This episode is independent educational commentary based on publicly available material, which may be incomplete or inaccurate. We have not evaluated Elizabeth Holmes, Billy Evans, or anyone discussed in this podcast. All psychological interpretations are speculative. They're certainly not diagnoses, they're not factual findings, and they're certainly not any allegations of wrongdoing. We do not claim knowledge of anyone's private thoughts, motives, or mental health.
Good morning, Dr. Malzberg.
Good morning. How's it going?
Not too bad. We're doing something a little different today, aren't we?
Yeah. What is it that we're doing?
Well, I think we both have interests in things like pop culture, society, and how personality plays into that area. And I think that the brilliant work of Nathan Fielder across the last few years, but especially just now in the last week or so, really puts us in a position where it's worth talking about these things on a podcast.
Yeah, and I think the movie that just came out, You Can See Everything, is rife with psychological content that two psychiatrists can babble on about.
That's right. So in case you're any first-time listeners, who are you?
Before I talk about who I am, I should say that whenever we do one of these podcasts, we expect to have tons and tons of listeners. So we introduce ourselves and tell the audience who we are. And then we don't tend to have a huge audience. But who am I? I'm Dr. Malzberg. I'm a clinical psychiatrist. Who are you, Dr. Fu?
I'm a forensic psychiatrist. I work primarily in the criminal realm, doing a variety of different evaluations for state of mind at the time of the criminal offense, but I also do some civil work. And outside of that, I teach psychiatry and I'm an outpatient psychiatrist as well.
And I think we both have a strong interest in psychoanalytic ideas, and I think that'll come into play a lot within this conversation.
Yeah, I think it's interesting. The film to me is a strongly psychoanalytic film, even though I'm sure it wasn't intended as such. Not getting too much into details. I think it's arguably true that Western art today just has psychoanalysis baked into its DNA. You know, when psychoanalysis was a lot more popular in the 20th century, Probably the majority of artists, certainly Hollywood artists, were at least peripherally dialed into psychoanalysis.
Many intellectuals and artists would read Freud and read psychoanalytic ideas. So I think it's just kind of in there, even if people today haven't gone back to the basics. And part of that is important to note because I think the film itself, you can see everything from Nathan Fielder and the Lance Oppenheimer, right? Is that his name? That's right. Or Oppenheim. Okay. It's also a projective test.
You can see this already in the online discourse about this film. And I think it's because it's purposefully ambiguous. All ambiguous things are projective tests. They let us let our guard down and then we put ourselves into it and our perception of it, right? We assume that our favorite patterns or our way of being is what's happening and what we're seeing.
Yeah, when you say projective tests, Rorschach is like the archetypal projective test. So it's an ambiguous stimuli and then you bring your own stuff to it in a sense. When you said it was psychoanalytic, what did you mean?
Well, before I go to that, I just want to say when you watch this film, then you should understand that what you're getting from it, what you're seeing is yourself. That's what I think anyway.
So in terms of how it's psychoanalytic,
you know, I don't want to get too much into that, but I also found that Nathan's interviewing style in the film was kind of interesting. If you watch his persona in the rehearsal or And Nathan, for you, it's a very different Nathan, in my opinion. This one, I presume is closer to who he actually is, but also still a character of some kind, maybe, I don't really know.
But he's more direct and his interviewing style, I think capture really well the psychoanalytic techniques of clarification and confrontation. We discussed this in another episode elsewhere. Even if his interaction with other people in this film doesn't have the other major aspects of therapeutic work, it's still kind of a therapeutic film trying to uncover what is really lurking beneath and motivating people to do what they do.
Yeah, and I probably should have done this earlier. Disclaimer, this is going to have a bunch of spoilers. So if you haven't seen the film and you want to see the film, maybe wait until you see the film to listen. Yeah, I actually, I loved the way his interviewing stories. He did such a great job of, you know, it seemed almost at times where it was like this battle of who's going to go first, but he would use his face really, really well to kind of get the He used his words very sparingly, but really powerfully.
Yeah, I mean, it's to the extent that I would say it's almost utilizable as a teaching film for therapists, psychiatrists, forensic interviewers, you know, and on top of the interviewing style, you can even see that there are Defenses. People are deploying psychological defense in the film. That doesn't need to be overly technical. I think anytime you see somebody avoiding a line of thinking, a way of saying something, or in many cases in the film, literally running away from an interviewer by making some kind of excuse, those are all good examples of psychological or interpersonal defenses.
