This is episode 1 of a 4-part special series on mental health with psychiatrist Dr. Paul Conti, M.D., who trained at Stanford School of Medicine and completed his residency at Harvard Medical School before founding his clinical practice, the Pacific Premiere Group. Dr. Conti defines mental health in actionable terms and describes the foundational elements of the self, including the structure and function of the unconscious and conscious mind, which give rise to all our thoughts, behaviors and emotions. He also explains how to explore and address the root causes of anxiety, low confidence, negative internal narratives, over-thinking and how our unconscious defense mechanisms operate. This episode provides a foundational roadmap to assess your sense of self and mental health. It offers tools to reshape negative emotions, thought patterns and behaviors — either through self-exploration or with a licensed professional. The subsequent three episodes in this special series explore additional tools to further understand and improve your mental health.
For the full show notes, including articles, books, and other resources, visit hubermanlab.com.
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Timestamps
(00:00:00) Dr. Paul Conti
(00:03:46) Sponsors: BetterHelp & Waking Up App
(00:06:55) What is a Healthy Self?
(00:10:41) Agency & Gratitude; Empowerment & Humility 
(00:16:13) Physical Health & Mental Health Parallels
(00:20:21) Structure of Self; Unconscious vs. Conscious Mind; “Iceberg”
(00:26:15) Defense Mechanisms; Character Structure “Nest”, Sense of Self 
(00:31:27) Predispositions & Character Structure
(00:36:01) Sponsor: AG1
(00:37:27) Character Structure & Action States; Physical Health Parallels
(00:46:20) Anxiety; Understanding Excessive Anxiety
(00:53:12) Improving Confidence: State Dependence & Phenomenology; Narcissism
(00:59:44) Changing Beliefs & Internal Narratives
(01:06:04) Individuality & Addressing Mental Health Challenges
(01:11:21) Mental Health Goals & Growth
(01:17:32) Function of Self
(01:23:00) Defense Mechanisms: Projection, Displacement
(01:30:14) Projection, Displacement, Projective Identification
(01:34:50) Humor, Sarcasm, Cynicism
(01:40:41) Attention & Salience; Negative Internal Dialogue 
(01:45:02) Repetition Compulsion & Defense Mechanism, Trauma
(01:58:55) Mirror Meditation & Self Awareness; Structure & Function of Self, “Cupboards”
(02:04:57) Pillars of the Mind, Agency & Gratitude, Happiness
(02:13:53) Generative Drive, Aggressive & Pleasure Drives
(02:21:33) Peace, Contentment & Delight, Generative Drive; Amplification
(02:24:18) Generative Drive, Amplification & Overcoming
(02:33:00) Over-Thinking, Procrastination, Choices
(02:42:20) Aggressive, Pleasure & Generative Drives, Envy
(02:49:46) Envy, Destruction, Mass Shootings
(02:55:38) Demoralization, Isolation, Low Aggressive Drive
(03:02:50) Demoralization, Affiliate Defense 
(03:09:32) Strong Aggressive Drive, Competition, Generative Drive Reframing 
(03:20:02) Cultivating a Generative Drive, Spirited Inquiry of the “Cupboards”
(03:26:06) Current Mental Health Care & Medications
(03:35:33) Role of Medicine in Exploration
(03:40:41) Zero-Cost Support, YouTube Feedback, Spotify & Apple Reviews, Sponsors, Social Media, Momentous, Neural Network Newsletter
Title Card Photo Credit: Mike Blabac
Disclaimer

Welcome to the Huberman Lab guest series, where I and an expert guest discuss science and science-based tools for everyday life.

I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine.

Today's episode marks the first in a 4 episode series all about mental health.

Paul Conte is a medical doctor and psychiatrist who completed his medical training at Stanford University School of Medicine and then went on to become a chief resident of psychiatry at Harvard Medical School.

He then went on to found the Pacific Premier Group, which is a collection of psychiatrists and therapists who are expert in treating all types of psychiatric disorders and life stressors.

Across the 4 episodes of this series on mental health, Dr.

Conte teaches us about the structure of our own minds and how to think about our own minds as a way to enhance our mental health.

He explains how our subconscious mind and our conscious mind interact to drive our emotions, our decision-making and our behavior.

And while any series about mental health requires that from time to time, we discuss personality disorders and psychiatric challenges, the main discussion in today's episode, and in fact, all 4 episodes in this series, are about what it means to be mentally healthy and how to build one's mental health through specific practices, either done alone or with a therapist.

Today's episode addresses several key questions, as well as provides protocols for you to address questions about your own mental health.

