XaiJu
Decoding The Gurus
Decoding The Gurus

patreon


Next Decoding: Dr. K

Yes, that's right... we just did an academic so we are back to the streamer world (the season ends soon!) with Alok Kanojia AKA Dr. K.

We already know we are looking at the material in the thumbnail above (linked here). Still, we have also consumed some other material from Dr. K and dug into related controversies.

If you have material you want us to know about, good, bad, or in-between, now would be a helpful time to share.

Thanks, everyone!

Next Decoding: Dr. K

Comments

I can't remember where he mentioned it, I watched a bunch of his videos about 6 months ago. If someone finds it help me 😅 there's always a chance I got it wrong and looked like a nutcase saying "aha I knew it!" in his comments.

Natasha Bride

@Natasha are you sure dr K has ADHD? Did he mention it somewhere? I watched entire dr K’s guide on adhd and everything he said on this topic until 2023 and I don’t remember that at all. He always says he has „vata mind” and adhd guide doesn’t contain his personal experience

aneladgam_varelse

For sure. Therapy should be accessible for everyone. It's in society's best interest. I have to be honest and say that therapy wouldn't have worked for me without the medication. The meds saved my life. But, I hope one day I can find another way. I'm doing EMDR atm, hoping that it might magically fix my brain haha. You never know đŸ€·đŸ»â€â™€ïž

Natasha Bride

Natasha, I’m do not, as far as I know, have ADHD, but quite a few have self-identified here as having it, so you are in good company. I believe therapy is helpful for most of us. I just wish we had more good therapists.

Linda Sears

Yes I understand what you are saying, and I think when you listen to Dr. K you get an understanding of who he is and his mixed approach to health and well-being. He does pull himself up often and note that he's stating opinions from his life, professional experience, and spiritual experience. I've watched quite a few of his videos, so I know that I'm getting a slightly alternative take on things, and that's what I like. Something thought provoking and different perspectives. I also think that people shouldn't take things that any doctor says as gospel, especially in the metal health space. It is a very new and experimental field with so many unanswered questions. Dr. K has ADHD too. He's one of ours 😂 I think he's pretty smart. He's not perfect, and he's made some mistakes, but I think he means we'll and does alright from what I have seen. I might change my mind after this episode though so we'll see 😅 I was very alarmed for his wife after the last episode!

Natasha Bride

Linda, you and me both. I've tried to suggest it's not just the economics of offering the most wonderful therapy, but the manifold difficulties of making wonderful therapists, that provide complex bottlenecks for each other. There are also compound costs to failing at both, at once, so even if we supposed our current treatments are cost efficient, "cost prohibitive" isn't such a simple term with "evidence-based" therapy just not working very well. This should not just be an emergency pointing us to question hegemonic clinical paradigms, but predominant forms of scientific inquiry. What are we even meant to be doing? The linked Shedler conversation is really great, with nontrivial overlap to ayurveda in therapy (but not medicine; most of the rest I know little about). I suspect psychodynamic treatment paradigms tend to be more epistemically modest, noncommittal and open, but wouldn't really know. I don't mean to excuse (or judge) Dr. K in saying this. I've said my reading makes him a top shelf clinician. As a public figure, he seems more human than monstrous to me, which makes the topic, warts and all, uncomfortable and interesting. It still sounds like Dr. K seeks to expand our sense of what tools should be considered viable for turning abject misery into regular unhappiness. That is, Anna, Freud's famous definition of the task of psychoanalysis. Give that one more precise read: you said the same thing. This is still the best formulation for what talk therapy should do. Our costs of failure are, by any stretch of the evidence, prohibitive. I had many more messy thoughts (economics, friends/family/career gossip, Life & Professional Opinions, more), but they'd need more editing than I can bother for. Appreciate you checking out Shedler.

Exai

I was curious and read this article about Shedler’s views: https://www.psychiatrictimes.com/view/psychoanalysis-re-enchantment-psychiatry-jonathan-shedler-phd. Personally, I would love to have the kind of therapy Shedler is talking about, but that would be cost prohibitive. As for Dr. K, I see too many red flags.

Linda Sears

Maybe two? Male and female?

Linda Sears

well actually it’s improvement from Western Medicine, because Western Medicine has only one (1) type!

aneladgam_varelse

The vata, pitta, kapha idea from Auurvedic medicine also seems to go against the notion that people are individuals, needing individualized treatment. If you can be put into one of three categories, how is that individualized? It somewhat reminds me of the different schools in Hogwarts. At least there were four categories rather than three.

