Decoding the Mind: The Evolution of Mental Health Diagnosis and Treatment – Keith Kurlander & Dr. Will Van Derveer – HPP 144

Keith Kurlander [00:00:07]:
Thank you for joining us for the Higher Practice podcast. I’m Keith Curlander with Dr. Will Vanderveer, and this is the podcast where we explore what it takes to achieve optimal mental health.

Dr. Will Van Derveer [00:00:21]:
Hey, Keith.

Keith Kurlander [00:00:23]:
Hey. Good to see you again.

Dr. Will Van Derveer [00:00:25]:
Good to see you.

Keith Kurlander [00:00:27]:
So we’re talking diagnoses and labels and the sort of evolution of that and what some of the downsides of it, maybe some of the positives. We’re kind of playing in that game today.

Dr. Will Van Derveer [00:00:39]:
Yeah. Seems like every new edition of the diagnostic manual, we have a mushrooming of more categories.

Keith Kurlander [00:00:50]:
I think a good starting point is just to say that prior to the 1950s, like, the average person wasn’t going around saying, like, I have depression, I have anxiety, I have ocd, you know, I have bipolar. Like, that wasn’t in the social milieu of culture. Prior to the 50s, mental health conditions weren’t as much in the social language of culture. It’s really hard to wrap our minds around that. Like, it’s so in the conversation of who we are and how we think about people and, like, you know, everybody knows these terms, right? So. And talk, these things get mentioned. So it’s like, kind of hard to even wrap our minds around, like, what was it like to not relate to mental health inside oneself with terms prior to the 1950s as a culture?

Dr. Will Van Derveer [00:01:44]:
It’s true, in a way. It’s pretty rapid evolution. I mean, there’s a lot more acceptance, there’s more. Hopefully, we could say there’s more understanding, there’s more identification, a lot more people being seen and diagnosed, so many more treatments available. I’m not sure that our diagnostic categories are more accurate than they were then, but that’s a whole nother part of our conversation.

Keith Kurlander [00:02:12]:
Yeah, well, I mean, again, there’s a lot of pros and cons here to what happened. And the start of the conversation is, you know, prior to the 50s, it wasn’t really seen that way. Throughout time, it’s been different things. Spiritual illnesses and, you know, other conditions and diseases. But, like, just sort of sometimes it was like the valued, you know, shaman and was the eccentric, you know, maybe even psychotic person sometimes. But then we have this kind of new wave of things that happened starting in the 50s, where post World War II, where a lot of people needed care and there was this collaboration with the government of, like, we need to understand mental health conditions better. And the DSM then comes to surface and now we have these different depression, anxiety with new terms and ocd and these different disorders come about, and then that gains a lot of traction, obviously to the point where this is now it’s social language. Now it’s just a part of the everyday conversation in a lot of the world.

Dr. Will Van Derveer [00:03:19]:
Well, the term PTSD is only.

Keith Kurlander [00:03:23]:
Yeah, that’s 80. 1980.

Dr. Will Van Derveer [00:03:24]:
Yeah, I think. Yeah. 45 years old. Yeah.

Keith Kurlander [00:03:28]:
Late 70s, less than.

Dr. Will Van Derveer [00:03:30]:
Less than 50 years old.

Keith Kurlander [00:03:32]:
Right. And so. And here we are about all the people.

Dr. Will Van Derveer [00:03:36]:
Think about all the veterans prior to 1980 who experienced trauma in combat, let alone all the non combat trauma that occurred, you know. Yeah, it’s kind of crazy. Shell shock was the World War II term for that. But really a very primitive understanding.

Keith Kurlander [00:03:57]:
Totally. And I think there was a lot of benefits out of the categorization process for people. It was like a way to understand ourselves and for providers to understand their clients and to really categorize things in these symptom clusters. And there’s certain treatments that hopefully work better for certain symptom clusters and others. And so. And then we have all the research that then really comes out of this and all the medications that come out of this movement where we start now being able to have indications, medications. And so a lot has happened right, with this movement. And then there’s a lot of downsides too.