I do want to jump into our analysis of the defenses, analysis of psychologically what's going on. Should we go for it?
I mean, you can. I'm going to follow certain ethical rules. I won't say anything that isn't supported or inappropriate, but let's see how far we can get.
Yeah. And that's because Dr. Fu follows the Goldwater rule. I will be talking about, you know, just some general concepts. I think this is a film that I think we're allowed to analyze films. I think I'm not actually talking about the characters. I'm talking about the characters as they were displayed in the movie.
You're not talking about the people. People are talking about the characters as they are portrayed. Yes.
Correct. And the thing that I saw that I think is important for people to understand, if we were to say, you know, borderline personality organization, I think is probably the most important concept to understand. To understand, I think a lot of what was occurring between the two main characters, Elizabeth Holmes and and Billy.
That's one frame, right? I think a lot of people are going to reach for another frame of understanding people when it comes to saying what's going on. And we have no way to say which one is more or less accurate. But I will say that that's something that Is worth discussing for sure. I actually before we get to any of that, I think it's just worth commenting on Elizabeth Holmes and how she appears on screen.
You know, I'm sure a large part of that is the Yeah. And she just has a very unusual face and a very unusual way of showing emotional expressions. I don't think that is controversial to say. To me, watching that film, it made me feel that Elizabeth Holmes is like this Fae-like creature. She's like some kind of an elf or fairy that comes out of the European forest in order to entice humanity in some fashion and lead them astray.
That was just kind of the emotional feeling I got from this. But just watch the film and compare her interpersonal and emotional responses to almost every other person that appears in the film. There's a lot of difference. The emotional reactivity is restricted and pretty kind of samey in a sense. There's a lot of frequent, almost inappropriate smiling and wide-eyed prolonged eye contact. And there's almost a, I don't know what word to describe this as, but there's a lot of nodding going on, a lot of nodding going on, right?
Yeah, what really stuck out to me is there was a constant smile, even when she's crying, she's smiling. And the nodding, it's this constant, just little up and down. Now, I'm curious, use the word unusual. I guess, what do you make of it? How do you make sense of that? Why does she have an unusual affect?
So I think we need to draw back from the frame of the film when we ask that question. We need to wonder to what degree can this film portray a reality and to what degree can any documentary or work Even written nonfiction portray reality. Because every time we try to make sense of reality, we utilize some kind of a frame. But the use of a frame obscures in multiple ways, the least of which is that it removes context and it removes other information.
And at least for this film, It's very obvious that everyone on the film knows that they are in a film for the purposes of doing something, right? So it's therefore entirely possible that every single person we see On screen has changed, altered their behavior or put themselves on as some kind of persona. So is it real? Is it not real? I think it's extremely vague and it's completely impossible for us to talk.
Yeah, and I actually think I need to do my formulation before talking how I make sense of these things. So you mentioned the way you make sense of it is we don't actually know if she's putting on in some sense. And you also don't know if when they're not filming, is her affect significantly different? Yeah. And... I think this is the beautiful, the film was named beautifully of You Could See Everything because that's almost the big joke of like, you could see everything that we choose to show you.
And the film actually plays with this idea a lot. I guess we'll talk. It's almost Billy's idea of we can show you everything. What's his idea of showing us everything? You get to see what I tell you. I'll stop when things are going too far. You can see my penis because my body is a part of everything. Spoilers. Yeah, we're just
going to go. I was full frontal nudity of him early in the film.
Almost like a childish view of like, and this is everything. You're seeing absolutely everything without like the obvious context of like, no, you know, the film is running. Of course, this is not everything. And within the first, I don't know exactly what day it was of filming. Within the first day, they closed the door and start talking behind the scenes of like, should we be talking about that during when the film is running?
It's a huge joke. Yeah. But I do want to see, what do you make of this strange affect? Even when someone's putting on, you can see in previous films that she has this constant smile, this little bit of head nod. It almost feels like a Parkinsonian kind of thing, but it's not, I'm not saying
it's not. That's a good point. I immediately wanted to know after I finished watching the film because I actually have not followed the Elizabeth Holmes story too closely. The most exposure I had to it before the dropout came out, which I didn't watch, I saw someone else watching. But before that came out, I'll tell a little anecdote. My experience about Theranos and Elizabeth Holmes was I was in the car with some other physicians.
