Marcus Shumate: Cultures & Beliefs in Mental Healthcare

In today's episode, Tripp sits down with Green Hill Recovery's Clinical Outreach Director, Marcus Shumate, about philosophy, the culture of organizations, the status of clinical mental healthcare, and ways to reverse-engineer Eudaimonia, the condition of human flourishing.

Marcus Shumate, LCMHC, LCAS, is a North Carolina native and grew up in the Eastern part of the state. He has functioned in various clinical roles and provided individual therapy, family counseling, group counseling, and supervised staff professional development. Through that process, he has developed a passion for linking systems of care to provide the best care. In addition, he has deep-rooted interests in human flourishing that began in his undergraduate experience when he was first introduced to different texts from classical philosophy.

Find us on the web:

• Advaita Integrated Medicine
• Green Hill Recovery

Transcript

Marcus, welcome to the business of human flourishing podcast. I'm excited to have you. Yeah, it's good to be here. Well, we, it's nice. We started our relationship, you know, with talking about the Making Sense podcast from Sam Harris. So it only makes sense that we now have a podcast. That was that was painful. Yeah. All right.

So I think it's super interesting to have you on, you know, the whole purpose of the business of human flourishing podcast is really to, you know, investigate the intersection of business and making people's lives better. And this word, Eudaimonia, comes to mind. And even though I have not read all of the Nicomachian ethics, I can say that you introduced me to this. And I think, I think maybe that's a good jumping-off point, just talking about, you know, your interest, maybe in philosophy and how that intersects with what you've done as a therapist. And now what you do as a business development professional. So I know I went through your bio on the lead end, but could you just give us kind of a rundown on all it is Marcus Shumate? Or isn't it? Yeah, once we get into the no-self stuff?

Yeah, exactly. Yeah, so I've done, I started my career off, working in inpatient psych, and then transitioned into the private pay world to help where I worked at a residential treatment program that worked with CO occurring disorders, substance use, and mental health. And so I spent the first eight years of my career doing that working with a variety of clients and patients, some adult, some young adult, in the course of that ended up helping design and build a program for young men. And I was partially driven into the therapeutic space, because I was an undergrad kind of going through my own, kind of like a deconversion experience, I went to undergrad, fairly religious and dedicated to my faith, and then kind of sort of fading away from that, and questioning that and put me in the course of that, I think I became a way more open sort of curious person. And that started to pull the strings of that. And so that ultimately led me into philosophy. And was looking at what to do professionally, I really thought maybe I'd go pursue some sort of Ph.D. work and philosophy and then realize that I wasn't really cut out to be an adjunct professor at working for barely minimum wage for the rest of my life as a doctor in philosophy. So I decided to try to look around and figure some other stuff out and still stayed a philosophy major loved it, fell in love with that as a pursuit, and then ended up in sort of looking at therapy in the process of being a clinician is kind of applied philosophy. And that appealed to me quite a bit, actually. So that's the path that I took.

So this word eudaimonia yeah. Just roughly translates to as human flourishing. But yeah, like, tell me a little bit about how I mean, I guess, like the intersection of philosophy and clinical work, what? Is there anything there? I mean, what's the what's kind of your, you know, going from philosophy, I think you probably had some other good reasons to be motivated to be to become a therapist. But I agree that like, I think one of the things you and I both like applied theory, yeah. And so it's one thing to understand or say you understand it, but if you can't apply it, then what's the point? Yeah, what's the point? Yeah.

Yeah, exactly. I mean, if you can't apply it, it's it's nothing. I mean, it means pretty much yeah.

So you didn't want to spend your whole life doing the trolley car?

Yeah, exactly. I'm what a good trolley car question. So Eudaimonia that was actually, probably the Nicomachean ethics is a collection of sort of, allegedly, you know, sort of speeches and lectures that Aristotle gave to sort of the aristocracy and the kid like the the children of wealthy Greek citizens, and he was really, really sort of interested in. In most of the classical philosophers, were sort of interested in the question of like, what is it to be a good human being like, everything revolved around that, and ultimately, because it's sort of applied, right, like, right, what's the point of being able to talk eloquently or think about sort of deep concepts if it doesn't graph on to reality at all, and some one of the reasons Aristotle really, really appealed to me was it's all about sort of what is the best type of human life to live. And so he captured a lot of Greek ideals with the word eudaimonia. We don't really have that. Also, I'm sort of an idiot with this. Like, if there's any sort of Greek scholar out there that listen and say Might be pulling the hair out. But I was always sort of under the impression and that we don't have a good English translation for what it is. And so we just sort of went with the word happiness. But in sort of the Greek culture, the idea of eudaimonia was something more akin to human flourishing.

