Episode Transcript

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Daniel Lobell: (00:00)
This podcast or any written material derived from its transcripts represents the opinions of the medical professional being interviewed. The content here is for informational purposes only, and should not be taken as medical advice. Since every person is unique, please consult your healthcare professional for any personal or specific needs.

Daniel Lobell: (00:24)
Hello, and welcome to the Doctorpedia podcast. This is your host, Daniel Lobell, I’m on the line and I’m honored to be speaking with Dr. Grant Brenner. How are you Dr. Brenner?

Grant Brenner, MD: (00:35)
I’m good, Dan, how are you doing?

Daniel Lobell: (00:36)
I’m good. I’m good. Before the interview, normally I’ll jump into at this point a little bit about your childhood and why and how you became a doctor, but I am still fascinated by what preceded the interview, our little chat for a minute or two as I was setting up the microphone, and I’d love to jump right into that. And talk a little bit about the work that you’re doing currently with people who are in the Ukraine.

Grant Brenner, MD: (01:07)
Absolutely. So I’m part of an organization called the Crisis Emotional Care Team, which is a program in a larger not-for-profit called Vibrant Emotional Health. And Vibrant, for example, runs the National Suicide Prevention Lifeline and is going to be doing the 988 number for mental health emergencies. And so I volunteered back in 2000 to work with a group called Disaster Psychiatry Outreach, and I’ve worked in India and Sri Lanka, in Baton Rouge after Katrina, in New York after 9/11. We’ve done distance learning recently. We’ve been working with Afghan refugees in villages, in the US, and our organization right now is getting more active with Ukraine response. We don’t know exactly what is going to happen yet, cause it’s too early right now. There aren’t any significant numbers of displaced persons in the US. Canada is starting to accept people. And of course in Europe there are. So today we were doing what we call a Just in Time disaster behavioral health training. And so we train mental health clinicians of all stripes in the basics of crisis response and disaster mental health.

Daniel Lobell: (02:35)
What are the basics of crisis response and disaster mental health?

Grant Brenner, MD: (02:41)
So, as contrasted with working in a private practice or a clinic or a hospital where you might be doing therapy or evaluation to prescribe medications or diagnose people, the core of disaster mental health is psychological first aid, which is analogous to physical first aid. And a lot of times it’s really very straightforward, being present with people, sometimes it means getting basic needs met, like getting food for them, and it means helping normalize most stress reactions and giving people education about what our normal response is in the midst of or shortly after a crisis. And then things like fostering self care, bringing families together, building resilience, messaging with useful and well constructed information so that various people in need and other stakeholders like governmental and non-governmental agencies can collaborate more effectively. And so it goes anywhere from supporting the individual and the staff to working on a systemic level to move things in the best direction possible. And not so much about connecting people with treatment unless they really need it, either because they have developed later on something like PTSD, which can’t be diagnosed right away anyway…

Daniel Lobell: (04:12)
Because it’s post. It’s not present traumatic, right? It’s post traumatic.

Grant Brenner, MD: (04:15)
Right. When people have symptoms like that, that are severe right after a trauma, it’s called acute stress disorder, used to be. Post traumatic stress technically develops after four weeks, sometimes much later, of course, but most reactions right after or in midst of a war or disaster are normal. Even things like trouble sleeping. So a lot of it is normalizing and giving basic supportive and then potentially connecting people with services if they need it. Giving short term treatments. And sometimes continuing treatments that may have been interrupted if people had preexisting conditions.

Daniel Lobell: (04:53)
Is there such a thing as pre traumatic stress disorder? Like you think something traumatic’s about to happen, you start getting stressed out beforehand?

Grant Brenner, MD: (05:05)
Yeah. I’ve sort of thought of that as kind of a play on words. You know, with panic disorder, people get something called anticipatory anxiety and that’s part of the definition of panic disorder, is that you start to get worried before anything happens and that can trigger a problem. And trauma does that too. People with post traumatic stress disorder will have a distortion a lot of times to how they interpret signals. From the very obvious, like if a car backfires, you jump, because it sounds like a gunshot, to feeling mistrustful of people who are trustworthy because there’s been some abuse, or vice versa.

Daniel Lobell: (05:52)
Yes. I mean, I think to a small degree, I went through that myself, years ago, and I certainly know to a larger degree, having worked with kids, I used to work as a group leader in rehabs for adolescents who were recovering from drug addiction. And I saw a lot of that there, where I’d have to draw on my own experience to try and relate to them, to understand that there are people in the world you can trust. And as crazy as it seems, when you’re coming from a background where there’s been some kind of abuse or something, the nicer somebody seems, the more untrustworthy they seem. Because you think they’re hiding something, whereas somebody who seems like not that nice, you’re like, “Well, I think they’re on the level.” [Daniel laughs]

Grant Brenner, MD: (06:47)
Yeah. I mean, in the extreme, the green lights look like red flags and the red flags look like green lights at first.

Daniel Lobell: (06:57)
Mhm. Absolutely. Yeah. I mean, I used to explain to these adolescents that I worked with, I’d say, look, I was the most mistrustful when somebody would come over kindly towards me and they would be like, “Yeah, yeah. I know.” I’m like, “Ah, this phony person.” Because you just don’t believe that you live in a world that’s kind.

Grant Brenner, MD: (07:24)
Well, some of it is like the early developmental trauma from caregivers especially, or permitted by caregivers, even if they weren’t the perpetrators. Perpetrators start off really nice and they groom people. And so someone who is nice, that’s threatening. And the behavior of being nice is associated with being hurt later. And so a lot of working with trauma is un-learning those connections and then developing the interpersonal skills, not to be sort of so, either need to be so defended or risk being easily exploited.

Daniel Lobell: (08:08)
Yeah. That’s why I don’t even trust dog groomers. Anybody who’s grooming. I’ve got a little bit of skepticism toward. [Both chuckle]

Grant Brenner, MD: (08:15)
Yeah, that was a little heavy.