Linda Sears

Vata dosha is definitely OP hahaha. And oh God when he started talking about how depending on the type you are you should eat warm or wet food or whatever. I just couldn't đŸ« 

Anna J

That was actually all rather interesting. I know you said it was your last word on the topic but I have some questions, it's OK if you don't want to engage further. Can you tell me who the Disney adult(s) are who you are thinking of? I get the picture of what "type" of person you're referring to, but you do seem to be talking about a specific person? I was not aware of Shedler I'm just reading his articles now. I will say though I don't really feel that it's the job or the aim of psychiatry to turn misery into actual happiness. Just like you wouldn't expect the orthopaedic surgeon to turn broken limbs into ones that can run a marathon. Their job is to fix them so that the patient can regain some degree of ordinary function. Whether or not they end up running a marathon is really a function of what the patient does after the treatment (+ other factors). I see psychiatry similarly. The common unhappiness that you speak of is really not something that psychiatry can or should aim to fix, no? The function of psychiatry as I see it is to treat and manage actual mental illness and related things like neurodevelopmental disorders etc. Not to optimise happiness, that is a far more lofty goal. Happiness is a function of much bigger more complex problems well beyond the scope of clinical psychiatry/ psychology. Like upbringing, relationships, culture, society etc etc. Maybe my view of the field is far too narrow. Maybe my medical education has blinkered me. It's possible I guess.

Anna J

btw don’t you think that vata dosha is OP compared to kapha and pitta? Being skinny, smart and quick learning with no obvious downsides

aneladgam_varelse

Decent video, she managed to demystify e a s t e r n bullshit

aneladgam_varelse

@Anna do you think dr K Ayurveda diet recommendations could interfere with regime recommended to patient by physicians for other illnesses?

aneladgam_varelse

How about classic secular gurudom: productivity and optimalization tips? https://youtu.be/GI594-ha2SQ?si=ClEyo9zC_rDfXzL4 technology usage https://youtu.be/Pa51EGS7Hnc?si=6rxV4tvwZLIjcLm9 productivity; here are stories how he studied only 2h in medical school https://youtu.be/Lw4dMehQkgs?si=ZPfIheHETB1jdp36 I haven’t watched this one, but (because?) multiple people recommend it to me when I complained about studying

aneladgam_varelse

Password, this hystericization seems like a trivial waste of our time. Have a great day. Anna, the "doctrine" refers to the training received by the Disney adult(s) I was thinking about, training I'm far from unfamiliar with, and which would be defended to the death by many above. She's not the worst of anything, either. A loving parent, decent person, and not the most competent car mechanic of a therapist. As I said, you probably need these car mechanics & manualized treatments: they're not going to do mountains of good for most profiles, but they can take a lot of patients with minimal training and do something with minimal harm. And that's pretty hard to improve on. She also knows to scoff at practitioners who are trying to do differently, because that's in the manual. Here, she makes me think of the Ben Shapiro meme where his wife told him women don't get wet. That's what I see when some people talk about Dr. K. This is the disgust and rage, envy and pride from the bottom of the pile. If you needed an RCT to spot this, I wonder if you're not looking close enough. This doctrine of your scare quotes, is also pretty close the one which we'll find informs the podcast. Surface-level cog psych epistemology with not much familiarity beyond it (Chris is here a bit more sophisticated). My problem isn't with cognitivism as such, or even its general narrow-mindedness, but its hegemony and hawkishness. I'd be saying the same about Freudians in the 1950s, I imagine. Rigid, certainly. Science progresses one funeral at a time. I think these funerals are already scheduled, so feel free to get back to me in 30 years about what my problem is, then. Maybe it'll be my head on the line. And, yes, of course, my problem with evidence-based treatments is their general quality and often distinct lack of evidence. I'm with Shedler, here. This is to me much about our failing mental health culture being justified with the safety dance of science, not so much our ability to turn misery into common unhappiness. There's less evidence of that, every day. You can imply scary, hysterical conspiracies out of this all you like. I find such realities far more boring and stupid than salacious. As I doubt there's much use debating this, such clarifications are my last word on the topic.

Exai

Finally, this video features a compendium of clips where Dr K goes completely mask off unhinged on the pseudo-science, promoting theories like personality and disease being related to facial features and body type etc. His content on the Dr Mike interview was extremely moderate in comparison. The narrator is slightly annoying haha but the clips speak for themselves. https://youtu.be/gsyfK2vX_o0?si=Pw4nirenGyxQZSrZ

Anna J

This doesn't count as source material but this comment on reddit by someone who claims to have trained as a life coach for Dr Ks business is pretty yikesy. He states amongst other things that there is a 50,000 fine if you quit early due to the costs involved in training you, that the other coaches were young and inexperienced, didn't know what a mandatory reporter was etc. Does anyone know if there is any truth to these claims at all? https://www.reddit.com/r/therapyabuse/s/ShBLMRSBou The coaching sessions are quite expensive too. It sure does make you go hmmm when you think about all the times he claims you can fix so many mental health issues with life coaching methods (as opposed to formal psychotherapy and / or meds).

Anna J

Watched the one on congruent depression. Yeah, sigh, the more I see of this guy the more I don't trust him. It would be nice if he openly mentioned the fact that "congruent" (situational) depression is not yet an accepted entity in clinical psychiatry, and evidence thus far (admittedly nothing that is high quality seems to have been done) does not support the fact that it's a separate clinical entity from regular old depression, and as such the recommendation is to not use the term until more evidence is available either way. https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/abs/situational-depression-validity-of-the-concept/B6F7CD46C205D3A08866E7973644548C Still, if he said that he wouldn't so seamlessly be able to say hey this might mean that if you feel like you have nothing to get out of bed for (eek..not an unserious state) you don't need a doctor or formal therapy with a licensed psychotherapist... you just need LIFE COACHING. (Which he provides. Surely a coincidence).