Yeah. Living like with a really purposeful, like, it's not Yeah, it's not like the kind of it's not just happiness, it's not hedonism, right? It's not like, Oh, I feel good in the moment. It's, it's part of being, you know, kind of uncon you know, thyself, and then also just being a part and feeling like your life is meaningful. Right, right. And then what you do has purpose and that kind of, like deep-rooted happiness, not not fleeting happiness, is that

yeah. So I mean, the metaphor that Aristotle used in that book was in those speeches was sort of this idea of, well, how do we know what's good for an acorn? Well, whatever leads it to be its most developed form, which would have been an oak tree or something, right? So we can reasonably deduct what's good for an acorn, simply by looking at what allows it to become its best, most flourished version, in where he differed from a lot of Greek philosophers was he just sort of cut through all events? And listen, we kind of know what a good human being is, we've all seen that. How do we reverse engineer it? And so that was really, really, really interesting to me. And I took that into my clinical work with you guys. You know, it's never one of the things that always sort of it, I guess, sort of, I found interesting was, you'd be working with a guy or a person, and they'd want to sort of muck around and their past and their history and the trauma and all this stuff. And then you start looking around and you realize, wait a second, this guy sleeping two hours a night, they have drank a thimble of water today, they haven't seen the sun in four days, and they've never eaten a vegetable or,

yeah, we can talk about all of your underlying issues, but like, how about you do the things that we know are gonna make you feel better at first? Yeah, we can talk about that shit, right? Yeah, yeah, let's get to it. I have to say like, I want to say that, thank goodness, I am not a therapist, or really a mental health professional. But Mark is, it's fun to have you because we're gonna get a pretty irreverent take on some of the issues that we don't mean to make light of, but at the same time, like we just went through, like, if you're not, if you don't have a decent diet, if you're not drinking water, if you're not sleeping, you're probably going to have a shitty life. Yeah. And so like, Yeah, but yeah, anyway, yeah, sidetrack you there.

No, no, I mean, I this. Arguably, I mean, some clients, if you found some way to interview former clients, who may say that I was a shit therapist, because I kept asking how much water they were drinking, or if they were sleeping eight hours a night, but it's really First things first, right? Like, if you're not taking care of this meat sack that our consciousness is attached to or emanating from, then no wonder that you're sort of your your basement for suffering is is your dwelling in it, right? Like, I mean, there's Yeah. So if you're not taking care of this sort of thing, it's going to be very difficult to get happy and no amount of insight, no amount of sort of digging around. And in this past that you think exist, or whatever is going to actually lead to any sort of well being. If you don't drink water, you're going to have a headache, and there's no amount of therapy that's going to make make that go away. Yeah, no,

was it we talked a little bit about I think we said this, I can't remember if this was an hour, just chatting before. But you know, so you started working at Green Hill, after I met you, we connected around kind of podcast philosophy. In general, I think that's what you know, one of the things in this, this idea of eudaimonia or human flourishing was something that I think we've seen in the kind of treatment world Yeah, was was tough. We work in a field where the, the outcomes measures aren't really that sophisticated, or even necessarily that useful. And it can be frustrating to a lot of us. Right. And, and I think, you know, working in substance use disorder, you know, one of the things people always talk about is how much time you know, someone has maintained sobriety or abstinence, but that doesn't necessarily get to, you know, living a purposeful life, and that's where, and for for a lot of us, you know, that may mean being abstinent, but that is that may be necessary, but not sufficient. And so what we, I think, like, what we always connected on was, we've got to do better for people. Like it's not just about one simple metric. It's about this, you know, and it is it's tough to conceptualize what is flourishing, but it's also not right, like yeah, like, do you you know, it is and as much as we don't like subjectivity, it is sometimes just like, do you feel pretty good Can I make you feel good about who you are? Right? Yeah. And like that's got to be the gut, like, we got to feel good about who we are. And so we really connected around kind of the shortfalls of the our current treatment methodology and everything else. And I spent the next, you know, two years since, after we met, trying to figure out how we would work together so that we could just, you know, record shitty podcasts. Yeah, and I and you could make fun of me for doing yoga like, make fun of you for your, you know, wrestling and tickle fights Tickle, tickle fights that you call Brazilian Brazilian jujitsu. Yeah. But so like, we always saw these kinds of shortcomings. And I'll be honest, like one of, you know, we always really connected around not just like, what we were, we were doing for kind of our shared patients or clients, but also, just like, I think you and I each have this interest in culture, you know, yeah. And without, and certainly like, you know, you've always worked at Great, great organizations. But maybe you could speak to a little bit because we talked about flourishing. And if we're working in healthcare, and we, if we really want our patients or clients to flourish, I think it's super important to focus on providers and how they're doing and so I don't know if you have anything on that, and, you know, kind of your your transition from being a a frontline therapist provider running a young men's program to now doing business development, like how, how did that happen? Why did that happen? Sure. Yeah.

So those are, I guess, a couple of different thoughts on that. But um, yeah, so I'll start off with culture, a site. And we can get into the weeds on this. God knows we have your it'll be endlessly entertaining for you and me, probably no one else. But the is, you've referenced earlier, sort of, like our appreciation of the Sam Harris podcast, and that was something we sort of connected on. And that started using his meditation app and sort of following different meditation teachers and thinkers that he had on on that, and something that really, really quickly resonated with me was this notion that there's not some sort of stable self, right, and there's no, whatever Marcus is right now sitting down is this ever-changing set of experiences that are happening internally, and there's sort of a rising and falling for reasons that aren't entirely clear, but it's never stable? Right, like, so even my memories shift as I try to pull them up and recall them? And it's and so,

so you think you recall memories? Or do memories appear? Yeah, exactly. That's, I'll get there. I'll get there to relax Yoda. But I mean, the Yeah, I

mean, that's even that's like a great point. Right. Think about even that, right? Like, are the language that I just appeal to, to try to illustrate this point? Is,

is it problematic? We don't have I mean, we don't have the language to accurate I mean, languages, you know, merely pointers. Sure. Yeah.