Dr. Will Van Derveer [00:04:41]:
Well, and in addition to the downsides, there’s also been, you know, depending on how you look at it, the weaponization or the political undercurrents and financial undercurrents of diagnosis and treatment, having to prove to an insurer that provides, that is, you know, that has a policy of covering, let’s say 12 therapy sessions for particular diagnoses to be able to show that that person has that condition, that those sessions will get paid for, for example.

Keith Kurlander [00:05:12]:
Yeah. As we, as we went through the sort of evolution, you know, from the 50s, the crazy like height of the managed care movement in the 80s and 90s, and now these conditions have very strict guidelines of treatments. And again, like some of this has been very useful. Right. There are people getting helped with different medications that weren’t helped before. We’ve been able to research psychotherapies in ways that we wouldn’t have been able to. There’s a understanding that’s really come from this end. The big end is we’ve really gotten reductionistic in our understanding of humans to. A lot of people are looking at symptoms and not below them. So these, you know, a lot of people are looking at the disorder and the symptoms as the issue and not looking what’s causing them. Right. And so that’s one of the biggest downsides of what came out of this last 80 years, 60 years.

Dr. Will Van Derveer [00:06:10]:
There was a big transition over the course of the editions of the Diagnostic and Statistical Manual at the DSM from richly descriptive paragraphs, understanding considerations of psychodynamic theory and the origins of symptoms in childhood and so on, to what you’re describing, which really came around the DSM 3 and, you know, DSM 4, symptom list, phenomenological diagnosis. Right. Five out of nine is this. That’s, that’s what you get. And if you don’t have five out of nine of the list of symptoms, then you don’t have the condition, right? Yeah.

Keith Kurlander [00:06:53]:
If you have, if you have like two symptoms across all conditions, you don’t have a condition.

Dr. Will Van Derveer [00:06:58]:
Exactly. Or you have all the conditions, right?

Keith Kurlander [00:07:02]:
Yeah, yeah, right. We all have all the conditions. So, you know, it’s the average treatment for a person going in this country to, for mental health issues is going to go and see someone for 15 to 30 minutes and they’re going to get a diagnosis, they’re going to get medication, and hopefully in some cases changes their life. They feel a lot better. They’re, they’re sort of saying they’re, they feel like themselves again. Their, their activities are getting back online in certain ways. And some cases that happens. Right. And that’s great.

Dr. Will Van Derveer [00:07:44]:
I agree. It’s wonderful when that does happen.

Keith Kurlander [00:07:47]:
I mean, we’ve seen that. Like, you and I have seen so many people who, and know so many people where it’s like, it worked that way, but then there’s so many people, it doesn’t work that way.

Dr. Will Van Derveer [00:07:58]:
Right, right, right. And I think your kind of frame of 15 minutes is really accurate because most of those prescriptions, we know that 80% of the antidepressant prescriptions, for example, are written in primary care offices where the, the description of primary care that I like the best is five complaints in five minutes for five bucks.

Keith Kurlander [00:08:20]:
Mm. Yeah.

Dr. Will Van Derveer [00:08:22]:
So it’s complex to manage mental health challenges in a primary care setting, because, first of all, reimbursement rates are, are really weak. So it’s extremely hard for practitioners to keep the lights on unless they see 20 or 40 people a day. You see that many people a day, you don’t spend a lot of time with each person, and everybody has complex problems. So it’s just very challenging.