And one of them, a PhD researcher and MD, was just gushing about all the things that Theranos was achieving. And I said, what are they claiming exactly? And they said, they're saying they can get all these tests out of one drop of blood. And I immediately said, that's impossible. That is not physically possible and that's not going to work. Okay. And I'm not a research scientist. I did have some experience with that as an undergraduate.
And you know what? I just felt very validated when it ended up not necessarily working. Okay. That's enough plugging myself in a sense. What did I make of the behaviors? Well, yeah, I immediately went and looked up interviews from before the fall of Theranos. And she's shown the same behaviors. It's not considerably different. I wanted to know if it was an act put on specifically for the Fielder film.
And it doesn't seem to be. And you can also hear her speaking in a particularly deep voice, even deeper than what you see in the film. So it seems to be something close to at least what she's used to portraying on film. Who knows if there's any difference in how she acts outside of filmed or recorded situations. But let's just break down the things. First, the unusual affect to me that is when you see that for whatever the underlying reason is, when a person doesn't have the micro expressions that match another person during a conversation, it's some kind of a breakdown of the ability of that person to fully and very rapidly comprehend what is going on in the other person emotionally.
Okay. There are a lot of different possible mental states or disorders that can cause that. And I'm loathe to speculate on them directly. You're free to do so. Okay. But the point is that I think there's a breakdown in the emotional understanding, the implicit emotional understanding of the other person. The second thing is the nodding. The nodding feels almost defensive. It feels almost automatic. Some kind of inborn motor tick that just wants to say constantly, yes, yes, yes, yes, yes, yes.
Never know. Never know. Always yes. And I'm with you. I agree with you. So those are the major things I took away from that.
Yeah, I agree. It's almost as if her affect is, and I think I'll have to give my formulation before kind of fully understanding how I'm thinking about it, but her affect almost mimics exactly what you read in research studies. The deep voice is something we've all read before. And also I'm sure I've read somewhere that like, you know, People like other people who are smiling. It's almost as if she's like a collection of research studies on what a CEO and someone should do to be powerful and develop trust immediately.
And I think, like I said, I'll have to give my formulation for how I understand her with regards to why I think she's able to make these long-term adaptations that I think other people would have more difficulty adopting.
Yeah. Yeah. Watching the film, I began to think, feel, remember about a older concept, a concept called the as-if personality. The as-if personality is not super well defined, but it was originally The reason why it's named that way is that it was supposed to describe personalities where they kind of looked and functioned as if there was some real self within them. Closer look would show that their self was quite malleable, kind of taking in various characteristics, attributes, and values from the people around them.
Generally a bit narcissistic, at least, and also kind of high functioning. How malleable is the self? How much can we allow ourselves To just take in other people's desires and wants or to be what someone else wants or needs us to be or to be a different person for some kind of And that's a type of dissociation we can argue, right? That if we can do that, then we're going to be a lot more likely to be able to form or portray different characters.
Now, the adaptive or at least socially normative version of that is playing pretend, role-playing. Or acting, right? Those are just general human characteristics. But the idea, I think, is that in a state of personality health, the true self is simply being put aside temporarily and that we would never act or think beyond the way we truly feel and think inside unless we're very prone to lying without feeling bad about it.
Yeah, and my understanding of the as if personality, maybe I'll be repeating what you kind of said, is their sense of who they are is essentially just not there. And so they take on other... I think that's what they, on the things that I've read, it's like from the outside, they seem totally normal. But when you actually get to know them deeper, it's all almost like a collage of what they think they should be doing.
And there's no real underlying structure for who they are. Mm hmm. Mm hmm.
And of course, this is something that's captured in modern, more mainstream DSM understanding under identity dysfunction, right? And the alternative model for personality disorders, DSM-5 alternative model, personality functioning is split up into self and interpersonal. And under the self realm, we have identity. And we have self-direction. So when thinking about the as-if personality, they can be directive, but they don't necessarily self-direct. They may direct based on the needs, wants, or values of others.
