Comprendere la disforia di genere e l’identità: il legame con l’autismo | Dr

I trained uh as a psychiatrist, then I trained as a forensic psychological psychotherapist. I set up a national gender dysphoria psychotherapy service, the first one and the only one I've written. I'm primarily a scientist and a doctor, so I don't believe in the imaginary world. Gender's a man-made concept, it's a social construct. Trans is a false solution to a different problem. 26% of my gender therapy patients regretted their sex change. And those are the ones that you never hear about. People like me are vilified for being conversion therapists.

Um so that's why a lot of us just don't do it anymore because it's too politically challenging. I was right about talking about this 25 years ago. Way before it was fashionable. What I found was the transsexual males were all autistic. All of them. What I want to happen is people to be able to go back to thinking normally, not medical schools teaching that there are 100 genders. Not saying pregnant people, chest feeders, or cervix owners. You know, allowing women to be women and men to be men. Allow people to look how they want to look whilst not colluding with false solutions. This is the medical scandal of our lifetime.

Welcome to Deliving a Life and Balance Podcast. My guest today is Dr. Ahas Hakim, consultant psychiatrist, forensic psychotherapist, and group analyst with over two decades of experience in the NHS and private practice. He spent 12 years at the Portman Clinic in London, where he ran a specialist psychotherapy service for adults with gender dysphoria and has published widely in the field. I hope you will enjoy. Abdullah. What motivated you to do what you do today?

What I've done is has evolved over time, but it's always been psychiatry. And I suppose all I was interested in school was art and English literature. And I narrowly missed doing a fine art degree or an English degree. But what I realized was that what interested me was when I was looking at art or reading literature, I was trying to ascertain something about the mind of the person creating it. And then I was probably about 11 uh when I went to my local library in North Wales where I grew up, and I found Freud's interpretation of dreams.

So I got out of the library, I read it, I did not know what it was going on about, did not understand a word of it, but I wanted to understand it. So I thought, well, maybe I don't do a final art degree, maybe I'll do medicine to do psychiatry. I thought that's what that's what psychiatry is, surely. Obviously, my Indian parents were totally overjoyed that I wanted to do medicine on the re on the on the pre on the on the subject to, but don't do psychiatry, do a proper, proper field of medicine. Um and luckily I chose a medical school where they would accept art as a third A level, so I didn't have to stop doing doing my art and uh went to UCL.

Okay.

And now fast forward decades, then I'm I'm still there, but as an honorary um professor of the medical school.

Art. Medicine and art are not that close.

Well, when I went to my fine arts degree, uh fine art interviews, they did ask me why I was doing so many science subjects. And but um I think well, maybe they're not, but psychiatry is a bit of an art movie. That that's maybe how I can fudge it. Maybe it's a bit of an art. But when I was when I was um when I was training as a psychiatrist, those who were really keen were encouraged to um train analytically.

Yes.

So that narrowed the population sample down to so not many psychiatrists these days train analytically. In the olden days, pre me, um, most would, but now most don't. But I thought, you know, maybe I can finally get to understand that Freud book that I had when I was 11.

Yeah.

So I trained uh a psychiatrist, then I trained as a uh forensic psychological psychotherapist because when I was about to look for higher training, um, as if by magic, they'd invented a new specialty, forensic psychotherapy. And it was meant to be for the people who were bad, not mad, who were having some sort of personality disorder, antisocial, committing crimes, which psychiatry said, Well, they've got this disorder, but we can't treat it. So the government said, Well, you've you've you've given them the name of a disorder, can't you invent a treatment?

So they invented this specialty, forensic psychotherapy, and that was in 2000, the first training number for doctors. Um, so I got one of those first training numbers. It was literally around the corner from where we are now at the Portman Clinic. And I was there for five years. Um, and the Portman Clinic is the only uh sexual perversion clinic in the NHS. So it started off. It's interesting, it was started off by uh the Bloomsbury Group, by a surrealist painter, H.G. Wells, and various people in the Bloomsbury set, and it was called the Clinic for the Study of Sexual Deviancy and Delinquency.