Keith Kurlander [00:08:48]:
Well, I think we’re treating. This is the downside of diagnoses. Like in that model, again, sometimes it works. We’re treating a diagnosis and sometimes that works, but we’re not treating a person. And, you know, what makes up A person and why these symptoms are there. And that. So that for me blends into a much wider part of the conversation, which is that that has greatly influenced culture in terms of our view of mental health. You know, if I’m not feeling well, I go to the doctor and maybe I get a medication to feel better because I have one of these conditions. That is again now in social language, I’m. I have depression, I have anxiety, I have ocd, I’m. I’m mentally ill and my neighbor’s not. Even though if you look between the lines, likely your neighbor is. Also, if you’re using this framework, the amount of people that will have one of these conditions in their lifetime is likely more than half of people. So this system, again, it’s helped a lot of people, but it’s also created a big problem right now, or we’ve created a big problem with this system, which is the. We’re thinking that this approach of let me go get rid of my symptoms is going to solve my problems and I’m. I’m no longer have this mental illness condition.

Dr. Will Van Derveer [00:10:19]:
Right, right, exactly. And the inattention or inability to either have the time or the education in the, in the clinic to look for root causes of those symptoms is a huge issue that, you know, we’re trying to address with the institute and teaching people how to uncover and treat root causes of symptoms. Unfortunately, outside of ptsd, which includes a criteria of having experienced a traumatic event, we don’t have root causes in our diagnostic manual at all, anywhere.

Keith Kurlander [00:10:59]:
Yeah, it’s definitely not the purpose anymore of the DSM is about causation. It’s. Or causes. It’s about. It’s just about understanding symptoms. And I think that the implications. So on a sort of societal level, we have the implication of like, people are like. It’s just sort of the understanding of like, if I have. Again, we’re talking culture, larger generalization, there’s differences everywhere. But it’s sort of like we go to a doctor, we get a pill, right, that’s going to take care of our problem. But what this has done is it’s really influenced the way we see each other of like, do you have a mental illness or don’t you have a mental illness? And so now there’s this a bit a big movement, I would say, mostly in the last decade of destigmatizing mental illness. Right. Which was useful. People can talk more about it and things like that, but there’s sort of another round that needs to happen of getting beyond the concept of Mental illness and really understanding. We have to understand suffering more as a culture. And it’s, we’re still seeing people as labels, which is, which is a problem.

Dr. Will Van Derveer [00:12:11]:
Right. And, and we’re also not in the conversation about first of all, how do you resolve your condition? And I’m not painting a rosy picture saying that everyone can resolve every problem. No, that’s not the point. But the point is that many, many, many people who have conditions that are resolvable are not getting the education, the support, the framework to resolve their condition. And so, you know, how I was trained as a psychiatrist is like, well, you better tell those people with depression or bipolar or schizophrenia, you know, these more serious, more severe conditions to stay on their medications for the rest of their life. That’s what I was taught to tell people. And I know so many people who have gotten to the other side of that through hard work who are no longer on medications and don’t need them and are doing fine. So it’s, I think it’s a travesty that we’re still in the conversation that you get put on your medications, your symptoms go away and you just stay on your medications. And that’s the whole story. And it’s great to have control over your symptoms, you know, experience less suffering. But as you said, if the question about the meaning of suffering and how we relate to suffering doesn’t asked, then we’ve got were stalled out in our human development.