Anna J

Why would Dr Ks "enemies" be "disgusted and enraged" by how well some of Dr Ks patients are doing? These enemies sound extremely sadistic if that is the case. Who are these enemies btw? Also what is "the doctine"? I presume this is a reference to the rigid and nefarious orthodoxies of big psychiatry?

Anna J

Thanks I'll check these out

Anna J

Yep you've highlighted why I find this approach ineffective and from the pov of him being a clinician.. shockingly naive. Like, does he think he's the first person to prescribe lifestyle changes? The sad fact is that for a huge proportion of people, lifestyle changes isn't a solution because for various reasons they just can't comply with it. Like of course it works for some people who can enact it and I'm sure he will reach those people who have the capacity/resources to enact his suggestions and were just ignorant and needed the education on why their behaviour is deleterious and why changing it will help them. But for other people without the same capacity to stick to lifestyle methods and perhaps more serious mental health problems I find this approach just sets them up to fail and feel even worse about themselves eek.

Anna J

Excellent point. Also I just could not cope when he claimed that aryuvedic methods had cured paralysis đŸ« 

Anna J

Btw Mino I do agree with your initial point that non pharmaceutical solutions to mental health conditions have an important role to play. I agree there are huge issues with pharmaceutical companies and their practices - there's no valour in being credulous in the face of this stuff. It's just that the non pharmaceutical solutions need to be "prescribed" responsibly and appropriately and by qualified people. You asked what harm can it do? Dr K is promoting and selling LIFE COACHING (not proper psychotherapy) by inexperienced minimally trained subcontractors to vulnerable potentially mentally unwell young people in his audience... I would argue quite a lot of harm could be done by this. Also - the benefits of lifestyle or other non pharmacological interventions should not be overstated in situations when a medication (or formal psychotherapy as opposed to "life coaching") is actually required, just as the same lifestyle interventions should not be overstated when a vaccination is actually required. Yes there are differences in the type of risk at a population level but it's the same principle ie People promoting that with sheer willpower, exercise etc they can win the fight against disease, no need for any medical input! Like ... sure, sometimes. Not always. This is where I feel Dr K is questionable. I gave the examples of him misrepresenting what the evidence is regarding best practice for ADHD. He also peddles utter pseudo-science like correlating peoples personality and physiology with the shape of their nose. Also the life coaching stuff as above. Like it's a lovely idea that instead of putting people on pills that we educate them and give them tools and lifestyle changes. But just like with physical illness, patients are often incredibly poorly compliant with this (for many reasons). Like yes I'd love for someone who has an elevated cholesterol and hba1c to change their diet and go for a run 4 times a week and stop smoking and drinking instead of prescribing them metformon and a statin. But the truth is they usually just... can't make the change. Sometimes I feel like Dr K dances with this idealised view of "patients" or people. Some people may frame it as being empowering and promoting better pathways to help. And I'm sure that this works for a lot of people. For others, perhaps those with fewer resources and more serious mental illness, I worry he's setting them up to fail. I do agree he's done a lot of good in reaching youngish male gamers though.

Anna J

It's a good question. If there was evidence of A. a significant black market for said drug (be that an illegally made substance or diverted pharmaceutical substance) B. That this diversion and use by the general population caused significant harm then I probably would be OK with relaxing access. The logic being the usual logic of every pro legalisation of drugs ... ie people are using it anyway, it's causing a lot of harm (harm to user, harm to society etc), let's legalise it, control it and that way reduce said harms. Prescription stimulants seem to fulfill criteria A certainly, but not B. Prescribed stimulants (talking about lisdex, methylphenidate etc) aren't 100% safe and can certainly be abused but they aren't as dangerous as say, alcohol, or meth, or crack. Other substances that I feel fulfil all of these are alcohol, marijuana, opioids. Edit: this is obviously an extremely complex topic and I'm not 100% confident that I am right minded on this.

Anna J

No worries I'll have a search around myself :)

Anna J

It's true that the state (at least where I live) can also enforce ongoing involuntary treatment of serious psychiatric conditions like schizophrenia and bipolar in the community when the patient is often "stable". But best practice is to only do this with patients who are A. at significant risk of deterioration if they don't take their meds and B. Has poor or fluctuating insight into their condition and don't want to take them / have a history of non compliance with medication leading to deterioration and harm to self or others. If the patient is happy to take the meds there is no involuntary treatment. If the condition is a less serious psychiatric condition there is no involuntary treatment.

