Re-Imagining Mental Health with Reef Karim, MD

Content By: Ari Whitten & Dr. Reef Karim

In this podcast, I am speaking with Dr. Reef Karim, a leading expert in human behavior, who has dedicated his life to educating, entertaining, and helping people understand themselves better. Dr. Karim is a double board certified psychiatrist, addiction medicine physician, relationship expert, writer, speaker (with recurring appearances on Oprah, Dr. Oz, CNN, Larry King Live, Dr. Phil, Anderson Cooper, and many others), comedic host, and media personality. 

We will discuss the “victim mindset” and how it appears to be rapidly spreading in the younger generations across the Western world, the difference between victimhood and vulnerability, conformism vs. authenticity/courage, healing from trauma, self-sabotaging behavior, and how to grow into the fullest expression of your own capacities and authentic self. 

Table of Contents

In this podcast, Dr. Karim covers:

  • The difference between having a victim mentality and expressing vulnerability. (And why vulnerability is a sign of strength.)
  • Does modern culture provide excessive validation for people feeling victimized or marginalized? 
  • The importance of vision and self-actualization in creating dynamic change, resilience, and adaptability in our lives.
  • The impact of trauma on the victim mindset.
  • Self-sabotage and its role in seeking attention or compassion.
  • How to use the pain and vulnerability in our lives to foster creative, unique, and valuable contributions to the world.

Listen or download on iTunes

Listen outside iTunes


Ari: Dr. Karim, you are absolutely one of my favorite people. I’ve been looking forward to having you on the show for a second time for a long time now, and it’s finally arrived. I saw a post of yours on social media recently, and I said, “This is such a great topic. I need to have you on the show to talk about this and a whole bunch of other topics.” You’re just one of my favorite people out there. You’re such a smart, original thinker. I don’t know why I don’t have you on the show 10 times already, but we’re doing number 2 right now, so we’re making it happen.

Dr. Karim: I love it. Thank you for having me on the show. I will come on whenever you ask me to because there is so much to talk about to help individuals, to help people to maximize their life because that’s really what it’s all about.

Victimhood vs. vulnerability

Ari: Absolutely. The post that I saw was on vulnerability and victim mentality, and you drew a distinction between those two. This was really getting at the idea that a lot of people currently, the current culture zeitgeist that’s happening right now, a lot of people are mixing up these two things. Can you explain what these two things are and why they are different and how to help people differentiate between them?

Dr. Karim: Yes. It’s obvious in the world victim mentality is on the rise. There are a number of reasons for this. I’ve been called a storm chaser. Just bear with me for a second. The storms are not tsunamis or hurricanes or twisters, they are storms of the human mind. In 2004, I predicted the opiate crisis when I was on Oprah. I was talking about this problem that I saw coming, and 5 to 10 years later, it exploded, along with the prescription drug crisis. I also looked at technology and how social media and technology was going to–

Now I see two things happening. I see this victim mentality taking over, especially a lot of younger people, whereby it’s going to have significant impact on the lens by which they see the world. That really freaks me out and it really scares me. The second thing is this epidemic of conformity that we find ourselves in where there’s less focus on original thinking and creativity because there’s more group think, there’s more validation seeking, there’s more impression management out there. In regards to victim status, if you look at if everyone’s a victim, no one’s a victim. That’s the first thing. I think people are utilizing victim status to differentiate.

Part of that is social media. Part of it is I want to be seen, I want to be looked at as different, I want more attention. The definition of victim, and in this case, I would say self-victimization because victimization is another person becoming a victim, you either were the perpetrator or you were part of that. Let’s call it self-victimization, which essentially is victim coming from a state of weakness is the action of declaring yourself a victim of cruel or unjust treatment, and enduring trauma and suffering in the process.

Vulnerability comes from a state of strength. It’s a willingness to show emotion, a willingness to allow one’s weakness to be seen or known, or to risk being emotionally hurt because you are coming from a place of strength to express yourself, to share a message, to follow your passion, to follow your purpose. You’re willing to take that risk from a place of strength in order to put that message out there. These two could not be more polar opposites, yet people are saying, “Yes, I’m a victim. I’m a victim. I’m a victim,” and they think they’re going to gain strength from that. They are not going to gain strength from that.

There’s even a cycle that I talk about quite a bit from victim to vulnerability. Victim is the beginning of the cycle. If you have been victimized, it’s okay to feel angry, to protest, to be upset because you’re just coming into awareness of the victim status that you have, and you want to tell people about it or you believe in a movement. We’ve seen all these movements that are happening. That’s okay, but you can’t get stuck in that victim status. You move through this cycle and eventually get to a state of vulnerability where you can take action on your feelings internally of being the victim at one point in time.

The problem with praising victimhood

Ari: You said something a minute ago that you’re not going to get strength from being a victim. There’s a confusion around that. People think they’re going to get something of value from being a victim and therefore are relating to the world through that victim mindset and almost virtue signaling, though virtue is not the right word. Trait signaling, I guess you could say, “Hey, I’m a victim,” where some people are advertising this to the world. It’s not that I disagree with you, but I want to push back on the way you said it because, in some way, these people are actually getting something from the world in some cases in the current culture by relating as a victim.

There is a group of people in the current culture that is wanting to praise or give value to people who are in this victim mindset in many cases and say, “How brave of you to acknowledge your victimhood.” I’m also finding that there’s a culture around trauma right now where a lot of people have become obsessed with their own traumas, and in many cases are retelling the story of their life really emphasizing what I would consider oftentimes pretty normal things, and framing them as traumas or as micro-traumas.

As framing them as these really bad things, and then framing trauma as something that is like a lifelong scar. This thing that harmed you and is forever harming you, and you carry with you and it’s forever limiting you. I think that there’s a dominant narrative around trauma that is framing things that way right now. Would you agree with me or disagree with me on that?