Keith Kurlander [00:13:45]:
Yeah. And it’s interesting, you know, history is interesting because we more started in the place of the why and the how. Like we started, you know, in psychoanalytic theory and there was more of a psycho, a depth therapy, psychotherapy tradition and understanding our mental suffering and from more the earlier part of medicine. And then we got more reductionistic over time. Not that I’m saying those systems had all the answers. They didn’t. That was also mono focused in many ways. Right. But now we sort of, it was like we didn’t transcend and include the understanding of mind. And that’s why we obviously focus a lot on, you know, integrative frameworks to understand suffering. And I think that there’s just, there’s a big disservice happening here in terms of society because we’re not in a sort of a cultural agreement or a communal agreement that we all struggle and it takes work to keep tuning like a violin, to keep tuning the instrument so that we can be in optimal conditions. And some people, you know, some people are short of string for the rest of their life. And that’s hard. There are conditions that are just really hard to deal with in mental health conditions and other conditions. But the general sense is like we’re not in a shared reality. Like hey, it takes work to fine tune this thing. It gets out of tune all the time and the more out of tune it gets and the more injuries it gets. There’s a lot of understanding and work to do and just a pill isn’t usually going to really. It’s not going to optimize that instrument for sure. Maybe it’ll sound okay for a little while. Imagine the impact you could have with your clients when you’re able to practice the most cutting edge modality available today. Psychedelic therapy is the future of mental health care and the Integrative Psychiatry Institute will empower you with the tools and knowledge you need to master this exciting modality. IPI’s comprehensive training and in person experiential practicums will elevate you personally and professional professionally. This in depth curriculum is the gold standard certification in the field. When you join, you will step into a global community of thousands of innovative colleagues who are integrating psychedelic therapy into their practices. Visit psychiatryinstitute.com apply where you will find all the information you need about IPI’s training. And when you visit psychiatryinstitute.com apply you’ll also receive IPI’s free ebook book Getting Started with Psychedelic Therapy so you can get the most up to date information immediately. Again, that’s psychiatryinstitute.com apply to learn more about the training and to get your free ebook.

Dr. Will Van Derveer [00:16:39]:
Life is full of many different kinds of challenges. And you know, the promise that pharmacology could eliminate our suffering is a false promise. We don’t know of any panacea that will do that. You know, we have, yeah, we have very blunt instruments that can dull the pain, but they tend to dull across the board all the experiences and there’s plenty of published studies to refer back to about that where people feel more dull, you know, their partners feel more, it’s more difficult to feel your partner often.

Keith Kurlander [00:17:24]:
Yeah, yeah.

Dr. Will Van Derveer [00:17:25]:
So.

Keith Kurlander [00:17:26]:
And that might be a needed relief for some period of time. Obviously suffering can get pretty bad. But it’s true. It’s, it’s, it’s very common for people to complain of dullness or sometimes the opposite. Sometimes see people a little more disinhibited on certain types of meds, you know, so it’s, it’s across the board there and it’s still primitive like, I think that’s the best word, like Maybe one day this conversation wouldn’t. It would be like, no, there is a pill and the pill like actually reorganizes your brain and like you’re, you’re really in optimal conditions. I don’t know. That’s probably one day down the road. Right. I mean, we’re going to get scientific on this thing called the human experience.

Dr. Will Van Derveer [00:18:16]:
It could be. I mean, I think one of the challenges in mental health is that each individual has a different set of contributing factors and causes across the board for them to have what gets, as you said, in reductionistic mental health care, one label. Right. Depression has very different roots in different individuals. So will we ever find a tool that is FDA approved, that that’s a pharmacologic tool that has enough specificity to individuals to where we can really say that that’s happening for people? I don’t know.

Keith Kurlander [00:19:01]:
Yeah, yeah. Not right now, probably not our lifetime, but who knows? Yeah. I mean, obviously there is a place and has been an amazing place for science to help us here. I mean, I wouldn’t want to rewind the clock 200 years that, you know, life was hard.

Dr. Will Van Derveer [00:19:24]:
I want primitive mental health care.

Keith Kurlander [00:19:26]:
Yeah, life was. Life was hard. And your mental health struggles weren’t dealt with in the kindest manner, typically. So we’ve definitely come a long way in a short amount of time and somehow we need to slow down here. We’re going to understand each other more versus the sort of speedy, address things so speedily and miss what’s really going on with the person, right?

Dr. Will Van Derveer [00:19:57]:
Absolutely.

Keith Kurlander [00:19:58]:
Yeah.

Dr. Will Van Derveer [00:19:58]:
I mean, and that’s hard in this culture that’s all about speed. Right. And the bombardment of inputs from everywhere. Social media, non social media, email, you know, phones going off all the time. There’s just a lot going on all the time for us. And of course, you know, that the changes are so rapid to what our human organism is trying to process. The change is so much faster than what we can evolve to keep up with, I think is part of the right. Part of the challenge.