For instance, you will learn what constitutes the most mentally healthy version of yourself.

You will learn to assess and indeed you will learn protocols for addressing levels of anxiety, levels of your confidence, how to think about your beliefs and internal narratives, how to think about your self-talk and restructure your self-talk.

We discuss common challenges such as overthinking.

We talk about the role of defense mechanisms and other aspects of the conscious and unconscious mind interactions that can lead us toward or away from the healthiest versions of ourselves.

You'll notice that during the first 5 minutes or so of today's discussion, Dr.

Conte describes a framework of what he refers to as the structure of self and the function of self.

And he describes several pillars for understanding what those are.

I'd like to highlight that while that short portion of our discussion does bring up a number of terms that are likely to be novel to you, they certainly were novel to me, that as our conversation proceeds, you will really come to appreciate just how simple and yet powerful that framework is.

It will help you understand, for instance, the relationship between your conscious mind and your subconscious mind in ways that you can really apply toward enhancing your mental health.

Conte has generously provided a few PDFs which illustrate that framework for you and that are available completely 0 cost by going to the links in the show note captions.

So you have the option to download those PDFs and to look them over either prior to, or during, or perhaps after you listen to these 4 podcast episodes.

As a final note before beginning today's discussion, Just want to emphasize my sentiment, which I'm confident will soon be your sentiment as well, which is that Dr.

Paul Conte shares with us immensely powerful tools for enhancing mental health that at least to my knowledge have never been shared publicly before.

In fact, as somebody who has done more than 3 decades of therapy, I've never before been exposed to a conversation about the structure of the mind and the subconscious mind, as well as tools and protocols for enhancing mental health as powerful as these.

For me, the information was absolutely transformative in terms of reshaping my thought patterns, my emotional patterns, and indeed several of my behavioral patterns.

And I'm confident that the information that you'll glean from today's episode and throughout the series will be positively transformative for you as well.

Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford.

It is however, part of my desire and effort to bring 0 cost to consumer information about science and science related tools to the general public.

In keeping with that theme, I'd like to thank the sponsors of today's podcast.

BetterHelp offers professional therapy with a licensed therapist carried out online.

I personally have been doing weekly therapy for more than 30 years.

And while that weekly therapy was initiated not by my own request, it was in fact a requirement for me to remain in high school.

Over time, I really came to appreciate just how valuable doing quality therapy is.

In fact, I look at doing quality therapy much in the same way that I look at going to the gym or doing cardiovascular training, such as running, as ways to enhance my physical health, I see therapy as a vital way to enhance one's mental health.

The beauty of BetterHelp is that they make it very easy to find an excellent therapist.

An excellent therapist can be defined as somebody who is going to be very supportive of you in an objective way, with whom you have excellent rapport with, and who can help you arrive at key insights that you wouldn't have otherwise been able to find.

And because BetterHelp therapy is conducted entirely online, it's extremely convenient and easy to incorporate into

So if you're interested in BetterHelp, go to betterhelp.com slash Huberman to get 10% off your first month.

That's BetterHelp spelled H-E-L-P.com slash Huberman.

Today's episode is also brought to us by Waking Up.

Waking Up is a meditation app that offers dozens of guided meditation sessions, mindfulness trainings, yoga nidra sessions, and more.

By now, there's an abundance of data showing that even short daily meditations can greatly improve our mood, reduce anxiety, improve our ability to focus and can improve our memory.

And while there are many different forms of meditation, most people find it difficult to find and stick to a meditation practice in a way that is most beneficial for them.

The waking up app makes it extremely easy to learn how to meditate and to carry out your daily meditation practice in a way that's going to be most effective and efficient for you.

It includes a variety of different types of meditations of different duration, as well as things like yoga nidra, which placed the brain and body into a sort of pseudo sleep that allows you to emerge feeling incredibly mentally refreshed.

In fact, the science around yoga nidra is really impressive showing that after a yoga nidra session, levels of dopamine in certain areas of the brain are enhanced by up to 60%, which places the brain and body into a state of enhanced readiness for mental work and for physical work.

Another thing I really like about the Waking Up app is that it provides a 30 day introduction course.

So for those of you that have not meditated before or getting back to a meditation practice, That's fantastic.

Or if you're somebody who's already a skilled and regular meditator, Waking Up has more advanced meditations and yoga needer sessions for you as well.

If you'd like to try the Waking Up app, you can go to wakingup.com slash Huberman and access a free 30 day trial.

Again, that's wakingup.com slash Huberman.

And now for my discussion about how to understand and assess your level of mental health with Dr.