Daniel Lobell: (08:17)
[Both chuckle] All right. Now we’ll backtrack. So you’re an MD, and DFAPA, what is that?

Grant Brenner, MD: (08:27)
That stands for a Distinguished Fellow of the American Psychiatric Association. So it’s a professional honor.

Daniel Lobell: (08:35)
Wow. Well, I’m honored to be talking to an honored person.

Grant Brenner, MD: (08:38)
[Grant chuckles] Well, I’m honored to be talking to someone who feels honored to be talking to an honored person. [Daniel chuckles] The honor is all mine, and the privilege.

Daniel Lobell: (08:46)
Yeah. So did you know from a young age that you wanted to go into becoming a psychiatrist? And if not, when and why?

Grant Brenner, MD: (09:01)
Right. Well, so I grew up in an environment where there were a lot of, therapist was pretty normal and psychoanalytic therapy was pretty normal in the 1970s in suburban New Jersey, and early on, I actually saw a psychiatrist. Everyone in my family worked — I don’t know actually if she was a psychiatrist, she was a psychoanalyst, this older lady from Germany, very kind. And what was happening is that in my family, there were certain problems. One of my siblings had some issues and my mother was dying of cancer and it wasn’t very good. But I was intensely curious and precocious for my age. I was the youngest of a few people. And I would read their textbooks. And so sometime like sixth grade, I wanted to be a scientist. And I was interested in medicine, of course I was seeing all these medical things going on without quite understanding what they meant. And then one time I was in the Livingston Mall, I grew up in suburbia. I was at the mall, and I went to the bookstore —

Daniel Lobell: (10:07)
Where is Livingston? I’m sorry.

Grant Brenner, MD: (10:09)
Oh, it’s in New Jersey, sort of due west of New York City.

Daniel Lobell: (10:14)
Okay. Continue please.

Grant Brenner, MD: (10:16)
Yeah. It’s on a suburban line from New York. And so I picked up a couple of books, Freud and Jung, and I read ’em and I was really interested. And I was very interested in psychology in general, in science and literature in general. And at that time when I was 12 or 11, I would’ve said I wanted to be a psychoanalyst. In high school, I did well, but I wasn’t in the best frame of mind, recovering from my mother’s death. And so I didn’t quite know what I wanted, but medicine was always on my radar. So I was in the Physicians of America Club in my school. And when I went to college, actually, I thought maybe I would go into physics and I studied physics pretty seriously for a couple of years.

Grant Brenner, MD: (11:07)
And then I returned to psychology and I realized I didn’t wanna be a psychologist. Because it was sort of the way it felt academically. Psychology is a very different field. So I went to medical school, kind of back to an early thing, and I really thought about psychiatry. I think that was kind of my assumption is I would go into psychiatry. But the head of the department in psychiatry in med school said, “Oh, you wanna work with people and be a therapist? You made a mistake. Psychiatrists in the future will not be doing that. They will be working for HMOs and prescribing meds for everyone.” And I took that to heart and I was very intrigued by surgery. And I actually was planning to be at that point then a urologist. And I did therefore the two required years of general surgery, but about a year and a quarter into it, I realized as much as I loved surgery, I really missed people and working with people. And so at that point, I went into psychiatry residency after doing a couple years of surgery.

Daniel Lobell: (12:15)
That seems like a pretty dramatic shift. How different was the coursework? How different was everything? I mean, when you make a decision like that?

Grant Brenner, MD: (12:23)
Well, it’s funny cause a lot of people who switch, they switch from surgery to psychiatry or vice versa, usually from surgery to psychiatry, sometimes anesthesia to psychiatry is what people say. But it’s pretty rare that you see someone switch from being an eye doctor or a dermatologist or internal medicine to psychiatry. So I don’t know if anyone’s ever studied it formally, but I think the idea is that it’s much more of an individualistic specialty. It’s much more like you’re doing something in surgery and you’re doing something as a therapist or a psychiatrist. That’s kind of what people say. I don’t know, do you have any thoughts about it?

Daniel Lobell: (13:08)
I don’t know. I never went through it.

Grant Brenner, MD: (13:10)
Yeah. I mean, like on the surface, they seem very different, right?

Daniel Lobell: (13:13)
Yeah. I mean, to me, it seems like two entirely different worlds.

Grant Brenner, MD: (13:17)
Well, almost the opposite, right? Like in one, you hardly ever talk to people and you operate on them or do procedures. In the other, psychiatrists are generally not making physical contact with patients, hardly at all. Like, we’ll debate whether it’s okay to shake hands with a patient. But at the same time, you’re sort of getting into people in different ways.

Daniel Lobell: (13:43)
It’s funny. Yeah. Getting into people, literally and figuratively. You should be allowed to shake hands and the other person’s pulling out a kidney or something, you know?

Grant Brenner, MD: (13:53)
Yeah. I mean, not shaking hands is a little bit old school, but —

Daniel Lobell: (13:58)
Well it’s back, I guess, since corona.

Grant Brenner, MD: (13:59)
It’s something you would debate.

Daniel Lobell: (14:02)
[Daniel chuckles] These days. Yeah, I guess it’s made a comeback. I think if I were to go into medicine, I would probably start where you started, in terms of wanting to become a psychoanalyst.

Grant Brenner, MD: (14:14)
So I did psychiatry residency. I finished my psychiatry residency at Mount Sinai. And Mount Sinai is fairly biologically oriented. They sort of say programs are more biological, but they also had a strong connection or have a strong connection with really the most classical psychoanalytic institute in New York, the New York Freudian Society. And a lot of my mentors were voluntary faculty members who were psychoanalysts. There was a time when psychiatrists almost automatically got psychoanalytically trained, many years ago. Nowadays it’s less common, but I actually did get psychoanalytically trained after my psychiatric training, which is sort of an additional four years of training, as well as doing a group sort of organizational psychology two year program and some other things. But the psychoanalysis that I trained in was not classical Freudian analysis. It’s what’s called an interpersonal relational model and it’s much more based on an interactive model of depth psychology, of insight oriented work.