Keith Kurlander [00:20:41]:
Totally. Now, on the flip side of all this, there is a positive aspect of categorizing the inner experience with more and more specific labels and categorizing the suffering internal experience from more labels, which is now we’ve externalized a conversation about what we’re all facing inside ourselves. And that does have a lot of positivity. It can be where we can really, we can work with each other around the spaces we are inside ourselves through shared language. And so there’s always right, there’s always Benefits and drawbacks in life to anything. And is a benefit here that we, we have a shared language. It’s, it’s. It’s outside of spiritual traditions, languages or religious languages which have their own languages for these things. And that, that, that is helpful because it’s sort of like the ordinary experience of people. There’s something to talk about there of like what we struggle with in ourselves now. Again, I think the underpinnings still have a lot of stigma and a lot of confusion that you either have these things or you don’t. I think there’s a lot of confusion there. There’s either mental illness or there’s mental health. I think that’s a very binary and actually not even accurate way to understand humans.

Dr. Will Van Derveer [00:22:14]:
Well, another benefit of diagnoses is driving the correct treatment. I mean, the great example, I think, for that is the difference between a unipolar major depressive disorder and a bipolar disorder, which can be very difficult to discern sometimes. But giving a person who’s on the bipolar spectrum the wrong treatment in the form of a antidepressant can be quite devastating or even.

Keith Kurlander [00:22:42]:
Right.

Dr. Will Van Derveer [00:22:43]:
Deadly. So.

Keith Kurlander [00:22:47]:
So I think, yeah, these, these diagnoses were really helpful for medication, actually.

Dr. Will Van Derveer [00:22:53]:
Right.

Keith Kurlander [00:22:54]:
For that reason.

Dr. Will Van Derveer [00:22:56]:
Right.

Keith Kurlander [00:22:57]:
Yeah. I mean, it definitely without them, you would know what the heck was going on. It would be so the subjectivity would be even looser when you’re trying to figure out which medication goes where, obviously. So that, so in that, in that sense, categorization and labeling is actually very helpful.

Dr. Will Van Derveer [00:23:17]:
It’s helpful, I think, especially in the context of having a conversation about this is not a life sentence, and this can potentially, with the right supports and the right effort, be integrated and overcome and put behind you. I think there’s also this shadow to it of people, and I encountered this in my practice quite a bit over the years As a psychiatrist is facing the challenge of, well, I can’t X, Y or Z because I have this condition. Right.

Keith Kurlander [00:23:52]:
Yeah.

Dr. Will Van Derveer [00:23:52]:
It becomes a hindrance to going out and fulfilling the gifts and talents that a person has that are their birthright to embrace and experience and show out in the world.

Keith Kurlander [00:24:09]:
Yeah. I think it’s really important for people to know that when you think about these terms like depression. Right. It’s like, well, you might be more depressed in this moment than maybe the four or five people right around you, and now we’re going to call you depressed. But actually you catch a person in the right week or month of their life and now they’re depressed, or you catch them in the Right moment. And now they have the symptom of depression, but it’s not going to stay so they don’t have depression. Like, I think it’s just really important for people to know that this is a spectrum of just looking at the suffering side of the mind, at which we all have all day. The suffering side of the mind. It doesn’t go away. It doesn’t disappear. And I think that’s where we just need, I think, a more compassionate and realistic understanding that, like, we’re all moving between suffering and inspiration and suffering and pleasure, and we can get stuck in suffering. And that’s what these labels are for. That’s really all they are. We’re hanging out in the pool of suffering a little longer than need be, Right. And now we have these labels. But, okay, now you’re back in the normal spectrum of, like, moving between suffering and inspiration. And, like, well, you still have these qualities in you. I think it’s a real important for people to not feel so alone when they think they’re, like, mentally ill and broken. They’re just a little more stuck than the next person that isn’t as stuck in that moment or that period of their life.

