EFR 769: Embracing Mortality - A Guide to Living with Purpose and Authenticity From a Dying Man with Dr. Mark Goulston

00:03 - Speaker 1 Dr Mark, welcome to Everford Radio. Thank you so much for being here today.

00:07 - Speaker 2 Well, I've really been looking forward to it and can hardly wait to find out what we talk about.

00:13 - Speaker 1 Well, we're going to just jump right in and what we're going to talk about, the subject matter might seem a little dark, might seem a little down, dare, I even say, you know, negative, maybe something that my audience isn't thinking about all the time, or at least on the daily basis. We're talking about mortality, death, dying, real light subject matter here. How can you, maybe, before we really get into the nitty gritty, how can you frame this for us, for the listener to really have a non-negative stance, a welcoming and hopefully getting to a positive interpretation, positive understanding of mortality? How would you frame this for us?

00:58 - Speaker 2 Well, in my career, one of my specialties was I was a deaf and dying specialist, so I focused on suicide prevention. None of my patients died from suicide in 30 years, so I learned something about that. How do you get through to people who are feeling suicidal and hopeless and have a real special passion for veterans and military because of the rate of suicide there. And also I did house calls to dying patients to try to help them. Oh, I guess, find peace, find meaning, find something, rather. So I you know being bathed in all this.

01:34 It's the kind of irony that I'm now facing my own mortality. I have an illness called high risk MDS, which is myeloid dysplastic syndrome, and it becomes acute myeloid leukemia in the not too distant future, which is kind of one of the tougher forms of leukemia, and ever since I found out about this it's changed my life for the better. I actually have a YouTube channel and a TikTok channel called I'm Dying to Tell you, because every day I'm learning things that I think mortality has taught me, that I'm wanting to share with the world, and you don't have to be dying to learn some of this stuff I'm learning. So that's part of my mission now, because every day, I'm just learning things about life.

02:36 - Speaker 1 I've talked about it on the show before even had some great guests like Dr Jay Tita and some other great thinkers in the mindset and personal development space. Jay is just the first one that comes to mind. My audience has probably heard me talk about memento mori, this great, you know kind of Latin term, stoic term that means remember you must die. Is this what we're talking about here? Is it more than just acknowledging one day we will inevitably die? What value, what other value does truly facing our mortality hold for daily living?

03:17 - Speaker 2 Well, I'll share a couple of things. The first episode of I'm Dying to Tell you is called Michelangelo Dying. I didn't know that I would just be putting out these videos constantly. I'm putting out more recently because when I get this treatment that I'm about to go into, there could be some cognitive impairment and my creativity could take a hit. Hopefully it won't. Well, hopefully it'll work and hopefully I'll be around for a while. We go from optimistic to slightly less optimistic, but I've basically been feeling more optimistic.

04:00 My first episode, michelangelo Dying, was kind of built on the idea that Michelangelo saw the angel inside the marble and he carved to set it free. I saw what's important in life and I carved away everything that's unimportant. There was lots that was unimportant. That was just. I don't even know why I was doing it, but I just lopped it off. The more you can just carve away what's unimportant, it gives the chance for what's important to show itself clearly. That was an insight that I don't think you have to be dying or facing death to recognize. Here's an exercise. It's one of the other episodes that I often share with audiences. I say imagine that your personality is a circle. In that circle are the parts of your personality that are trying to prove, show, hide or please Prove, show, hide, or please Now go for a long walk and imagine getting rid of all of those what's left, and a lot of people will say nothing. I'm proving, showing, hiding or pleasing, and if that's the case, you don't belong to you, you are leased out to the world, and when you can eliminate those, just having the intention, you may discover as high of discovered that there's a calling that's been calling out to you for decades which has never got through because I got a busy signal, and so these are things that I'm learning.

06:09 Something else I used to do presentations where I would play Steve Jobs coming back from the dead. I had a turtleneck on, I had glasses, and in my work as a therapist, as a suicide specialist, I developed the ability to look at the world through anybody else's eyes. I could just let go of what I was seeing and I would look at the world through other people's eyes. So when I did this one man show Steve Jobs Returns I kind of channeled my inner A-hole. I had fun with that, and what I realized is and this is probably worth writing down, you may even want to write it down that visionaries not necessarily leaders.

07:01 Steve Jobs and Elon Musk aren't necessarily the best leaders. They're certainly not great managers, but they follow the three D's. Which is the first one is define reality beyond what's possible and what's even imaginable. So for Steve Jobs, it's well, I think everyone's going to have a personal computer, maybe a few years later they're going to have this thing called an iPhone. And for Elon Musk, it was well, we have batteries and laptops. I think we could do this in cars, and maybe we'll privatize space travel.

07:39 And so the first thing is you define reality way beyond what anyone else can see. The second D is you declare your intention to make it so. So Steve Jobs had this thing called a reality distortion field. He could convince everyone, including himself, of something, including that he didn't need Western treatment for his cancer. And then the third D is you decide strategy. So how are we going to do this? And again, visionaries aren't good with people, so anything after that is operations, and they don't do a very good job. So it's really good to bring in a Tim Cook or someone, because you're going to run all over your people with your three D's.

08:24 And so I have visionary dying. And so I've defined reality. I can see so clearly what a good death is. I can see it and taste it and I'm living up to all of it, except living till I'll be 90. So I had a mentor who was a death and dying specialist and he wrote an article which I featured parts of it on my website called the good death, and there's all kinds of criteria. It's not rocket science and I have all of them except live till you're 90. My favorite was something he got from one of his mentors which was a good death is dying so as to be as little a pain in the ass to your family as possible.