Dr. Karim: There’s two things you’re talking about. Let’s talk about the trauma one first. 100% I agree with you. First off, there are varying degrees of trauma. The most significant trauma ever to one person can be absolutely debilitating. Unless they get true professional help to process that trauma, which could take their whole life if it was a really significant, severe trauma, that could just wipe out somebody. Whereas that same significant trauma in somebody else may not present as a really challenging event to them. It could be bad, it could be something they endured, but their coping skills were different.

The baseline by which they see the world is different. Their support network is different. The capabilities that they came in with from a psychological perspective and their foundation were different. From a trauma perspective, I do see more and more people, as you suggested, that see trauma as a lifelong scar, that use trauma in telling their story, which is fine as long as you keep moving to go past the trauma. The trauma is not going to be something you just forget, but it’s something that doesn’t have to contain the same emotional value from a negative perspective throughout your life that you started with. Our scars don’t have to dictate our future.

When we look at trauma being advertised, I like the idea that people are more willing to communicate and talk about their trauma because it’s a way of expelling it. It’s a way of moving it through you and processing it. However, if you get stuck in your trauma and you define yourself by your trauma and you identify as your trauma, the individual you are, not the person who suffered from this trauma, but you have become the trauma, that’s a real problem. My background, one of the things I do is I was trained as a humanistic psychiatrist. I say humanistic because, no, it’s not about just prescribing pills. There is a philosophical end to what I do and an existential end to what I do.

Part of that is I tell clients– When I used to own a treatment center in mental health and personal growth, I would tell people, no, you are not an anxiety patient, you are not bipolar, you are not depressed, you are not OCD, you are not ADHD. You are an individual. You are Bob. You have an entire aura, an entire energy, an entire person that you are who happens to be suffering from these symptoms. The constellation of these symptoms make up this diagnosis of ADHD and there are many elements to how you move past this ADHD. It’s very important when you look at identification.

Now, to get to the first thing that we were talking about, which is this sense of victim mindset, and I’m not saying don’t be a victim, don’t portray the anger, the protest, the sorrow, the worry. I’m not denouncing being a victim by any sense of the imagination. What I am saying is that victim is the first step in a cycle. You move from victim to vulnerability. I don’t want people to get stuck in a sense of victim mentality by which they then identify as a victim throughout their life to the point where they start to see the world through the lens of someone who is a victim because then the world becomes a much more narrow, limiting, negative place whereby–

If you look at some of the studies out there, the research studies on victim mentality, it’s one of the primary reasons why people have a poor sense of well-being. The research is pretty clear on it, that when you’re stuck in a victimization stance or mindset, you’re not promoting well-being. You can’t forgive, you have a hard time with forgiveness. You personalize everything. You ruminate. You have intrusive information. You become unhappy and those around you don’t like to be around you because of it.

The last thing I’ll say on this is that there’s many reasons that you can be and stay stuck in a victim mentality. First off, when you were a victim, there’s– Some people are victims. Let me just say I want to think the best of people, so when someone is in a victim stance– By the way, negativity is part of being human, to endure pain is part of being human. You, me, name a person out there, we have all suffered. We all have the potential to be victims. I’m sure you’ve got a story where you were a victim. I’ve got lots of stories being a brown-skinned Muslim guy in the US when that’s not really the popular way to be. I’ve been discriminated against all the time, bullied. All sorts of stuff.

My last name is Karim. Karim is like Bob in the world. Southwest Airlines has my name on a watch list, the last name, which is like putting the name Joe or Bob on a watch list. I have to go like an hour early just to go to the airport. An hour earlier than everybody else because I don’t know what’s going to happen randomly when their selection processes. Everyone’s got some kind of a story. Now, some are really terrible tragedies of bullying and other things, and some maybe are not so much. When you’re in that victim stance, some people get lost in it and it becomes a form of escapism from doing and activating other aspects of who they are.

Some people go and stay in victim status because of community-building because you do enter a community of other people that feel the same way. That’s a good thing That is not a bad thing. For some people, the victim status creates an expressive outlet for them, and it’s a way to say, “Hey, this thing happened to me,” and that’s fine. However, you can’t stay stuck in that. That is the biggest thing that I want to get out there.

Ari: Do you see that there’s a culture right now that’s being reinforced that essentially praises the victim, almost where people get social validation from being victimized, being part of a group that is victimized, that is a group that is oppressed in some way? I see in the young generation, especially the teenagers that I know like family nieces and nephews and things like that, that it is almost a constant obsession with the various ways that they’re being oppressed or victimized in some way.

I know Jonathan Haidt has talked about this and specifically why young girls today are so prone to depression as a form of essentially negative CBT is how he calls it. I don’t know if you’ve seen that, but negative cognitive behavioral therapy. It’s essentially the opposite of cognitive behavioral therapy. It is training people to think in negative ways instead of positive ways

Dr. Karim: Yes. Absolutely. I’m glad you brought that up. I am familiar with it. It goes back to what I was talking about, the lens by which you see the world. Let’s try to break it down. First, you’ve got a culture that is raised on social media. In that culture, there is social comparison, there is validation seeking, there is wanting desperately to stand out, to be seen, to be heard, to be accepted, to be validated. In doing so, there’s this promotion, as you said, this reward of a victim status as a way of being distinctive, as a way of differentiation, as a way of gaining support, of gaining praise, of gaining some type of social validation and social reward.