But they rebranded it to sound nicer, it was the Portman Clinic. So I was there for five years, uh getting inside the heads of people that you would not normally meet. Or if you did meet them, you wouldn't want to because they were murderers, paedophiles, rapists, and general per perverts of all description.

How old were you there?

Twenty-seven.

Twenty-seven.

So I was there for I was there, I I trained there for five years. I currently I'm working there as a consultant. Um I I set up a national uh um gender dysphoria psychotherapy service, um, which was the first one and the only one in Britain. And I stayed there until 2012, mid-midlife crisis. Then I went to Australia for a year. I had a five stage midlife crisis, it was great. And then then I came back, um, and then carried on working in the NHS and then decided actually I need to do private practice.

Nice.

And then I've been doing that for the last 13 years. Wow.

Can we can we go back to more your childhood for a bit? Um, so you have Indian roots?

So my parents moved from India after the partition to uh North Wales. Um, I did one of those ancestry uh gene blood tests, and apparently I'm I'm 90% Persian. Um, but my parents were India, and you know the partition of India was a massive genocide, and they were medical students at the time, and all they could see were sort of dead people and bloodshed, and they wanted to get as far away as possible. So what I their decision, which I I was quite impressed by, was not wanting to move somewhere which is full of people from India. So they chose a remote rural town in North Wales, and literally were the only brown family that we knew of, apart from the boarding school where there were other people.

Um, but I'm so glad they did that. Because I I consider myself Welsh, because I've learned Welsh and I've um so I'm glad they did that. I think my life would have been very different if they'd have moved to Birmingham or London.

As one of the few, probably at that time, uh, being foreign to the country. How did you perceive that growing up there?

Well, it it was the norms, I didn't know anything else. And also, my parents had lived there for 20 years before I was born, and you know, there they were doctors and they were well respected, and even the Welsh nationalists got on with us because we'd been there for decades already, so there wasn't really a problem. When I went to school, I went to a a boarding school Rydal, although I wasn't a boarder, where there were people from all over the world there, so it wasn't really a thing.

Yes, yes.

I mean, I was weird enough at school to stand out anyway because I was a goth. I had a buzz on my left, I had a a a purple Mehican. So, you know, I I made a thing of being unusual.

Yeah.

Hasn't stopped.

Maybe you can explain to us what uh do this mean to you?

I think it's when I when I I was at I was at a conference last year and I was talking to Jordan Peterson in awe, obviously. And Jordan Peterson said, So what's with what's with the skulls? I think I should have prepared this. I said, I said, I like skulls. But I think there's I I think you know, once a goth, always a goth. And being a forensic psychotherapist, you're used to sort of delving into the dark side of life. So that's the most intelligent response I can give. But I think basically I just like skulls. It's become a motif for everywhere.

I mean, it looks very exciting and fancy. I think it looks subtle and understated. Yes, probably, and your perspective. But if I if I would imagine, yeah, explain a psychiatrist, maybe I would explain like a bit of more straightforward, boring type of explanation.

Those scruffy psychiatrists.

How many do you have at home?

Well, I think this is it. My mother said you don't have to wear all your jewelry at once when I was when I was 15, and all of a sudden we take that in. Okay.

Maybe back to your childhood. How was how was your childhood growing up?

It's fine. My parents did something which was very sensible. They um in back back in their childhood, they had they'd have an aya, which is a live-in nanny who would who would look after the children. And I listened to my patients who are struggling to find nannies who, you know, they last one or two years or, you know, they have affairs with a husband or whatever it is. Whereas my parents, working in a local hospital, basically adopted a single, they wanted a single older woman who was about to retire and would otherwise be lonely. And they had a short list of three.

They had the hospital cook, the hospital headmistress, because it was a TB fever hospital, lots of children there for years, and the hospital cleaner. The hospital cleaner was ruled out because she smoked.

Yeah.

Um, and I think the hospital headmistress didn't use soap, she used she used beef fat. Anyway, but she remained a friend. Um, but the hospital cook was she she she got the post, but it was transformative because she was with our family for decades, and she immediately inherited a family and was totally, she was with us every day. My parents pick her up, take her back, and she organized all our children's parties, all the party games. She taught my parents how to, you know, cook British food and boil fish and milk and all that sort of stuff.