09:15 - Speaker 1 I like that one. I think we can all get on board with that. That should be a goal for us all, right.

09:21 - Speaker 2 Yeah. So I've defined that reality and then I've declared my intention I'm going to do it Whatever it takes. And then deciding strategy. And here's another one of my little episodes A good team and partners are really, really critical. I have the best doctor I've ever met. He has 265 five star patient reviews. He's a unicorn amongst unicorns, and before him I consulted someone who is very bright but really arrogant and unapproachable. And I have a feeling I wouldn't be as calm as I am If I didn't have this amazing doctrine team. And it's just so part of my strategy and part of your strategy. If you want to accomplish anything in life, you can't do it all alone. Make sure you have the right team, Make sure you have the right spouse, you know, and make sure you're the right team person. If you're sloppy, clean it up, Be accountable.

10:28 - Speaker 1 You know I'm hearing you say in this correct me if I'm wrong here the importance really of the necessity of meaningful relationships of community when facing mortality? Is that really the only way that we're going to or lack of a better phrase survive death?

10:47 - Speaker 2 Oh yeah, absolutely. Here's one of the other things. I don't know if I'll we'll see I could get there. One of my other episodes is the power of total vulnerability, because I've lived my whole life to serve I was a therapist, a psychiatrist. I wasn't comfortable with people caring about me, helping me. I'm here to help you. And so whenever I'd speak to someone it would be, you know, they'd say how are you doing? I'd say I'm fine, and then I'd flip it. So you know, you know, what are you trying to achieve? That's what I one of the things I said to you, chase, before we got on. So how do we make this good for your audience, for you, for your mission? How can I support that?

11:43 And about five months ago, you know, I guess someone was reaching out to me I have a pretty good network and they said, well, how are you doing? And instead of saying, oh, I'm fine, I don't know what, overcame me and I said, well, I got a couple issues and they said, like what you know? And they were multitasking, I was probably the seventh and the 10 calls that we're going to make to try to grow their business or something. But I happen to like the person and you know we had some sort of relationship and they said, oh, it's that I said. And then I looked right into the camera and I just felt whatever I was feeling and I said I might be dying. And I just paused and I got emotional, not boohoo emotional, like oh, helpless, it was just. It just overcame me and I apologized. I was embarrassed. I said I'm so sorry. This is right, I'm sorry.

12:45 And he said don't apologize. I said, oh, this is so no, he said don't apologize. And then I said yeah, but I shouldn't let you said, mike, this is a gift. And I said how is this a gift? He said this is the most emotionally intimate conversation I've ever had in my life. And you might think how sad. It's not that rare. A lot of people just don't connect. And then what happened is I got slightly more comfortable showing my feelings in it and then another person said I'm envious of you. Why you envious? Well, I don't want your illness, but you're so open right now, I mean, you're so real, you feel safe with me and you can feel safe. I'm not going to do a bait and switch on you. And I'm envious of you because I see you, marcus, free, and I've never felt the way you feel right now. I've never felt totally free.

14:05 - Speaker 1 I've never felt. Free of the fear of death they're talking about.

14:10 - Speaker 2 No, just free emotionally. Free emotionally, I mean. Basically what he was saying is I'm not paranoid, but I always have my guard up to a certain degree. What does the other person want from me? My food show, hide, these things. And he basically said your guard is completely down and I think you're free. And then these people and so one of my other episodes is called my personal 700 Club, because these people started saying to me 24-7 Mark. And I said what is 24-7? And they said you can call me 24-7. And these are people. If I hit on them with some cockamamie business idea, they would say well, that sounds interesting. I got a lot of money. Good luck with it. Mark Can't help. But they were the ones who were saying 24-7 Mark.

15:16 - Speaker 1 As in, we're here for you, no matter what, no matter when.

15:19 - Speaker 2 And I was trying to figure out why did they offer that? And what I realized? Yes, it feels good that I'm letting them care about me, but they have spontaneously said 24-7, because they want more of a conversation like this, because they just don't have it.

15:43 - Speaker 1 So it's maybe not as much all about you, not as much of hey, we're here for you, but rather they understand the value of exchange here and it's kind of helping them out. So this is really more for them.

15:56 - Speaker 2 Oh yeah, I think that's what the 24-7 is. Yes, it helps me, but there's something very rare about it. I remember one of the people I won't mention him. He's a former top CEO. He was in the book Good to Great, one of the most admired CEOs, and I love this guy. He's really decent, earnest, and he's on the spectrum. He's a little bit Asperger's, and so we're having a conversation and his face gets all contorted because I can feel that he cares about me. I'm letting the caring in, I'm just telling him where I'm at and his face squinched up as if to say what Mark is doing is really important and I don't get it, but it's really important, meaning he's probably a little bit Asperger's and he was concentrating like there's something really important about this, but it doesn't fit an algorithm, but it's really important. And there was a point at which he just said this is a real honor. Mark, you can call me anytime.

17:23 So I'm building on what you said two tangents ago about the importance of connecting with people and something I'll share with you and your listeners. There's a difference between your loved ones knowing that you love them and their feeling that you love them, and a lot of times people go through an entire life. People are opening up to me. I remember one person, real busy, and he said oh, my dad had this illness and I figured I got to make time for him. So I went to the hospice, stopped everything and just held his hand for three days until he died. And this man, powerful man, was crying. He said most powerful moment of my life. So I'm just trying to share these things with people and I thought that is tragic. Why do we wait so long?