I'm very excited for today's episode and for the series because I, like so many other people out there, have a lot of questions about myself and themselves, and not just about ourselves, but how the different personality types out there, the healthy types, the narcissists, the, you know, all the things that we hear about these days, gaslighting, all these sorts of things, what all of that really is, perhaps we can dispel some of the myths that exist during the course of this series.

And also raise certain important questions that we should all ask ourselves in terms of trying to understand who we are and how we can be the best versions of ourselves, how we can experience the most happiness, also the most richness in life, because of course life isn't just all about being happy.

So to start off this question, I wanna raise a parallel with something I think for most people is more concrete, which is physical health.

While there isn't an ideal physical self that's been defined by the medical community.

We know for instance, that there is a range of blood pressures that are considered healthy.

There's a range of body mass index that's considered healthy.

Although that's a little controversial because it depends on how much muscle, how lean people are, et cetera.

But, you know, I think it's reasonable to say that the healthy individual is not going to get exhausted walking up a flight of stairs, that they could bend down and lift an object without hurting themselves.

They might even have some additional strength or endurance, et cetera.

Within the physical health domain, all of that is fairly well scripted.

And there are protocols that people can follow to improve their physical health.

We've covered many of them on this podcast before.

When it comes to mental health and it comes to concepts of the self, things become much more abstract for people.

In fact, I think most people, including myself, are kind of wandering around in the dark, wondering whether or not we are the best versions of ourselves, whether or not we're thinking about ourselves and the world around us in the best ways.

So to start things off, you tell us, what is the healthy version of self?

I mean, what should we all be aspiring to?

You've worked with people who presumably are healthy and people who have severe pathologies of different psychiatric types, right?

Bipolar, narcissistic, sociopathic, and everything in between.

So for me and for the listeners, what is a healthy self?

Healthy self approaches life through the lens of agency and gratitude.

If you look at happy people, people who like their lives, no matter what stage of life they're at, no matter what their socioeconomic status is, race, religion, there's so many things that we think matters, right?

Do they matter to, is someone happy or not?

The factors that tell us, is this person enjoying life?

Are they engaged productively in the world?

And if we have those 2 things, then it's interesting you almost never see someone go wrong, right?

And even if there are difficulties, even if there are, if things happen in life that can make some unhappiness, right?

It doesn't take away the person's engagement in life, the person's enthusiasm for life.

And I think if you look at even traditions of understanding, how are people happy, whether it's in psychiatry or it's through literature or through a religious lens, it is always people who approach life through the lens of agency and gratitude.

go a little bit deeper on agency and gratitude?

When I hear the words agency and gratitude, I think agency and ability to affect the world around me in

And we did an entire episode all about gratitude practices, some of the neuroscience and neuroimaging and neurochemical changes that occur in the brain and body when people exert a gratitude practice.

But I have a feeling that when you talk about agency and gratitude, you might be talking about something slightly or maybe even quite a bit different than the way that I'm defining it.

Yeah, I would say agency and gratitude are these amazing rewards that sit on top of the highly complex brain function inside of us and the highly complex psychology in all of us.

So if we think about a self, that I identify a self, I'm an I, If I'm gonna approach the world with agency and gratitude, that's sitting on top of a lot of healthy things, right?

And the idea that, okay, there are ways in which we can be mentally unhealthy, right?

But to start with, what is going on inside of us, right?

And what does it look like when we're healthy?

So there's a structure of the self, right?

And if we look at the structure and the function and the parts, the components of structure and function, we can come to understand what is going on in us, what might we change for the better, how do we build empowerment, right?

Empowerment is the ability to navigate the world around us and to bring myself to bear in ways that are effective.

And from empowerment arises the sense of agency, right?

I have agency because I am empowered, right?

And also from a healthy structure of self and function of self, we end up with humility, right?

We come through that with a sense of our place in the world and our power in the world to navigate as we choose, but also a sense of the world around us that's far more complicated than just we are, extends beyond us to other people, to the climate around us, to the health of the whole planet.

We feel a sense of humility that I'm here and I can do good things.

I'm fortunate to be here and I'm part of this bigger ecosystem, right?

All the way up to the scale of the ecosystem of earth, right?

And if we feel that humility, then we approach the world through the lens of gratitude.

So the idea that a healthy structure of self and a healthy function of self leads to empowerment and humility and then upon that we are sort of imbued with agency and gratitude and that leads us forth to happy lives.

Okay, so it's clear to me why having agency and gratitude would be wonderful, perhaps even the goal state that we should all be seeking to achieve.