Now you’ve been rewarded for your victim status. Because you’ve been rewarded by that victim status, you start to identify as the victim status. You don’t just suddenly go, “Okay, that’s great. I was a victim then and now I’m not a victim anymore. Cool.” No, the socialization is kicked in. Now you start to identify and build a foundation with this victim status. In the victim status, there’s always the oppressor, the perpetrators, the ones who have done this to me, and forgiveness is such a huge part of that. The true victims, you forgive yourself and say, “Look, there was nothing I could do about this.”

There has to be self-forgiveness. It’s usually healthy, maybe not in all circumstances, but in a lot of circumstances, to eventually forgive the person, people, or group that was a part of that for your own mental health. If there’s no forgiveness in the lens by which you see the world as a negative place, where you’re angry, and you’re upset by this whole thing, even if you’re getting social reward, you’re still coming from a place of anger and negativity. That’s what Jonathan is talking about with this negative CBT. You are training your mind to look at the world with negativity, and that cognitive behavioral effect then is eventually you train to develop permanence in how you see the world.

Now, when you’re looking at the world in a negative state, as I mentioned with well-being in the research on well-being, the world becomes a scary dark negative place, and you become more angry and you become more impulsive and you become more difficult to deal with. There’s more rage and there’s less ability to attract positivity, attract opportunities, attract deep relationships because you’re in that state. Then all sorts of things kick in, depression, worry, loneliness. All that stuff kicks in after that and it just spirals.

Why we need to develop mental strength

Ari: There might be some people who are listening to this and maybe thinking that we’re making a traditionalist, almost patriarchal argument in favor of mental strength over mental weakness, for example. I could see some people interpreting things in that way. My response to that would be essentially we have to have some universal agreement about what we’re actually concerned about.

I think human happiness, human flourishing, the extent to which people are depressed or have anxiety or other mental health problems would probably be a good measure that we could objectively agree upon to say, “Here’s these people with these kinds of mindsets and here are their propensity for depression or for anxiety for other mental illness, and here’s these people over here with other mindsets and here’s their propensity.”

The argument that Jonathan Haidt makes is essentially, hey, young girls who have these kinds of ways of thinking who are popular are extremely prone to becoming depressed. That’s how I would respond. I’m just wondering how you would respond to maybe somebody who’s criticizing our way of talking about this issue right now.

Dr. Karim: I’ll tell you where these ideas came from for me. They came from the treatment center I was running. When I look at mental health, the way I was trained, I was trained at a very high-end, world-renowned institute, UCLA, the Institute for Neuroscience, and a number of things. I had great, great training. I felt like something was missing in that training, but I couldn’t really figure it out, but it was great biological training, great therapeutic training. When I opened a treatment center, I took some of the best providers and best clinicians I knew to develop an integrative program where somebody would come in for a mental health problem or some kind of crisis.

We would do crisis management, move them towards stabilization. Some of that was psychopharmacology. A lot of it was therapeutic measures, whether it was family of origin work or cognitive behavioral, or dialectical behavioral. We even did some energy work and Chinese medicine and a number of things, nutritional work, all of that, to get them to a point of stabilization.

Then because insurance companies don’t cover anything beyond stabilization and most people have been trained in their mind to not focus on anything else once they’re stable from a therapy perspective or a treatment perspective, and I don’t mean therapy once a week, I mean coming in on an intensive therapy, people would go home. Maybe they’d go see their therapist once a week or something, but there was no more intensiveness to it.

We would consult with people, we would talk to those clients and those patients, and they would be like, “I feel fine. I feel okay, but I’m coming back to the same environment. I’m coming back to the same pressures. I’m coming back to the same work.” I’m coming back to the same fill-in-the-blanks. I said, “I want to try to do something different here. I want to develop a program. You could call it an aftercare program. You could call it an extension. You could call it whatever you want to call it. In that program, I want to completely focus on existentialism, identity formation, creative vision to be able to see beyond your current circumstances.”

That’s part of the moving out of a victim mentality. I’m not in any way denigrating victim because it’s something we all go through. It’s that if you stay in victim, it’s going to impact your mental health. Yes, there are benefits of community. There are benefits of socialization. There’s benefits of expression. There’s many benefits initially to let out that emotion, to let out that anger, that feeling you have about having something done to you or the injustice that occurred to you. That is very important, but don’t get stuck there. That’s what I’m saying. I’ve seen it play out. When we put that extra program in, that aftercare program, we had phenomenal results.

When I talk to those same clients, they’d be like, “Yes, I just feel like I have more of a foundation. I have more of a belief system. I can see more potential opportunities that I can go.” They have more confidence. They had more connection to who they are in a deeper way. They enhanced their cognitive flexibility. There was more soulful expression and connection in this disconnected society to who they really are originally. That gave them the confidence to go do the stuff that they wanted to do instead of just letting the environment, and for some of them, negative environment, dictate who they should be and what they should do.

Are we masochistic and do we self-sabotage?

Ari: I want to circle back to some of the things that you were talking about there later on, but I want to ask you about masochism. Here’s what I mean by that. I went through a PhD program in clinical psychology with emphasis on the psychodynamic tradition. We learned a lot about personality styles and the different ways that the ego can defend itself, can relate, and try to get a connection with others or love from others.

The masochistic personality style was like– The stereotype of how this style forms is you imagine a little boy or girl who has very neglectful parents that are generally cold, uninterested, don’t give a lot of attention and love. Then maybe one day the little girl or boy falls off their bike and skins their knee or breaks their arm or something like that. All of a sudden the parents come running and they’re giving so much attention, they’re giving love, “Sweetie, are you okay? Can we help you?” All of a sudden, these otherwise cold and neglectful parents give a lot of attention and love.

