped me because it is easier for me to identify hope or an ultimate hope, right? That is maybe over and beyond necessarily just what we see.

here on earth. Right. But, but whatever, but I, I see that as my job right now. Right. Whether, whether a person, a person is religious or not, regardless of the, the, the, the, the circumstances of his or her life, I assume the role of connecting this person with hope, right? Finding what hope means for that person in his or her own circumstance. Right. And helping them see that they can get there.

And whether that's clearing up some lies in this messaging that we talked about before, like, for example, the messaging connecting strength with not needing any help, I think is only one example of this. But there's many, many lies that I think all of us are subjected to all the time and forced to believe. And I see it as one of my roles to break down lies.

These lies or help somebody break down the lies and break down the effects of those lies in the way that they've been affected, you know, personally. Like these associations we have, right? And like kind of rewiring, reframing these associations. Be like, look, this is like a bunch of bullshit. Exactly. You know, you need to see beyond that and see it for what it really is. Don't believe the lies. Don't buy into it.

Because there's going to be a lot of narratives that are pushed on us all the time from all sorts of places about what we should do or how we should be. We're bombarded by messaging every day, every second of the day. All the time about what it means to succeed, about what it means to be a man, to be a woman, to be responsible, to be pretty, to be strong. There's all of these things. And there's, I think...

I see it upon myself, like I said, again, to help people deconstruct this, right? To see the effects that it's had on themselves and to say, no, I'm going to take control of this narrative now, right? I'm going to take control of it back and I'm going to rewrite it in a way that works in my life.

Yeah. Well, I think a lot of these messages and these associations have existed for a very long time. It's always been around. But in modern day with the advent of technology and social media and how fast-paced everything is and how connected everything is now, it's like taking all that messaging and everything we're talking about and like,

making a potion out of it that's like concentrated and like injecting it into like your directly into your veins like every day right because like everything's through our phones now it's with us every second of the day it's it's always in front of us we're always checking it it's like we're we're plugged in like yeah we are plugged in man whereas before like we could go out like you know when we were like you know obviously when you were growing up but even when i was growing up

Smartphones weren't invented yet. The internet was hardly even invented yet. So like when I was a kid, when we were going out playing, like we didn't have phones. We didn't have, like if we forgot our phone number, like that was it. There's no way we're going to like reach anybody. Oh yeah, that's it. We used to have these ID bracelets or like necklaces that would have our name and phone number and address just in case, you know, like we passed out on the street. Yeah.

But like you were like, when you went outside, it's like such a weird idea now, right? To be like that disconnected. But like once we set foot outside our house, like we were on our own. - Yeah, your mom couldn't call you. - We're basically quote unquote in the wilderness. There's no way to reach us or know where we are, right?

But now it's like, I don't hate that. I don't hate that either. Yeah, I don't hate that. But that goes back to like this idea of like, you know, like maybe we haven't caught up to how fast society has developed yet, you know, our bodies and our minds. And in a way, I think we are not, yes, you're right, and we are not adapted to it. And I think that's why one of the big, big, I think, areas of research in my field, but also in technology are what are the sequelae

of being so connected? The what? The sequelae. What are the consequences of being so connected? What's sequelae? Is that the word for consequence? Yeah. What are the consequences or the effects? Making me feel dumb here. Sorry. No, it's a clinical term that I kind of fall into. But yeah, what are the consequences of it? I mean, we do know there's been numerous studies that shows, for example, that social media use negatively affects anxiety in people.

Right. For sure. Right. The amount of that as social media use increases and social media engagement increases, that's correlated with higher levels of anxiety. Yeah. Right. Excuse me. For sure. And also higher levels of suicide. Right. You know, yeah, possibly. Possibly. I think suicide also is something that needs to be understood. Right.

There's not only one reason people feel suicidal. So I think suicidal is quite multifactorial, and it's something that we really, really need to spend a lot more time understanding and something we need to spend a lot more time destigmatizing. But definitely with anxiety, definitely with mood disorders, definitely with things like lack of sleep. These are all clear correlations.

And being non-sedentary, right? They say exercise is actually like, if you can capsulate all the benefits that you get from exercising, whether it's anti-aging effects, mind clarity. Metabolism. Metabolism, just like overall health, even down to the rebuilding of your cells. Cardiovascular fitness. If you can encapsulate all that into a pill, it would be the best-selling medicine.

Drug ever in human history. Yeah, right because it's like you can't replicate that. Yeah Yeah, and and I think for specifically for social media use and technology, you know, there are teams and teams of highly paid well-trained professional Professionals whose sole mission is to make sure that your eyes don't leave the screen Right, and there are people who have backgrounds such as mine in psychology. I

Right? Because it's profoundly psychological. We need to make sure that people don't put the phone down. We need to make sure, and I say this not only as a clinician, a psychologist, but also as a person who used to be in sales and marketing, we need to create in people a need for something that previously wasn't there. Right? A desire is not enough. You need to create a need. A desire does not motivate you to spend a thousand dollars on an iPhone.

A need does, you know, you need that. I need that in my life. I need that new iPhone. I need that thing. And not only do I need the iPhone, I need to be engaged in it. I need to be looking at the Instagram or the WeChat or the Weibo or the whatever, right? Fill in the blank social networking media platform that we're on.