And so I think that as if formulation works really well with the borderline personality organization formulation. Do you mind if I kind of go into that? Oh, I mean, you should absolutely, because personally, I do think the alternative model, DSM-5 alternative model, their personality functioning is essentially the same thing as borderline personality organizations.
So first, I guess I'll give my super oversimplified understanding of borderline personality organization. And the first thing we need to understand is kind of how an oversimplified idea of development. So I think, Dr. Fu, you'll probably push back because it's probably too oversimplified, but I'm going to give it a shot anyway.
Before you do so, shouldn't we just at the outset say it is not the same as borderline personality disorder, which is a more constrained and older, not necessarily older, but it's more constrained DSM simplified model and borderline personality disorder, as people popularly talk about, is only one category within the organization, borderline personality organization, which would include things like narcissistic, antisocial, histrionic, and other types.
Absolutely. So borderline personality disorder is a part that patients with that have a borderline personality organization, but not all patients with borderline personality organization are BPD. That's right. So let me give my first very, very brief understanding with regards to development. I'm going to also connect it to the film. So initially, there's a differentiation between self and other. So as a person, when you're a baby, there's like this oceanic experience where everything's one.
Through a series of minor frustrations, a person individuates. So they start to understand what's me and what's the other person. And whenever there's any sort of like massive frustration, concepts of what's me and What's the other person can get disrupted. Now, we see a ton of that in the film with regards to the way that Billy and Elizabeth describe how they understand each other and the way that they talk about each other shows that there's a real lack of clear differentiation between me and another person.
We'll get to that in a second. Now, borderline personality organization. So first, you have the split between me and another person. And then there's what we call the libido, which is a psychoanalytic term, which I can kind of consider like the-
Life energy, mental energy is how I like to refer to it.
Yeah. And I think of it as like the more positive connecting force. And then there's aggression, which is the more negative aggressive force. And our idea of self and other also, so our self differentiates according to lines of So we have how we view other people as what we call like, quote unquote, all good or quote unquote, all bad. So the things derived from the libidinal force is all good and the things derived from the aggressive force is all bad.
How do I think about this? So when I see my nieces and nephews and they view my sisters, when my sisters, they adore my sisters They love their mom and their mom takes care of absolutely everything. But then when their mom says they can't have the ice cream, they go into this full temper tantrum and they hate my sister. So there's really no understanding. The mom that tells me that I can't have ice cream is also that same mom that I adore and need.
So what happens is, again, through a series of minor chronic frustrations that improve your ability to understand that the all good mom and the all bad mom are the exact same thing. So splitting develops when that process is interrupted in such a sense that the images of the all good and the all bad can't be merged.
Yeah, that's a great description. I'd like to clarify a little bit, if I will. As adults, we think of mental development as adults, so it can be confusing. We want to remember and consider that young Young children and people with underdeveloped or poorly developed personality function, they may not think and feel in the way that most adults are used to. And that the emotional development is a different set of skills or development than the cognitive intellectual development.
So someone can be very high functioning intellectually and still be emotionally childlike or underdeveloped. So what you refer to here are about emotions and specifically emotions as they refer to other people and ourselves, right? And I also want to say that splitting then is not just something that happens when you get older. Human beings originally just think about black and white and aren't very realistic. And it's only if we are given the right development and support that we can integrate good and bad together and see them in the same person.
Yeah, you did a great job. And please feel free to keep adding things because I'm sure there's tons of little nuance that I'm missing that is important to kind of understand this concept. But the core of borderline personality organization is that the merging kind of So splitting is the fundamental defense mechanism that they use. So splitting protects the ego from any sort of conflict by maintaining dissociation or an active keeping apart of the ego.
So the way I think about it is, you know, the easy way to view it is these people with BPO have they think things are either all good or all bad. And when whenever things are all good, the the. The way that they think about things takes on, so the all good takes on the full, the way it's put in like Kernberg books, it takes on the full emotional, ideational and motor consciousness.
So in a sense, if I'm thinking of, there's only two ways to really view myself and they're mutually exclusive. I either view myself as all good, I'm doing really well, things are wonderful, I'm incredible. Or I'm terrible, I'm the worst thing in the world. And these two things don't coexist. So patients with this, they don't have a comprehensive, realistic view of themselves and other people. It's either...