The idea is with enough instances like that, a child can learn that the way to get love and attention and human connection is through their own pain. I’ve seen this in my life. I’ve known certain people that I feel really relate very strongly through that as a central way to try to get human connection is through their own pain. It seems to me that in some cases, it can be almost like they go looking for creating their own suffering and creating their own problems to try to get attention and human connection. There seems to be a constant stream of problems for some people.

This style of relating I think is– You tell me if you disagree, but my understanding is that this is something that we all do to some extent, that all humans relate to some degree through our own pain and suffering. We try to get attention or sympathy, connection, love from others through our problems. Again, my understanding is that this is a more immature way of relating to humans.

It’s like the baby cries in pain or discomfort to get attention from mama, whether it’s hungry or it’s injured or whatever. That as we grow more into adults, we want to do that style of relating less and less and relate through other styles of human connection that are considered healthier. Again, that’s my understanding of that picture. I’m curious if you would agree with that framing as I presented it, or how would you disagree?

Dr. Karim: I have a two-and-a-half-year-old, and you see the brain developing. You have to be so careful as parents, as I’m sure a lot of your listeners know and your viewers know, that what are you reinforcing and what are you priming in your child’s brain? That consistency over love, attention, pain, attention, it’s all very important. When you brought that up, I just immediately thought of that. Look, we live in a disconnected culture. It’s true. It’s not rocket science, everybody knows it. The question is, what are people doing about that disconnection? How are they seeking connection? How are they actively seeking connection?

I do it through partner dancing. That’s a big thing for me is I love to dance with other people. It’s like having a three-minute conversation without saying a word just through eye contact and body language and connection to the music and connection with somebody else. There are many other ways to connect with other human beings. If you don’t have an active way of connecting with other people, you’re going to need to connect somehow. Then suddenly unconscious drives will kick in.

We know the term self-sabotage. Self-sabotage, people think that, oh, it’s this conscious destruction of your job or you’re screaming at your boss or destroying your relationship or whatever else. A lot of it is, as you mentioned, relating through pain and relating through pain and suffering. It’s seeking connection, but not knowing how to get it. In doing that, you’re creating drama, you’re creating pain with the hope that something good is going to come out of it, but usually, it’s not.

When you apply this to the conversation about the victim mentality, I totally agree with you that victim can equal love and attention in our society. People are getting rewarded. Not everybody. I will say that. It’s almost like some people are allowed to be victims right now more than other people are allowed to be victims, but pain can equal attention. Pain can equal love. If people are creating their own suffering to seek love, first off, I think, as a human, it’s just a hard thing because you want people to feel love in a healthier way.

I talk about secondary gain associated with being stuck in victim status. The secondary gain can be positive. It can be I’m expressing myself or I’m putting it out there that I’ve had this problem to have community rally around me or have healing and recovery and attracting opportunities for healing and recovery. It could be, I call it inspiration for sublimation. Sublimation is when you’ve taken something that’s potentially negative and turning it into something that’s a little more positive. You may discover your purpose and your passion through the fact that you went through something really painful and had some kind of injustice.

Being stuck in victim status can also be a form of– There’s a term for– Victim narcissism where I’m special, look at me, it was intentional, I’m special because I’m a victim. Also, in speaking for the type of individual this is, they could get more marketing, they could sell products based on it, they could feel special and entitled. “The world owes me something because I’ve suffered.” I really believe in the perspective of victim as part of the cycle toward vulnerability, but I also see many pitfalls with rewarding the victim status as much as it seems like our culture is right now.

Narcissistic injury

Ari: Yes. I’m glad you brought up that narcissistic element because it’s a covert narcissism that in a way, in one sense, it’s the opposite of typical narcissism, and in another sense, it’s the same. What we typically think of as a narcissist is somebody who’s going around and beating their chest and saying, “I’m the best, I’m the smartest, I’m the wealthiest, I drive the best car, and I have the nicest clothing and the nicest watch. I’m better than that guy over there.”

This type of narcissism is different from that in the sense that it’s, “Look at me, I’m so weak. Look at me, I’m a victim. I’m oppressed. All these other people have it so easy, I’m so oppressed,” and yet it’s also similar in the sense of the degree of self-obsession, of self-centeredness in the true sense of that word of having so much of one’s daily attentional resources and energy invested in analyzing oneself.

Dr. Karim: Yes. The other piece of it is narcissistic injury. If you look at narcissism, there’s this term, narcissistic injury, which is essentially if you don’t validate the fact that I do have the best car, I do have the best watch, I am better than everybody else, then you’re my enemy or I don’t like you, or I’ve got conflict on you. Same thing here. If you don’t validate the fact that I am a victim, if you don’t validate that I’ve been oppressed, if you don’t validate that I’m entitled to more because I’ve suffered, then I don’t want anything to do with you, or in fact, I’m going to get aggressive toward you because you’re not validating my idea that I am a victim.

For whatever reason, I need to be a victim because I’m either stuck in the victim status or it’s early and I’m still discovering it, which is healthy, or it’s something unhealthy or manipulative. I’ve got a book coming out and I want to make sure that everybody knows I’m a victim before the book, or just for whatever reason that somebody has.

Do you live in conformity or joy?

Ari: Yes. You said something recently in one of your posts that I flagged as something I wanted to discuss with you. You said, do you live in conformity or joy? Most people wouldn’t consider those as being opposites. We would consider something like joy and sadness or joy and pain, joy and suffering, not joy and conformity as opposing concepts. Can you explain what you mean by do you live in joy or conformity?

Dr. Karim: I follow many historical psychologists. I was raised Sufi, so my parents have been reading Rumi and Hafiz and Kabir to me since I was very young. There’s a quote from Rollo May, a psychologist, that basically says, “The opposite of courage is not cowardice, it’s conformity.” I love that quote for many reasons, but I look at originality and creativity as elements that get thrown out the window, that leave us when we’re in a state of stress, fear, overwhelm, overstimulation, or cognitive rigidity where things just shut down in our mind.