Daniel Lobell: (15:23)
What is depth? Do you just go into depth about things, or…?

Grant Brenner, MD: (15:27)
Yeah. Yeah. It’s like the deeper meaning of stuff, rather than, say, like focusing on changing thought patterns.

Daniel Lobell: (15:34)
Yeah. I mean, I don’t think I’ve ever heard of the shallow psychologist. It’s like, “Tell me a little bit about what’s going on with you, but keep it light and impersonal.”

Grant Brenner, MD: (15:44)
Well, it’s like a deep conversation.

Daniel Lobell: (15:45)
Right. Right.

Grant Brenner, MD: (15:46)
But it’s not meant to say that other things aren’t as good as it. But it’s heavier. It’s about what things mean. It’s about your childhood. It’s about how things play out in relationships. It’s about your deep dark secrets. It’s about vulnerability. It’s about having insight. That’s not everyone’s cup of tea.

Daniel Lobell: (16:08)
Right. So as a psychoanalyst, you wouldn’t have to have gotten the psychiatric training, correct? You wouldn’t need to have done that to become a psychoanalyst, right? That’s something extra.

Grant Brenner, MD: (16:23)
Yeah, that’s right. You can become a psychoanalyst. There’s a few different roots to it. But usually people have some degree, either an LCSW or a PhD or an MD or a DO. In certain states there’s psychoanalytic licenses, which is probably boring for anyone listening. But like in New York, for example, you can get a license in psychoanalysis, there’s an educational path and you need any master’s degree. So you could have an MBA and get trained as an analyst. But the training is, it’s not trivial. You have to do a lot of hours of therapy, there’s a lot of academic, you have to be in treatment yourself, usually.

Daniel Lobell: (17:04)
I looked into it once, like I said. If I were to go into it, that’s what I would’ve done.

Grant Brenner, MD: (17:09)
Well, I mean, if you wanna do that in the future, I’m sure you could. But I thought you also are sort of an entertainer or a filmmaker, right? Or…

Daniel Lobell: (17:19)
That’s true. That’s —

Grant Brenner, MD: (17:20)
Do I remember that right?

Daniel Lobell: (17:21)
That’s what I do, but I mean, I guess I had another passion, this is what it is. I love being able to help people. And I love… I’m an analytical per — a good comedian is a good analyst, because… Maybe they’re not good in terms of what a patient needs, but they can analyze things well, is my point. And…

Grant Brenner, MD: (17:44)
Yeah, absolutely.

Daniel Lobell: (17:45)
The analytical mind can be put to use in different ways. So I think I have a fairly analytical mind. I’ve just used it to analyze stupid things, to make people laugh. [Daniel laughs]

Grant Brenner, MD: (17:59)
I don’t believe that for a second. Well, do you think it’s true that things are funny because they’re true?

Daniel Lobell: (18:06)
I don’t think that’s always true. No. I think —

Grant Brenner, MD: (18:10)
What do you think the other determinants are?

Daniel Lobell: (18:12)
I think things are often funny because they’re false. I think things are funny because of misdirection. I think, you think something is gonna be one way and then it’s… If somebody slips on a banana and it’s funny, it’s not because it’s true. It’s just because it’s unexpected. And it looks —

Grant Brenner, MD: (18:31)
I thought it’s funny because that’s the universal truth. That you could all… Anyone could slip on a banana.

Daniel Lobell: (18:38)
Well.

Grant Brenner, MD: (18:38)
It has a certain appeal cause it’s a universal truth.

Daniel Lobell: (18:41)
I suppose once you apply a universal truth to everything, it’s hard to get away from anything not being a universal truth. But I think, because there are truths to the universe. I think, is anything funny cause it’s true. Is anything untrue?

Grant Brenner, MD: (18:57)
Yeah, but I mean it’s a specific thing though, is kind of having a sort of a random accident is something we can all relate to, right? Or no.

Daniel Lobell: (19:05)
Well relatability, I don’t know if relatability is synonymous with truth, but… I don’t know. I think, when you ask if it’s funny because it’s true, I think of that as a very specific kind of thing. Like, you nailed it. That’s exactly the truth, therefore I’m laughing, you know?

Grant Brenner, MD: (19:28)
Well, that’s not the full story, but people will say that. Won’t they kind of say like, “Well, it’s funny because it’s true,” but you’re saying it’s funny because it’s not true.

Daniel Lobell: (19:35)
There are things like that.

Daniel Lobell: (19:37)
Well, certainly I’ve seen a million laughs gotten because of it being funny cause it’s true. I don’t think something being true disqualifies it from being funny. Certainly a lot of humor is because of that, but I don’t think all humor is because of that. I think something being blatantly false is often just as, if not more funny.

Grant Brenner, MD: (20:06)
It’s funny because it points out, I guess by contrast, what is true.

Daniel Lobell: (20:11)
[Grant chuckles] Right. But then again, you only have two options, true or untrue. So you could say that everything that’s funny cause it’s true is only funny cause it’s contrasting what’s untrue.

Grant Brenner, MD: (20:21)
[Both chuckle] No, well I wouldn’t say that, cause someone else would say that the truth is relative. [Daniel chuckles]

Daniel Lobell: (20:30)
Yeah. Right. Well, I mean, the truth being relative to what? To untruth, right?

Grant Brenner, MD: (20:37)
Right, and that’s — yeah, go ahead.

Daniel Lobell: (20:40)
Well, I mean, if it’s a relative truth, then, A: it’s a truth, still, right? It’s a truth relative to this thing.

Grant Brenner, MD: (20:51)
Yes.

Daniel Lobell: (20:51)
And it’s also a relative to contrasted untruth. So you only really are working with two options here, true or untrue. Is that true?

Grant Brenner, MD: (20:59)
Well, I think there’s a third option.