And so is I think about that I think about most healthcare delivery systems are sort of predicated on burnout, like it's a running joke, right? Your clinicians are always going to be underpaid. And they're always going to be you know, that's the running sort of joke is clinicians are underpaid, and their work overworked and they're burned out emotionally. So you think about this, like if the job of a will just take the sort of psychotherapy, yeah, we just we can focus there and not pull in other disciplines. But like, let's just take the process of being a therapist, right, like, psychotherapist is your job is we no one's ever really defined exactly what that is. But the best that is sort of the most common thing seems to be to be present undistracted available, with, you know, unconditional, unconditional sort of regard. And yet, we are constantly therapists are sort of constantly fatigued and burned out. So how are they supposed to be present and available for a client? And if if the whole outcomes are based on on that, right, like this sort of attachment to the clinician, or the attachment to the perception of their relationship with a therapist and the therapist is burned out and fatigue? Are we going to be really skeptical that there's going to be any sort of modality that overcomes that. And so this may be this goes back to what I was kind of joking about earlier. If a client's not well fed, well watered all that sort of stuff like hydrated, then any amount of therapy is not going to matter. And well, what if your therapist isn't, and the whole outcome is based on their attachment to a client and the client's attachment to them and That therapist is taking care of one, when God's name would we think that they're going to get decent outcomes?

So we jumped into some of the more kind of patient client facing stuff. But my original question, which I would remind you was about, it was about culture. And and no, so I just, I want to get back there. But I want to talk about like what, you know, I guess one of my questions, that would be one of the things we always talked about was before, you know, coming to green hell, you know, there was a perception that there was a pretty good culture. But I honestly, I mean, I've always been a part of the Greenhill culture, I don't, I don't know what it feels like not to be. This is the normal for measure. Yeah, I don't know where it's good, where it needs improvement. But talk some about like different experiences you've had in healthcare and how we actually, I mean, I think there's a really good story, very appropriate story, somewhat inappropriate, about your first day showing up a greenhouse. So

I'll tie this back into the culture piece. The reason I think culture is important is if we don't have this, if we're this ever changing set of experiences, you put someone in a culture that's healthy and vibrant and challenging and sort of edifying in some sort of way, because all the parts of that culture are healthy and edifying, then you're probably probably going to get better client outcomes. So absolutely. You're, you're sort of making an allusion, I've talked about this my first day at a on site at Green Hill, I show up and

we just had our worst sexual harassment type issue. We had just, we were actively dealing with it. Yeah,

it was, like, literally, I pulled up. And this is great, right? Like I quit my I quit this job that was relatively cushy and safe, and I could have been safe in and my first day, I'm jumping into this new discipline of business development and outreach. And I have this, you know, quote, unquote, product that I'm supposed to represent. And within the first hour, there seems like there's a seminal crisis event. And I'm, you have this rush of anxiety. And what was absolutely remarkable about me about it to be was, I didn't think about it the rest of the day. Yeah. Because the culture, addressed it and took care of it appropriately and made sure that everything was sort of rectified and managed and handled. And it was done in a way that was so reflective, that it was ingrained in the culture, it was really interesting to me is like, to your point that you've always been a part of it, so you didn't even notice it. And by the end of the day, I'm, you know, like, I'm thinking, This is my job to have to sort of manage and understand this and deal with the fallout of this. And then neither one of us had thought about it the rest of the day, because the culture took care of it. into into me, I mean, that sort of illustrates my point that I was making the culture is probably the most, it's tough to establish what it is, is probably stuff tough to study, but culture is probably the most important factor and undetermined factor in healthcare outcomes. Yeah.

And that's something we're certainly interested in looking into. Because I think there's a probably a really high correlation between kind of job satisfaction over the long run, and patient outcomes, ultimately, and that's something we're, we're hoping to run some kind of, you know, do some analytics around. Yeah. Yeah. So we have a decent culture. Yeah, I think it's pretty good culture. That's good.

Yeah. I mean, I have to say that now, I'm, quite literally,

you don't actually have to? That's the thing. I mean, we're a little unfiltered here. Yeah. I mean, well talk some about what I mean, we, like I don't want to be too leading with some of these questions. But, you know, like, tell me, what's the difference between kind of our what's a new kind of newer organization culture versus maybe a more stagnant? Yeah. And and why would you leave? Because you did you were, you had built a young men's program, you were kind of the face of that, for the organization. And you were, you know, you were interested in in leaving to start a role in business development? You know, was that a personal burnout thing? Was that about like the, you know, the culture or the mission? You know, tell it tell us a little bit about that?

Yeah. It's a really interesting question. So how about I'll start off with like, old culture versus new culture. So when systems I think when healthcare systems become older, what ends up happening is you just have this it's almost like a hoarding of rules and constructs and constraints that sort of arise over the course of time. And I don't think it's like a fault or that there's mouth, like some bad actors or anything like that. I think it just, it just happens in the course of human systems that it builds up.