18:36 - Speaker 1 That's the question, I think, for the ages, whether we're talking about facing mortality, accomplishing what we want in life, saying no to someone, saying yes to someone, taking risk, asking that person out, asking for the raise, taking that vacation or just saying screw it, you know, and double make hair kind of attitude for the day.

18:58 You know, why does it take a travesty, why does it take a traumatic event, why does it take getting sick, getting injured, you know, being around someone that is on a countdown for us to really kind of go wait a minute. Today can be that day. Right now can be that moment when I let my guard down for myself and in the presence of this other person that is clearly doing so for themself and for me. Today could be the day, and now could be the moment, that I finally allow truth to come out of my mouth, to sit with these emotions, these fears love, I mean anywhere and everywhere on that spectrum of the emotional experience of being human. How much of that do we keep at bay? Do we keep, like you said earlier, keep that wall up, but why, you know? Until we kind of face the finiteness of life, our own life or somebody else, it kind of has to just be that ultimate experience for us, for most of us, to really kind of cross that threshold and to be so free like you're talking about.

20:09 - Speaker 2 So are you open to a little insight that I have into you right now?

20:14 - Speaker 1 Please, absolutely yeah.

20:22 - Speaker 2 So I'm going to channel my inner chase. Get ready for this. Okay, I'm going to speak for you, all right.

20:28 - Speaker 1 Good thing I'm sitting down.

20:32 - Speaker 2 Mark, have at it. Everything you're saying, mark, it's home. But I tend to be emotionally shy because I default to where I feel very confident, and I'm really confident at understanding, solving, figuring things out, conceptualizing, making sense of things. Even in this interview I'm making sense, I'm trying to. I'm the host. My listeners want me to be able to make sense of what you just said, mark, and I think I default to that because I'm really good at it.

21:17 But it may be at the expense of really being emotionally real and I think I think I'm capable of making people I love sometimes feel a little lonely because I'm figuring things out, I'm solving them, I'm being so competent and capable and that's how I show caring and I don't want anybody. I love to love me around that because that's my strong suit and I'd like them to feel you know, dad, husband, you were so real today, was that okay? I'd love it if you could be more like that. So I know I'm taking a chance with that and maybe I'm and I apologize if that is way off but I just run into such really fine people like you and they and I think part of the reason people let their guard down. They let their emotional shyness down to the end is because the jig is up, we're out of time. We either say it now or we never say it, and that's where I think that's what I'm trying to share with people.

23:04 I'll share an anecdote with you. My dad died 1995. And I'm 75 and I went to college, and you know, during the hippie era I went to UC Berkeley, at the heart of it. You know the anti-war, all that stuff.

23:23 - Speaker 1 Yeah, the heart of the heart.

23:26 - Speaker 2 Oh, something I feel deeply ashamed and embarrassed about the anti-war stuff, when most of us were just afraid of getting drafted, I mean to be honest, and I remember I would fly home and I'd see my dad and I'd group in Boston and I'd see him at Logan Airport and there I was.

23:47 You know, I was a child of the, you know, of the love generation, so I'm wearing sandals, I got a beard, you know, and I go up and I give him a hug and his arms are just frozen and I go to my. I think to myself, uh-oh, this is bad. So of course I let go and I thought, oh, I just did something wrong, and then so the next couple of visits would be the same thing, so I wouldn't hug him. And then I said you know, I think I got it all wrong. I don't think he's rejecting me, I think he is starved to be hugged. He just doesn't know how to do it, cause I knew something about his dad. And so I remember I came back, I think I'd washed and showered a couple of times, but I still had the beard and the sandals.

24:50 - Speaker 1 He probably appreciated that.

24:52 - Speaker 2 And I go up to him and I hug him and his arms are frozen and I whisper in his ear and I say hug your son, it's long overdue and we both need it. And then his arms were like the floppy arms of that ET. You know that figure. Et had the floppy and he put his arms around me and then he evulsively pulled me into him because he was so starved, wow, wow. And ever after, or ever forward, he started hugging people in my family.

25:37 - Speaker 1 He finally got that permission that day from you Wow.

25:44 - Speaker 2 So again, I hope we're not making this a morbid episode. I mean, I'm just sharing these things as fast as I can because you don't have to be facing mortality to realize these things.

25:59 - Speaker 1 Do you feel that death is death scarier for people that have never seen it or experienced it? It's more of just this known unknown, like we know death exists. We know one day I'm going to die. We know the people around us are going to die. Because, you know, I think about people like myself that have, unfortunately, seen quite a bit of death. I've seen death of loved ones, you know, from natural causes, you know aging. I've seen illness, I've seen disease, I've seen suicide. Do you think that, for those of us that have not experienced it, is that where the fear lies? If we have seen death and therefore maybe have a relationship with it already, is that really where the difference lies here?

27:00 - Speaker 2 I think, as you're describing those situations, something that's almost universal, you know, unless you can approach it differently or feel it differently, which I'm hoping we're accomplishing a little bit about in today's episode is there's often a feeling of incredible powerlessness and helplessness, like my dad wanted me to hug him but he felt helpless or powerless and he was frozen. And I think what happens is most people, especially men, especially military men, we can't stand powerless or helpless. I mean, we hate it, we feel out of control.