What’s left when you don’t have originality? What’s left when you’re disconnected from your soulful experience in the world as a human? What’s left when you don’t have the creative vision to see expansive perspectives or opportunities beyond the routine by which you live by now? What’s left? You’re then stuck, flatlined in this place of stabilization. You’re not going to feel joy. You’re not going to feel the rush of something new. We’re humans that we love novelty. We love connection. We love to do something a little different here and there. We love safety and stability, but we also like to feel something, feel emotion.

When you’re stuck in conformity, in my mind, you’re no longer original, you’re no longer creative, you’re stuck in groupthink. You’re reactively allowing your environment to dictate your circumstances as opposed to taking charge of your own circumstances through your own energy, your own creativity, and your own originality. In my mind, conformity is the opposite of courage, and you’re not being courageous when you live in conformity.

Ari: I would almost interpret– I guess where my brain goes in response to you presenting that conceptual framework is to imagine two forces. One force is society and culture’s pressures on you to think a certain way, behave a certain way, do so-and-so as your profession, and so on. The other one is some innate thing that’s individual, that’s unique to that person of what Joseph Campbell might call is one’s bliss when he said to follow your bliss. It’s like something that’s in you that’s only in you that is meant to direct you in a certain way.

I would interpret what you’re saying as almost like the extent to which society’s pressures have overwhelmed and suppressed that unique part of that individual and made that fire die out versus the opposite. Versus if one’s inner calling and inner vision and uniqueness is the driving force, and they’re saying, “Screw society and what they want me to be. I’m going to go do this and I’m going to think and do this unique thing because that’s what I feel drawn to do.”

Dr. Karim: I’m smiling because you just nailed my entire framework for how I see the world in those two minutes or whatever that was, a minute. I’ve lived a very suppressed is conscious, repressed is unconscious. I come from a very conservative Indian family, immigrants completely fearful of the world around us. I was raised in that fear, a lot of fear. A lot of fear. I can’t even begin to tell you how intense it was. I’ve always felt this inner energy, this inner drive, this inner soulful connection to do something different than the safe play that societal pressures and family pressures wanted me to be. I’ve always connected to the word madness. I love the word madness. As a psychiatrist, I love the word madness. We haven’t talked about this, but I’ve been a performer for a long, long time. Television host, writer, actor, dancer. I love expressing, you know? As a performer, I love the word madness because madness is a word of duality. It’s got two sides like a coin. On one side, if you let your madness reactively dictate your life from a negative perspective, madness is conformity. Madness is neuroticism. It’s stress. It’s fear. It’s cognitive rigidity. It’s being locked down. It’s not expressing who you are.

I don’t mean tattoos and piercings and outfits. I mean expressing who you really are. The other side, the flip side of madness, that’s ingenuity. It’s creativity. It’s originality. It’s your soulful experience of being human in this world. You know, Rumi says, “You are not a drop in the ocean. You are the ocean in a drop.” It means we are all collectively joined, energetically joined, but yet we still have our distinctive drop.

I’ve always been a really big fan of the word madness in my entire brand. Everything I’m doing is based on the word madness. Aristotle said, “In every genius, there is a touch of madness.” Madness is a good thing. Madness can be a really good thing if you take that same energy source that you are allowing to exhaust you of this precious resource that you can use to become the source of your passion and purpose.

If you can harness that energy to build more distinction and disruption in your work in starting a new business and starting a nonprofit and being an entrepreneur and being an expert to express yourself authentically by expressing your madness, what I call master the madness, which is the name of my brand, it’s amazing what happens to you. The world opens up to you. In my work, when you are fully expressing who you are creatively, you have the visionary, the creative vision of where you’re going to go in the world. You activate that potential through your originality and your distinction and your drop that you carry with you.

When you’ve done that and you have the courage, what I call mad courage, to really put yourself, your ideas, your unique, your disruptive ideas out there in the world, then you are operating as a mad genius. You have tapped into your state of mad genius. I have a program on mad genius, how do you tap into that state, and I have a program on madness. That program on madness, it’s my contribution to the world about reimagining mental health and personal discovery because I think so many people are not discovered. So many people are leading their lives.

Yes, they have a job and they make money and they’re doing okay and they look good on paper, but deep down, they’re uninspired, they’re unexpressed, and they’re unrealized. I know because I was. It took a big, disruptive time in my life to realize what was going on and I woke up from it. That’s why I want to help others do the same.

Ari: I’m debating in my head whether to say this next piece because it might be disrupting some of the natural flow of this conversation, but I’m going to say it anyway. Who knows? We can edit it out if it’s disruptive. From an evolutionary biology perspective, I think that we can examine the extent to which people are either programmed to be followers or be more contrarians, to follow the herd groupthink or to say, “No. You guys got it all wrong. I’m going this other way.” In a simplistic sense, I think we could imagine the benefits of each of those personality types.

One being to have the majority of people who conform to society and conform with whatever the perceived authority says to think or to do, that most people would be inclined to follow that, I think would lead to a more harmonious society compared to if everyone was programmed to be really contrarian in their thinking. Yet, if the majority is making a really bad decision and running themselves off a cliff, literally or figuratively speaking, it really helps if one or two people say, “Hey. You know, I think you guys got it all wrong. I actually want to go this other way.”

You can see how from a purely evolutionary perspective and natural selection, how each of those personality styles and thinking styles might have evolved. Obviously, what I’m presenting here is oversimplistic but I think has some validity. Do you see that as being relevant to your framework in any way, like personality types that are cognitive types that are more inclined to follow perceived authority versus to be more contrarian? I think I’m more wired to be contrarian, and I’d suspect you are too, but I’m curious if you see that as having relevance to this discussion at all.