You build layers of bureaucracy, because the whole goal, you know, and in doing that is to prevent bad things from happening. Yeah, but if you focus entirely on risk minimization, yeah. I mean, you you That's all you do.

Yeah. And I, I'll tell a quick story that was really, really seminal. For me, I just want to, like one of the is like a throwaway comment from the person that would throw away story for the person that was telling it. And yet it impacted me drastically. There was this Clinical Director for a treatment program that had been around for years, right. And they started having bad relationships with their alumni and sort of the recovering community around them. And one of the things they did was, they did a institutional fourth step where they sort of came in, and they took their inventory, and they looked at where they were failing, and they had, all their benefactors come in and do this and, and what they kind of came away with was, we have all these arbitrary rules that have developed over the years, and all of them were in reaction to events. So something bad happens, we create a rule for it, something bad happens, we create a rule for it. And then it's a totally natural response. But over the course of time, those rules become disconnected from wire wherever they started. And so you have people enforcing these rules that have no ties to anything. And so they just become about the letter of the law versus the spirit of the law, and they become very constraining and suffocating. And so they ended up doing this really cool thing where the clinical director said all of the all of the power players in the organization down and he tore a piece of paper in half and had everybody write down only the most necessary rules they needed to function govern. And it really interesting exercise. And that became something to be honest, that kind of became a thorn in my side. And the same that really made it difficult to sort of abide in that kind of roles and sort of thing. Not that they don't have meaning or anything, but they become divorced from context. So I take all of that it's a coming into a new culture, something that's been really, really interesting is there's a tremendous amount of room for freedom and creativity to try to figure things out and to question sort of assumed constraints, because really, any of those constraints that we think we have, especially at Greenhill, I mean, it was coming up on for years. And those things aren't deep, no constraints are deeply rooted. So they're easy to sort of pluck out of the garden and toss away if it doesn't fit. So that that's been for me. It's been this. This like, enlivening thing. One of the issues I actually struggle with now is like getting sleep, because I sometimes wake up in the middle here, right, like, I'm legitimately excited about starting today. And that's a totally that's an inverse from other positions. I've been in where you felt the sort of suffocation of bureaucracy or a whole lot of rules. And, and again, I don't think there's no one there's nothing. Did I don't have a bad spot?

Yeah. Now,

I think it's just natural. And I think at some point in the course of our development here at Green Hill, we will have to sort of sit down and do our own fourth step sort of work. And

I always say this is just returning to first principles, thinking, yes. What are we trying to do? And exactly, I'm, I'm sure at some point as Greenhill and other companies grow, we'll have to do that. But I mean, I, I maybe it's because I'm spoiled on my child. I don't know. But I believe I should have what I want when I want. Yeah. And if I can't have what I want, when I want, I want to know what, yeah, and but I will say on one hand, that does keep me that keeps me and I think in turn to the organization often, like what outcome do we want to see? What do we actually want to see? And what's the shortest path there? Yeah, it's not all about fitting in. And we say like, we're, you know, we have accreditations we have to worry about we have to do things in the right way. But yeah, but I do think that that's kind of an interesting one. I have a question for you. Because I know you I think you'll be somewhat truthful with men. But so you and I cannot stand kind of the bullshit schpeel that people give, right? Like we don't want to hear especially like, in our field, everyone's trying to help people like this is table stakes. Right? I don't I don't I don't want to hear that. You got into this because you want to help people. I want you to assume that. Right? Right. I assume you became a therapist, a doctor, whatever, because you were interested in helping people. Right. But I, on the other hand, always talk about and I hate when people talk about ethics. Yeah. Not just the Aristotelian ethics. But, you know, like, if I were to tell you that, you know, as I have, we're a values based, mission driven organization. I mean, if I hear that from most people, I'm just not going to believe them. And I talk a lot about our values, and how they're super important and I believe that they are as much as words can be important, I think like having a coherent set of values that actually guide you. Are is incredibly important and really necessary to flourish. But help me reconcile that. Like, am I not? What's the difference between talking about values and ethics and like, really upholding that as an organization? Yeah, man, that's an interesting I don't know. I don't have a good answer. I'll let you noodle on it. Yeah. noodle on it noodle on it. I've heard that's a new one for me. I like oh, no, it's it's cute. Yeah, I'd say it's cute. The that's an interesting man. Because like, right, well, here, I've got a good example of something else. We'll talk about the difference. We had a previous episode where we discuss some of the for profit versus not for profit health care. Yeah. And I think like this goes back to and this is why the business of human flourishing podcast exists. But what is our goal, and it is to flourish, when in healthcare, our goal needs to be to help people, you know, reduce suffering and increase well being. And so how we do that whether an organization is a for profit, not for profit, it doesn't necessarily matter. Now, granted, that is part of the context in which they're operating in. And so there may be different incentive structures, which we need to take into account. But just because you're a for profit organization or not for profit, one is not necessarily, you know, holier than another, it really just depends on kind of how, like the behaviors that are occurring. And so, you know, I got into it, I got really angry one day when someone talked about how like, they were holier than thou, because they were a nonprofit. And then I got to see that their executive compensation was off the charts. For someone who is a for profit healthcare provider like that. That just really irked me. Yeah. So yeah, I