27:42 - Speaker 1 That was one of the most difficult areas for me all during the time where I was active duty and my father was terminal. It was exactly as you just described and many people have been there. You want to be there for a loved one, regardless of if you're a military, civilian, but given your circumstances, life circumstances you can't be there and despite your best efforts, you are powerless to the situation.

28:10 - Speaker 2 And you have to compartmentalize. During the pandemic I wrote a couple of short books. One of them is called why Cope when you Can Heal. Why Cope when you Can Heal? How healthcare heroes can overcome, can recover from PTSD. It would also fit, I think, first responders and military, and it's a good book.

28:44 It was a stupid title, the subtitle because a lot of people need to heal but they don't want to because they run away from it. Military do not seek help. They do not like the VA system. Healthcare providers do not want to open up that. They're having a hard time because, oh, they're kicked off, their license will be taken away. So it was a mistake. That subtitle why Cope when you Can Heal was good. We should have said recovery from trauma is possible. It would have exploded. But I think because of the second title and it's because I co-authored it with this incredible woman who was the CEO of the hospital where an employee of the month came in and he killed his two supervisors and himself and she led the hospital through that. So but one of the things that we talked about in that and see if you can identify this because I think it applies to the people in the military veterans I know first responders is that when you experience something so horrendous, so horrific, what gets triggered into you is what we call the horror terror panic trifecta.

30:08 It's so horrendous and a lot of times if you take a break you can just say oh my God, that was just terrifying and you want to panic. But your duty bound, your band of brothers, your healthcare, you go back. You know you get drunk because you can't go to sleep from what you've seen with all the bodies and those storage units from COVID. But you go back because all your partners and coworkers go back. You know you don't want to go back, but you're not going to let them down because they wouldn't let you go down. So what happens is you bathe yourself in this horror, terror, panicky things and you push it down in a way to function.

30:55 And danger supplies adrenaline. Excitement does too, but danger gives you enough adrenaline that it insulates. It insulates you from the pain so you can function. As one of my former patients, a military, said, you know what it's like. It was like. You see something horrendous and it's like a feral alley cat screaming and you just lock it in the basement and then you lock another one, then you lock 50. And they're all locked up inside to function and as long as there's enough danger in adrenaline you can do that. But then when the danger goes away, the insulation goes away, meaning all it feels like all those cats want to just rip you apart from inside out and eviscerate you.

31:48 - Speaker 1 Meaning those walls between us and those cats, those problems, those issues, those emotions that you know to your point. The horror, terror, panic becomes thinner and thinner. The distance between us and them becomes less and less.

32:03 - Speaker 2 Totally yeah. And so you know some of the pilot programs. I mean I'm not sure that we started some and they were good, but you know, getting thing done in the military, the bureaucracies in the world are just they're stifling. But the whole idea is bring together and I'd welcome if you could identify where we could do a pilot on this identify a squadron of people who have this PTSD and they're just not doing well, and the idea is that you meet and you live through all the stages that you pushed away, but you do it in a unit. You have someone facilitating, you start crying, you start heaving. No, it'll be okay. No, no, you're not falling apart. You're just remembering everything that you pushed aside because you didn't have the luxury of feeling it. No, it'll be okay. This is why psychedelics help, because it takes away your control.

33:09 - Speaker 1 Oh yeah.

33:10 - Speaker 2 And you have diarrhea.

33:12 - Speaker 1 That's exactly how I navigated all my cats in the basement.

33:16 - Speaker 2 Yeah, and it takes away your control. But that's why you need someone guiding you, because you're thinking am I going loony tunes and I'm not coming back? No, no, this is part of it. What's happened is you've been so tightly wound, so tightly wound, you can't function, and the ayahuasca, the ketamine or whatever, it's just taking the control away and it'll be okay and this is part of the process and you're coming apart so you can come back together again. And that's why we wouldn't recommend people just doing it on their own, without someone who's experienced, and what they're doing is they're helping you, guide you through, coming on glued, so that when you just let it come up and out, when it reconfigures, it's like, wow, wow, I found God. Now, you didn't find God.

34:18 What happened is you've been so tightly wound. When control was taken away from you, it freed you and you thought you were gonna die, but what happened is you didn't die. You feel relief and again, I'm not putting down if you wanna say no, no, that was God, that was fine, that's fine. We don't want whatever works, but do you follow me? It was the actual having the control taken away from you and surviving it. That feels like this totally religious experience.

34:57 - Speaker 1 Yeah, I've shared many times on the show before, in conversation with guests and a couple of solo episodes actually over the last few years. Psychedelic assisted psychotherapy gave me my life back since beginning of this journey about three years ago and it really, if I had to put a pulse on, the main healing component is just what you were talking about. It was really this unequivocal level of surrender to letting go of the control, even the sense of controlling how I was gonna be healing. We think we have an idea, a framework, and that's true, but in that I realized how much control and power I was still seeking over how I was going to heal, how I was gonna navigate these traumatic events, how I was going to get on the other side, with the other side looked like surrendering fully, completely to that. Letting go of any and all self-proclaimed power, control over that is the only way that I was able to kind of get through that and be on the other side. So what you're describing is spot on from this older's perspective, that's for sure.

36:10 - Speaker 2 You know, something else I talked about is the difference between acceptance and surrender. So to me, acceptance is letting something in, surrendering is letting go of something, and so you know I get interviewed a lot. So what else is giving you so peace? I mean you just seem so calm, mark. I mean it's, and I am the calmest that I've ever been in my life and I'm just trying to help other people and it goes. I think one of the reasons is this acceptance and surrender. So I have fully accepted that I might die, which has enabled me to let go of having to live.