And it also makes sense to me as to why Empowerment and humility are Important components that feed into our ability to have agency and gratitude.

Yes, right because all of that at least to my mind sums to it a very clear statement about Having agency and gratitude is the best way to approach life.

And yet I've never really thought about it that way.

And I think most people haven't ever been told this, right?

So we've heard endless number of podcasts, including this podcast about physical health.

And we've been told by physicians and everybody else that we should seek to have a relatively low blood pressure, we should seek to have a relatively low heart rate, that our cholesterol should be at a certain level, et cetera.

So within the physical health domain, there are strong, clear messages about what we should all be striving toward.

And in a similar way to how we're discussing the self in psychology, I don't think anyone seeks to have low blood pressure or low heart rate because that's what they want per se.

They want those things along with some capacity for endurance, the ability to lift an object, so some strength, et cetera, because of the way that those metrics of health allow them to move through the world in the best possible way.

In other words, having some degree of endurance allows you to walk down the block, maybe a lot further, or to walk up several flights of stairs, or to have some strength allows you to pick up objects and effectively move through life.

You're telling us that having a sense of agency and gratitude and that agency and gratitude are undergirded by empowerment and humility.

And that's the best way to move through life, the most effective, happiest, if you will, way to move through life.

Well, then I think we have to ask ourselves the same thing we would ask about physical fitness, which is what goes into creating a sense of agency and gratitude, empowerment, and humility?

Because if I want more endurance, I know to get on an exercise bike or a treadmill or go out for a run a few times a week or more.

If I want to get stronger, I'm going to lift objects that are difficult to lift until they're easier to lift.

I mean, it's all pretty straightforward in the physical domain, but in the mental health domain, in the psychological domain, it does become a bit more abstract.

I think in part because no one's ever told us, certainly no one's ever told me, what you really need is agency and gratitude in order to have the best possible life.

So I very much appreciate that you're telling us this, and I'd love for you to tell us, what are the action steps that go into creating these things that we're calling agency, gratitude, empowerment, and humility.

There's actually quite a strong parallel between the physical health dimension and the mental health dimension.

So as you're saying, like, why do you put in the time, the energy, the learning, right?

It's a lot of effort and we put so much of ourselves towards it if we decide that we value that, right?

Because as you said, it's the best way to approach life.

Like there may be some thing that I want to do.

Or I, you know, I want to climb a mountain, right?

But ultimately we take care of ourselves physically because we don't know what's coming next in life.

And we want to be prepared for it, good, bad, and otherwise.

And the same thing is true of mental health.

I can feel grateful that I'm still breathing right now.

But that doesn't mean that I'm living life through the lens of agency and gratitude, which is consistent with every opinion.

If you look psychologically, through the lens of literature, through the lens of sociology and psychology, agency and gratitude make happiness, right?

And just like physical health is undergirded by cardiovascular health, heart health, muscle strength, right?

There's an undergirding of agency and gratitude And empowerment and humility are ways of describing, okay, what arises from understanding ourselves, taking care of ourselves, that then gives us the agency and gratitude.

So, we have empowerment, We have humility, but where does it all come from?

So just like we have to understand the physical body and what to do to it in order to be healthy, we also have to understand the mind, the self that wants to be healthier.

And that comes through understanding the structure of the self.

And we have enough science through the lens of neurobiology and psychiatry to understand the structure of self, and then the function of self, right?

So it's actually not more complicated than physical health.

It's just that we don't spell it out that way, right?

We come at it through the lens of pathology, of what's wrong and who has some diagnosis.

And, you know, we're looking for the problematic instead of saying, like, what do we look like when we're happy right and then going and digging down into the mechanics of it all right and if we're not in that state right to go and look at that and to make changes just as if you were very very physically healthy right but you know your heart rate couldn't go up that much without you feeling very, very fatigued.

We'd say, well, look, you're doing a lot of the right things, but let's work more on your heart.

We would go look at the specifics of it because that's how we understand it And we just don't apply the same science, logic, common sense to mental health as we do to physical health.

But it's time for that to change because we have the knowledge and ability to do just that.

Andy Galpin on this podcast to do a series on physical health and fitness, essentially, he said something that really stuck with me, which was that the number of different workouts that people can do out there, body weight workouts, work with weights, with machines, you can run far, you can run shorter distances more quickly, you can do planks, sit-ups, so many variations on exercise routines.

But what he very clearly stated was that there are only a few core adaptations that the body can undergo that lead to these byproducts that we call lower blood pressure, enhanced endurance, improved strength, improved neuromuscular function, improved brain function for that matter.