Right. And it's because teams of people like myself know how to do that. We use variable reinforcement. It's the same thing. It's classic. It's the same reason why people are addicted to slot machines. You don't know. You pull the slot one time. It's random chance. You might win nothing. You might win a thousand dollars. Who knows? And the fact that you don't know.

makes it fun. Well, is that the reward feedback? The dopamine? The dopamine effect. The dopamine effect. Yeah. Because you don't know. And so it makes when you do win that, that burst. Yeah. And it becomes addictive, right? Like you need it. It becomes addictive. You do need it, but also it's addictive because you don't know when it's going to happen. If you knew what's going to happen every 20 pulls, right?

Or even every 100 polls, if you knew, it's boring. It's not fun anymore, even though you're still winning every 20th poll. Do you see what I mean? Yeah, I never thought about that. Yeah, it's addicting because it's variable. You might not. Am I going to? You know, it's that, right? And it's the same thing with social media. I don't know. You post however many WeChat moments a day or however many Facebook posts a week, some of them might get

five likes some of them might get 200 likes right what's the effect of those likes what's the effect of the comment what's the effect you know am I changing am I clicking and refreshing every time just to see such a rush right such a rush how many people are tagging me right how many people are right and I'm not even that so I'm not that engaged social media in social media but I feel it like I didn't even get an iPhone until I moved to China I didn't get a smartphone until I moved to China so that was seven years ago that was seven years ago

Wait, when did the first iPhone come out? Oh, my gosh. I mean, people were... I mean, I come from the Bay Area where there were like Palm... I mean, the place is full of early adopters, right? So, like, people were using Palm Pilots in like...

Blueberries. Blackberries. Blackberries. Palm blueberries. Palm Pilots. I mean, from the early 2000s, I think. Yeah, right? I guess. So you didn't have any of that. I didn't have any of that until 2013. So what were you using before the iPhone? Like a flip phone? Like a flip phone. The Nokia phone? Yeah. Razer? Motorola Razer? I had a Motorola Razer. I had like a bunch of Nokias. Okay. You know, maybe one of them had like a bigger-ish screen, but like nothing, not a smartphone.

Like I was literally texting people. And it was only moving to China that I got a smartphone because obviously you need like WeChat and all that. But that was the only time. And that was when I didn't get a Facebook account until I moved to China. Yeah, I don't use Facebook. I'm like you. I try to stay away from social media. Kids nowadays don't do Facebook anyway. Well, yeah, it's out, right? What do they use now? Snapchat? Is that a thing? I think it's like a lot of TikTok. Yeah, well, TikTok, but are like...

So everyone's just on TikTok now or like it's still Instagram, right? Snap is big. Instagram is still big, I think. Yeah. Yeah. I'm down with, cause I see a lot of kids and adolescents in my practice. And so I, I'm, you know, I don't, I'm not that engaged, but I, I'm adjacent to it. So, okay. So in your practice and in your experience over the years, what are, what are like kind of like the most common things you see?

Here in China, anxiety. Yeah. Okay. In the States, a lot more depression. And it's a very interesting, I think different people process distress in different ways. Over here in China, there's a lot more like anxious and anxiety presentation. Is anxiety a precursor to depression?

Or are they just completely two separate things? No, I think they're both, they're actually like two sides of the same coin. Yeah. And I think it's really telling if we're to take a pharmacological perspective just for a moment.

that the same first-line treatment sort of pharmacologically for both are the same ones. They're SSRIs or SNRIs, right? So the same drugs are used for both anxiety and depression? Typically, for first line. Okay. Yeah. So really, they're two different ways of responding to distress, right? And I think there's a variety of reasons why maybe a lot of folks in America respond with more depressive drugs

you know, kind of presentation and why a lot of folks here respond with a more anxious presentation. What's the difference though? You know, I think those two terms get jumped. Like for people who don't know, like myself, I think those two terms are almost like interchangeable in a way, even though I know they're not. No, you're right. No, you're right. But I think to the average person, they throw it around very loosely. Like it's like kind of the same thing. What are the real differences? Oh, you are asking a very good question. Oh,

I mean, I can tell you sort of like the clinical definition differences, but I think that that's a little boring, right? Because you know from personal experience about depression, right? Yeah. So what is the real difference? So depression typically withdraws a person, right? They'll feel something what's called a depressed mood, right?

And what that means is that it might cause them to have what we call anhedonia, to not find pleasure. It's like a loss of pleasure in what they previously found pleasurable. Is it like a numbness? Yeah. It's also sometimes described as a numbness. Also, it can look like withdrawing away from social relationships and engagement, whereas you typically would have, but then you stop.

It can look like difficulties with appetite or sleep, whether that's sleeping too much oftentimes or sometimes even sleeping too little. So depression can look like a withdrawing or a damping down of a person's functioning.

anxiety can look a little bit different in that it looks like somebody is engaged, but maybe too, but maybe feeling too overreactive, right? Like, um,

they're always worried or they're always nervous or they're always like responding a little bit too fast or too soon or, or what we call in, in, in Chinese school, right? With a little bit too much, right? It can also have a lot of physical anxiety, kind of a lot of physical correlations, like with gastrointestinal problems or like itchiness with headaches, um,

with tingling with muscle tension things like that so i so i get what you're saying that now that's clear when you said like kind of both sides of the same coin because it kind of feels like they're the same thing but their vectors are going in opposite directions one is like withdrawal removal of yourself yeah and one's like an overreaction kind of an over almost an over engagement maybe well the way but the way you um describe depression um

Sounded very mild compared to how I heard it described before. You know, like people have said depression is like just this, it's like hell. It's just this unrelenting kind of tormenting experience that they wouldn't wish on their worst, worst enemies. Like it's just like complete hell and hopelessness.