36:54 - Speaker 1 Wow, please go back and make that statement again. That's powerful.

37:01 - Speaker 2 I'm not being negative. I mean people say you gotta be positive, you gotta fight this. I say I've been chasing peace of mind for 70 years and I finally have it. I'll trade you a piece of mine for a positive attitude. Any day I have a positive attitude, but I just love the peace. But what it is is I accepted and might die, and that enabled me to say I could let go of having to live, whereas if it was the opposite, think of it. I can't accept that I might die. I just can't accept it. I have to live. I would drive everyone, including me, crazy. So can you do. You see, there's a certain irony there, but it's, and I'll give you. There's a joke that I share, but you have a little gallows humor. Someone says well, what else has given you peace? I said, yuck, everybody who has ever lived has died. If they can do it, so can I.

38:11 - Speaker 1 Nothing to it right, nothing to it. Well, as we kind of get towards the end here, I just want to first acknowledge your life's work and your vulnerability and your honesty here today and I'm very excited to kind of follow along your journey next and see where you go next in your healing process. I know that you've got these six values that have guided your life and have really kind of helped, have helped craft how you now help others make sure that they can have a good death. One of them really stands out to me and I think, really resonates with ever forward, and that's getting stuff done. You say that if you're not moving forward you're not going to get caught spinning your wheels, that if we want our life to continue to be full of determination, enthusiasm and fulfillment, then you need to be the force that drives it forward. How, through our understanding and developing of a better relationship of death, can we better get stuff done? How can we stop spinning our wheels? What role does our relationship to our mortality play in being able to move forward in life?

39:34 - Speaker 2 So one of the other episodes of I'm dying to tell you is I think it's about transformation, but I recommend people following what I'm about to say I'd like you to imagine it's the end of your life. I'm feeling optimistic today so it could work by me sometime, and I talk about the three P's. And the three P's stand at the end of my life, looking back professional, purposeful and personal and I want to be able to look back and I said I gave it a good ride. So for me, professional means did I make an effort to support my family? I'm a very responsible person. I want to be able to support my family and then some. I never focused on money, so the then some is in huge. I was never able to take them on the $15,000 family vacation and yada, yada, yada, but I was able to support them and their launch. Now Also people who work for me. I want them to be able to support their families.

40:53 Purposeful is when I went about doing it and I look back in my life, did it serve a purpose? I don't want to look back and say I made money off the backs of other people. I made money by taking advantage of others. I made money by being this incredible sales person and I got people to buy stuff that they really didn't need and couldn't afford. So that wasn't my case. I was a therapist, a suicide prevention specialist, so it had a purpose To me.

41:29 The real work in progress is personal, and for me that's not just did I take care of myself? I've never been an alcoholic, I was never really addicted to anything. To me, the most powerful part of the personal and I mentioned this earlier do the people in my life that I personally connect with them emotionally. Do they not only know I love them, but could they feel it? I don't know, but could they feel it? I had actually a breakthrough. Well, you know, you might see a little emotion, so I don't want to scare you away on this one Chase, bring it on, bring it on. I have a pathological desire to not be a burden to anyone. I mean big time, and it's pathological because a lot of people would say you're not a burden, you're not a burden, but this thing I'm going through is not a walk in the park.

42:48 - Speaker 1 Of course.

42:49 - Speaker 2 And I remember a couple of months ago I was there with my 34-year-old son and this is out of context and I was well aware what this procedure and the burden on care take, just what it's going to take on my family, and I looked at him and I got emotional and I said I'm thinking of dying sooner than later Because I don't want to put all of you through what I'm about to put you through. I hate it. You're all busy. I love the heck out of all of you. I've had a good life, but I just don't want to burden any of you.

43:35 - Speaker 1 Meaning what exactly you choosing your timeline?

43:41 - Speaker 2 Well, you know how the caretakers I'm going to need 24-7 caretaking, probably by family members who are already, you know, filled up with all their responsibilities, their job, their families and all that stuff and, again, as I said, didn't make tons of money. So, you know, I guess I could probably pop for the 24-7 caretaker that I'm required to have after this procedure. But what happened is it just overcame me and my son, who can be a little bit tightly wound and a little bit shy about his emotions, because my God was down and I said I just don't, I just hate what I'm about to put you through. And he looked at me and he said I don't want you to die. What he doesn't know, that I know because of my field.

44:52 That's going to be one of the top conversations of his life. I hope it's not, but there's a real opportunity here. There's a real opportunity here for your listeners and viewers, and it's not weakness, it's openness. I think what happens is I still maintain my composure. Sometimes I get overly emotional. What I realize is, when I can let my guard down, you'll let your guard down.

45:50 - Speaker 1 Absolutely.

45:52 - Speaker 2 When I keep it up, you'll keep it up and don't miss out on those moments when you can let your guard down. I'll tell you there's been a handful of times in my life because I've been through some traumatic things and when, instead of running away from the hurt or fear into something else, I just let it show through.

46:27 - Speaker 1 What does that look like?