And um, she sort of normalized everyone. My parents would would find me, you know, her pushing a pram with me and holding pig trotters for for her to have later. Um that was great. So she was she was a great influence on our on our family.

When when was the time when you realized you're you're different? Oh, I was born.

Um but I've thrived on being different. Um, I, you know, at school I was in the art set, the sort of the um, you know, sort of backcombed eyeliner, lipstick wearing, floating around in a sort of crushed velvet crew. Um and that was I wasn't the sporty jock type who was fitting in. I was the on the outside. And uh even when I came to do my qualifying paper for my when I when I trained as a group analyst, um my my paper the paper was meant to be on understanding your life, and mine was about um existing in the liminal space on the boundary, being neither one thing or the other, but but sort of um being on the fence.

So so yeah, I'm I'm I'm comfortable with being an outlier.

What about your parents? Did they did they accept it from the beginning?

I think they were so exhausted by the time I came along. So I was the youngest. I mean, I'm obviously the youngest. Um and there's a big gap. My mom my elder sister was like 16 years older than me. So um all my parents cared about was whether we were bright, and and then if you were clearly going to do medicine, then obviously that was the the jackpot. So um by the time I was backcombing my hair and wearing eyeliner, they didn't care at all. They were they were thinking, well, at least he's bright, and at least he's going to do medicine.

Yeah. You studied medicine? Yeah. What uh how how did your career go on?

So studying medicine, um, then did my house jobs, and it was getting through the house jobs because all I wanted to do was psychiatry. I was I wasn't that interested in anything else, but I but I'm glad I did it because now you know when when people have their physical problems, I can I can oh yes, that's that thing. Uh and then I went straight into psychiatry, um, did the rule-free training for three years, and then that's when I did the forensic psychotherapy five-year training, which was a combination of forensic psychiatry, psychotherapy, and then a combined forensic psychotherapy. And it was it was like an indulgence, yes, because everything I'd done so far had been very practical.

Whereas I was starting a specialty where no one had done it, there were no jobs, and nobody knew what was going to become of you at the end of it. But I thought it's gonna be a very interesting five years.

Explain to us just a bit more about the the forensic psychotherapy. So, what's what's different from traditional psychotherapy and the psychiatry?

The easy answer is forensic psychotherapy is psychotherapy with patients that nor that normal psychotherapists wouldn't go in with a barge pole. But the the real difference is there's a three-party relationship. There's the patient, the therapist, and external agencies. So if you're dealing with people who transgress body boundaries and may try you know transgress the law, then you've got the third party is the law, or you might be on probation or whatever.

Yes.

Um, what we said to people is it's normal to feel murderous, but if you actually have committed murder, then you're a forensic psychotherapy patient. So that they call themselves a forensic psychotherapy at the Pullman Clinic, but it wasn't strictly forensic because they hadn't all broken the law. They transgressed some sort of body boundary. So whether they had been violent or perverse, that was the ticket to come in.

How how is it to work with these type of people, you know, who are put away by society? Fascinating.

Absolutely fascinating. I mean, if I think about my cohort that I was sharing a house with the medical students, you know, we all started off the same, as you know knowing nothing about anything, and then we all, you know, fast forward go into our different specialties. And if I look at my friend James, he's now, you know, a head of A ⁇ E and trauma in a hospital, and he has to see people coming in with their brains hanging out, and you know, I'd be hopeless at that. You know, seeing horrific injuries would I can I I'd be useless. I'd be hiding under the table, quivering.

But listening to the account of something that someone's done or is I think that's that's far more doable, you know, the secondhand version that someone's telling you than seeing the first hand version.

But what was the goal working with these type of Well, that's the thing.

So the idea was that you'd get them better.

Yeah.

But what I realized was, and I was seeing people who had been in this NHS clinic for decades. You know, I'd look after someone else's therapy group, and there were people who'd been in the therapy group for literally 30 years, and they hadn't changed. What I realized is once something becomes a sexuality, it's very difficult to change it. I would go as far as say you can't change it, because it gets locked in. Um, so and when I was working in prisons and high security with psychopaths, you're not gonna change a psychopath. You know, that there are some people who, you know, by an unfortunate circumstance ended up murdering someone.