You know, because you were describing it more as like kind of the symptoms of it, like lack of sleep and things like that. What is like the psychological experience? Yeah, the actual emotional experience can be quite hellish. And I've been there, right? It can feel very dark. It can feel like I cannot for the life of me find any meaning, happiness, hope or joy in anything. Right.

And it's scary sometimes because you realize that, okay, I used to find that a lot and now I don't. And that's really scary because that can feel like what hope is there for me then, right? How can I ever feel differently, right? And there's no clear, sometimes, you know, there's no clear explanation. And that's really, really scary. And it can feel, and part of it is that you do feel hopeless, right?

So any sort of attempt, right, to sort of like from somebody like a friend or a relative to try to get you to see things differently, it just is useless. You know, it doesn't work. Yeah. Yeah. It can be very, very dark. And the word depressing has this, excuse me,

of kind of keeping and pulling and holding you down. And it can feel like that. Like there's a force that is either pulling or pushing you down, right? This weight that's on you that you just can't shake. You know, it's like having...

sometimes like sunglasses that are way, way, way too dark. And it just is coloring everything that is coming in. It's coloring everything. And no matter what you do, there's no way to take those sunglasses off. Like you just can't take it off. You can't see it any different. Literally the stimuli that's coming in is getting colored. Yeah, that sounds so terrible. It can be. I mean, there are obviously different grades, right? There are such things as being...

being like mildly depressed, right? In which it's like that, but less, you know, less, less so. Right. And then also such thing as being severely depressed. And, and it has an effect on motivation too. Like people who are depressed feel very unmotivated, right? They just can't get themselves to do anything. And, and, and a lot of times we connect suicide with severe depression, but you know, clinicians, we see that, that, that the most severely depressed people don't generally kill themselves because

it takes a lot of effort to actually kill yourself. It's not that easy to do. Right. So it takes planning. It takes effort. And so a lot of times people who are really, really depressed, they're too depressed to kill themselves. It takes effort and they don't just, they don't have the energy. They don't even have the motivation to kill themselves. Yeah. Yeah. I heard, I was watching this TED talk before and it was, I forget his name, but it was by the speaker who had, yeah,

you know, legitimately tried to kill himself. He tried to hang himself. But when, when he tried to do it, the, the noose that he made broke and he got like all these rope burns around his neck. But didn't die. He didn't die. And then here he is now giving a Ted talk about it. And he's like you, he was, he was talking about these very, these very personal experience in his life and,

And his whole message was trying to destigmatize depression and suicidal people. And the analogy that he made to it was like, you know, when 9-11 happened, right? Twin Towers. And then, you know, you saw people from like, you know, they were on the floor that was like full of flames burning. And there were people that were literally jumping off to their death. Yeah.

So he was equating it like that. He was saying like being depressed and deciding to have suicide, it's not an easy decision. Just like what you're saying is it's like being that person on that floor. Either you're going to die by the fire and that's excruciating. Or you're going to die by jumping. Or you're going to decide to jump and die. And there's no easy way out. And...

And he was talking about the stigma of people who commit suicide. And oftentimes in society, there's this stigma of, oh, this person was weak. This person is selfish for killing themselves. And he's like, well, you wouldn't call the people who jumped off of the building selfish. Selfish.

Right. Cause you could clearly see the rock and the hard place that they were stuck between. Exactly. Yeah. You know, and it's this idea. And when you put it like that, I'm like, damn. Okay. Like if it feels like that, like I just can't even imagine. You know, it's interesting cause I'm hearing that. I've not heard that, that Ted talk and, and, and hearing that now that really, really jives with my experience. Yeah. Right. Like I, I really like that analogy where you see the burning building behind you and you know, you're going to die.

And you see the ground because you're like 80 floors up. You know you're going to die. Either way, you know you're going to die. It's just that are you going to choose which one you're going to take? Because maybe one is just a little bit more tolerable. But both have the end result. And I think that for the person who is making a suicide attempt or seriously thinking about it, they see both as having the same result, the same intolerable result.

And looking back upon the times when I felt that way, I felt the same way. I felt like if I were to continue living, that would be intolerable.

Absolutely intolerable. Yeah, it really highlights how tormenting depression actually is where suicide becomes the answer, becomes the relief, right? Where suicide is, where hanging yourself is... Is somehow more tolerable. Yeah, is actually...

Yeah, it's better than still continuing to be depressed. Yeah, or continuing to live. And again, I want to emphasize that not all people who kill themselves are depressed. Not all people who kill themselves...

meet criteria for clinical depression, although many do. So I don't want to make it sound like... Yeah, you can't like them all. Everyone's... Yeah. And I think a lot more research needs to happen so that we understand why people or what are the multitude of reasons that might cause someone to feel like they should choose to die.

Well, like going back to what you said, it's the idea of hope, right? Yeah. And when you're in that, I can only imagine when you're in that position of

You just, you want, you're desperate for hope. Any sort of little bit of hope you can grasp onto, right? So in your experience, did you just get lucky where you had maybe supportive people around you where you happened to stumble upon hope? Because when you're in that such a dark place where suicide is a real option for you, like how, it's easy to say, oh, just find hope. But in that position, like how do you, how can you find hope? I got help.

So you went out and sought help?

And I think, you know, it's interesting because I think that many of us that grew up, we have particularly and narrowly defined ways of being successful or having a fulfilling or meaningful life. Yeah. Right? Like there's a certain, there's like this one path and one vision. There's a certain formula. Yeah. There's a certain formula. And when you realize that, man, I don't fit that formula or I might not, it might not happen that way. It can be really, really hard for us to process that. Yeah.