46:32 - Speaker 2 I dropped out of medical school twice for probably untreated depression. The first time they said well, everybody's allowed to take a year off, see if they can get their act together. I sort of got my act together, came back, but then it fell apart again the second time. It wasn't just confusion, I was just depressed. I had to tell my dad who's a numbers kind of guy a strong guy, tough guy, a guy who did all the firing in his company. The CEO made my dad do the tough decisions. I had to tell him that I'm leaving medical school. Is that more?

47:27 - Speaker 1 difficult or the hug. Probably neck and neck there, I'm sure.

47:38 - Speaker 2 This was more difficult. The hug was awkward, but here was the breakthrough. He said while you're flunking out? I said, no, I'm passing everything, then why don't get it? If you're passing everything, you'll get a tutor. You'll get a whatever. He's very strong and he was making the case. There was a point at which I just looked down, I stopped talking and then he just kept saying so, we're agreed, you're not going to leave, you're not going to drop out, you'll get a tutor. You're somehow making it through. Now you'll make it through. We're going to do such and such.

48:24 Inside, I'm thinking, if I go back, something bad's going to happen Self-destructive. I've never been someone to hurt other people. I'm just thinking that it's louder and louder in my head and he's just talking to me. This was probably the most powerful moment of my life, because he was a tough guy, a strong guy, but down deep he loved his kids. I remember I looked up at him and he said so, we're agreed, you're not going to drop out. I looked up at him and I stared in his eyes and I said you don't seem to get it. Tears were coming down, not boo-hoo, but just tears. I looked at him, not unlike when I was having those conversations with these people and I said I think I'm dying. I looked at him and I said I'm afraid. And I just stared at him. He could have said oh, that's silly, be a man. But I just stared at him and there were tears coming down my cheek. What happened is it was like David and Goliath. He looked down, he clenched his fists and he said do what you need to do, we'll try to help.

50:02 Here's something I'm going to tell you as parents. I'm involved with a good friend of mine. His 14-year-old son killed himself five years ago and he created a documentary based on one of the suicide notes called Tell my Story. That was one of his 14-year-old son's suicide note. That's on, I think, prime Video, amazon Prime. He recently has another documentary which we're trying to get shown in 500 high schools to parents, called what I Wish my Parents Knew. He just interviewed eight teenagers about their low point and all of them said they couldn't tell their parents what I've been telling parents when we do the presentation. I say one of the reasons your children don't open up to you is because the language of teenagers is blaming, complaining, excuses and threats Blaming, complaining, excuses and threats and they trigger you as parents when you hear that.

51:16 - Speaker 1 Sure sure.

51:17 - Speaker 2 What happens is your teens do not know that they're triggering you to not be able to show that caring because they're being evasive. One of the reasons they're being evasive is because when you're triggered, you don't come off as caring. What the video demonstrates and what I learned from my own experience is when you can actually look at your parents in the eye and just be raw and open and say what your deepest fear is. I think I might be crazy, mom and Dad. I think I'm broken and no one can do anything to fix it. And all these specialists don't know what to do either. You think sending me to them is making me better. I don't talk to them. What I am telling you, if you're a teenager, a young adult, is down deep. Your parents aren't judging you. They are worried about you. They're not disappointed in you, even when you feel all of my parents are really disappointed in me. I'm such a loser. Blah, blah, blah, blah, blah. Yeah, you may do a bunch of those things, but they're not disappointed in you. They're worried about you, but it doesn't come out like they're worried about you. You get into a pissing match. So what are you going to do about it? You should go see someone. I don't want to see someone. I want to get this really across. Actually, I'm going to give you and your listeners the four prompts. Because I give these four prompts?

53:17 If you're trying to break through to someone, especially a teenager, that you think is in a dark place, this can sometimes break through. You have to do it while you're doing something, driving in a car. You can't be face-to-face Teenagers hate face-to-face stuff like nails on a chalkboard, and so do it when you're driving, when you're both looking in parallel, whatever. And here's the script. You can modify it, but you can just follow the script. You said your kid.

53:50 A lot of us parents are worried about our kids, with the pandemic, with the shootings, with everything, and a lot of us really spooked about our kids, and I'm one of them. Can I run some things by you and just make me feel better? Can I just run some things by you and, if you're lucky, you're doing an errand together. Whatever, okay, okay, dad, whatever Okay Mom, and you don't look at them and the first thing you say is at its worst, how awful are you capable of feeling about your life for yourself? Are you going to go what? At its worst, how awful are you capable of feeling about your life for yourself Pretty awful. And the technique that I developed to reach suicidal people is surgical empathy. It's not logic.

54:43 You go in there and you say pretty awful or real awful, okay, okay, real awful and prompt. When you're feeling that, how alone do you feel? Pretty alone, pretty alone or all alone. When you fall in, you get them talking.

55:11 And the third prompt is take me to the last time you felt that and they're going to go what, or WTF? You say yeah, it was a 2.30 in the morning a couple of nights ago. You heard you stomping around your room there. When was the last time you felt it? And here's something magical that happens when they can describe exactly what happens so that, as you, as the parents see it, they relive it, but they're not alone. Yeah, I couldn't get to sleep. Yeah, we heard that. What was going on? Well, I had a big test. I couldn't get to sleep.

55:48 So what happened next? Well, I don't know whether to kick the wall, punch the wall. And what happened next? I started looking for cough medicine, your sleeping pills. You really did a good job hiding them. And you keep them talking. But then what happened? Well, the sun rose. And then the fourth prompt, and if you're fortunate, you will have earned the right to eye contact and you say look at me. But it'll be OK, look at me the next time you're feeling that or you're heading in that direction. You do whatever it takes to get your mom or my undivided attention, because there's a million things in our mind, but there is nothing more important than helping you to feel less alone. And you're feeling that awful, and so would you do me that favor. You don't even have to say, you could just say it's back, because we don't want you to be all alone there.