mean, I think we're dealing in these sort of arbitrary constructs anyway, like for profit, nonprofit, they have different rule sets, that sort of thing. But I mean, to take this back to sort of your original question, right, like, I think of values as, especially if, especially if they're well defined, and they're explicit. The thing about values is they are sort of guardrails, they become intentional, con, like mental cons, constructs and constraints that we will use to sort of organize and steer an organization. And the downstream effect of that is it allows you to build a culture that's in alignment with that, because you can coach, you know, even your most frontline employees, all the way up to the executive leadership team, on how to be in alignment with these sort of values. If those things aren't establishing clear and explicit, then you're sort of a rudderless ship. And it doesn't matter if you want to define yourself as a nonprofit, or for profit, or some combination thereof, or any of that. Because ultimately, it's going to, I think it'll come down to the culture. And if your culture is not well defined through its a clear understanding of its values, and a clear commitment to its values in which everybody on the ship is in alignment with, it didn't matter what you call yourself, you're going to probably be less effective, and you're going to be away with ship. And then when hard decisions come and God knows hard decisions will come in any healthcare system or any business life like life. Yeah, if those things are non existent, then you've provided yourself no sort of guardrails or mental framework to to begin to make decisions.

Yeah. And I would I like to say that, you know, culture is really just the externalization of what we value. So, culture, while it's nebulous, it's all that kind of soft stuff that operates is in the context of work that really what what exists in a culture is just what is valued by the people that are members of that culture. Yeah, absolutely. And it takes a while. It takes a while one to establish a culture because even if you want to be a values based culture doesn't mean you're going to be overnight. And I honestly, I think for us, for greenhow. It took about two years and from rolling out this kind of values based mission driven to having that permeate most of what we do, and then hopefully over time really permeating everything, right. Well, what uh, we're gonna wrap up here in a few minutes, but you got it. You got anything for me. You got anything else we didn't cover for a little rapid fire? Yeah, Lissa.

This is a real big for us to take off at the end. But I would be remiss if we I think if we didn't, I'm interested in the con, this idea that we've talked about with both in our I think meditation practices around tend to be something that's more non dualistic. Yeah. And this is something we've talked extensively about, but I'm, I'm very interested in what that starts to look like in terms of health care, like if we, if we talked about this a little bit earlier, but I'd be curious to hear like you give your best.

Yeah, let's have all right. So we're talking non duality, and no self, I'm going to tackle those in order. So non duality, I am incredibly unqualified to speak on this. However, you know, I've always been interested in, you know, not always but as soon as I got interested in meditation, I wanted to go deeper and understand as much as I could. And over, you know, a five to seven year period, I found my way to some of these kind of non dual teachings, and a lot of them stem, you know, Eastern philosophy in general, but a VEDA Vedanta, which the word of VEDA kind of roughly translates from Sanskrit into non dual. And the way that they were thinking about this was that, you know, historically Indian kind of religions and spiritual thought was they often talked about kind of the, the eternal soul, and then everything else, you're purusha and prakriti. So, basically, that there's a soul. And then there's everything that's not the soul. And in Advaita, Vedanta, they just talk about, hey, it's all just there. Everything is is just there, there's not this arbitrary distinction between, you know, a soul and and not soul. And really how that shows up more in the teachings. Is that this distinction between what is me who I am, and outside and not me, that doesn't really exist. Yeah. And so that's, to me, the non duality piece is just that, you know, we like to think that we are, I don't know, what we like to think I can only speak to myself is that, you know, typically in the normal mind identification status, we're identified with thoughts. Yeah. But only the thoughts that we seem to be having not our whole field, right? Yes, yeah. And so when we go into kind of non dual states, we start to see that everything that's occurring is occurring in the same place. So there's not us and other, there's really only our perception of what it is.

So some one of the reasons this is really interesting to me, before I jump into why it's interesting to me, and I can see why we resonate around this, I struggled for years with meditation, like, follow your breath, said, I can never see the why of a liquid. Cool, I can pay attention to my breath for two seconds before my squirrel brain jumps off on to something else, right. But a lot, Kelly's a non dual sort of come from non dual traditions, and a really, really wonderful meditation teacher. And it was either him or Asante. I can't remember but one of them talked about this idea that we often enter into a meditation practice with this idea that we're peeling back layers, without realizing that even the experience of peeling back layers is coming from our own mind, it's still

the same place Still, the still literally the surface, there is nowhere to go, there's nowhere to go, you have a thought there is no drilling into the thought it's there. And then it's gone.

Yeah. So with this gets really, really interesting to me, as you look at most traditional therapy in psychotherapy is probably I mean, Freud is sort of the wellspring from all of this, it comes into this idea of, let's unpack your past. And let's resolve your past. And let's resolve the traumas of your past. And let's make sense of it. Except the experience of doing that is all coming from the same space. Yeah. And so I want to I think about a lot of potential benefit coming from what if we just give that struggle up? What if we just give up the struggle of trying to resolve our trauma or fix ourselves or fix our brain and just sort of settle into this experience of experience?