Dr. Karim: Yes. I agree with it in some ways, and I disagree in others. I feel like, yes, there are some people that are more inclined or more wired to be contrarian, and there are some people that are more wired to be part of the herd and part of the group mentality, but within every one of us is access to creativity, to the energy of originality within us. I don’t think that some people are just unoriginal in who they are. Their soul is not groupthink. Their soul is not a herd soul. It is distinct and unique within them, and their story is their own unique story and their routine–

Now in the herd routine, they’re much more likely to be in this routine, in this herd group routine, but that still can be disrupted. In my mind, if you take a contrarian, they’re already going to know, I want to be more contrarian. I want to get my disruptive ideas out there. I want to get my story out there. I want more access to my creativity. I want to challenge social norms. I mean, it goes back to mad genius.

The contrarians want to be the mad genius because they’re the ones– You know, the mad genius of old was, think back to the future, some white-haired old guy who’s a loner who lives in his house and it’s super cluttered, and his role or her role in society was to challenge social norms, but as an outcast, as a loner. The modern mad genius is the person who is the contrarian, who challenges social norms and has a community behind them who loves the fact that they’re doing that, and they’re making things new or they’re making things better because they’re willing to disrupt and get divergent in their ideas to bring something new, but the herd also has their own creative power.

The herd can still disrupt the routine they’re in to make more money or to be more influential or to have deeper relationships or to get in a better relationship and to be able to tell their story because the withholding of your story, your ideas, whether you’re a contrarian or you’re a herd member is unhealthy, and the ability to express yourself, even if it’s just to your family or your neighbor or your spouse, is a really important thing in our own mental health and our own culture.

Are we too fixated on pathology in mental health?

Ari: I want to talk to you about sort of meta-level of mental health and what that phrase means, and maybe what it should mean. I want to present my understanding. I know you have a much greater depth of understanding, so you correct me wherever I’m wrong here. I think for 100 years within the discipline of psychology, starting with Sigmund Freud and Carl Jung and Skinner and Carl Rogers and all these types of people, Rollo May, and then later on with psychiatry, everything was focused for 100 years on pathology, on mental illness.

It was depression and anxiety and schizophrenia, and we’ve got these hysterical women. Maybe let’s try cutting out their uteruses and see if that helps, and let’s develop this psychoanalytic approach, and let’s talk about Jungian archetypes and let’s do Rogerian therapy where we just focus on connecting and mirroring and being empathetic and loving in this human connection and behavioral therapy and cognitive behavioral therapy and a million other things that were all really focused on pathology.

You’ve got this problem. You’ve got this illness. We need to fix what’s wrong here. Then psychiatry came along. Initial psychiatrists were trained also in psychotherapeutic methods but then the paradigm later shifted to really one of, I think probably heavily influenced by pharma, one of saying, “Hey, we’re really sciencey. We’re going to figure out the specific chemicals in the brain that are off, that are causing your depression, causing your anxiety, causing your schizophrenia, and your psychosis. We are going to then develop drugs that interrupt the chemical imbalances in your brain.”

The most famous of which is, of course, the idea of serotonin deficiency with depression. That was framed as a really sciencey approach, but the whole thing for 100 years was focused on path pathology and fixing pathology with the idea that if only you fixed what’s wrong, then you naturally arrive at health. Then the field of positive psychology arose not that long ago and basically said, “Hey, maybe we should instead of only studying disease and problems and pathology, we should also examine really happy people and people who are flourishing and having great relationships. We should maybe figure out what’s going on there and seek to move towards that,” which I think was a great breakthrough.

That’s my conception of it, but how do you see mental health and the fixation on pathology and what we should be focused on?

Dr. Karim: I’ll take it one step further. I agree. I think you set it up really well. Mental health is not mental illness. Mental illness is what we’ve been obsessed with over a long, long time. From bloodletting leeches to all the crazy ECT from the ’50s to everything we’ve talked about. Everything’s based on a childhood trauma. Everything’s based on psychoanalysis and then to the crazy pharmacology, the whole focus on medications. Mental health diagnostics, I think is quite scientific, whether it’s everything from pharmacogenetics to eventually getting to the point where there’s neurotransmitter testing.

I still don’t think that’s very accurate or very good at this point. The diagnostic idea that, “Hey, there’s some clinical symptoms that define when you’re depressed or you’re having a panic attack, or you have OCD,” or whatever it is. That doesn’t mean that mental health treatment should be solely scientific. I believe that there’s so much missing from mental health treatment because first off, mental health is not just biological. In fact, it’s probably as much spiritual, existential, and creative visionary as it is biological. You have to envision something new and have a worthiness to pursue a bigger, better, bolder, more healthy life.

You have to understand who you are from an existential perspective to get a sense of meaning in your life. If you are devoid of energy, devoid of passion, devoid of meaning in your life, you’re not going to be motivated. If you are not inspired to lead a better life or to move towards something, you’re going to stagnate. If you stagnate, your reactionary environment is going to take over, and then whatever comes your way, you’re not leading from your heart or your soul. You’re just leading from your intellect. Our intellect, it’s fine, but it carries a lot of baggage with it.

All of our defenses are attached to our intellect. The perfectionism, imposter syndrome, procrastination, avoidance, repression suppression, blah, blah, blah. All that stuff comes with our intellect. I love the positive psychology disruption of mental health. I think mental health, there’s a lot missing from the conversation, even though a lot of corporations now have mental health programs and the government’s finally paying attention to mental health. Listen, I’ve been a mental health advocate for 20-some years since I finished my residency in psychiatry.