Anna J

The "state" doesn't "think" anyone needs to be on anti psychotics. The treating psychiatrist is the one who "thinks" that and makes that decision. The state ie the legislation is just the mechanism via which the decision of the psychiatrist is able to be enforced. Secondly, your blanket objection to non consensual administration of psychoactive drugs is at odds with the best interests of many patients that this is applied to. What do you suggest we do with an acutely manic or psychotic patient? Just allow them to destroy their life, put themselves and others at risk of harm? Physically, mentally, socially, and occupationally? What would you do with a woman with postpartum psychosis? A disorder that is deadly to both mother and baby? Just let them kill themselves and / or their infant? When a patient is in the grips of an acute psychotic or manic episode they have impaired insight, sometimes partially, sometimes completely. They do not have the capacity to give informed consent to treatment (this includes to refuse care). In the case of psychosis, are you aware that each episode of psychosis induces an unknown and permanent degree of brain damage? That with each episode of a psychotic episode the patient becomes less and less functional, more depressed etc. It can get to the point where they need assisted living.

Anna J

I hope the irony of using the the term 'non sequitur' while at the same time proposing a psychiatrist's choice of favourite art has anything to do with the quality of therapy they provide is not lost on you. You throw around a lot of bold statements without much of an evidentiary basis. Is this not suggestive that you yourself speak as if a wise sage descended from the mountain? "I have no doubt his clinic overperformed in ways that would more than anything make his enemies disgusted..." Great, but why does your lack of doubt mean anything here? Any evidence to suggest the successful outcomes of his patients? By which metrics? Who are these mysterious 'enemies' you speak of? Ahhh but an evidence basis is a sign of doctrine, so alas we must take your opinion as gospel. You write a lot without writing very much at all. Clearly you have been paying attention to the skills utilised by the gurus covered by this very podcast, well done, Padawan.

Password1234!

I find that a silly non sequitur, frankly. You could argue the case with minimal rigor rather than stating it at me like some wise sage descending from a mountain.

Exai

They can and do in the UK

Minotaurus Rex

I want to make one thing clear and EOT: “The state forces them to take antipsychotics” - yeah when they’re in active psychosis debilitating enough to get hospitalised. State (and which one, there are many states around the world, you know) doesn’t have measures to force person with schizophrenia in remission to take meds. Not taking meds will likely result in another psychotic episode in the future.

aneladgam_varelse

Wherever you land on topic of medication, there is still issue of shilling “eastern spirituality”, which is ridden with very real cults and united with conspiratorial right.

aneladgam_varelse

Excellent points! I’m afraid I’d have gone down an alcoholic path had I not received antidepressants, but it is impossible to know. I think a mix of therapeutic options is good rather than relying on meds alone. If a person doesn’t need or respond well to meds, then they shouldn’t be prescribed.

Linda Sears

The state forces those it thinks needs to take antipsychotics to take them. In all other cases it's rightly at the discretion of the individual. I personally couldn't disagree more with the non-consensual administering of psychoactive drugs. Either way you are arguing against a strawman as this guy's content is clearly aimed at depressed gamers

Minotaurus Rex

I've already answered this in my previous replies

Minotaurus Rex

but it requires very careful communication. So happens that people seriously mentally ill are drawn to content about mental health done by qualified people, like psychiatrists, to learn how to live better with their mental illnesses. About schizophrenia - it would be nice if everyone with schizo was responsible about their mental illness. Sadly it’s not the case, especially when schizophrenia is triggered by marihuana/psychodelics use. Many people with schizophrenia have remissions and live just normal, so stopping meds might be temping when paranoid thoughts return.

aneladgam_varelse

I like the cut of your jib

Minotaurus Rex

I know a few clinicians who could've already been replaced with GPT-2. A significant portion of therapists today are barely literate, and their favorite piece of art is probably the Star Wars film series. But that's also most of their patients. Until that changes (I doubt it will), medication and manualized therapy are often the treatment options available at some fraction of the (exploding) scale needed. This shouldn't be underestimated, or taken lightly in terms of what limitations and material circumstances shape/maintain this dynamic. Dr. K is a very smart guy whose epistemics are far less naive than most people who can repeat talking points they vaguely recall from undergrad (this is grounded on "evidence" in the doctrine). I have no doubt his clinic overperformed in ways that would more than anything make many of his enemies disgusted and enraged at how well his patients were doing. That would speak to a sad state of some hegemonic therapy discourse. A hot take which seems less contentious every year. I digress. This is of course separate from how you should think about his pivot from clinical work to whatever Healthy Gamer is. The channel's probably helped more people than it's harmed by a factor of thousands to one. Maybe hundreds to one if you're big into medicalization and think he's a threat to pharma. He's also overstepped boundaries in ways that look beyond shaky, on the other hand, while trying to break new ground in answering problems in the previous paragraphs. I wonder how you do that math (if it sounds simple, you're probably wrong). The coaching side gives me pause, but would have to look into it.