Yeah. Well, let me let me hop in right here because I think like we're actually starting to get into something good. Maybe this podcast is about to be over. Yeah. So you just said something. Oh, give up on the fixing? Yeah, right. So this is actually even though I think non duality, no self are basically kind of two sides of the same coin. I will say like the you know, when you talk about no self, I find this really interesting. That man. Okay, so one of the things you and I have talked about that we dislike about kind of the current state of, you know, what is mental health treatment, it is all built on the premise that there is someone inside of you that we can, like, I like there is no mental health treatment, for the most part, right, like in common that I'm not trying to fix you. If I'm your therapist, you're showing up and I'm going to do something to you with you. Yeah, it helps you what is behind what I'm seeing. Yeah, yeah. And, and I think that that's bullshit. I think it's crazy. Yeah. You know, because like I show up one way for you. I mean, he here let me give you a quick, a quick question. Yeah. Go back to you. I know you're married. So before before you were married. If you if you wanted to If you had you really, really liked, you know this this person, you wanted to be in a romantic relationship with them. Yeah. And you had you had three options on how you could gather information that you could use to try and win them over. Right? Yeah. So your first option is talking to their friends or family you got you got 15 minutes, you can ask whatever you want from a couple of their friends or family. The second option is you can talk to them for 15 minutes, you can ask whatever questions you want. And again, they can answer honestly or not. The third option is you can actually go into their house, apartment, whatever, and look around. Yeah, which one of those three would you take? I'm going into the house. Yeah, absolutely. Because I mean, I don't care what someone tells me. These are words, these are exactly ephemeral bullshit. But when I see what's on their bookshelf, when I see what movies they're watching, when I see what they're eating, like, I'm a vegan, I I'm not gonna go in your house and think that I want to live there because you're gonna have all these dead animals in your fridge. Yeah, see, like, but I wouldn't know immediately. We're incompatible. Okay, yeah. But so like, let's try like, so. Why is that important? Like, because theoretically, if I want to get to know Marcus, I should talk to Marcus. Right? Why would it be more effective for me to go into your house? Okay. Oh, man, this is how we're going. Yeah, now we're going took a while. Yeah, we didn't pull it. Yeah. All right.

So I'm going to answer this with with something. Will Wilford beyond is this, he wrote this. He's a psychoanalyst who came writes probably right after Freud. And I've only read like one of his essays. So I, there's probably people that

Yeah, well, we know that people can pick us apart. Yeah, let's just assume that, you know? Yeah,

yeah. He wrote this essay called on memory and desire. And essentially, what he challenged therapists to do and the analyst to do, is to enter into every session and abandon the ideas and your desire for the client. So you know, theoretically, we get into this because we want to help a client. And the problem with that is there's it's impossible for us to enter into that as a neutral sort of open space, we always enter into it with this idea of what the client should be. We have this memory of the client. And we are we already can establish memories pretty fallible, right. So like, you have a client come in one time you get this great experience with them, you love them, you they're just wonderful person, right? But then they come in, let's say the next session and you're coming after lunch, you're tired, your blood sugar's dropped you, whatever, you're just off and you're sleepy, and the clients not particularly feeling well. And you just don't have a great session, you're not vibing, whatever. And then, so the next time that comes in, you have this experience of dread with this person coming in. But which one is true? Right? The first experience was this, your you loved it, and you vibed and was great. Second wasn't very good. And so the third one, you're you're going into these mixed ambivalent feelings? What if you just found a way to enter in with a wide open space where there was no memory of the client, there's no desire for the client. And that's a really, really hard sort of thing to wrap your head around. But it allows you to sort of be wide open and present. And I can sort of think of my own experiences in therapy are with like, yeah, it's, I feel way better if I'm just entering into some sort of open space versus fighting the car, like the ideas that this person has about me. And so when you say, like, let's walk into the can we walk into the person's environment and look around? If you do that you're you're you're sort of seeing them as they are. Right, you know, and I put quotes around they are, right. Is that person is, but you're seeing roughly what are their inputs? Like what are sort of permeating into their consciousness? What are their sort of impulses driving them to you know, what sort of Amazon?

Yeah, let me stop it. Yeah, no, no. So here's one of the things I always like to bring up. I use this a lot in conversation. Yeah. Is what is it like to be me? And yeah, you know, often like if I asked you what, like, what is it like to be Marquez? Chances are you're gonna start having thoughts where you're picturing yourself. Yeah. Like, you're, you're seeing yourself in the third person, right? Like we think about our own face. Yeah. But like, at this point in my life, I've spent way more time looking at your face and I have looking at mine just right. Right. I am never the A you are never the person who's presented on that couch. Yeah, like if I want to know what it's like to be you. Yeah. Like you don't you don't see your face. So I don't need to see your face to know what you look like. Yeah, right. Yeah. I actually don't need to see you. What I need to see if I want to understand Marcus is I need to see what Marcus sees. Yeah, I need to experience what it likes to what it's like to be Marcus. Yeah. And I think that that like that's the difference between, like, the difference between walking in and trying to connect dots as as either a therapist or anything else like I got a piece too. What it's like to be you, whereas like, if I could spend one day going through your routine doing doing Marcus? Yeah, that didn't sound right. We are, then I would, then then I would understand a lot more about what it's like to be you. Right like not to see you in your thing. Like I need to actually be in it.