I can’t subscribe to the psychiatric system in its core, which is doctors create diagnoses, pharma companies make medications for those diagnoses, insurance companies reimburse for those diagnoses. There is so much missing from that system that just really impacts the ability for people to improve and to better their mental health. Mental health is everything from deep human pathology to the very brightest in our human potential and human performance. I personally, as an individual, just as a human in this world that’s had the opportunity to be trained pretty well in all this stuff, I didn’t want my life to be just about helping people in pathology.

I wanted people to move, to activate their potential, to find more meaning, purpose, and passion in their life, to perform and be as productive, and have the deepest relationships that they desire. I couldn’t do that in just traditional psychiatric medicine. I needed to really expand who I am just as an individual to develop these programs, to help people far beyond just being in a crisis.

“Whatever one can be, one must be”

Ari: You did a post recently on your Facebook profile where you quoted Nelson Mandela saying, “There is no passion to be found in settling for a life that is less than the one you’re capable of living.” It reminded me of one of my favorite quotes from Abraham Maslow, said basically the same thing in a bit fewer words. He said, “Whatever one can be, one must be.” I think that might be a good thing to finish on. I’m curious because I think it fits with everything that you just explained, but that I think for me, crystallizes the focus of what a person should be focused on. It’s becoming whatever they can be, living their life to the fullest potential that is possible for them.

Dr. Karim: They’re both great quotes and I would just add– Here’s what somebody would say. In fact, somebody has said something like this that I’ve worked with. If you look at that quote, whether it’s the Mandela quote or the Maslow quote, let’s take the Maslow quote, “Whatever one can be, one must be.” Theoretically, that makes sense. Whatever one can be. Okay, I can be something beyond what I am now or I can be– Maybe I’m at what I can be. Maybe that is my potential. You have to be able to envision what you could be to become that. Whatever one can be. If whatever one can be is the lowest level because that’s all you see, your worthiness is low. Your creativity is low.

You aren’t able to envision what you could be. Now, you’re not depressed. You’re not anxious. You don’t have human pathology as we’ve talked about. You don’t have the creative vision. You haven’t developed the distinction or the disruption to go and expand your perspective, to attract opportunities, to creatively disrupt your current thinking, your old thinking, your conditioned thinking. To follow that quote, “Whatever one can be, one must be,” I would add one must need to see what one must be. You need to be able to envision what you must be.

If you don’t have that vision of what you could be, your potential that needs to be activated, well then you need to do something about that. You need to talk to somebody about it. You need to do a program. You need to expand and have access to your creativity because people talk about creativity all the time, but nobody really knows what it means. It’s this ambiguous thing. I’ll tell you what creativity is. Creativity is in all of us, and creativity is what we need to be able to envision what we could be. I’m glad you mentioned that because it’s a really important point in this, in mental health, in personal growth, in personal discovery, in personal branding.

You have to know what you could be. Again, creativity, originality, and courage are the platform by which I help people personally.

Ari: Actually, I changed my mind. There’s one more thing I want to ask you about. Maybe we finish–

Dr. Karim: All right.

Pain and suffering is not optional, it's mandatory

Ari: One other thing you said that I really liked, though I think it’s a bit cryptic. The meaning of it is not obvious on the surface. You said pain and suffering is not optional. It’s mandatory. Your pain is part of you. I think some people might react negatively to that at first. Actually, I was just having a conversation last night with my wife’s sister, who I’m very close to, and she was explaining. She’s dealt with a lot of suffering, chronic pain from migraines for many years. She had a very hard upbringing. Literally from the time she was baby, she had a severe intestinal– I think it was called intussusception. Folding in of the intestines, where they gave her a 1% chance of living.

The doctors gave her a 1% chance of staying alive to the mother, and she survived. Literally, from the day she’s been born, she’s been fighting. She’s dealt with a lot of stuff. I was talking to her last night, and she was saying that she wants to get back to this pure part of herself, like undoing the traumas, undoing the pain, and being this person that never had to deal with all these problems and traumas and pain. What do you mean by, “Pain and suffering is not optional? It’s mandatory. Your pain is part of you.”

Dr. Karim: I would differentiate chronic, severe, severe pain that never lets up versus acute pain. That’s the first thing I would mention in there. “Pain and suffering is not optional. It’s mandatory. It’s a part of you,” means we want to express the fact that we’re human in everything we do. Whether we’re personal branding and we’re putting stuff out on social media, we’re doing a TED talk, we’re doing anything that we do to express ourselves, pain and suffering is who we are. Do not hold back your pain and suffering.

Now, we’ve talked earlier, you don’t want to promote it as a victim but to be human. One of the things I work with people on is, how can we make you more human in everything you do and connecting you and your story to your relationships, to everything that you do? First off, when I say, “Pain and suffering’s not optional. It’s mandatory,” I mean we all suffer. We all have pain. It’s what we share in common. It’s why storytelling is such a powerful device because we empathize with pain and suffering because we all have it. I also would ask, what have you learned from your pain?

There are many people that are incredible. They have set up incredible nonprofits. They have set up incredible businesses. They are just charged and they feel alive because their suffering led them to their purpose. Their suffering led them to their passion. Their challenges led them to something that they were able to define themselves with in the world. That’s what I mean by, “Pain and suffering is not optional. It’s mandatory.” You can’t hide your pain. You can’t pretend you’re holier-than-thou. We all make mistakes. Every one of us has made mistakes. Every one of us is human.

The hard part about that quote when I said that is that there is the chronicity of pain whereby it doesn’t let up. When you’re in so much pain that you’re not able to reflect, when you’re in so much pain that you’re not able to think and turn, and creatively find your passion and purpose because you’re in so much pain, and you’re either numbed out from the medication that you’re taking for the pain, or you’re in so much pain that you just can’t reflect and you can’t go existential at all, that’s a different type of pain and suffering. Obviously, I empathize with anybody who’s in that state, but what I mean is the humanistic element of pain and suffering that we all have.