Exai

Even the argument that "some people genuinely need these drugs or similar, therefore ~everyone~ should be advised to take them or else the people that need them might think they don't need them" is pretty stupid imo. People should be treated like adults and be given a honest array of options to deal with their own health issues, especially as they will be the ones experiencing the consequences

Minotaurus Rex

Thanks for the podcast links

Minotaurus Rex

I didn't watch the video but I doubt he's advocating for people with a schizophrenia diagnosis or similar to try non-pharmacological methods first. Seems his target audience is gamers who haven't been taught good self-care skills. I agree it's a bad idea for anyone taking any of those drugs to stop without a very careful plan and lots of support as the withdrawals can be very long lasting and mimic the symptoms of the original diagnosis and worse. But I doubt that's what he's advocating so it's a bit of a strawman argument you're offering. Anyway such unfortunates as those diagnosed with psychotic disorders are usually forced by the state to take the drugs, so the opinions of some youtube talking head would be pretty irrelevant in practical terms for those cases anyway..

Minotaurus Rex

there are 2 more episodes, which I can’t find by buzzword search. Before Conspirituality, Derek Beres had solo podcast on that topic https://open.spotify.com/show/6AdiqWJX1QQQyJgJmNWdYh?si=xkb9gSXnQUiLzi1T3GJFfw

aneladgam_varelse

Antidepressants https://podcasts.apple.com/pl/podcast/conspirituality/id1515827446?i=1000492446271

aneladgam_varelse

https://podcasts.apple.com/pl/podcast/conspirituality/id1515827446?i=1000609065809 ketamine

aneladgam_varelse

Psychodelics https://podcasts.apple.com/pl/podcast/conspirituality/id1515827446?i=1000629499593

aneladgam_varelse

Do you know which episodes? There’s quite a lot to scroll through on there

Minotaurus Rex

“What’s the harm of offering a different solution” - it really depends on to who you talk to. No doubt that many terminally online people will highly benefit from hearing that, so in that sense mission of Dr K brings real value to Twitch community. Dr K is right that sometimes depression is congruent with external circumstances and symptoms associated with depression aren’t caused by clinical depression. Dr K is also right that sometimes it isn’t adhd, but the person spends too much time on the internet and can’t do real work even if their life depended on it. But there is also population of people seriously mentally ill: schizophrenia, bipolar, recurrent depression. They shouldn’t stopping meds, they really shouldn’t. But because they are on meds long term and their life is very medicalised, they are most prone to trying out something different
 and it’s recipe for disaster. Therefore advocating against meds generally, without proper caution, is not the most responsible thing.

aneladgam_varelse

FYI Derek Beres from Conspirituality is very critical of antidepressants and of medical usage of psychodelics too. They have interesting episodes on that

aneladgam_varelse

@Linda generally I feel the same way, but imo psychiatric drugs can easily slip into realm of quick fix solutions for problems that don’t need such measures. Especially with what happens online I often feel like we need mental health unawareness, because at some point happened concept creep around diagnostic criteria and now almost everything is pathologized. So on one hand I really like message of resilience and building personal skills to deal with hardships of life, but on the other hand I know many people who really need medications to live normal life, because struggles can’t be attributed to lack of social skills or wrong attitude

aneladgam_varelse

I for one am in support of anyone in the mental health field offering non-pharmacological solutions to mental distress. There’s an absolutely endless amount of people promoting psychiatric drugs on the internet, it’s impossible to avoid, so anyone that wants to go down that route will have zero trouble finding material promoting it. What’s the harm in someone offering a different solution? This isn’t like vaccines where everyone needs to be on board to stop a crisis. I find it weird that to be card carrying member of the left in 2024 you now need to be completely uncritical in support of everything the pharmaceutical industry does. Those drugs come with plenty of potentially life-altering side effects that you’re not warned about before they put you on them, and they’re extremely difficult to withdraw from, so alternative interventions definitely should at least be on the table. Some of the biggest fines in history (billions) were given to the manufacturers of some of those drugs, for deliberately concealing side effects of various psychiatric drugs and for marketing them for conditions they should never have been marketed for. Everyone knows about these drugs and it is trivially easy to get prescribed them so no one need panic about someone offering something else to try beforehand. These drugs will always be there for anyone that wants them.. Anyway I think it’s important not to make blind allegiance to massive companies a partisan issue. That just makes each political wing just a different demographic to be bought and marketed to by different corporations. This is a completely different issue to vaccines and shouldn’t be conflated with it

Minotaurus Rex

Probably the purpose is to monetise the videos

Minotaurus Rex

There are not insignificant side effects and contraindications with alcohol but they’ll sell that to any bastard over 18 any time they ask

Minotaurus Rex

What ones would you legalise then while keeping amphetamine restricted

Minotaurus Rex

Indeed it’s not

Minotaurus Rex

wow great point! Tho I guess “Eastern” stuff can be broadcasted, because everyone can try these things out and see if these works? re: does he present himself more as an educator who is helping to destimatize mental illness? No. He’s very much a self help guru: start watching, meditate with us, change your life with my AoE healing.

aneladgam_varelse

I can’t recommend anything, not-therapy streams were never my thing :/

aneladgam_varelse

What I thought was kind of strange about this interview with Dr Mike is that Dr K kept saying that Eastern medicine, like Ayurveda is more individualized and patient centered, yet he is also streaming to a large audience. If he truly believed that the best practice is to treat patients as individuals, what would be the purpose of having a large streaming method of reaching people? I’m not familiar with his stream, so I’m sure someone who is can help me with this seeming contradiction. Does he present himself more as an educator who is helping to de stigmatize mental illness for a largely young male population?