Daniel Lobell: (21:01)
[Daniel chuckles] What’s the third option?

Grant Brenner, MD: (21:03)
Well, like “I don’t know if it’s true or not,” or “it’s true for me, but it’s not true for you.”

Daniel Lobell: (21:10)
Okay, well, but…

Grant Brenner, MD: (21:11)
There’s gradations.

Daniel Lobell: (21:12)
But you still had to say it’s true for me and it’s untrue for you. So it’s a truth based on your understanding of reality. It’s still…

Grant Brenner, MD: (21:19)
No.

Daniel Lobell: (21:20)
Or your understanding of a situation or your understanding in general. So, if you’re working with somebody who’s ignorant of certain things, they still live in a world of true and untrue, whether or not their idea of what is true is true or isn’t true. That could be debated. I mean, certainly you could debate if anything is real. I mean, if you want to get more philosophical with it. Is this world true? I don’t know. I mean, then you can… I think Jung had a lot to say on that one, but…

Grant Brenner, MD: (21:54)
I wasn’t gonna get that abstract, but, I think you set it up as a dichotomy though, between true and not true. I just said, I thought people say jokes are funny cause they’re true, and then you made it into true or not true, [Daniel chuckles] but you could have chosen to make it more sort of on a continuum at the beginning. So I think there’s a name for that type of logical fallacy, but I don’t remember it. But this is where comedy and depth therapy maybe overlap. Cause, is it like a pointless conversation that’s sort of a waste of time? Are we just amusing one another? Entertaining each other? Is there something being clarified or understood? Or something else, or all of the above? And there’s a level of irreducible uncertainty, which, psychoanalysis is really about how do you live with that uncertainty? That’s one of the things that it’s about. And I’m still thinking about why are jokes funny, though. And you’re a trained, professional comedian, right? So there’s a whole art to it, I think.

Daniel Lobell: (22:57)
I think the best comedians are unprofessional, but yes. [Daniel chuckles] As soon as they become professional, they kinda lose something. But —

Grant Brenner, MD: (23:06)
Well, it’s hard to be spontaneous, right? You do the same set over and over, but it’s gotta seem like you just thought of it.

Daniel Lobell: (23:12)
Right. And you know what, it’s never the same when I do it. It’s never the same exactly. The wording is a little different. I mean, there are guys like Jerry Seinfeld who are very specific to their wording and punctuating every single thing. And that is a way of doing it. And I think very highly of Jerry Seinfeld, it’s just not my taste in it. I like a more jazzy approach. Like a… I don’t know if you’re familiar with, like —

Grant Brenner, MD: (23:37)
Improvisational.

Daniel Lobell: (23:39)
The late Mort Sahl or somebody like that, who’s more conversational with their comedy. Not so much improvisational, but conversational. Whereas like it seems fresh every time you go on stage, because it feels like you’re having a conversation with the audience rather than hitting certain notes every single time in a specific, structured order. If that makes sense, you know what I mean? So…

Grant Brenner, MD: (24:05)
Yeah, it makes sense to me, it sounds like it’s grounded in authenticity.

Daniel Lobell: (24:09)
Right. The jokes may be the same, but the presentation is always varied a little bit. If not slightly, then in a big way. But I think what I do is never exactly the same two times in a row.

Grant Brenner, MD: (24:23)
Right. You can’t step in the same river once.

Daniel Lobell: (24:27)
You know, I paint messy, I speak messy, I’m a messier person. And I think —

Grant Brenner, MD: (24:33)
Are you messianic?

Daniel Lobell: (24:35)
I’m slightly messianic. [Both chuckle]

Grant Brenner, MD: (24:38)
I have a theory that people who are messy may also be messianic because it may be that a level of sloppiness is required to save the world.

Daniel Lobell: (24:47)
I like the looseness of it. You know, man, I like it being loose and… [Daniel chuckles]

Grant Brenner, MD: (24:52)
Right, well, that’s what a psychoanalysis is fundamentally, it’s about free association. It’s about being open to whatever comes to mind spontaneously and not editing yourself. Not necessarily saying everything out loud, of course. That’s the difference, I suppose. I made up a joke. I make up jokes, some of them are funny. And a lot of them are dad jokes and some of those jokes are funny, but I made up a joke. It’s these two businesses —

Daniel Lobell: (25:19)
By the way, I’ll just tell you, a dad joke is just the same as a bachelor joke with kids.

Grant Brenner, MD: (25:26)
How so?

Daniel Lobell: (25:27)
Well, I mean, you can have the same joke when you’re a bachelor and you tell it when you have kids, now it’s a dad joke.

Grant Brenner, MD: (25:35)
Right. But I think dad jokes —

Daniel Lobell: (25:37)
Dad jokes get a bad reputation and I think it brings down the whole opinion of dads, in general.

Grant Brenner, MD: (25:43)
Well, I think the content is often different, even if the spirit is similar.

Daniel Lobell: (25:47)
I know what you mean, but I feel like… I’m stopping you there because I don’t like what the term “dad jokes” has done to the reputation of dads, but…

Grant Brenner, MD: (25:59)
Well, I’m trying to reclaim it.

Daniel Lobell: (26:00)
Yeah. I mean, look, the jokes are there whether you have kids or not. I mean, if you’re good at telling them and you’re a father, look, I was worried when I had kids that my jokes would become dad jokes. And then I realized it was a made up construct that people who weren’t so great with jokes sometimes, or were a little corny, would just blame the fact that they have kids. It’s not the kids’ fault. It’s your fault for delivering them poorly. Anyway, I’m sorry. Go on.

Grant Brenner, MD: (26:26)
No, no, I hear you have a soapbox there. [Daniel chuckles] I mean, I agree with you 100% and at the same time, I totally disagree.

Daniel Lobell: (26:33)
Okay.

Grant Brenner, MD: (26:34)
Because —

Daniel Lobell: (26:34)
As long as you have two conflicting opinions. [Both chuckle]

Grant Brenner, MD: (26:38)
I don’t have a problem with self contradiction.