Other than going, shoot, I failed. Like I had one job and I failed. Yeah. Right. And that's obviously not the only perspective to take, but you can get so mired in that, that you can't see it any other way. And in my case, I was privileged enough to be able to access professional help to help me see the circumstances of my life differently. Right.

So it wasn't like changing. It wasn't like becoming an automatic Pollyanna. Do you remember that movie? You're probably too young to remember that movie. It's a Disney movie from about this girl that like saw everything positively. So it wasn't about like becoming a Pollyanna, but it was about getting a flexible mindset that as soon as something happened to me that I assumed to be bad, I could actually utilize this different skill, this flexible mindset to take a look at it differently.

And as I grew that muscle, right, I began to be better able to view the circumstances of my life with a certain degree of hope. Yeah. Well, when you sought help, did you have to – oh, did I unplug? No, just give it to me under the table. I'll plug – no, just under the table. I'll plug that back in. No, please. There we go. Now your headphones back on. I think I pulled it, yeah. No, but I was going to ask you like –

Like when you sought help, did someone have to convince you to seek help or were you able to just do that on your own? No, someone suggested it to me. Okay. But I took it. And then you just took it. But I think, and that's because a lot of times, but I was in a place where I actually took it.

And I think that's privilege to some extent, right? Like I was in a place where I could take it. I was in a place where I could access it. Like I was a college student at the time. So there was like a college student like health center. Like there aren't a lot of college campuses. In my particular case, I went to like an outside provider, but I had like an insurance plan that I could use and pay for it. You know, these are all like privileges, right?

And I had the time to get out there to their office and talk with them and do all of this. And these are all privileged kind of resources that I had access to. But yeah, someone suggested it to me. And I said, you know what? It can't hurt. I'm going to try it. I need someone. And at that point, it was like, I need somebody whose job it is to understand me. Yeah.

Whose job it is, I mean, I don't know that I necessarily thought about it in terms of whose job it was, but it was more like this person understood me and I could say things to this person that I've never said out loud before about how I felt because I was too embarrassed about what I was afraid of, right? And it's their job to listen. And also it's protected. It's confidential. It's legally mandated to be confidential. So...

He or she and I could like, I could say something and put something out there and we could really look at it and say, okay, that's what you're thinking. Does it make sense? Why do you think that way? Where's that from? You know, are there any other options? Right. And we could really go through this process that I was too afraid to go through myself that I felt like nobody else could help me go through because I didn't want to admit that that's how I felt or thought to anybody else around me. Yeah. My family, my friend, like I didn't want to admit that because it looked weak.

So it was like this idea of vulnerability. Yeah. But it was safe to be vulnerable because he or she was literally legally mandated to keep it a secret. Right? So I felt like, all right, I could do that. And this is professional. Like, I was paying them. You know what I mean? Like, it actually felt like this was a safe place that I could do that. But it was a privilege that I could have that. Yeah. How long did the whole process take? I mean, you know, the...

I mean, define process, right? In terms of like, once I started to see a clinician, I just kind of kept going, you know, different things came up.

And I saw a therapist off and on for 10 years before I got married. So it just became part of your lifestyle. Kind of became part of what I... Like going to the dentist or something. Like a resource, yeah. Like a resource that I would draw upon consistently. And that I maybe didn't draw upon every week, but I drew upon consistently.

And, um, and then continue to, even after like we got married, like I did, you know, totally continue to this day. I see a therapist, you know, a lot of, you know, now my, my, my, um,

My work obviously is as a psychologist, right? So there's a lot that I have to process through a lot of stuff that I hold from my typical day that I need help sort of sorting through once the day is over. And it's not always fair to put that on your spouse, right? Put that on your wife. And so I have a therapist that helps me through it. Well, when you go to a therapist, like you being you, like do you, are you like just like...

I'm George, just a normal person, kind of going to see a therapist.

Or is it inevitable that you're George, the chief of mental health persona, where you pretty much know everything your therapist knows, right? Yeah, but it's not about knowledge. It's not about knowledge. It's not. It's about the relationship. It's not necessarily that I or he or she knows more about technique. Okay. For me, it's not about the knowledge. For me, it's about the fact that there's a safe space for

That I can look, I can take a thought or feeling outside of myself and look at it and also gain the perspective of another person who is more objective. He or she is not a part of my life, right? But here's what I tell him or her about my life, right? And can look at this thing and help me examine it, right? Because if I were to do that myself, I would be too influenced by so many things, right?

You know, my own fears, my own worries. I can't get out of myself enough to do that. And this person helps me do that. And that helps my mental health because it helps me have a different opinion or perspective on that thing, you know, on that thing. And maybe it's not as hopeless as I thought. Maybe I have more strength or more agency or more power in my own life than I was led to believe. Mm-hmm.

maybe there's a source of hope here that I didn't see before. And that's powerful. Just that even possibility. That possibility. That maybe is powerful. That possibility can pull somebody back from the brink because they didn't want to be on that brink or on that precipice because they thought it was fun, right? They were there because they thought they were forced to and there was literally no other way. So just the possibility that there might be

is enough sometimes, a lot of times, to go another day, another week, another whatever, right? Month, right? And I don't want to make it so dark, but like, you know, I think that's really, really powerful. And that's something that we don't do enough of for each other a lot of times in quote unquote normal life because of stigma, right?