Linda Sears

Idk if I’ll be able to find it, but he somewhere explained what sort of recommendations he gives to his patients: meditation, diet, it turns more into coaching relationship! Attack illness from all fronts at the same time! Personally I hate this approach, because I barely stick with meds and probably wouldn’t do any of that as result <- especially during depression episode

aneladgam_varelse

I'll definitely check that out Ty- happy to watch one you recommend? Otherwise happy to find one myself too

Anna J

What is worrying to me is when people (not necessarily Dr. K) automatically view meds for psychiatric disorders with suspicion or even hostility. I’m thinking of those who are so upset at “Big Pharma” that they think meds are unnatural and just a way to for them to make more money. Almost all meds have some side effects, many are costly, and there are good examples of meds that were disastrous, so I understand why people are reluctant to use them, particularly when they are used long term. As a person who has been taking antidepressants and anti inflammatory medications (psoriatic arthritis) for years, I consider the costs/benefits. Would I rather be depressed and in physical pain now but avoid future medical issues? What quality of life would I have if I’m in constant pain?

Linda Sears

dr K happily shared anecdotes from his practice too. I’m under professional confidentiality too (my English fails me here; not NDA, I mean client-lawyer secrecy) and it’s always off putting to me when people do that, unless it’s super super generalized. I don’t even know if these anecdotes are real, because dr K does so little practice nowadays

aneladgam_varelse

HOWEVER I think you should watch some more recent not-therapy stream and don’t judge dr K solely based on Reckful not-therapy sessions. It’s been 4 years, maybe he learnt some lessons
 Idk that seems fair.

aneladgam_varelse

I looked up more material on the "not therapy but actually definitely therapy" with Reckful and I feel quite mad and almost upset about it. Like, this guy was seriously vulnerable with so many risk factors for deterioration and harm to himself. I don't think you should stream therapy with ANYONE but it's 100x worse to do it with someone as vulnerable as Reckful with a serious diagnosis like BPAD 2, former suicide attempts, completed suicide of a first degree relative, history of trauma etc. And saying it's not therapy so you can completely disregard any possible duty of care that you have - how manipulative. And did he not even consider that someone as vulnerable as Reckful likely had a diminished capacity to even consent to these sessions being streamed? Did Dr K forget everything he learned about medical ethics during residency? Just thinking of Dr K counseling this (often acutely) mentally unwell person, getting him to divulge secrets and personal details, questioning his diagnosis etc while thousands of people watch, sending purple hearts and money to Dr K like it's some random stream topic makes me feel kind of nauseous.

Anna J

Having said that I am tentatively pro-legalising a lot of recreational substances for harms reduction purposes. So that's not very consistent of me haha.

Anna J

For anyone who is interested here is another video of him er.. lying ... about the evidence re ADHD treatment. https://www.youtube.com/watch?v=4PTl27tTmfY&t=811s. From the "stimulant" section - “there are head to head studies that show that stimulant medication and non-stimulant medication basically work the same, in terms of the effect size”, and then goes on to explain that the big difference between them is just that stimulants work faster so patients subjectively “think” they work better (this isn’t true – evidence shows greater efficacy of stimulant medication based on outcomes other than simple patient self-report) – he gives the example of buproprion (non-stimulant) saying it takes weeks to work but that it’s “just about as effective” as a stimulant. I mean, it’s true that bupropion can take weeks to work, and yes a stimulant works straight away. But his claim that they are both as efficacious once you reach that timepoint where they are both “working” is just not borne out by the evidence. He also says “I don’t think that stimulants work the best, the data suggests that they don’t” Like where are these head to head studies? I’d really like to see them. Because all of the current guidelines, the RCTs, the meta-analyses etc contradict him. Here are some further articles for anyone who wants to read them, they are both open access: Evidence-based prescribing of medications for ADHD: where are we in 2023? https://www.tandfonline.com/doi/full/10.1080/14656566.2023.2169604# “Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis “ https://www.sciencedirect.com/science/article/pii/S2215036618302694?pes=vor

Anna J

Yeah honestly the information he peddles borders on anti psychiatry propaganda sometimes. He seems very anti-medication in general. He says medication is just useful because its "easy". It honestly reminds me of some anti vaxxers who instead of claiming that vaccines dont work at all they claim you wouldnt need a vaccination if only you had a healthy lifestyle. Like of course environmental, lifestyle etc factors matter. Of course various therapies can be helpful. But for some (many) psychiatric disorders you need medication, it isn't just that medication is the easy option. He says multiple times that he tries to steer clear of medication in general and that only 30% of patients in his practice are on any medications. This is a very odd disclosure for a psychiatrist if he has a "normal" patient casemix. Like is he only treating mild depression, mild anxiety and personality disorders? Maybe I guess. Why though? He's clever about his anti medication, pro CAM nonsense too. He weaves this stuff in between nuggets of truth and interesting descriptions of the pathogenesis of mental illnesses and genuinely helpful tips etc..it's quite manipulative.