And so that's why we see... Other characteristics with BPO are identity diffusion, a reliance on primitive defenses. Really, the big difficulty is difficulty integrating positive and negative aspects of relationships. And that's really what we see in this movie.
To put it simply, there's a lot of jargon, there's a lot of history, and that can really lead the layperson astray. The ultimate takeaway is that it's a stunted or slowed or difficult emotional development, interpersonal and emotional development, how to understand ourselves and feel about ourselves and about our relationships and other people.
Absolutely. So this is what I think is underlying Elizabeth. And then I also see in terms of what other flavors of pathology, I see very strong narcissism. So I think there's a very So, how do I make sense of her relationships with regards to splitting? I actually think that So there's a few things that kind of happened in the movie that really hammered this home. The first thing is my understanding of how she uses relationships.
So there's a big repetition compulsion that kind of occurs with all of her relationships. And we actually watched the repetition compulsion kind of take So I think she actually uses her male partners as a sense to cut off the all bad aspects of what her goals are. So I think she has these very grandiose dreams of saving the world. And she's able to only, whenever you're very ambitious and trying to take on goals that have, you know, That entails, you know, fudging the numbers, that entails firing people, that entails a lot of negative things.
She's able to use these men to compartmentalize and have the things that she does in her world be only the good things. And then the men, in a sense, she completely cuts off from the fact that she's having them do their negative biddings. When she walks away and has Billy discuss the money, it's almost like childlike. It's incredible how she doesn't think twice about the fact that he's going to be taking care of the money.
So I think she uses in terms of like, what does she get out of these men? Well, I think she uses them to do all the all bad with regards to her grandiose visions.
Well, you know, that's the theory of the film, I think. Anyway, the film seems to put that forward. But I think that's even less interesting than the question of being, can you only do this knowingly? Can this be done unconsciously? And which one is it, right? One possibility is that if somebody has this pattern of relationship, Being in relationships, that it is done unknowingly. And I do think that most people in life, they go through patterns in their relationships without having any clear awareness of it at all.
Even when it's so clear to an outside observer, even a friend or a colleague that has no professional training, it can be very clear, we have trouble seeing ourselves because it can be painful or unacceptable to see ourselves in a certain way, right? At the same time, Especially if you look at certain data that is out there about this specific case, I think it's pretty reasonable to have doubts that someone can be completely innocent and have no knowledge about what they are doing that may be wrong or at least shielding or denying the truth.
Yeah, and I think the thing that captures this the most was when Nathan asks her, have you ever lied? And she says, I've never lied. And this, to me, perfectly epitomizes how this split works. So because things need to be all good and all bad... Her image of herself is such that even normal human lying is something that she is completely outside of her awareness. So, I mean, like he captures it perfectly of like, I forget how he says, but he's like, Liz, are you for real?
Like, how can you make sense that you're one of the most famous liars in current times and you're saying that you've never lied, which is inconsistent with any human life. But this is really how her... This is the splitting. Her idea of herself is such that never... It's such an absurd extreme.
Yeah, that is an area where... And this is not the first time I've seen this kind of thing. That is where I begin to think, oh... This is not necessarily just run-of-the-mill modacity. Run-of-the-mill attempts to deceive someone. When the lie gets so big or so contrary to the shared reality, the undisputed facts for most other people, but one person is there saying it doesn't matter about any of that, this is what happened.
You see that? Not infrequently in serious cases. And you see that not infrequently in cases with personality problems. But why does that happen? Why might someone insist on one reality when it seems like 99% of the world believes otherwise? There are a lot of possible explanations, but I do think that in many of these cases, it becomes something emotional and that it is Just so impermissible, as you say, to not live that reality that it just cannot be acknowledged at all.
Because a master manipulator, a master liar wouldn't make that kind of claim because they'd understand that the other person would never believe it. So why might someone make an incredible claim like that? I think it's to soothe themselves, to make themselves have the identity and the emotions that they need in order to survive mentally. And watching the film, I really thought of the classic George Costanza bit from Seinfeld, because this is frankly a technique that can be used by people.
It's not a lie if you believe it. It's not a lie if you believe it. And in support of this, if you read Nathan Fielder's recent published interview with Wired magazine, I'm going to read from it here. He says, It almost feels at times that it's not so black and white what's going on in her head. A lie, a classic lie, is someone who's like, okay, I'm saying something that I'm consciously knowing is not true in this moment.