Dr. Will Van Derveer [00:26:07]:
Yeah, I agree. I think the statistics on how common mental health challenges are can really help in that regard as well. There tends to be a sense that I must be the only broken person or I must, you know, my problems must be the worst that, you know, my therapist or my doctor’s ever seen or that kind of questioning about, you know, is there hope? Is there a way out of this?

Keith Kurlander [00:26:39]:
You know, I mean, Gabor’s recent book, the Myth of Normal, like, the title says it all. And then, you know, the whole term abnormal psychology or abnormal psychiatry, it’s like, it’s not that abnormal anymore.

Dr. Will Van Derveer [00:26:54]:
Right.

Keith Kurlander [00:26:55]:
I don’t know if it ever was. Like, normal is, you definitely suffer mentally and you definitely get inspired, but hopefully it doesn’t have a drastic impact on your life.

Dr. Will Van Derveer [00:27:08]:
You know, it feels to me like what we’re talking about is a distinctly American culture phenomenon. Like, when I meet people, I remember as a child, I knew a very small group of people who. There was a English professor across the street where I lived, and I moved from there when I was six. So I remember that when someone asked him, he was British, how are you doing today? You know, he didn’t answer the way everyone else did that. I knew everyone else would say, oh, I’m fine, I’m good, I’m fine. You know, it’s an American thing. He would Say, well, you know what, my lower back is hurting me today. And yesterday I had this experience and that experience and it was like he was in my estimation today when looking back on that, like he was willing to acknowledge a name and you know, discuss. As a matter of fact, I have some things going on that don’t feel great to me, you know.

Keith Kurlander [00:28:14]:
Right.

Dr. Will Van Derveer [00:28:14]:
You ask me how I’m doing, I’m going to give you an answer.

Keith Kurlander [00:28:17]:
Yeah, yeah, yeah.

Dr. Will Van Derveer [00:28:19]:
You know, totally.

Keith Kurlander [00:28:20]:
Yeah, I would say it’s definitely. American culture is definitely stronger here. I think obviously globalization and there’s a lot of influence in the world now cross culturally and things where you’ll come across these mindsets. But yeah, I’ve experienced the same thing in a lot of my travels where it’s, it’s just like different frameworks and, and some of these terms haven’t sort of invaded culture as much like, oh, I’m, I, I have depression or I, I have anxiety. Like, it’s just not even, it’s just like, yeah, I’m kind of down in the. So I think there is a difference there. And then I think, but what to move toward is really like where I go, it’s like, well, again, there’s nothing wrong. These labels have been very useful. But I think what to move toward is just a growth oriented mindset of we’re optimizing, we have struggle, we have suffering. We might get stuck in these things that we can actually use labels and talk about. I’m stuck in depression right now. I’m depressed, I have a depression. But if we can gain more of a growth oriented mindset, it’s just like, oh, yeah, okay, well, I was there and here’s what helped me. And it’s just more of a. We’re constantly just trying to grow and evolve right. Through this balance of pain and pleasure. Yeah, yeah.

Dr. Will Van Derveer [00:29:54]:
It’s like there’s a whole world in between these two artificially distinct categories of illness and wellness.

Keith Kurlander [00:30:02]:
Right.

Dr. Will Van Derveer [00:30:04]:
And there are ways to get from one to the other.

Keith Kurlander [00:30:08]:
Yeah, it’s like, and who, who decided now you’re ill and now you’re well, like who, who gets to decide that? Your doctor. So that’s what it is right now. Right, Right. I mean, basically, we’ve basically said, well, your doctor gets decide. And if we’re just talking about mental illness, not physical, but like they decide if you’re ill or well, in terms of like, who’s the, who’s the one that has to say when you have mental illness or mental wellness. Right. Or mental Health.