Yes.

And they may feel regret and remorse, and that's different. But the cold psychopathic person, you're not gonna change them. And then what I realized was I missed getting people better. You know, because my my parents were doctors and surgeons, they got they fixed people and got them better. Yes. And I realized that as interesting as it was getting inside the minds of the, you know, the sort of person you wouldn't normally bump into in society, how much of it was was for my interest and how much of it was them getting better. And so I left forensic psychotherapy and went back to treating people who weren't forensic and but carried on the gender stuff.

Um and they the gender people did get better. And um I think but that's that's what I'm known for, even though I don't do that anymore. Um, that's what I'm known for because I've probably done more therapy hours, therapy person hours with gender than anyone else has. Because I was seeing them for in individually and in groups or one and a half hours a week for 12 years. And they would they'd be in with me throughout. So um I got to know them really well, and it and it revised my initial understanding of what it was into the complexity that I know now know it is and what I often talk about and write about.

Yes. In my book I haven't read.

Yes, of course. The when you when you define gender, is this always related to sex and and and um what someone is interested in and how they feel?

Well how how do you so I'm I'm I'm primarily a scientist and a doctor, so I don't believe in the imaginary world. So there's biological sex, male, female, and a tiny proportion of people are intersex, but gender's a man-made concept, it's a social construct, you know. So there's biological sex, gender is is gender's a bit like religion. You can you can invest into it as much as you want, but essentially you can live without it. You're not gonna be. Not the biological No, it's nothing biological about it, it's a social construct. So if in if you live in a society where it's feminine to have long hair, um dresses and makeup and high heels, by repeating it over time in that society, the society learns that this is feminine.

Whereas if you go to some parts of Africa, it's feminine to have lots of metal rings around your neck or a big tongue plate. And in that society, that's so the society creates a notion of what feminine and masculine is, and it repeats it, and that ingrains the idea of it being real. But actually, that the only real thing is biological sex. You know, gender's this this construct. So I say gender doesn't essentially exist. And so people often get confused between sexuality and gender. Sexuality is what you fancy, not who you are.

Gender is whether you're happy about being male or female, basically. And it's become this I I always say that that trans is a false solution to a different problem or a different set of problems. So the person presenting with, I think I'm the wrong sex, the problem isn't that they're the wrong sex. The problem is something else. But a bit like in my maths A level, which I was rubbish at, I do the working through, and I and I get one step wrong, and I don't end up over there rather than over there. So that's what they do. They they they they have this quandary, they try and work it out, and they they end up over there.

Yeah.

And what I found was you know, we people refer to trans and as if it's a a uniform thing. It's not. So trans is people who are formerly called transsexuals, who believe that they are the wrong sex, trans restites, who nobody talks about anymore, who are far more common, who are generally men who get excited by wearing women's clothes, who don't want to change their sex but just like dressing up. The autogynephile, which is a small number, which is a sexuality where men are sexually turned on by the fantasy of having women's bodily parts.

And I that's my definition of autogynophilia. Autogynephilia was first described by Blanchard, and he had a much wide-ranging definition of autogainophilia, which I think is unhelpful because it overlapped with transvestiles. I used what I call the pure autogynophile description, which is the sexual fantasy of a man um having uh having breasts or vagina. So you could be a transsexual, a transvestite, an autogynophile, and then you've just got drag queens, which are the least pathological. And I'll explain why, because the the transsexual and the transvestite are heavily invested into their belief of what the rules of gender are.

Men like this, this, this, and this, women like this, this, this, and this, and they they their interest is by transgressing their perceived um framework of gender. Whereas the drag queen isn't mocking women, as lots of people think. The drag queen is saying, look how ridiculous your framework of gender is. I'm following your rules. I've got big hair, makeup, a dress. But look how nothing like a woman I'm like. So women often say, oh, drag queens are making fun of women. They're not, they're making fun of the gender, gender framework.