like how we socialize and how we communicate with each other yeah yeah because we don't want to seem weak yeah and we don't want to burden other people I guess more so with guys I think so would that be like when you're interacting with guys I think so like at the risk of sounding controversial and having all the women I know kind of come after you but like girls but girls like to talk they like to

They like to talk, right? Every girl I know loves to chat with her girlfriend. They can chat for hours and hours and hours about all their personal stuff. But it's not often that guys are more like bros. We're bros, you know what I mean? And you're not really going to open up with each other as much. Especially maybe a lot of... I don't know. It could be more of an Asian thing too as well. Maybe there's something there. But I think guys are just guys, right? Guys are always just more guarded and less...

wanting to be or threatened by vulnerability, right? I think that, I think you, I believe you hit the nail on the head there, threatened by vulnerability, right? That we are socialized to view the possibility of being vulnerable as threatening to our ego, right? And like a lot of times, like us sitting across the table right now, having, you know, talking to each other, I think is a rarity for guys. Girls do that all the time. They sit across the table.

from somebody, from their girlfriend or whatever, right? And they talk. Girls are podcasting all the time without knowing they're podcasting. Not even knowing. Guys, they're sitting like next to each other, you know, a lot of times, like doing something else, right? In a triangle shape, right? Where like you and I might be sitting next to each other, but we're doing, we're playing a video game or we're doing something like over there. Yeah. And then maybe talking

as we're doing it but like our attention but only with the attention on something else because it's a little uncomfortable like this right if it feels vulnerable and i think we're conditioned to feel threatened by that to some extent right and and and and i think that i think that we're a little bit lesser for um believing that messaging you know that that we're that that that we um

you know, that we suffer for it a little bit. Like research, psychological research shows us too, that as men and women age, they are different in their levels of socialization. So as men age, the amount and quality of social relationships usually declines. Whereas as women age, it usually decreases.

Right. And so that's very, very interesting to now, obviously, statistically, men die earlier than women as well, right, just physically speaking, but, but men typically decline in the number and the quality of relationships as we age.

That's true. Like almost every, including my father and all the elder people I know, like they just don't have a lot of friends anymore. Yeah. You have their wife maybe, right? If they're still married or whatever. And maybe like a couple other people, like their family. Yeah. Like maybe, maybe like, but their buddies, their friends, but they're not like, yeah, they don't have a lot of people. Whereas a lot of times women are the opposite. Maybe they're still involved like in the community or in social, social circles, or they're still like,

You know, going out and having coffee or having tea. Yeah, for sure. Like my mom, she's like, she does like, she does like these salsa dances. Sure. Like she's out there. She's getting out there. Yeah. She's a part of all these like WeChat groups and everything. Like, yeah. And does it have some effect on life expectancy? I don't know. You know, but maybe. Maybe.

Definitely, maybe it has some effect on subjective satisfaction and quality of life, for sure. Yeah, well, social connection is the biggest factor, influencer of happiness, right? Yeah, absolutely. Subjective happiness and subjective satisfaction. Absolutely. And we as men are not socialized to invest in relationships. We are socialized to invest in our own power, right?

Our own ego, our own sense of accomplishment and skills, which is not a bad thing. They're great. I'm pro skill sets and pro advancing ones. But we're not necessarily socialized all that much in the relational sphere. And I think we suffer for it.

Yeah. Well, what do you see now? Because I feel, I don't know how accurate this is, but I feel in Western cultures and in America and Europe...

There is recently more of a willingness and open discussion and more dialogue going on around mental health. You know, you see it everywhere. You see it in schools. You see it when you turn on ESPN and they're talking about like athletes going through like mental issues, mental health issues and stuff like that. So there seems to be more of an awareness of mental

in like putting in place like a mental health uh resources for people yeah at all levels yeah um whether it's in government or in education or wherever right agreed um

Is there anything like that going on here in China where there is more of an awareness of mental health? There is a more of awareness of implementing mental health resources for people, young and old. I would say so. Yeah. Yes. I don't know that it's nearly as, you know, we're at a different stage of development in terms of this field here in China, for sure. But there are, especially post-COVID.

I think COVID has also, you know, obviously it's brought to light many things, but one of the things that's brought to light is mental health and the amount of the amount that people struggle with mental health. Right. And how important it is to make sure that mental health resources are available and accessible. So conversations around online platforms, right. Distance platforms, stigma, you know, is it right that for much of mental health here, we still have,

require people to show up at a hospital or a clinic before they can get really good quality mental health treatment, right? Or how quality is that mental health treatment is another question, right? But here in China, there have been actually a lot of online platforms that have been operating for quite a few years and that really exploded post-COVID.

What people don't also know is that here in Shanghai, but also in Beijing and some of the other cities, that there are hotlines that people can call that operate both in English and Chinese, right? Run by Chinese institutions and also international NGOs, right? Here in Shanghai, there's Lifeline, right? Not just here in Shanghai. Lifeline operates using a toll-free 400-400 number, you know, in all of China, but they're based here in Shanghai, right?