But it's not just the were, it's the design of every aspect of her life that feels like a part of what is going on. What's interesting about her to me, I think, just goes beyond that in any given moment. I can't piece it together. She makes these claims that are like, how could anyone believe this or say they've never done this? Is it a lie in that moment?
Is it a lie if she believes it to be true?
And yeah, he kind of captures it perfectly. And I think the reason why this is occurring is because the way her brain operates is different than the way my brain operates, especially the way that she uses language. And I truly think, like, is she manipulating? Yes. Is what she's doing manipulative? Yes. Is she manipulating? No. And I think in her mind, I don't think she's telling a lie.
But I think the way her brain works is a manipulative process.
Well, you know, I originally thought that in the first part of the film. But then as time passed, and especially after the film, I began to doubt this. Because I think today, in October 2026, we are now seeing repeatedly that big outrageous lies work. Okay, even if the viewer might think this is outrageous and no one would ever believe it, there's someone out there that will believe it.
Because again, it's the matter of function and projection. If it is adaptive or pleasurable in some way, we will believe it. That's just human nature.
That, by the way, as an aside, I thought
it was a very interesting thing about this film as a piece of art. You know, Nathan Fielder is a magician. He's apparently pretty good if he's a member of the Magic Castle. There's this concept from the film The Prestige. I don't know if it's actually real in magic, but they talk about how magic tricks follow the structure where they're There's the pledge, where you kind of show something that seems ordinary.
The turn, where you show something that seems to be out of the ordinary and it can't be explained. And the prestige, where you write things again, but in a manner where it's satisfying, emotional, and people just don't understand what happened. I kind of feel like this film takes that structure. It's like a magic trick itself. It shows you Elizabeth Holmes, who we all know and understand to be a scammer and liar.
That's the pledge, right? And then the turn is showing her as human and indeterminate. And just this person who has hopes, dreams, and wishes in the family, but there's something odd about her too, right? And then the prestige, I think, is bringing us to the end, but instead of showing us something ordinary, we're showing the extraordinary, that we can't be sure, the characters in the film can't be sure about the truth.
Perhaps the people themselves, the subjects, cannot be sure what's true or not. And we, the viewers, cannot be sure what is true or not as well. And of course, that I think follows more strongly if you've followed Nathan Fielder's work across his career.
[music] Yeah, this really captures the brilliance of the film and the fact that he was able to get linked with Elizabeth Holmes because Nathan Fielder's whole shtick is you don't know who the real Nathan Fielder is. Where is the act's end and where does he start? And he managed to get linked. I don't know how this is ridiculous that Elizabeth Holmes agreed to this. He managed to get linked to a person where that also exists, but in a different sense.
So it really is like an unstoppable force meets an immovable object with these two. And he did a really good job of capturing the Yeah, I got a kind of feeling from the film that it was like two thieves recognizing themselves, recognizing each other in the night.
A thief always recognizes another thief in the night. And I think there's a line that Fielder says where he says, oh, it's personal for me. He personally wants to make sure he's not hoodwinked because he, I think, I'm guessing feels that he is suddenly subject to the same thing that he does to other people. Right. And he's not sure what is going on with that. It's very telling.
I think that he tells that story about David Blaine, who I think famously puts a spike through his hand, but he actually has a hole in his hand. You know, the trick is real. So overall, for me, this film is about the hyperreal. It's about our role today in 2026 as observers, as watchers, not participants, but watchers, not even watchers, but people who are viewing something and we know we're viewing something, right?
It's this recursive thing that just goes over and over in Nathan's work. And I think it says something about how we exist as subjects within the social media landscape.
Post-postmodernism? Yeah, kind of. And also, I think, how we exist as individuals with our culture and the political landscape and not knowing where the acting begins and where we're being controlled and where is the truth.
Yeah, because there's an argument I've read from some people that what Elizabeth Holmes did was pretty much par for the course for a lot of people seeking venture capital. You know, that these kinds of Silicon Valley startups that what you do is that you lie. I think it was the engineer in the new company that was kind of referencing this before their interview got cut off. But is this just something that everyone's doing or at least a small subset of the population does to great effect?
And if you manage to fool people long enough until you get a viable product, you win. And then if you don't, you lose.