Yeah, I yeah. So. And I think this in lies, like some of the problems with contemporary therapeutic practices, is that there?

There's this notion that someone can can show up on a couch and get fixed. Yeah, I think that's ultimately, and we're also not like, therapy can be an incredibly valuable. Yeah. You know, for you. I mean, it's been valuable for me, like, I think it's great. But just that that nature that there's, there's someone to get fixed. Yeah. So.

So we're thinking about this and the role of a client, but like this, for this example, let's take it for a second. And let's flip it to the role of a clinician, and I can tell from sort of personal experience. That's freakin intoxicating. Yeah, someone's showing up and you're going to fix their brain.

Yeah. Oh, yeah. Like you talked about in the ego trip. Oh, yeah. Yeah, it was good feedback. Oh, I'm such a good therapist. I saved him. I saved her. I did the sad thing. Great.

Yeah. Yeah, it was. And that's what's always funny. Sometimes I have clients that are just, like, wonderful people that I'm still in touch with. And they'll tell you, like, call me up or something that, you know, they picked a couple years up sober or something, and they'll just, you know, edit this sort of sense of gratitude. They'll express how, how powerful I was in their life. And it and you know, I got accepted, or I tried. But the thing is, we spent like, six hours together. Yeah, like total, yeah, six or seven hours together, we talked about some stuff, I probably, you know, just like I wasn't, I wasn't as big of a part of their life is sort of the experiences. But, and I know that because really, if you think about that for like, six hours, right, something that I spent with them in the, in the time one on one, one on one, right, versus this person is spent, you know, years working on becoming like achieving some sort of flourishing, or betterment. I had no role in that. Right. But nonetheless, I can I recognize that right? Like, I recognize that. But nonetheless, when I hear that, there's a I can feel my ego sucking drew Yeah, it loves it. Right. Yeah. And we, it's, uh, this, this is one of the things that gets really interesting to me is because that's so intoxicating, it feels so good. And as a clinician, we go to these trainings, and we learn about these new things, and all this all this crap, right? And it makes us feel like we're loaded with the tools to be the expert in what it would be like for this person to be happy or like, fixed. Yeah. And so we enter into it with that intoxicating sort of,

I mean, you get to play God, you get to play God. And we also like, I just want to reiterate that therapy is great for people. And even, you know, like, reach out if you need help, whatever, not whatever. But we have to be like, we do need to, we need to hard hold ourselves to a higher standard with this, and like what's actually so like, when we talk about, like, how are we going to fix healthcare? Like, the answer isn't just like, Hey, we need more, we need to be paid more, we need to understand, like, if we want to affect someone's life, how do we do it? Like most of their life, like if they're showing up to an office to sit on a couch? That's a component of it, but how are we getting out there? And actually, you know, helping them with the struggles that they face? Yeah, different questions.

So totally different question. And I had this at a supervisor early, early, early in my career, like in an internship. And one of the things he said, to me that was it was interesting was essentially, he was like, structure your sessions, and structure your office in such a way that if a client comes in, and this is the only hour of their week, in which they're not existing in chaos and turmoil, yeah, just cultivate that environment. Yeah, for no other reason than just to give the sense in the taste that that's possible. And his ultimate point in this and he went on to sort of elaborate his ultimate point in this was, you're not there to fix them, you're just there to sort of create some sort of space where, you know, they have something to get you to, to, to explore. I'd like a sense of calm a sense of peace, contentment, or just safety. That if you can create it in my office, there's no reason you can't create that elsewhere. Like I'm not right. Yeah, some dumb chump. Like anyone else, like stumbling through trying to manage my impulses. And, you know, like, what kind of like,

I know you're, you're far from perfect trust. Well, hey, we do need to kind of start wrapping up. But one thing I want to touch on that we talked about you You always like to talk about, like sacred cows. Yeah. So tell me just I want to talk about one I want to talk about this, which we hit on kind of briefly, but just this, I got into this to help people, I'm helping people on helping. So I really kind of want to take a couple of minutes to Well, I personally want to rant but I want to hear if there are any other kind of sacred cows that that you have, like we work in Greenville was originally just a private pay treatment provider. Yeah. And we've moved into building while, you know, having a private pay service, we've also moved towards, you know, having an insurance driven service. And eventually, whether it's Green Hill or other organizations, like we, you know, I Anyway, I'm going off. I'm going to save that for later. But what sacred cows are out there? Yeah, that you want to talk about?

Man, I love this. So one of the things that drives me crazy is we, you look at this industry, especially the private pay sort of industry that we're in, and you can see,

these

are caught, like availability entrepreneurs, right? It's, there's some like really cool literature on that phrase, you can look it up, like availability entrepreneurs. And essentially what it is, is, when there turns into some sort of crisis, or moral panic, or something that's really scaring the populace, you start to see people rising to give responses and answers to that. So one of the things that I noticed in these, like this private pay space in his private pay world, especially in the therapeutic space, is we create all these niche programs to solve these niche issues. And the thing that I question is whether or not those are actually issues and whether or not they actually require special services. But the problem is, the second we turn it into an issue, and we slap a price tag on it. We start to create systems and structures that hold it and keep it in place, and they have to sell it. And so it makes me wonder how much how many of the these mental health crises are we seeing right now? That we're actually sort of creating by trying to raise awareness around something that's maybe not an issue that needs professional resolution?