They're saying how ridiculous the gender rules are. Okay. So they have a an accurate sense of what biological sex is, and they're um they're um they're mocking the gender framework, whereas the transsexual and the transvestite are slabiously adherent to the to the gender framework that they perceive exists in society. So I so to come and see me in my service at the time, you just had to have the presenting problem of either I think I'm the wrong sex or I like wearing other people's clothes. And sometimes they thought they were one, but through a careful understanding of them, they ended up to be something else.

Lots of transvestites thought they were transsexual and vice versa. And the autognophiles often came too late because they, I mean, I had at least two who had, you know, if they're masturbating furiously at the fancy of having a vagina as a man, and you've got a six-minute appointment with your GP, it might be embarrassing to say that to the GP. So you just say, I think I should be a woman. You that's the that's the abridged version. And then the the GP will say, well, there's a there's a two-month wait to go to the gender, the two-year wait for the gender clinic, putting the waiting list, and they go, Well, okay, I can't wait two years.

I'll just go to Thailand and have it done. So they go to Thailand and they have it done. And because it's a sexuality, it's not a belief that it's a sexuality. The first thing that goes when you have a physical sex change as a man and castrated is your libido goes through the floor.

Yeah.

So everything that was once exciting is now not exciting at all. So they wake up, literally, they wake up from the anesthetic and go, I don't want this.

Yeah.

It's too late. So I had a number who came too late, who woke up and realised this wasn't what I was meant to be. This wasn't a good idea.

How many, how many of them have you seen?

Um, it's a small number, but 26% of all my patients in the service were postdoc regretters. But they weren't all regretters because they're autchinophil, autoconophilia. My definite autoconophilia is quite rare. Yeah. But uh 26% of my my gender therapy patients were re regretted their their sex change. And those are the ones that you never hear about because the whole new sort of woke agenda is to promote the idea that no one regrets it. But they do. And I I saw them all. And none of them were were followed up.

You know, it's the it's the one intervention where there's no follow-up studies. It's astounding. You think that you know, even if you go and have a you know a broken finger mended, there'll be follow-up studies. But if you have a sex change, there isn't. And the the main criticism of the the CAS review recently in the UK on child gender services was there's no follow-up.

How how is how is the procedure if someone decides one to change uh gender?

It's interesting to ask because you know, when I was a house surgeon, I thought the most interesting branch of surgery to do is plastics. So as a house surgeon, I was attached to the plastic team, you know, very junior, holding the retractor back, not not doing anything useful. Um I got to watch sex change. Happened. Yeah. And I mean, do you want to describe how it happens? No more step by step if you want.

More theoretically, when the process is.

So it's quite basic, really. So you've got to say to your GP, I think I want to be a woman or whatever. Then they refer to the sex change clinic, the gender clinic, and then they they basically see you and and and they they they basically ask you whether you you're sure, and they rule out whether it's because you're psychotic or something else, or and then they see you in six months, and if you're still sure, then they'll give you hormones, and then and then the next time you're still sure, they'll put you in a waiting list to have surgery.

Yeah.

So that's it, really. They don't they don't have therapy. Lots of people think that in order to have a sex change, you have to be in a course of therapy, you don't.

Yes.

And in fact, people like me who did do therapy, analytic therapy with them, are vilified for being conversion therapists. Um, so that's why a lot of us just don't do it anymore because it's too politically challenging. Um, I'd much rather see people who aren't going to try and vilify you. Yeah. So, but you know, while I did it, I learned a lot. And unlike the other patients in the clinic, they all got better. All got better. Less than 2% of my gender patients went on to pursue any physical intervention.

So, what you're suggesting is to have therapy before getting into this.

Well, what I found was that the the transsexual males, so the ones who were certain that they wanted to be women, were all autistic. All of them. And, you know, you show me any male to female transsexual, and I'll show you an autistic person. Because it's very black and white. And, you know, men are like this, this, this, and this, women like this, and they believe that if they put a wig on and have a dress or whatever it is, you will see me as a woman because I I look like I'm following the rules. And you must have seen recently how how invested they are in pronouns, and how if you misgender them and get the pronoun wrong, what you see is an autistic meltdown.