And they're English only, but there are a whole host of Chinese language resources too that run 24 hours a day. Yeah, that's what I wanted to ask you because when it comes to mental health, because I know people like you and there are other real Westerners that come in that are part of this. So I wanted to ask you, is the mental health discussion, quote unquote discussion being had here and movement and help here

Is it predominantly more populated by people from international Western backgrounds like yourself or are the locals and local resources and local doctors more

Are they the ones just as much or even more a part of that as well? Yes, they're a part of it. Absolutely. Absolutely. They're the main conversation, right? Because us operating here in the international sphere, even people like you and I who kind of can operate kind of with one foot in each area,

in each domain, you know, we are only just the tip of the iceberg in terms of the actual kind of populace here, right? And so in the Chinese community, definitely the conversations are happening. Unfortunately, I think that in the Chinese community, there still is kind of an old way of thinking about this that is profoundly psychiatric, like thinking about mental health in terms of mental illness, right?

Which is a great topic, which we should discuss because we want to bring down the levels of mental illness. But I think that we need to have the discussion way before things get to the mental illness kind of stage. So when you say mental illness, is that like bipolar, schizophrenia? Is that what it is? No mental illness in terms of like depression, anxiety, but also including bipolar, schizophrenia, depression.

Anything, post-traumatic stress, acute stress, adjustment problems, you know, all sorts of things, right? But I think we want to talk about what supports mental health, what supports good adjustment, mental adjustment, before it gets to the clinical phase, right? Before somebody needs to see a doctor. Yeah, yeah. I think we want to back way up.

We want to have these conversations about how can we support good mental health among students. So it's more about prevention. Yes. Or early intervention, right? Early, before it gets to like the clinical level, right? So what does it mean to support good mental health in a school for students? What does it mean to support good mental health in a company for the staff and employees? What does it mean to promote a good mental health in families? Right?

right? In churches, in wherever people go to gather, right? How can we promote good mental health in these places and start the work there before people get to a place that they feel like they have to go to a hospital? You know, they feel like they have to present to a clinical encounter, right? Because that's going to have much more stigma attached to it. Yeah. And then also at that point, I would have to imagine there's

only so much you guys can do. I mean, you can do a lot of things, but at that point it's, it's really treating an illness. Yeah. And now we have a resource question too. We have access questions. We have all of these things, right? So I'm really passionate in my work about pushing mental health, quote unquote intervention way earlier and pushing it out into the community. Right. I think that's really where we have to start because,

And we really have to honor and recognize the fact that people are connected to their communities, right? So the more that we can promote and utilize existing community structures, the better that it will be for our mental health as a whole, as a society.

So I do a lot of school-based work. I work with a lot of school-based people. My wife is a school-based mental health person herself. I work with companies. I want to be able to address these things and to promote healthy ways of living from the mental health perspective, healthy ways of living generally. Well, that's a beautiful purpose to have in your life and a mission, man. I mean, yeah. Like I really appreciate what you do.

I mean, I think mental health is something that we kind of always mention on the show. Yeah. But we never really got to sit down with someone like you to really kind of

talk about it um i've talked to other psychologists and we've talked about anxiety as well yeah yeah i don't know if you know david armistegger oh yeah yeah i had him on as a guest and that was a fascinating discussion as well um but today with you it was very different um but before we wrap it up um i do want to ask you because you mentioned uh you know about the quality of care you're getting as well because that's obviously a very important factor when you're seeking help

Is that something that has to do with what you're doing with the Shanghai International Mental Health Association? Yeah, it does. So what's the mission with that? So the mission is actually multifold. One of the things that we have, we call it SIMHA, Shanghai International Mental Health Association, SIMHA. One of our missions is to really help the community understand what they're looking for and what they're getting when they access a mental health clinician. Mental health is...

a part of healthcare that here in China, at least, is not regulated very consistently or very well. I think that here in China, when you access, you know, when you try to access an endocrinologist or a gynecologist or a dermatologist or one of these other specialties, right, you can go and as long as you go to a hospital that is pretty,

you know, reputable, you can sort of trust that the person you're seeing, whether it's a dermatologist or a gastroenterologist, like that they've had a certain amount of training and they more or less generally know what they're doing. Right. They probably went to an accredited institution and got licensed via the, the formal kind of way. Right. And so you can have a certain level of trust in, in this person. Right. Um,

Mental health sometimes is a lot more mysterious, particularly in the international space, where you have people that are coming from all around the world. They're coming here and they're calling themselves whatever they're calling themselves, counselors, psychotherapists, psychologists, psychiatrists. And maybe me as a general person from the community, I don't even know what the difference is between these terms.

Well, are there a lot of bad players as well? You know, there are some. Yeah. Right? I mean, and I won't say bad players necessarily. I think that the terms mean different things in different places. Like, for example, the word psychologist, right? Coming from where you and I come from, that term is regulated. You can't call yourself a psychologist unless you have a doctoral level degree.

In a psychological field, right? That's the only way that you can use the word psychologist. There are some exceptions, right? School psychologist is a little bit of an exception, but basically you can't call yourself a psychologist unless you have a doctoral degree and you can't call yourself a clinical psychologist unless you've been licensed by one of the 50 states, right?

Because you can have a degree but be not licensed. Because to be licensed, you have to go through all this training. You have to take tests. You have to do all this stuff. Oh, it's like being a lawyer. Yeah, exactly. It's like graduating with a law degree versus being a member of the bar, for example, right? So except that for us, like for me, I'm licensed in California and Hawaii. And in California, we have to go through 3,000 hours of supervised clinical training and pass two tests.

in order to be licensed. It's a lot. $3,000. It's a lot. And one of those tests we have to, you know, pass with like skills that we, we have to pass with the 70, 70th percentile or larger or higher. And the other one we have to pass at 90th percentile or higher. So it is quite, it's a high bar in California. So anyway, so that the term is regulated, but it's not regulated everywhere else. Like for example, somebody can call themselves a psychologist, but be from the UK that has a very different definition of,

or be from Romania or Italy or Brazil or Cuba, right?