Daniel Lobell: (26:40)
Yeah, apparently not.

Grant Brenner, MD: (26:40)
Hypocrisy, not so much, but self contradiction is normal for most people. [Daniel chuckles] If you master self contradiction, then you’ll master yourself. But I think the reason they’re called dad jokes in the best possible sense is that you’re conveying some wisdom.

Daniel Lobell: (26:57)
Okay. I like that. I don’t think that that’s where most people go with it, but I like that.

Grant Brenner, MD: (27:02)
You’re helping to establish the patriarchy with paternal wisdom. So I made up a joke and this one’s a little bit abstract. It may not be funny. But two business suits are walking down the street in Midtown Manhattan and one business suit turns to the other business suit and the business suit says, “Hey, that’s a really nice human. Where did you get it?”

Daniel Lobell: (27:28)
[Daniel chuckles] All right. I like it. I like it. It’s definitely…

Grant Brenner, MD: (27:31)
A little bit dry.

Daniel Lobell: (27:32)
Yeah. I wouldn’t even classify it as a dad joke. I’d say it’s a more abstract, surreal type of joke. I like it.

Grant Brenner, MD: (27:41)
Yeah, that one isn’t… I agree with you. That’s not really a dad joke. But you know, my kids, they cringe when I tell dad jokes.

Daniel Lobell: (27:49)
I think most of the time when you hear about dads, the association is negative, unfortunately, in our culture. So like a dad joke denotes a lesser joke. And while I’m not pulling up other examples at this exact moment, unfortunately, as a dad, I’m very conscious of these things. I should write them down, but I’ve noticed a lot of times when you were — oh, a dad bod is not a good body. Anything when you add “dad” to it is like a negative association.

Grant Brenner, MD: (28:26)
It’s pejorative.

Daniel Lobell: (28:28)
Yeah. And I don’t like that. As a dad who’s very proud and happy and loves being a dad, I think we need to reclaim, us dads need to stand up and say, look, we’re exhausted from the kids so we haven’t had the fight in us, perhaps, to stand for ourselves up until now. But I think we can do it. I think we can take back dad pride. And…

Grant Brenner, MD: (28:52)
I’m just not sure if that’s so much in the term as much as it is… But I agree. Dads get a somewhat of a bad rap.

Daniel Lobell: (29:00)
Yeah. Dads are wonderful.

Grant Brenner, MD: (29:03)
So you should do a Netflix special called Dad Jokes.

Daniel Lobell: (29:06)
[Daniel chuckles] Done. Call Netflix and tell them I’ll have it on their desk by Wednesday.

Grant Brenner, MD: (29:12)
What do you call a pachyderm who never says anything worth hearing?

Daniel Lobell: (29:17)
Okay, what?

Grant Brenner, MD: (29:18)
An irrelephant.

Daniel Lobell: (29:20)
[Daniel laughs]

Grant Brenner, MD: (29:22)
Is that a dad joke?

Daniel Lobell: (29:23)
That would probably fall into that category, but… It’s a more clever dad joke.

Grant Brenner, MD: (29:30)
You’re like, “No more dad jokes. I’m gonna edit all this out anyway.” [Daniel chuckles]

Daniel Lobell: (29:35)
No, it’s staying.

Grant Brenner, MD: (29:37)
What do you call a non-existent notebook?

Daniel Lobell: (29:40)
A non-existent notebook. Okay. Go on. What is it?

Grant Brenner, MD: (29:43)
A not book.

Daniel Lobell: (29:44)
A not book. Okay. So that one not as clever, but… [Daniel laughs]

Grant Brenner, MD: (29:47)
Well, you were questioning the reality of everything earlier, so it seemed topical.

Daniel Lobell: (29:53)
Yeah. Yeah.

Grant Brenner, MD: (29:54)
That’s what we call a callback in psychotherapy.

Daniel Lobell: (29:57)
I didn’t know you guys had callbacks in psychotherapy. That’s amazing.

Grant Brenner, MD: (30:01)
We have doorknob comments actually.

Daniel Lobell: (30:04)
[Daniel chuckles] You know, I always wish that I had recorded all my sessions with psychologists because I’d come up with some really good stuff in them, but I don’t record ’em and then I forget. But I think, when you’re reflecting on your life in a very deep and personal way, you come up with some great material.

Grant Brenner, MD: (30:22)
I’m not sure why, but I wanted to start heckling you when you said that.

Daniel Lobell: (30:26)
[Daniel chuckles] You ever heckle your patients when they’re… [Daniel chuckles]

Grant Brenner, MD: (30:31)
No. Absolutely not.

Daniel Lobell: (30:34)
“My mom never loved me.” “Boring! Boring. Heard that one already.”

Grant Brenner, MD: (30:41)
Right. “What else you got?” It’s like an audition. Well, no, but I think playfulness is really important. The playfulness and the creativity… Humor has great potential to be healing, though it can also really sting.

Daniel Lobell: (30:57)
Yeah. Yeah. And it can also really wake you up to things, going back to your truth in comedy, if you poke holes into societal narratives, you can wake people up to certain realities that they’ve either become unaware or oblivious of. So it serves a great purpose there as well.

Grant Brenner, MD: (31:14)
Like social commentary, like George Carlin, for example.

Daniel Lobell: (31:17)
Yeah. One of my favorites. What do you think makes a great psychoanalyst?

Grant Brenner, MD: (31:24)
Oh, I don’t know.

Daniel Lobell: (31:26)
[Daniel laughs] Well, thanks for joining us today. [Both laugh]

Grant Brenner, MD: (31:31)
Yeah. Yeah, that just… Yeah, I don’t know. I mean, who am I to say? I think being a good listener obviously, but… I think there’s a certain kind of wisdom. I think humor is part of it. Perspective. And there’s a knack to really making it a little bit easier for people to come to understand who they are. As we say in my analytic school, the good me, the bad me and the not me. And it’s the “not me” part that people have the most trouble with, or in Jungian psychology, which technically isn’t psychoanalysis, it’s analytic psychology. People talk a lot about shadow work. You see that term nowadays. And I think it’s really important cause it’s how do we deal with the dark side in a world that is not always looking so great, especially nowadays?