Yeah, and I think the motto in startups is break things as fast as possible, which is a wonderful thing when you're selling books. It's not such a wonderful thing when you're dealing with patient care, which is, you know, I think venture capital in medicine is, yeah, we'll leave that for another day. Switching gears to another topic that I really wanted to touch on, and it has to do with Billy and Elizabeth and how they describe their love.
So going back to the borderline personality organization, one of the fundamental defense mechanisms So, as I was mentioning, the way that they view other people and themselves is all good or all bad. So, when we're talking about all good, you hear these people... And someone can't just be, you know, when you think of a good relationship, it's like, think of your partner. It's like, yeah, they're special to me.
And, you know, I adore them and I love them. And that's, you know, they have flaws. But when we're talking about someone with these kind of psychologies, they're all good. Links in a sense with their grandiosity or can link with their grandiosity. So when their relationship isn't just a good relationship, it's special in a cosmic sense. The all good takes on grandiose elements of, you know, this is a cosmic love of unfathomable proportion.
And we really see that the idealization phase of how they kind of interact with each other, that the way they talk about the relationship is almost otherworldly. And there's a sense of like other people can understand. This is a magical type of relationship.
Well, there's one point where she even says something like, was it her? She says like, I'm coming to an understanding that... God is love itself, right? But then that's right after talking about the love between her and her partner, which is saying that our love is God almost, right?
That is quite a thing to say.
That being said, I do want to emphasize that idealization and devaluation is very human and we all do it. That's not the unique part. I think it's the degree and how it seems to be. And I think maybe both of them, or at least Billy, make reference to this feeling that I can know what they are thinking because they are inside of me. That made me really think of the common concept of introjection, that we hold people we care about or aspects of them within ourselves.
We take it into ourselves and keep it with us, right? And that's a very normal part of development. It's something we all do, but it's sort of like, how much do you do that as an adult? Well, maybe you do that more if you don't have a lot of yourself to begin with, and then you can dissociate more and take in or cast off various different traits, attributes and values depending on the context.
Yeah. And he, to me, really represented his poor self and other differentiation. Um, and that he felt like when, when, uh, they were talking about the Twitter and, and so, and Nathan asked, um, like, did she write it? And he basically said like, well, basically, uh, Well, I typed it, but basically I could write for her. There really is a really poor self in other boundaries. And with regards to what I was saying with the idealization, first off, I think I categorize Billy as as highly narcissistic.
I also think of antisocial as a subsection of narcissism. So I think he's on the antisocial spectrum. But the way that she would talk, you know, when we're talking about the idealization, she would I forget the exact quote, but it's something like I want to spend my life building monuments of dedication to our love. You know, this the the. Cohut talks about the twin countertransference, where people with these kind of pathologies, the way that they view the other people needs to be idealized to such an extreme extent that it takes on a magical, almost spiritual quality of shared specialness.
Yeah, that's pretty much all I had.
I will say for me, it's a bridge too far to go to diagnosis. We don't have the data for it. I think what's more important to note is that you can watch this stuff and you can say, these are not ordinary people. I think they're a lot more ordinary than we want to I think we have a lot more of this, or at least a capacity for it within ourselves and everyone around us than we give a credit for.
And to deny that and to say it's only one or two people who are like this and they're the problem and I'm not, I think that's why we're And the situation we're in today, all across the world. But this is not new. This is what humanity has been doing for the entire time that we've been around, if history is any indicator of this. But I do take your point, this idealization, There's a sense of fusion between the self and others in the partnership.
There's degrees to that, and at a high degree, it's as if you're the same person. But we need to counter that. We need to remember that even if we can feel this way, There's a strong argument that we never really know anybody else, that it's impossible to truly know everybody else, and that our experience of other people is always a simulation of some kind that we take into ourselves, right?
Because the frame of our existence does not allow us to occupy the position or the subjectivity of an entirely other different person. All we get is a little box frame, just like in the film.
Absolutely. And I think, you know, I'm glad you say that. I think all the things that we intuitively, when we're watching, it feels uncanny or kind of ridiculous that, you know, Elizabeth and Billy are engaging in. They're typically more extreme versions of things that we kind of all do. And actually, sorry, I'm going to use that as a riff to another point that I wanted to make with regards to Elizabeth.