Anna J

That's interesting. I wonder how he keeps up his registration if he's not seeing patients. Where I'm from you need at least (I think...from memory) 5 weeks of clinical practice per year to retain your medical license.

Anna J

I don't agree. They aren't wildly risky meds or anything but stimulants have not insignificant side effects and there are certainly contraindications, like any medication. When prescribing them you need to do a risk:benefit analysis. ADHD can be incredibly impairing in both children and adults so for these people the benefit outweighs the negatives. Also you're often combining stimulants with other psychoactive medications so you need to consider medication interactions. Not to mention the precautions surrounding stimulants and alcohol. You have to be either a psychiatrist or a paediatrician to even initiate stimulant treatment (at least in my country - after initiation GPs / junior doctors under a psych etc can take over for repeats). So yeah not to be taken lightly.

Anna J

This was supposed to be in response to Anna and Natasha’s exchange below 👇

Minotaurus Rex

Just legalise stimulants so anyone who feels they benefit from them can take them and people that don’t want to don’t feel pressured. If they’re safe enough to give to a large proportion of children surely they’re safe enough for all informed adults to decide whether they want them or not

Minotaurus Rex

also keep in mind that dr K doesn’t practice since he started healthygamer.gg. It’s possible to schedule appointment, but he’s “out-of-network” and it very much looks like something he’s doing on a side now https://kanojiapsychiatry.com/appointments/

aneladgam_varelse

Totally understandable that you would believe him as he's a licensed psychiatrist, which is exactly why it's extra annoying that he's misrepresenting the evidence. https://www.ranzcp.org/clinical-guidelines-publications/clinical-guidelines-publications-library/adhd-across-the-lifespan Down the bottom of this page from the royal australia and nz college of psychiatrists is a list w links of current medical guidelines from various countries (Canada, UK, Australia etc). They all recommend stimulants as first line treatment for moderate to severe ADHD (with an exception for very young children population esp if not severe).

Anna J

https://youtu.be/gMBuMAtr8xk?si=en0ijXcbMyKPnOIM <- It’s interesting back and forth between “I’m the evidence based guy and there is no evidence for manifestation” and “I believe in manifestations despite lack of evidence”. Also he’s weird toward his wife again (wife non present)

aneladgam_varelse

Dr K is imo pretty sus on topic of depression too. Idk if I misunderstood or what’s going on, but I really got impression from his content that depression is periodical illness lasting up to year and longer depression isn’t it. It’s more explicit in the guide, but I remember something like this from these videos too: https://youtu.be/xcEVntNv9ik?si=J_2RKOzA6T7gr4-9 <- segment “what is depression”, I like that video overall https://youtu.be/zktbKbbqGvE?si=CSEQsMjxPR8cYaum https://youtu.be/bDhqTf5eJH4?si=VoGcUfdVjDJoW0ct <- this video gives weird vibe that congruent depression is different than clinical also I haven’t watched this one but judging from timestamps wtf https://youtu.be/1s8PHo7SpNg?si=dqDyixd2VRxuawhd

aneladgam_varelse

Oh shit I believed him there, I still use stimulants but focus on everything else than ramping up dose than minimal + use stimulants like benzo, when I need it

aneladgam_varelse

Also I think it's reasonable to have concerns about long term effects of the meds btw (the review article I linked addresses that in case youre interested). I have adhd too so it's a big concern of mine also 😊

Anna J

Hi Natasha thanks for reading my long comment haha. I watched the whole video and I also enjoyed a lot of it. I agree it is interesting and he makes a lot of good points and gives some engaging explanations about adhd in it etc. It wasn't my intention to come across as shutting down people who are not pro medication though, I agree it is important to discuss these topics openly. My issue isn't that he is criticising the use of medication per se. It's about the fact that he makes factual statements about the efficacy of stimulants vs non stimulants, and the efficacy of stimulants vs psychotherapy that are just not supported by the evidence and are contradictory to current best medical practice. If he thinks there are issues with the guidelines or the evidence then that is fine - he can say that and give his reasons. But he doesn't. He just misrepresents what the evidence is, which is a very different thing. I hope that explanation made sense, I'm not the best at written communication eek

Anna J

I have ADHD and I'm a psych student, and I was interested to read Anna's perspective on Dr. K 's lecture/video here. I had previously watched about half and found it very interesting. I didn't feel strongly about his opinion on meds either way, because I'm happy to hear different opinions. I always worry about the long term effects of taking the medication, so the more conversations about the topic the better. I don't think shutting down people that are not pro medication is a good way to go. It seems like a very informative video, but I could be wrong. I'd love to know what Matt and Chris think. Also do these guys have ADHD? I wonder while I'm listening. Especially suss about Chris 😁