It sounds to me like there are a lot of parallels in creating the healthy psychological self.

So what are the core components that I and others should think about in terms of understanding, I think you described them as the structure of the self and the functions of the self.

Again, just to draw a parallel, if we were talking about physical health, we'd say, okay, there's connections between nerves and muscle that allows us to move our limbs.

If you apply a certain amount of resistance, you get a certain adaptation, which is the neuromuscular connection gets stronger, the muscle might get bigger or just stronger, et cetera.

Flexibility, you just push your range of motion just a little bit into discomfort.

It so happens to be the case that you do that for just a couple of minutes each day over the course of about a week or so, you get a significant increase in flexibility.

Okay, so it's all very clear in the physical domain.

In the psychological domain, I hear you telling us that the action steps that we all should be taking in order to be the happiest version of ourselves by achieving agency and gratitude is to explore the structure of self and the function of self.

So if you could Tell us about what is the structure of self?

Like what goes into Andrew being Andrew and Paul being Paul and whoever the listener is into being who they are?

How does a psychiatrist think about that?

Okay, if I could start maybe to set the stage for that, by pointing out that as we go up the hierarchy of health, everything should get simpler, not more complicated.

If you think about physical health, there's so much complexity on the initial levels.

So we think about your physical health status versus mine.

We're gonna have different cardiac function and muscle function and pulmonary function.

And if we're gonna be healthy, we could do a lot of different things.

There might be a whole set of choices that would work well for you, different choices that would work for me, and we can gauge intensity, timing, frequency.

It's very complicated when we're on the lower levels of the hierarchy.

As we get higher up, let's say you and I both do the right things, right?

Things are getting simpler because we're approaching the unique idiosyncrasies in all of us, right?

And we have to look at that and look at that in a very specific way.

But what we're trying to get to is something that's common for all of us.

So stamina, for example, in physical health and endurance, right, and agency and gratitude in mental health, right?

So then if we go and we look and we look at the structure of the self and the function of self, we find that there's more complexity, but that it is also understandable.

I mean, there's tremendous complexity in the body, just as there's tremendous complexity in the mind, and we can understand what is the structure of self, what is the function of self, and we can look at that and assess that in the same way we would physical health parameters, so that we arrive at the place we want to be, be it endurance or agency or gratitude.

And we pay so little attention to this part of us that really is the biological supercomputer, right?

So millions of things are going on all the time, like in every split second.

So for example, I can say these words, right?

You can listen to the words, you can say things back and I can listen, right?

There are millions and millions of things going on under the surface, much of which comes from either biological predispositions, or habits over time, thought processes, patterns.

So this unconscious mind, this supercomputer, is doing all of these things.

At the speed of light, There are electrical and chemical signals and, you know, multiple pathways as common as complicated as superhighway systems that then get consolidated and communicate with others, right?

And then what comes up from all of that is the conscious mind.

And it's a really, really big iceberg, right?

And we see the part above the surface, right?

But there's a huge part of this iceberg, maybe 95% of it that's underneath the water, right?

There's this hulking mass that we don't see.

And it's feeding up to the conscious mind, which is a much smaller part of our brain function, right?

But it's the part that we're aware of, right?

It's sitting on top of all the unconscious things which are extremely important, but then we become aware so that we can engage in the real world.

In order for us to have this conversation, the millions of things per second have to be going on underneath the surface so that you and I as conscious eyes, as conscious selves, can ride along on top of it.

So that's the part of the iceberg that's above the water.

Then imagine that the conscious self is girded by a set of long tendrils that come out from under the water, right?

That there are defense mechanisms that are unconscious to us that sort of gird the conscious mind.

Are these things in us in ways that we can observe and change, but that are there to try and protect the conscious mind from the slings and arrows of the world around us.

So if you imagine there's the big part of the iceberg under the water, the unconscious mind.

The conscious mind is riding on top of it, but the conscious mind, that part sticking out of the water is vulnerable, right?

So imagine that there's a defensive structure then that arises from the part of the iceberg that's underwater that is there to defend and protect the conscious mind.

So when you say to defend and protect, when you say that the conscious mind is vulnerable, what do you mean?

Do you mean that it's vulnerable to physical attack or that it's vulnerable to us realizing that we're just a bunch of neurons that are clicking away underneath?

Like, in other words, where does the vulnerability of the conscious mind really reside?

But you know, what am I so worried about in terms of my safety?

I mean, right now we're in a room, I feel pretty safe.

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GUEST SERIES | Dr. Paul Conti: How to Understand & Assess Your Mental Health