Daniel Lobell: (32:36)
I’m not familiar with shadow work. I’m curious. Can you tell me what that is? I think I can put it together from what you said, but please.

Grant Brenner, MD: (32:43)
Yeah. Well, so in Jung’s psychological model, people had different kind of parts of themselves that were called archetypes. And so there’d be like — don’t quote me on this, cause I’m not really well versed in Jung at the point, but like the persona would be the face you present to the world. The animus is the “male” part. It’s a little bit heteronormative, the anima, the female part. There were certain archetypes like the hero, like from religion or myth. Trickster, like Loki, the hero, like Thor. And, or the wise. The wise baby. The mother, the earth mother. And so the shadow was like all the kind of dark stuff that lurks in the unconscious that comes out in wars, that comes out during the Holocaust, or during genocide. And so shadow work is kind of coming to terms with all the parts of oneself. The light and the dark, so to speak.

Daniel Lobell: (33:45)
Well, thanks for shining a light on that.

Grant Brenner, MD: (33:47)
Yeah, sure. [Daniel chuckles] I see what you did there.

Daniel Lobell: (33:51)
Yeah, no, that’s interesting. So shadow work is basically the dark side of the human consciousness basically, and the exploring it? Or what, or pulling it, or getting to… You sit with somebody and go, “It turns out you got a lot of Hitler in you or something.” What is the work in shadow work? Is it finding the negative in the person’s psyche?

Grant Brenner, MD: (34:24)
Yeah, I’m not sure if “negative” is the word I’d use, but it’s the things that we are scared of. Or even things like mortality. But it also could be sadistic impulses or psychopathic parts of who we are. But I think the main idea, which is often the sort of main idea, the main idea in insight type psychoanalytic or psychodynamic therapy, is becoming more of a whole self and being more integrated. And so that means that you need to know all the different sides of yourself. Probably also important for being a good comedian or a good artist of any sort.

Daniel Lobell: (35:05)
Yeah. Or a good anything, probably.

Grant Brenner, MD: (35:09)
Arguably, but that gets in the way of certain professions, I would think too. I think there’s certain things people do that may work if you’re not aware of what you’re doing.

Daniel Lobell: (35:19)
Like bricklaying?

Grant Brenner, MD: (35:22)
I don’t know about bricklaying. [Daniel chuckles] Why bricklaying?

Daniel Lobell: (35:26)
I don’t know, just cause… Maybe just, it would get in the way if you’re super conscious of yourself, you’re just getting in the way of laying the bricks. Just gotta put the brick, one brick on top of another brick. And if you start getting lost in your head or you become too self aware, you may drift from bricklaying and you won’t wanna put any more bricks on the wall and then you only have half a wall.

Grant Brenner, MD: (35:48)
Maybe, maybe so. That makes sense to me. Reminds me of Pink Floyd too, which is also kind of shadow work, but I’m thinking more of people who go into professions, who are generally sort of very intelligent people, but they don’t necessarily think about like why they’re doing what they’re doing and whether it meets their needs as a person. They did what they were supposed to do. They went to the right schools. And you could argue that a lot of people in my profession may do that, though medicine has this kind of… You’re helping people, calling element to it for most people.

Grant Brenner, MD: (36:30)
But I also, I think I respect everyone’s sort of individual decisions, but what I see a lot is that people reach a point in the middle of their lives where they start to take a step back and they kind of go “Is this really how I wanna spend my time?” And of course there’s a lot of books written about this. Even in the business world, right? Like how are you using your time?

Daniel Lobell: (36:54)
Yeah. Well, if you’re using your time to read that book, is that a good use of your time?

Grant Brenner, MD: (36:59)
It’s very meta.

Daniel Lobell: (37:02)
[Daniel chuckles] So let me turn it on you for a second. What do you think it is about yourself or about your childhood that pushed you towards this “I’m gonna help people” calling?

Grant Brenner, MD: (37:15)
Well, to some extent, I think it’s nothing to do with my personal experience. I think it sort of runs in my family. I come from a long line of teachers. And so I think, I like to teach, and teaching is a way of helping people. And then I think sort of in terms of socioeconomics, like the way I grew up. The time that I grew up is, I could have probably ended up as an artist in some alternate reality. But the things that made sense for me were medicine or law. And I think I’m lucky because there was psychiatry and psychoanalysis that allows me to exercise all the different parts of my personality, cause I have a creative side and scientific side and a helping side. But seeing my mother be ill and pass away, seeing other forms of illness in my family and in myself growing up, from a very early age, I just felt a strong desire to help people, even to the extent that on — I remember in elementary school, I had read a book on acupressure, massage. And I liked helping the other kids. I remember one kid had an ankle cramp and I did some acupressure thing that I had read about. And he was like, “Oh, that worked.” [Grant laughs] And I was the kid who liked to hear people out and learn about them. But a lot of it is also kind of my scientific curiosity, like to understand about human nature. So in addition to psychology, growing up I also loved reading anthropology and sociology, as well as kind of computer stuff like artificial intelligence. And there’s something about how consciousness and intelligence works that’s really just fascinating to me as well as helping people. But they kind of go hand in hand, I think.

Daniel Lobell: (39:17)
Well, you gave me a good lead-in to talk about Doctorpedia with regards to the computer stuff. How do you —

Grant Brenner, MD: (39:25)
Well I’m still wondering what you have against Jerry Seinfeld, but go ahead.

Daniel Lobell: (39:29)
Oh, I’ve got nothing against Jerry Seinfeld. [Grant chuckles] He was one of the great influences on me that made me wanna become a comedian. I have nothing against him at all. I admire him.