Natasha Bride

I put this in a comment on main page but probably more appropriate here so will paste ... Dr K misrepresents/lies about clinical guidelines and evidence based treatment for common psychiatric disorders. Good example here: https://www.youtube.com/live/qbPpZCjeur8?si=1tcxN6v1fENmYE1S @  timestamp 01:11:40 but you could start a little earlier for some context. He opens with some subtle "drug companies sort of bad/misguided" stuff and then goes on to state that non stimulant therapy is equivalent to stimulants for the treatment of ADHD (unequivocally no) and also at some other point in this stream (sorry can't remember where will try to find it) that non pharmalogical interventions are equivalent to pharmalogical interventions for ADHD (also no). This is so irresponsible as ADHD, especially when it's severe, can be very impairing to both physical and mental health.  So telling someone that the gold standard treatment they are on (stimulants) might not be necessary can have real effects. He also compares stimulant use for adhd to benzodiazepine use for anxiety ie they both make you feel good.  It's an absurd comparison to draw.  Benzos are bazillion times more habit forming and deadly than stimulants, and shouldn't ever be given as first line treatment for generalised anxiety. (whereas stimulants are first line for adhd). Just more anti pharmaceutical bullshit wrapped up in a nicer package.  Like its subtle but it's there. Obviously it's great to give people with adhd non pharm tools to help them with their daily life. But you don't need to lie about how necessary their medication may be to their function to do this? He also says (paraphrasing) "people come to see me after they've seen 12 doctors who still haven't fixed their adhd issues, I tell them I don't have the answers.  I don't know more than those doctors" .. but then goes on to basically describe how he will then tailor a unique approach with them that is different and special lol Oh and conveniently has a mental health guide for sale that can apparently give people tools for their adhd.  I haven't purchased it but yeah, interesting.... Oh and I say he lies instead of he is mistaken about these guidelines because if he is a board certified psychiatrist there is no way he is not aware of the guidelines for treatment of a very common neurodevelopmental psychiatric condition. Every first year psych trainee or resident who has done a psychiatry rotation knows how to treat adhd, let alone a consultant like him. Good open access recent review article on current evidence re ADHD to show his claims are nonsense https://link.springer.com/article/10.1007/s44192-022-00030-1

Anna J

I’m listening to the episode you linked to, and I have to admit I am struggling to distinguish who owns the which voice. Dr. Mike sounds unnervingly similar to Dr K. It doesn’t help that they are both asking each other questions.

Aaron Holder

I joined this podcast on Patreon specifically because I've been a Dr. Mike fan since before the pandemic.

Alice Fielding

I remember he interviewed Contrapoints and 2/3 of the way through the stream she referred to being trans and he was taken aback and said he hadn't known, and so apparently he does zero research on who he is interviewing before he does if they are outside of his brosphere. Like that is one of the most fundamental facts about her as a YouTuber and how she presents her content.! That said if I were you I would look into recent posts about how he is looking to grow his company, since he is looking to capitalize on being "a community" and build out more mental health content than just the videos (apps, groups, courses, coaching etc products). He's been posting recent videos about that in the last month or so. Here's a link to a survey they just put out: https://healthygamer.typeform.com/to/i5BXV4mr?utm_campaign=social_media&utm_source=youtube&utm_medium=social&utm_term=PriceSensitivitySurvey&typeform-source=www.youtube.com

Sam D.

It’s not hard to find Dr. K spouting too confidently about alternative medicine, it’s also easy to find him having normal, relatively solid lecture-style conversations about mental health topics. But you will be missing out if you don’t see Dr. K talk to Sneako, the Andrew Tate knockoff who believes psychiatry is only for blue hard liberals. At the beginning of the talk sneako has his fake online tough guy persona in full effect, which Dr. K gracefully sidesteps somehow without being overtly combatant. Really a unique piece of content for him: https://rumble.com/v40c8ot-sneakos-full-therapy-session-with-healthygamergg.html

Yoloswag42069

Interesting thing I've noticed about Dr. K and Destiny - Dr K is the only person I've seen Destiny be really calm around and seems to really respect, destiny seems to be very skeptical generally so I found it interesting that he seems to not question anything Dr K says

Erin

I recommend watching mrgirls video called “Dr. K: Reckless mrgirl is very controversial and should be taken with a giant grain of salt, but the video gives a good overview of the more egregious interviews/therapy not therapy streams.

Mert

I liked your commentary on Zizek’s humor, playfulness, and self-deprecation as part of his likability, and I feel like there is something to that too with the success of Dr. K here—it even inclines me sometimes to give him the benefit of the doubt that some of the more concerning behavior on the surface is just his humor—but I’m not sure exactly where the line is or should be drawn given there’s more responsibility in what he’s doing as a clinician. I will say one thing that stood out as bizarre was when he broke down crying hysterically while streaming when talking about the suicide of Reckful. Maybe that was genuine, but it seemed very out of left field and even counter to his own self-described more emotionally stoic nature that makes him suited as a psychiatrist. https://m.youtube.com/watch?v=NDZRLHIQUEM&pp=ygUTZHIgayBjcnlpbmcgcmVja2Z1bA%3D%3D

Milquetoast Ramen

Excited for this one 😁

Erin


More Creators