And so now we all end up here in Shanghai and the consumer wanting to find a resource goes and it's like, oh, this is a psychologist. What does that even mean? Right? So part of Simha's mission is to deconstruct that for the consumer. And what we also do is we verify, we attempt to verify where possible the credentials of our members. So if you find a person who is a Simha member,

then you know that there has been another set of eyes on this person's credential, right? They're not just coming from wherever they're coming from and saying, hey, I'm a

They've been audited. They've been kind of, there's at least another set of eyes, right? Now we are not like a legal entity. We don't take responsibility for a license or anything like that. But what we do is we try to verify that license and try to make sure that this person who says they're an X from wherever they're from actually is an X from whatever they're fact checking. Yeah. Yeah. So we can, you can be reasonably assured that at least another set of eyes has tried to do that for the person that you are, um,

that you're trying to access. Well, I think that's great. Yeah. I never, like once you say that, it's like, yeah, of course there should be something like that, right? There should be some sort of, like you say, another set of eyes, some sort of standardized bar where you're like, sure you're held to. And we're not the standardized bar because everybody comes from their own country where there probably is a standardized bar. Sometimes, sometimes not right. It can be very variable and I think surprisingly variable for some people and

But at least you know that somebody else has taken a look at it too. And also what we're trying to do is we're trying to come out with something on our website that defines all of these different terms for the general consumer and defines like these terms in context of where that person is from. So the word psychologist, for example, you can take a look at what psychologist means in the US versus what it means in the UK versus what it means somewhere else.

Wow. Yeah, that's really great. It kind of demystifies it a little bit, clears everything up. Yeah. And yeah, wow. I think that's... It's kind of like...

I equate it to like being verified on Twitter or being verified on Twitter, right? A little bit. Because like. A little bit, yeah. Like your verified official account, right? Like the blue check. Yeah. If this is Kevin Hart's like page, like you know it's actually Kevin Hart's page. Yeah. And not just other person pretending to be Kevin Hart, right? Exactly. Kind of like that. Exactly. Wow, that's great, man. Yeah. That's great. How long have you guys been doing that? So we've been doing that over 10 years now. Wow. Yeah. Wow.

That's great, man. Yeah. Yeah. So we're really proud of what we're doing and, and, and we, we hope to keep, keep improving the service that we do for the community. Well, George, thank you for your time being here. Thank you, Justin. This was a wonderful conversation. I really enjoyed it. Absolutely. Thank you. And, uh,

let's do this again sometime. Yeah, let's do it. Yeah. I'm serious. This was a great conversation. There's so much more we can talk about. There's a lot more. Right. There's because this is, this is the, the, the great and non great thing about this whole mental health issue is that it's never ending. You know what I mean? And there's, it's an ongoing mission. There's, there's the work is never done and it's going to constantly evolve. And as the way I think things are playing out here, especially post COVID, like you pointed out,

there's more of a need for it now more than ever. Yeah, absolutely. And I think an interesting thing that might be tangentially related, but not really, I think is like you and I's experience as ABCs, not only growing up in different parts of the U.S.,

But also the complicated relationship with our ABC identity as we come back to the country of our sort of like cultural heritage. Oh, my God. We need to have another podcast on this. We need to have another podcast. Can you come back and talk about this at a future date? Because that is something I've always thought because, I mean, I'm just going to mention it really quick and we can save it for next time to be continued, right? Yeah.

I've been going through that personally. Oh, yeah. Like the way, like my identity, my feeling of identity, my feeling of where my home is, like quote unquote home, my national identity,

allegiance and just views and perspectives is all twisted up right now. Totally. It's completely changed. Totally. Where now, whenever before, obviously before COVID, when I went back, because I've been in China for so long, when I went back to the United States where I grew up, I felt like a complete foreigner. Oh, I know. And a lot of that might just be in my own head, you know, the way I'm, you know, kind of interacting. Yeah, yeah, yeah.

But I couldn't shake it, this feeling of like, I just felt everywhere I went, like I'm just foreign. - Alien. - Yeah, I just felt like I was such a foreigner. And that in some way I didn't belong, you know? And I don't know what that is. I don't know what that is. I still haven't figured it out, but it's a very, it's an isolating feeling and it's confusing.

You know, it's really interesting because I think there's a growing body of research focused on what we call TCKs, right? Third Culture Kids. So Third Culture Kids are people who grew up in a culture that's not their own. Like, for example, a lot of like dip kids, diplomatic kids, right? They're American, but they grew up all over, going to international schools in like Italy or in Russia or in China or wherever, right? And so they grew up like...

American?

but not necessarily connected to that identity. Right. And so they grow up in a, in a, with an identity that is not connected to their passport, nor is it connected to like the place that where they're at geographically, like China, like their actual daily experience. Yeah. And it's like something else. It's this third culture. Right. But I think that what you and I are talking about are, is it like a very particular type of third culture where we grew up from an immigrant kind of like place in the U S and,

And now we're migrating, we've migrated back, right, to sort of this, our sort of country of our own cultural heritage. But we didn't grow up here. We were born here. And we didn't necessarily grow up mired in the culture and the history here.