Ari: What is the difference between somebody who goes through pain and suffering, trauma, and is healed from that, heals their trauma, or is made stronger by it, or wiser by it, versus someone who is forever scarred by it and forever traumatized, or post-traumatic stress disorder, or in that direction of somebody who is forever harmed as a result of going through those hard experiences? What fundamentally is healing from trauma and pain and suffering?

Dr. Karim: Wow, that is a deep question. I love how you’re throwing the deep, deep difficult questions at the end here. When you look at healing, because really what we’re talking about is healing from trauma here, I have so many places I could go with this. I feel personally and professionally, based on just the decades of experience that I’ve had, for many people, their lack of healing from trauma comes from not exploring their unconscious. The dynamic programs that psychoanalysts have, psychoanalytic therapy, says they’re focussed on the unconscious.

Certain breathing techniques or meditative techniques that get really deep will say they focus on the unconscious. Plant medicine, psychedelics, focus on the unconscious. Spirituality and deeper spiritual work says there’s a focus on the unconscious. If you are treating your trauma and just treating it with medications, you’re not treating your trauma. You have to do so much more work therapeutically, existentially, and in your unconscious exploration, and I would add creatively too. That’s how you can heal or you can manage your trauma. Now, those people that have been made stronger, healed, and became wiser from their trauma, regardless of the healing modality, probably still did some of that.

They can look back at that trauma and they could say that trauma empowered me, or that trauma informed me, or that trauma led me to where I am today. A lot of them do in their stories, their origin stories. Those people that are still suffering from that trauma and have not healed, the first question I would ask them is, what have you done so far to help you through that trauma? I would want to see, have they done all these things?

If they’re like, “Yes, I took a medication for it.” Okay, well, there’s a lot more you can do. “I’ve done medication and therapy for it.” Okay, there’s still a lot more you can do. If they’ve said, “I’ve done all the existential work. I’ve done the unconscious work. I’ve done this, that, and the other.” I am a fan of psychedelic therapy in mental health, obviously regulated, and obviously set setting, and with a professional. As you go through all that, if somebody has not healed from that, then I would look at their foundational coping skills versus level of trauma they endured.

I’ve mentioned this before that if the trauma is all the way up here and their coping skills are down here, you’re going to really feel it. You’re going to feel that trauma. If the coping skills are at an even level– Coping skills aren’t just medications. Coping skills are, what are all the things you’ve done to be able to stabilize your autonomic nervous system, to be able to think through things, to explore your unconscious? All of that is part of that coping skill basis. What I would say is, pain and suffering and healing trauma, it’s a deep process. There’s multi therapeutic ways of getting through that. I think it just needs to be looked at in a very comprehensive way.

Learn more about Dr. Karim’s work

Ari: Reef, I could talk to you for five more hours, but I’m going to let you go. To be continued on another, or several more podcasts in the future. I love your work. I love the way you think. It is really a joy to have conversations with you. For me, you’re one of the most interesting and fun people to speak to. Thank you so much for coming on the show. Let people know where they can find you, what you have going on as far as programs, and anything else you want to let people know about.

Dr. Karim: Yes. First off, thank you for having me on here. One of the things I really enjoy about this is that you’re a deep thinker and you’re courageous. You’re not afraid to ask the difficult questions and not afraid to go into places that are murky. I feel like we’re similar that way. To talk about, to go against the grain on this perspective of the victim when there’s so many people out in the world that are claiming to be a victim, and maybe a lot of them rightfully are, but there’s something to say about this because it’s really growing in numbers. To be able to put this out there and talk about what’s wrong with mental health and what’s missing from the conversation.

Can people get so locked into their trauma that they’ve lost who they are? All of these things are really important and controversial topics. First of all, I want to thank you for putting it out there because I think these are important things for people to hear and it’s taken me quite a long time to be courageous enough to speak about these things and not take the traditional way of thinking and to be able to go against the grain.

Thank you for the opportunity. The second thing is, yes, if people are interested in this work and the work is how do you let out that mad genius? How do you have access to that most disruptive, distinctive, courageous person in you? I have a website, You can go there. There’s lots of different programs. You can set up a call with me and I’ll talk to you directly about your mad genius and what you want to explore.

I also have a program coming out later this year about this madness energy and looking at mental health from the perspective of energy and creativity and soulful expression. That’ll be coming out later. Then I’ve got a variety show that’s going to come out because we didn’t really talk much about the performance, but I’ve always loved utilizing comedy and pop culture and a little more of a fun approach to learning, and so we’re going to be launching a variety show probably early next year on connecting personal discovery to comedy. I think it should be super fun.

Ari: Epic. I look forward to all of those things you mentioned. Reef, it is an absolute pleasure. Thank you so much. I look forward to our next conversation.

Dr. Karim: Okay. Thank you.

Show Notes

00:00 – Intro
00:35 – Guest Intro
03:03 – Victimhood vs. vulnerability
07:34 – The problem with praising victimhood
21:00 – Why we need to develop mental strength
26:43 – Are we masochistic and do we self-sabotage?
34:34 – Narcissistic injury
36:48 – Do you live in conformity or joy?
51:07 – Are we too fixated on pathology in mental health?
58:50 – “Whatever one can be, one must be”
1:02:15 – Pain and suffering is not optional, it’s mandatory
1:11:31 – Learn more about Dr. Karim’s work


Recommended Podcasts

Like this article?

Share on Facebook
Share on Twitter
Share on Linkdin
Share on Pinterest

Leave a comment

Scroll to Top