The reason for that is the core deficit in autism is the lack of theory of mind. So the autistic person is unable to gauge what you're thinking or feeling unless you give him macro clues. Yeah, smiling, frowning, shouting, whatever, that that shows them your emotion. They can't gauge it. So they, you know, if if some interpersonal situation happens and they can't gauge, oh, they must have experienced this. They can't. They struggle. So if I decide that I'm now going to be a woman, and if I tell you that my pronouns are she, her, if you keep referring to me as she, her, that means you believe I'm a woman.

It's not just that you're trying to get the words right in order to not upset me, you believe I'm a woman. But if you slip up and say he, therefore you don't believe I'm a woman, and that's what causes the meltdown. What I found was that all 100% of what of the males who would formally be called transsexual are on the spectrum. Totally. 100%. 100%. 100%. I was the first person to say that. Because I and the it differs from the female to male transsexuals. Some are autistic, but there's also an overrepresentation of internalized lesbophobia. So girls growing up, women fancy other women, having no role models of anyone interesting or exciting as a lesbian.

And um, or cultural homophobia. So they might be be in cultures or societies where they perceive it's terrible, um, and and trauma, sexual trauma. So those those those three things factored more in the females. And then and just on the just on the sexuality thing, um, you might have heard of the Tavistock um child adolescent gender clinic. So I was attached there when I was training, and my main role was the troublemaker, going, what on earth are you doing? This is you know, and what I saw were small children, four, five, six.

And when you're four, five, six, you have no idea what the concept of genderal sexuality is. But what I saw were these sort of camp boys and these tomboy girls being brought in by parents who weren't that happy about them being tomboys in camp. And they had, I called it um trans housing by proxy. It was a bit like they had trans their children into believing that they're the wrong sex, or they'd bought into this idea or something, or or the child might have said, I don't want to be a boy, they go, Oh yes, you're trans, I take the gen clinic. And um I said to the to the people running it, or the man who set it up, I said, Isn't what you're doing mad?

Because if you leave these kids alone, we know that they're gonna grow out of it. And they'd probably grow up to be gay or lesbians. So isn't what you're doing mad? The idea that you might chemically castrate them, give them hormones, and make give them a lifelong medical career of being a patient. And he said, Oh Az, would it be any more mad if that than if they were to grow up to be gay? And that was astonishing because the Tavistog was rooted in homophobia. You know, it's it believed homophob uh homosexuality to be a perversion or inversion, inversion, sorry, and it was a bad outcome. So if you could trans away the gay and th and make them into a heterosexual trans person, that was perceived as better than just leaving them alone.

Yes.

I thought that was horrendous. And it was that the that's where these clinics were coming from.

Let's say they have done this transition, they are now women. How do they usually feel? They're not women, they're trans women. Yes.

Yes. So what I found was the degree of autism predicted whether or not they'd regret it. So if they were really quite autistic and they really believed that by having a wig and long hair and a dress and lipstick, that people believe that they're almost because they've got a female name and pronouns, then they might be happy. Because people are just humoring them, saying, Oh, yes, she, her, one, Janet. Um, and they they might accept that.

Yes.

But it was the ones who weren't that autistic that they started off with gender dysphoria, then they go to transgender euphoria, and then because the they didn't have enough protection, waterproofing from enough autism, they then had this sense of what if what if they don't really believe that I'm a woman? And they were the ones who regretted it.

So what you're saying is like the environment is support is is too supportive, too quickly supporting it's a false solution to a wrong problem.

So what you typically well, you know, I I took details histories out of all of them, and what you'd find is they there's a they grow up with it, and at some point they have a sense of something's different about me.

Yes.

Because they're autistic. That's what that's the difference. But you know, it's not they weren't told they're autistic or they just knew there was something different about them. And at some point the idea that they were the wrong sex is put into their mind. So not everybody autistic becomes transsexual, but if you're if you're autistic and you don't know you're autistic, but you feel different, palpably different to your peers, and then you come across the concept of being trapped in the wrong body, it might appeal to you, and that's where they, you know, I talked about the the the calculation error.