57:02 - Speaker 1 No one wants to be or be in that feeling of being alone alive, and no one wants to have a feeling of being alone facing death, which kind of brings us full circle. To your entire emphasis here on facing mortality and navigating the concept of death and dying, the concepts of death and dying, the same lesson I'm hearing applies. It's the same lesson. To navigate life is the same lesson. To navigate death is to not have this sense of feeling alone. And if we can accomplish that or choose to put ourselves on the path to accomplishing that probably more so a process than just a decision we are going to become fearless. We're going to become fearless in the way that we choose to live and we're going to become fearless in the way that we choose to die, and all the while cultivating the right people along the way, whether that's for the rest of our life, days, years, or in the grips of death. You know, I think that's what really matters most here. Well, I do want to ask you my final question mark.

58:22 This has been very insightful and very real. This is so much more than just two people talking about these concepts. This is an expert on the concept, you, so someone who is quite literally going through. You are walking the talk, and I'm very, very appreciative of that. This is not not just another podcast episode. This is not just another guru or expert. This is someone that has probably some of the most unique insight on these topics. So thank you. To bring it home to ever forward. When you hear those two words, what does that mean to you, mark? How would you say that you live life ever forward?

59:15 - Speaker 2 I had eight mentors. They've all died. My last mentor was Larry King. He used to go to breakfast with him every morning, with a quirky group of people up until COVID, and Larry was one of the most curious people you've ever met. People love being on his show because he was never judgmental. He never hit you with a gotcha. You could be a serial killer and he'd say you shot a lot of people. What was that all about? Non-judgmental People loved and in some of our conversations I remember what came up once is he said you know, you can't be curious and furious at the same time and you can't be curious and fearful at the same time.

01:00:15 So this is an adventure to me. You know, I'm going back and forth in the hospital making the final steps to go in, and I'm just curious about it. I mean, I'm just so. What I would say is, in part of curiosity, is the willingness to be aware. But when we circle back and we talked about first responders and military, I can't be aware. I can't be aware that my best buddy just got his head blown off. I have to get back and report something. I'll grieve about this later or I'll get drunk or something, and so a lot of people are afraid to be aware because they don't think they can handle it. I'll leave you with one thing One of my books was Post Traumatic Stress Disorder for Dummies PTSD for Dummies and I've been trying to change the diagnosis.

01:01:16 I gave up for 20 years because I think what people live is not PTSD or PTSD post traumatic growth. And tell me what you think of this. I think what people live is retraumatization avoidance, rta. Because when you ask someone who's been deeply, deeply traumatized and you say, oh, you're so courageous, you got over that, they will look at you and say I didn't get over it, I got past that. But what do you mean? I'm not the same, I'm not that carefree, tentative. I check things out and something is gone and I don't know where it is. And then if you say, well, do you think you could have gone through all of that again?

01:02:15 Number of the people I've spoken to in the military they say I don't know why it didn't take me down the first time. I don't want to give it a second chance. So a lot of the symptoms of PTSD to me are retraumatization avoidance. So what do you do instead? I keep to myself, I drink a lot. I don't socialize much. I love driving my truck, you know, because I can lower my guard oh, this is great. But a truck pulls up next to me in a backfires. I'm going to go through the roof. And when I've asked people, or I've described that, many of them say that's what we live. You're right, it is retraumatization avoidance. So I don't know what your thoughts are, but because it's very spot on.

01:03:14 - Speaker 1 I think kind of just unpacking my own experience with PTSD, that's really. That's really it. It's a unique kind of spin on it. Just same same but different, if you will. Yeah, I probably wouldn't really add anything else to that, because it was so, so, spot on.

01:03:37 - Speaker 2 And here's the thing. But if I've given up, you want to introduce me. You know like I don't have all the time on my hands for things, but see, rta is what people live. I live my life trying to avoid getting triggered because is this the one that's going to take me down? Whereas the problem I have with PTSD even though you know I wrote a book on it is it feels static, it feels self-incriminating. Oh yeah, I've got PTSD. It feels so self-accusatory and it often doesn't feel like you can do anything with it. Okay, they've sugar coated. It's not PTSD, it's not a disorder. I've got a post-traumatic stress or post-traumatic growth. But I think what they live viscerally is people really relate. No, I got this retraumatization, avoidance. I live that every day of my life. I mean, I love my wife, I love my kids, but something happens and they yell at me or they yell at each other. I'm just, I'm scraping myself off the ceiling.

01:04:54 - Speaker 1 Always experience with it. You know, big T, little T is so unique and I think having a reframe like you're proposing here is a very powerful tool, especially when we get into the world of a diagnosed disease, a diagnosed disorder, a diagnosis in general. It kind of puts parameters on what it is, what it is, not, who we are, who we are not. But to just hypothesize, to consciously choose a different perspective, really does reduce, if not eliminate, a lot of those parameters which, for me, immediately, I kind of feel like how freeing that is, how freeing that is and how much I actually, you know, can navigate the circumstance in a different manner from what maybe they, the collective, they, are telling me about my situation in my life, my treatment, my recovery, my everything.