Grant Brenner, MD: (39:37)
We’ll have to come back to it next time.

Daniel Lobell: (39:39)
[Daniel laughs] I just, I’m different than him, that’s all. We’re just different personalities and we approach comedy very differently. That’s all.

Grant Brenner, MD: (39:50)
We can take it offline. [Both chuckle] I’ll text you.

Daniel Lobell: (39:57)
Great admiration for him, but… [Grant chuckles] So let’s talk about the online health space for a second.

Grant Brenner, MD: (40:05)
Absolutely.

Daniel Lobell: (40:07)
Do you encourage or discourage people to look online before they come in to you?

Grant Brenner, MD: (40:15)
I think it would depend. I think some people that’s really helpful for, and for other people it can be really problematic. I think it depends not only on the person, but it also depends on the information resource, cause, not only is there a lot of not very credible information or even frankly misleading or dangerous information, there’s also not necessarily kind of information about how to use that information. And I don’t know actually if Doctorpedia covers that. I know Doctorpedia has very good expert medical opinion, but then I think there’s this question of how do people use that? I think you’re asking a really good question. So if you go to look for information, some of that information should be how to properly make use of it.

Daniel Lobell: (41:14)
Well, I think Doctorpedia is doing a good job with that. How did you get involved with Doctorpedia?

Grant Brenner, MD: (41:21)
Oh, I think Doctorpedia must have reached out to me. I don’t remember because I am so busy that it took me quite a long time to kind of think through my involvement. I think probably Jeremy reached out to me. And probably because I write a lot and so I’ll pop up if you’re looking for content. And I started a company that provides mental health and network for people called Neighborhood Psychiatry and Wellness. And I write, I guess a popular blog on Psychology Today called ExperiMentations with a capital M, and I published a few books on relationships with co-authors and…

Daniel Lobell: (42:07)
Yeah, I was looking at some of the books, and you sent me a link to “Making Your Crazy Work For You.” Do you wanna talk a little bit about that and then we’ll come back to what you’re doing at Doctorpedia?

Grant Brenner, MD: (42:18)
Yeah. So this is the most recent book that I co-authored with Mark Borg, a psychologist and also a psychoanalyst who trained at the same place I did, and John Daniel Berry, who is a registered nurse in an MHA, a mental health… What does MHA stand for? Mental health administration masters. And Making Your Crazy Work For You is the third book. The first book is called Irrelationship, which is sort of our manifesto. “Irr,” like irrational, irrelationship.

Daniel Lobell: (42:49)
And then you have Relationship Sanity too, is that, I guess the second book, correct?

Grant Brenner, MD: (42:52)
That’s the second one. So the main thesis is irrelationship is a two person, is a relationship, which isn’t really a relationship because the purpose of the relationship is to hide from intimacy because of anxiety. So it’s called How we use Dysfunctional Relationships to Hide From Intimacy. Relationship Sanity is a sort of a workbook, textbook for couples, and Making Your Crazy Work For You, it’s almost like group therapy for individuals. [Daniel laughs] So it’s all about how you get the different parts of yourself working together, starting with self compassion. And understanding.

Daniel Lobell: (43:29)
So it’s like group therapy for people with multiple personalities.

Grant Brenner, MD: (43:33)
Well, it’s group therapy for everyone because we all have different facets to our personality.

Daniel Lobell: (43:41)
So what’s the difference between someone who has multiple personalities? They’ve got multiple facets to each personality?

Grant Brenner, MD: (43:50)
Well, so if you’re talking diagnostically, then there’s a psychiatric diagnosis which is current — it’s now called dissociative identity disorder, which is very popular on YouTube and TikTok. And there are criteria for that. In dissociative identity disorder, the personalities are so different that the person has two or more personalities that aren’t aware of everything that the other is doing. And so there’s a dissociation, which is a loss of memory, but I’m just talking about normal multifacetedness. We all have different roles we play and different sides of our personalities, right? You might act differently in the boardroom than you do on the golf course. But the thing is, everyone is a bit different. So there’s some general principles, like there’s five or six different personality traits, according to most theories. But you can have different blends of those traits. And you might be a very agreeable person in general, but with some people you might be less agreeable and more agreeable with others.

Daniel Lobell: (44:52)
I disagree.

Grant Brenner, MD: (44:52)
And learning your own responsiveness so that you have kind of a running sense of it yourself, leads to greater integration, if you wanna say integration.

Daniel Lobell: (45:03)
I didn’t wanna say it.

Grant Brenner, MD: (45:05)
It’s like smoother functioning. It’s like [Daniel laughs] oiling up the machine.

Daniel Lobell: (45:11)
Right, right. Interesting.

Grant Brenner, MD: (45:12)
Not that people is a machine, but… So Doctorpedia.

Grant Brenner, MD: (45:18)
So I got involved because I believe in the mission of bringing good information to help people. And so I’m one of the folks who’s helping out with the mental health channel. And I think a big piece of that isn’t just sort of psychiatric diagnosis, cause I think at best, psychiatric diagnosis is a tool to help people change and grow. And certainly the diagnostic system we use is very much a work in progress, cause in psychiatry we really don’t have a strong biological basis yet for diagnoses, and that’s why they change. That’s why multiple personality disorder is now called dissociative identity disorder.

Daniel Lobell: (46:01)
I thought they just changed it up every now and then to make it seem like there’s advances in the industry.

Grant Brenner, MD: (46:09)
Yeah. [Daniel laughs] Yeah. I read that online too. I didn’t read that on Doctorpedia though. [Daniel laughs] Cause on Doctorpedia, you would get more high quality information.

Daniel Lobell: (46:19)
Yeah, of course.

Grant Brenner, MD: (46:20)
And not some conspiracy theories [Daniel laughs] that the medical, legal, corporate, military, you know, but of course there are corporate influences and you do have to be careful. I was the kind of person, believe it or not, my fellow residents during training would be annoyed at me because not only would I not take stuff from the drug reps. At that time they were still giving people stuff. I also would share information that marketing would influence prescribing behavior.