Yeah, we pathologize normal behavior all the time.

Yeah. When if you think about it, there's an incentive, like a financial incentive structure to do that. And that's, you know, that's particularly damning. And,

and that's why we need people who are actually values based leaders, because that's where Yeah, I mean, it is in your financial best interest to, you know, pathologize behavior. Yeah. Well, I think it's, I'll push back on that a little bit. I think it's in your short term, right. Oh, yeah. It's

a it's a I think it's a short term. But if you're not creating healthy ecosystem, this stuff ends up devouring itself or eating its own towel and falling apart. And so the thing that I that's my sort of sacred cow that I am on right now is like, what do we

I think you did a presentation about drawing dicks. Yeah, exactly. Like, let's, let's just pathologizing normal behavior. Let's talk about like, an 1819 year old male who, you know, draw perfect. Yeah. You know, does something ridiculous. Yeah.

I mean, so trips making this reference to I've had text threads with other younger, like providers for young men, street men, and we all had these like running, we would take pictures of all the phallic drawings we found all over campus and everything. And, you know, it was, it's funny because it says, you know, I'm a 35, almost 36 year old male, and I still couldn't help but chuckle if I found one. It was like a little bit. Some

people get angry about what you do at that age. Yeah. Listen, that's I mean, that's my point is like, I'm almost 36 and I can't I still laugh.

I still love I don't want to laugh.

I thought I was more mature. You know, I'm not I'm waiting for the day that like I, you know, I

kept waiting for this day when I would come out and like, you know, find a phallic drawing or dick drawing somewhere carved into a tree that it didn't make me chocolate, but I can't, you know, like it. Yeah, but there's no reason to pathologize that or that is

that would that you know, you do that at school and you get sent to a psychologist and all of a sudden you have Oppositional Defiant Disorder, right? Something right. Like you do that a couple of times. It's like No, man, I was. I just wanted to impress my friends. Yeah. Maybe I need better ways to impress. Like, maybe I should try and get good at something. But developmentally, like that's pretty Yeah, appropriate. Yeah. Well, I'm in I'm waiting to developmentally get out of that stage. It hasn't happened yet. So. So Well, here's mine, which I already kind of alluded to. But it's this notion. I don't think I again, and this isn't about politics, certainly, but one of the things is like most people who are in you know, healthcare typically tend to be, you know, more liberal. And a lot of times, you know, social justice matters a lot and sure matters a lot to me. But we can kind of get divorced and we're not putting our you know, we're not showing with our behavior apps that we are actually what we value. So, for me this shows up with what I already alluded to is when Greenhill started, we were completely a private pay program. We cater to the top 1% of income earners in the United States. Like, that's just a fact. Do I love what we do? Do I think it's great that we're delivering value? Absolutely. But for me, like, in my personal values of, you know, I've got a pretty good life. Now it's my job to help other people build meaningful lives. Like, I've got to help people who don't come from all of those resources. Well, and so, you know, for me, that's been a couple years long process of learning how to work with commercial insurance and building health care offerings that aren't tailored to the top 1%. And this is actually something we see, there's a great article, I'll post in the show notes from city block around the fact that like, a lot of funding that goes into healthcare, whether it's pharmaceutical, pharmaceuticals, wearable technology, this is all you know, the investment money is coming from people who have all the means in the world, you know. And so the investment money is often flowing towards things that they might need help with, not the average American. And so we have to do a good job as leaders to start really asking questions, maybe we've made it, maybe we're secure, we've got good insurance, we're willing to pay out of pocket, but there are a lot of people who don't have any disposable income, and they still deserve, you know, help. But what that looks like, you know, and how we build things. It shows up differently. So my sacred cow that I want to, you know, slaughter eventually, is the is just an maybe it's not a sacred cow. I just don't like when people are inconsistent with Yeah, you know, what they say that they value and the impact that they want to have, and then they just rail against the system? Like we've been at conferences in our kind of private pay world, people will rail against the system. Yeah. And it's like, you don't have to do this. Yeah. Like, you can go work for a community mental health agency, and maybe you should, or, you know, you can work in the private pay world and also try and find ways to expand, you know, expand access and make services more affordable. But like just hearing people, you know, what I consider, you know, it's the the man in the arena, kind of quote from Theodore Roosevelt, like, if you're not in the arena fighting Yeah, to increase access to services, then I don't want to hear your opinion, because it's bullshit. And quite frankly, there are a lot of people who are really good at changing their social media profile pictures to support the cause of the day or the month, but then don't do anything to actually support it in real life. And I'm also okay, like, we don't have to support the same causes. But don't tell me that you really value increasing access to mental health. But the only thing you can do you It's too hard. You're gonna always have rich kids. Yeah. Yeah. Yeah, I'm right there with you. Yeah. Anyway. I think we should probably wrap it up, but we're gonna have I think we'll have a lot of fun conversations. Marcus, thank you for joining the business of human flourishing podcast and we'll see you next time. My paychecks.