01:06:01 - Speaker 2 Well, I'll give you a simple thing. I'm partners with Colonel Chris Colenda. He led 700 power troopers. He has something called the Sabre Six Foundation. Last year he drove from Nebraska to Arlington on a bicycle to visit the graves of his fallen men, and I love Colonel Chris and we developed something.

01:06:28 - Speaker 1 I used to live right outside of there.

01:06:34 - Speaker 2 And we developed something called the 22-day Trigger Mastery Challenge, and 22 stands for the 22 veterans who die by suicide. And it's very simple, and you can find it at Sabre Six Foundation. Because here's one of the other things that we believe is that one of the things that all mental health problems, all marital problems, all work problems have in common is all people with these problems trigger too easily. I mean, they just trigger too easily. And we're talking depressed, anxious, schizophrenic. It takes very little to trigger you. And so what we have developed in the Trigger Mastery Challenge and you can go there and you can get wristbands is the next time you're triggered, what you say to yourself is I'm feeling triggered, not I'm being triggered, because if you say I'm being triggered, you have to retaliate. I'm being triggered, I'm not going to let that happen. But if you can just say I'm feeling triggered.

01:07:52 And then the second step, which is the pivot, is downshift. So downshift is like downshifting a stick shift car you gain control of the road instead of stepping on the accelerator, and so it's a good male military metaphor I'm feeling triggered, downshift. And so you even lower your voice that way. And then the third thing is reframe, look at it differently. And the key pivot is the downshift, because, see, one of the things that nearly everybody in the world doesn't know is that when you get triggered, you have a choice how you respond. But nearly 100% of people don't believe they have a choice when they get triggered. They don't know they have a choice until it's too late. And so, and what's happening is, if you go to the site, the testimonials you know from veterans in military, they say this gave me back control of my life. It's just so simple.

01:09:02 - Speaker 1 Yeah, especially for the military community. It's a very common concept for us as a concept of detachment. Detachment is what you have to do, or it's what I would recommend and definitely is, you know, a good leadership skill to develop when you know, in training, when in the field. Just this concept and again to carry over in life this concept of detaching from the scenario, because it's not you're just going to stay stuck in it. If you can catch yourself out from it, you can observe it in an entirely different way.

01:09:31 - Speaker 2 The point is, when you're in an active war zone, you detach by pushing away the horror, terror, panic trifecta to function. So you really haven't detached, you've pushed it away for to eviscerate you at a later date. Whereas the idea of downshift means and here's another thing that's helpful when you're in the downshift mode, you say to yourself up until now, I've always gotten angry when someone cut me off. Up until now I always yelled back when my wife said something you know, dismissive. Up until now I always went a little bit apeshit when my kids broke something. So the up until now which is part of the downshift is, it's a way to say, oh, that's just, up until now, I don't have to do it anymore.

01:10:34 But those two are important because, see, we believe, yes, it's good to meditate, yes, it's good to exercise, but the point is you're putting lipstick on a pain, you're running away from it and calming yourself down, whereas downshift is you lean into it and you take it on and you feel empowered by that, which is different than go meditate now. Now, we're not against the meditation, but you feel like you've been defeated, go for a walk, whereas downshift is like I'm not going to let this push me over the edge. And then the reframe someone cuts you off in traffic. I feel triggered. Instead of flipping them off, you go downshift and then you look at them and you think I'll bet they got fired today. There you go.

01:11:43 Yeah, yeah, I'll bet they're rushing to the emergency room because one of their kids just overdosed. Wow, because if they said that instead of getting in a fist fight they said I'm so sorry I'm racing the emergency room because my kid overdosed, we'd immediately go, just go, just go. It's okay. But we don't know, we have a choice. We do now. So downshift is a way of taking charge, and so I mean testimonials are remarkable, I mean it just makes so much sense.

01:12:22 - Speaker 1 Well, mark, your work is so needed. This conversation no doubt for even just one person listening tuning in here today was so needed. I know I'm pulling so much value out of this myself. Where can my audience go to connect with you more, to learn more about your work and to follow you along with your own journey now?

01:12:46 - Speaker 2 Well, I'm pouring a lot into dying to tell you. So, if you go to YouTube, dr Mark, youtube, I'm dying to tell you, dr Mark, I think we have 60 videos up and I'm loading and they're four minutes to 15 minutes and there are a lot of the tips that I've been giving you. And then I have a TikTok channel, which is a little more wide ranging, and that's I'm dying to tell you, I think, at Dr Mark, and those are shorter, less uniform. They're good, but I think the main one is YouTube and also several people who are creating a legacy for me. I'm very humbled by it.

01:13:38 And so I have MarkGulstoncom, and so in the next couple of months I hope, I think I'll be around, but they're redoing my website, markgulstoncom. They've created a MarkGulston bot, meaning you can ask it any question, and I have 10 books, 1300 articles, 300 podcasts, so they've scraped all that content and so that'll be also available at MarkGulstoncom. And then LinkedIn. I'm still sort of active on LinkedIn because I mentor a lot of people on LinkedIn and I want to help them land in their future. I'd love to help you land in your future, because when you give to live, it's wonderful.

01:14:32 - Speaker 1 Thank you, thank you. We'll have all the information listed down on the show notes for everybody to check out. Mark, I really, really, really appreciated this conversation today. Thank you so much.

01:14:44 - Speaker 2 Well, thank you for giving me a long leash, which I took advantage of.

01:14:48 - Speaker 1 My pleasure. That's the beauty of long format content. Right, God bless the podcasting.