Talking about her turtleneck This is before the movie, but she would wear the same turtleneck that was pretty much Steve Jobs. And her voice. How do I make sense of why she kind of engages in those things? So the turtleneck, first off, it's normal to... I actually have an example from this podcast. You often say, Dr. Fu, if you explain something and it's not that clear, you end it by saying, I appreciate you, Dr.
Fu. I look up to you and I take on little characteristics.
I will say for a moment, as a good example of lack of self-insight that's normal to everybody, I had no idea I did that.
The thing is, I don't have the most perfect stable identity in the world, but I have a relatively decent sense of who I am. When I adopt someone else that I look up to, I don't wholesale steal what they do. I sort I haven't started talking like Dr. Fu. The way that she takes on things, it's almost like a childlike quality of adopting things. When I read about Steve Jobs, I was like, oh, that's actually a pretty good idea.
I'm going to have a closet with only... You know, six shirts that I can wear with most other shirts. But no, she wholesale takes on his full identity. There really is a lack of a strong sense of self in such that it's not like she's taking one little feature and integrating it into a well-developed idea of who she is. She wholesale steals in this sense. To me, very childlike.
It's like, you know, when a child looks up to Spider-Man, they go full on as Spider-Man. They don't just take on little qualities.
Well, I mean, again, I think steel is too strong of a word, right? We don't know what the motive is. It could be fully automatic. It could be unknown. Who knows, right? It's a very difficult thing to tell. By the way, did Steve Jobs actually only have six outfits?
I think he just always wore the black turtleneck. He wore the same exact thing every single day. Okay.
I don't know. It just kind of made me think, you know, speaking of Bay Area type people, if we will, when I was a kid, I read the Dilbert cartoon where Dilbert had a closet full of all the same outfit. And that's why he's always dressed the same.
And I thought, you know, that's a really good idea.
Find one outfit that works for you and follow the day.
And then lastly, I haven't heard anyone ever give a good take on the voice, how I make sense of the voice. Again, I remember when I was in ninth grade, I read something like a deep voice. People trust you more if you have a deep voice. And for the next 20 minutes, I talked a little bit. But then 20 minutes went by and I totally forgot about it and I wasn't able to keep it up because naturally my voice isn't that low.
When you have an unstable identity, I think how low or high your voice is something, even something as intrinsic as the biological frequency of your voice is something that's a little bit more negotiable. So I think it really underpins a sense of self that isn't that strong, that even biological aspects of you can be adapted and really feel like you.
Well, that's one way of saying it. You could say that it's because the self is weak, therefore you can do that, right? And then I would say the obverse of that is that because the self is weak, we must do it. We must take on other characteristics in order to survive, to feel whole, to feel alive or good enough, or else we fall into that deep pit of despair where we are awful, terrible, or even nothing, dead.
Ooh, that's a little scary.
Well, that's object relations. It's a lot of fun writing and literature in that area, even if you don't fully believe everything that they believe.
You know, one another thing that I thought was silly, just now just random things that popped in my head. I sent you a message about this at the beginning of the film when they were calling her Liz. It really reminded me of that office scene where Andy Bernard comes back from anger management and he goes up to Pam and Pam goes like, Andy, how are you doing?
And he's like, it's true now. It's true. Yeah. It really reminded me of the office scene where it's like, okay, you take out a new name and we're supposed to completely forget about who you were before.
That's a solid reference.
I see we're at 55 minutes. Is there anything else you want to touch on before we...
No, I just hope this was kind of interesting to people. I mean, we're usually educational podcasts, but I do like this kind of stuff, and I think there's a lot that can be said about it. And frankly, I once heard a tale of, I think it was a New York psychiatrist faculty somewhere, Who would advocate deducting his movie tickets as business expenses. I can tell you right now that is not kosher when it comes to the IRS.
But there's something to that. Knowing pop culture, media, art, and just general culture, that is so important to doing psychiatry correctly. So I hope people enjoyed it.
Yeah, and I feel like I could keep rambling. I had a bunch of other theories with regards to, you know, kind of how I think about Billy. I feel like I didn't get into a lot of my theories with regards to, yeah, Elizabeth. So, I don't know. If people like this, I can do another one.
Yeah. Yeah, I'd be open. All right. Well, until next time.
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