Dr. Will Van Derveer [00:30:36]:
Well, you know, it’s interesting, like this is a problem in, in medicine, not only in mental health. Like I remember when I first started exploring integrative perspectives on mental health and I, I started looking more carefully at thyroid labs, you know, and the way I was taught is a person either has a thyroid disorder or they don’t. Either the number is outside the range or it’s in the range.

Keith Kurlander [00:31:03]:
Right.

Dr. Will Van Derveer [00:31:04]:
And it doesn’t account for the fact that these ranges are determined by population averages.

Keith Kurlander [00:31:10]:
Right.

Dr. Will Van Derveer [00:31:11]:
And you can, I mean, maybe even a better example is diabetes. Like there’s a whole range of blood sugar and insulin regulation short of diabetes that runs up to that, that takes about 10 years to get to a really severe irreversible situation. And we don’t acknowledge that in medicine.

Keith Kurlander [00:31:30]:
Right, right. Yeah, this is again, totally. Well, again this is the, this is just the downside of getting too reductionistic and too binary. I mean, obviously there’s a lot of places where it’s really helped to just be reductionistic and binary and be like, no, that is cancer. So we know what we’re dealing with. Maybe, I don’t know, maybe one day, you know, we thought the world was flat one day. So who knows. But right now it’s cancer. Right. So. But yeah, I think again it’s the downside. We can get way too binary in our thinking about things and we’re missing the spectrum. And that’s the, in the spectrum of growth too. Right. It’s like the spectrum from illness to growth. And just where are you on the spectrum? Where’s the starting point? Right. And so I don’t know. I think I would. Just as we’re wrapping up here, diagnosis can be helpful. Diagnosis can be hurtful. And you’re. Anybody with a diagnosis, isn’t that different than the person who doesn’t have the diagnosis that. I think that’s the real key here. They’re on a spectrum right now in their life. There’s always opportunity for healing and growth.

Dr. Will Van Derveer [00:32:43]:
Absolutely. And the growth oriented mindset that you brought up before I think is a really important thing to keep in mind that if you are the kind of person who likes to tackle problems in your life and see if you can solve them, not all problems are solvable. Right. Through self directed effort. Sometimes you need surgery, sometimes you need the right consultant or the right medication and so on. But taking the attitude that you’re going to try your best to maintain your balance and your resilience, your capacity to face the challenges of life is a, is a way to empower yourself, and that’s a really important factor when you’re facing very challenging mental health experiences.

Keith Kurlander [00:33:34]:
Totally. Well, maybe we end there.

Dr. Will Van Derveer [00:33:37]:
Thanks for chatting about diagnoses and the ups and downs of these categories.

Keith Kurlander [00:33:44]:
Yeah. And who knows? In 500 years, these probably won’t exist anyways. They’ll be called something else. And they’ll be talking about, remember those primitive diagnoses 500 years ago?

Dr. Will Van Derveer [00:33:56]:
Right. We might have those, but that’s not.

Keith Kurlander [00:33:57]:
Even a thing anymore. Yeah, yeah. I mean, they didn’t exist 500 years ago, so if you had it, you didn’t know that that’s what you had.

Dr. Will Van Derveer [00:34:09]:
Right.

Keith Kurlander [00:34:09]:
So there. It’ll be something different in the future. So it’s good to just always keep perspective. We can get so narrowed in on this is truth and reality because we created these terms, but it’s a moment in time and moment in history, and then there’s. It’s good to just hold that when we get so narrow focused on what. What we think is wrong with ourselves.

Dr. Will Van Derveer [00:34:33]:
Totally agree.

Keith Kurlander [00:34:35]:
Yeah. Okay. Till next time.

Dr. Will Van Derveer [00:34:37]:
Till next time.

Keith Kurlander [00:34:38]:
We look forward to connecting with you again on the next episode of the Higher Practice podcast, where we explore what it takes to achieve optimal mental.