Daniel Lobell: (46:54)
Wow.

Grant Brenner, MD: (46:55)
[Grant chuckles] And they would be like, “Go away.”

Daniel Lobell: (46:58)
Yeah. Wow.

Grant Brenner, MD: (46:59)
They’d be like, “I know what they’re doing. It can’t influence me.” I was like, “Okay. Keep prescribing that particular drug.”

Daniel Lobell: (47:05)
Right. Wow. Well, good for you. I’m…

Grant Brenner, MD: (47:08)
I mean, I love the psychology of sales. There’s a guy named Bob Cialdini who wrote a book called Influence, which is really great. But like I said, Doctorpedia, I mean, I’m not quick to jump into stuff. And I believe in the mission and I believe in sort of bringing, not just psychiatry, but really emotional, mental health to people. And I do think that involves kind of self-awareness and what I call deep self care, not sort of like, okay, well it’s important to exercise and eat right, but really learning to take care of yourself in a sort of a full and loving way.

Daniel Lobell: (47:51)
You’re a deep guy. You go into depth therapy, deep self care. I imagine I would never see you on the shallow end of the pool.

Grant Brenner, MD: (48:00)
I mean, I have plenty of shallowness, but early in life I was exposed to very serious life and death stuff.

Daniel Lobell: (48:09)
Yeah. Yeah.

Grant Brenner, MD: (48:10)
And I have the personality to embrace it, I think. Versus kind of just run into something else.

Daniel Lobell: (48:17)
Thank God you were, because I think we’re all richer for it. And…

Grant Brenner, MD: (48:21)
That’s very kind of you to say.

Daniel Lobell: (48:22)
I’m looking forward to checking out these books. Are they available as audiobooks too, for people with severe attention deficit disorder?

Grant Brenner, MD: (48:31)
Yeah. I think there, at least the first two, I think, have already been transcribed into audiobook form. I don’t know if Making Your Crazy Work For You has. But I think if you get it on Kindle, Kindle may read it to you.

Daniel Lobell: (48:44)
Oh, interesting.

Grant Brenner, MD: (48:46)
You might be able to get it to read it to you in whatever way you want.

Daniel Lobell: (48:49)
Maybe I have to bribe it or something.

Grant Brenner, MD: (48:51)
Maybe in baby talk. [Daniel chuckles]

Daniel Lobell: (48:54)
Very cool. Very cool. Well, this has been a pleasure. I think we’re out of time, but I could do a whole nother hour with you. And if you’re interested in doing that sometime, I would love to.

Grant Brenner, MD: (49:05)
Yeah, absolutely. There’s a number of things I’d like to follow up with you on. [Grant chuckles]

Daniel Lobell: (49:10)
Yeah. Yeah. Well, this is great.

Grant Brenner, MD: (49:13)
You can analyze me too.

Daniel Lobell: (49:14)
I already have, I’ll be sending you a bill. [Both chuckle]

Grant Brenner, MD: (49:19)
It’s an old one, but a good one.

Daniel Lobell: (49:20)
Yeah.

Grant Brenner, MD: (49:23)
All right, good.

Daniel Lobell: (49:23)
I’m looking forward to checking out the stuff on the Mental Health channel, Doctorpedia, of course. Doctorpedia.com, if people wanna check that out, I hope you will. And I’ll ask you the question I ask all the doctors to round off the interview, which is, what do you do to keep healthy?

Grant Brenner, MD: (49:42)
Well, so many different things, but I’ll tell you my favorite thing right now, in addition to all the other things I like, is photography. And I do a lot of street photography. I live in Manhattan. There’s a lot of really interesting people and things. And I get to walk a lot and think and capture photographs. And you can check some of that out at @granthbrennermd on Instagram.

Daniel Lobell: (50:09)
Awesome. I’m gonna follow you right now. Grant H Brenner MD.

Grant Brenner, MD: (50:13)
Cool. I’ll follow you back.

Daniel Lobell: (50:14)
Okay, cool. Yeah. Well, I have to accept you. I made it private. I’ve become a private person, a private public person, but yeah, that’s great. My father is a photographer as well. What do you think attracted you to photography?

Grant Brenner, MD: (50:27)
Well, I mean, I’ve always liked it. And I’ve painted and poetry, but I like photography. I’m doing digital photography. I love the combination of kind of art and tech. I love the kind of instant gratification. I like this idea of being an observer. But also when I do photography, sometimes I really engage with people. It’s almost like journalistic. So I live in a part of Manhattan where there’s a really exciting kind of social scene. And I don’t go out as much cause of the kids, but sometimes I’ll go out with my camera and just start talking to people like on St Mark’s Place. And then they find out what I do, and then I have these incredible conversations and human beings are just so amazing, for all of our flaws. I mean, most people are just fantastic when you get to know them.

Daniel Lobell: (51:24)
Yeah. I agree. And I think you’re in the right business. I’m looking at your photography right now. It’s beautiful. It’s interesting. You love looking at people inside and out, so…

Grant Brenner, MD: (51:35)
And then you get to do stuff with the computer afterwards. So it hits the tech buttons too.

Daniel Lobell: (51:42)
Mhm. Yeah. It definitely makes sense that you would gravitate towards this, and you found some really interesting subjects here. Really interesting. I’m loving what I’m looking at here.

Grant Brenner, MD: (51:52)
Cool. Thank you.

Daniel Lobell: (51:53)
Thank you so much, Dr. Brenner. I really enjoyed our conversation today.

Grant Brenner, MD: (51:58)
Pleasure, Dan.

Daniel Lobell: (52:04)
This podcast or any written material derived from its transcripts represents the opinions of the medical professional being interviewed. The content here is for informational purposes only and should not be taken as medical advice. Since every person is unique, please consult your healthcare professional for any personal or specific needs.

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