And it's a very particular type of third culture, I think, that's really fascinating to talk about. Yeah, it is. And yeah, I don't think, I mean, is there a lot of research about this? On third culture generally, but not on what we're talking about. Really? Yeah. And I think that'd be really interesting to explore. That is fascinating. Yeah. I started to write about it a little bit recently. I haven't published anything, but just on my experience, you're right. And what you talk about, this very complicated relationship with my opinions about culture

China and America, right? You know, having had one foot now in both for a while and growing up with an identity that I was forced to have, like growing up in America, I don't know about you, but for me, I was forced to take on a hyphenated identity because I wasn't always viewed as just American enough.

Yeah, I had a similar experience where I grew up in a place where, well, in a community where there really wasn't too many Asian kids. And especially within my circle of friends and at my school, I was literally like one of the only Asian kids. So I grew up with all non-Asians. Wow. Yeah. So I was the only ones, which at the time I never thought about. Like that was never a thing that I thought consciously at the time. But there was always this feeling of like,

I don't know, just weirdness. I almost felt like the token Asian kid, especially with confronting white girls. It was this extra sense of nervousness of male, Chinese, Asian male identity. Yeah, exactly. It was weird. And I never could put my finger on it until much later in my life. And then coming back here, and I still remember, and also feeling foreign. Yeah.

Yeah.

And part of the licensing exam was paper and pencil, which we did. And then part of it was an oral presentation in which I sat at a table like this in front of like six old men, right, who are grilling. And they gave me a little like kind of paragraph and they asked me to read the paragraph and kind of give my opinion about that clinical case. Right. They grilled me.

And then one of them was just like, hey, tell me about you. Why are you here? And I talked about my experience growing up as a Chinese American. But back then, I didn't have a command of Chinese enough where I was nuanced in describing myself. I said, growing up as a 中国人, I used the term 中国人. And the guy stopped me. He was like, you're not a 中国人. That must have stung a little bit. And I was like, what do you mean? I was confused. I'm not a...

So I don't know what you're talking about. Right. And he was like, no, you're a Huaren, but you are not a Chinese. You're an American. Hmm.

And I was like, oh, the conversations we could have about this, but I'm going to leave it alone, right? Because I know where you're going with it. But I was like, oh, that's an identity question that is complicated. That is really complicated. But what he was saying was, you are not under the administrative jurisdiction of Zhongguo. Yeah, what he was talking about legally. Like legally, but it just opened up this like... Well, that's such a good point because like growing up,

Well, us growing up in the States, like when we say like we're Chinese, we almost meant it like ethnically. Like we mean Chinese American ethnically or Chinese American. Yeah. When I say like, oh, I'm like when people ask me, like, oh, I'm Chinese. Like, obviously, I'm American. And we say Zhongguoren. We don't say Hua Ren. Yeah. Right. We say Zhongguoren. Yeah. Because I'm like a Chinese. And it was more like an ethnic thing. Like I'm Chinese. I'm Chinese descent. Yeah. And that was like understood. But coming over here, it was not. It was like, you're not a Zhongguoren. Yeah. Like you're clearly foreign. Yeah.

Yeah. Right. And, and that was like, and, and it was this, this thing about like what means, right. Cause like I grew up, yeah. Using that term, like at least in Chinese, when I spoke Chinese, which was a long, you know, significant amount of time, but yeah, something to explore in a later, in a later conversation. We need to, we need to have you back on this again. Let's do it. But cheers. Cheers. Thank you, George. Thank you. Thank you for having me.

That was a great time. Do you have anything? Again, the whiskey is good. It is very good. But you've been, I guess, within character, you've been nursing that one glass. I'm trying to not be buzzed. Would you get drunk if you finished that glass? I don't think so. No? You've never been drunk before, so I would know. No, I haven't, but how would I know? And I had a glass of scotch over at Steven Yen's place before, even though it was 11.30pm.

And I said, it's 1130. But that's how he rolls. Yeah. He was like, I'll do it. If I was like, okay, I'll have some. Shout out to the Shades of Yellow podcast. I was just talking to Steven when you mentioned that you were there before and we were laughing over text messages. Yeah. Yeah. He's like, I'm like, you beat me to the punch, Steven.

Anyway, thank you. Do you have anything? Are you working on anything like any books or do you have any talk engagements coming up? Yeah, I have a lot of talk engagements coming up. Like one in particular is coming up in November, which is the Shanghai International Mental Health Association Training Day. And this year we're doing it a little bit different and we're partnering with TEC, which is the Expatriate Center. So the Expatriate Center and Simha are partnering to put on a mental health awareness event.

featuring speakers from all different kinds of mental health disciplines and also a panel discussion. And the theme is going to be finding hope in a changing world. And I think that this is something that we're going to, it's a big topic now after COVID, obviously, but also, you know, because our world is changing, you know, in so many ways, right? And it can be quite tumultuous for many people. And so, yeah.

We want to help people find, get connected to hope and resilience. Well, I think that also very well sums up a lot of the things we talked about today. Yeah. Yeah, definitely. When is that? So that's Saturday, November 14th. November 14th. Is it open to the public? It is. Okay, great. For free. All right.

All right. Anything else? No. Well, yeah, I'm actually working on, I'm actually, all my guests to start writing books. Yeah. I'm actually co-authoring a, or I'm authoring a chapter in an upcoming publication on international mental health. Okay. And so I'm going to be, I'm in sort of like the outline and design phase of a chapter focused on psychopathology and the presentation of symptoms and disorders in different cultural contexts. So more to come for that. Yeah.

Once again, for the third time, George, thank you for being on the show. Thank you, Justin. All right, guys. I'm Justin. That was George. We love you guys. Peace. Be well. Take care.