That's when they and being autistic, they hone in on it, they become blinkered, and they run with it. And if you decide something with an autistic mindset, then you are right, and everyone else is wrong. And if you're either for or against them. So if you col if you collude and agree with them and affirm them, then you you're you're for them. If you challenge them or critique it, then you're against them. So what I found is if you're doing therapy with um an analytic therapy, thoughtful, challenging therapy with someone who is autistically trans a transsexual, it's very difficult because you get into a yes, no, right, wrong, male feeling, like a pantomime.

So that's why I did group analysis, because group analysis is analysis of the individual and the group by the whole group, including the conductor. So it's not just me saying clever things. Everybody in the group is a is the therapist. And they they can you they can all challenge each other. And everybody in the group had some sort of gender situation, they'll say, apart from me. And so rather than all the challenge coming from the other non-trans person, it came from another trans person. And they would say, Well, you sound just like me, but you sound completely mad.

Or or the regretter might say to the the other person, you sound exactly how I sounded when I was convinced I needed to have a sex change, but now I look back and I can see that and I know it was the wrong thing. So they they were really helpful to the therapy, it was done by them themselves. And what we did in the group was we deconstructed the very strict notions they had of gender. So, in a way, I wanted them to become less certain and more confused.

Yes.

Because they'd come to this sort of, you know, some of the ideas they had about what male and female were, and they they gender everything, a bit like being French, whether everything's le or la. And they they'd say, Oh, I I bought this painting the other day, oh, but it was a very male painting. So, what's a male painting? Well, you know, I I I I know I should be a man because I bought a grey washbag, or little micro details which are irrelevant. But because they're gendering everything, this is adding more evidence to them. So the their rules of of gender were deconstructed and challenged by the group all the time, so that gender became uh less of a valency, less importance.

So if they, you know, we're we are a collection of variables: height, weight, race, ethnicity, class, gender, and we may or may not have a problem with any of them. So the anorexic has a massive problem with their weight. Um, you know, someone else might have a problem with their social class. These people had a problem with their with their gender. If we reduced the importance of gender to neutral and benign, then they won't have a problem with it. So we deconstructed gender, which was pivotal in their minds at the outset, to a benign variable, they were all fine. They realized that they had honed in on something which was a nodal point for some other set of problems, like being different, autistic, whatever it was, and they'd run with this false solution for a non-problem.

The problem was they had a different mindset, they're autistic, or they had internalized lesbophobia, homophobia, you know, that that was the real problem, but they had displaced it onto a non-problem. And you know, my first papers that I wrote, I mean, I've been writing on gender stuff um for 25 years. My first papers were asking, is it, you know, if they if they've got the false belief that they're the wrong sex, is it a psychosis? Is it a delusion? Are they mad? And my response to myself was, no, they're not mad, we're mad. So they are confused, they're autistic, they've come to the wrong conclusion.

We are are the mad ones because we're colluding with a false solution. Like enabling it, uh and I I mean when I was when I was a trainee psychiatrist, one of our cohort, between um being a core trainee and a specialist registrar, left as let's just call him John, and came back the next week as Janet. And we all knew it was John, although John now had uh big hair and a sparkly ball gown every day. And uh and but we it was almost like we weren't allowed to acknowledge or refer to reality.

It was like we had this new person, and I remember the one of the nurses said, This new doctor looks so familiar, but I can't quite place her. And we're all colluding with this false reality. So that that's the madness. It's like the Emperor's New Clothes, you know, the the you know, the the Hans-Christian story of the Emperor, who, you know, if you couldn't see his clothes, then you were stupid. He was wandering around naked, and yeah. So I'm the little boy in the Emperor's New Clothes going naked. So, and one of the criticisms I get, because I'm gender gender critical means you're critiquing the ideology of trans. One of the criticisms we get is, oh, therefore you must be anti-trans and transphobic.

No, I believe schizophrenia is psychosis, but I don't hate people's schizophrenia. You know, I recognise what it is and I treat them for it. I didn't specialise for 12 years in treating gender patients because I I did I hated them. No, I I saw it for the problem it was and not for the non-problem that it was purported to be, where the whole of medicine surgery and psychiatry seemed to collude with it.

Yes.

It was that was the madness for me.

How how was the outcome now, the long-term outcome of those you have been treating over over time?

So um I don't know because I've left, but they the the the the through time, the the ones who had previously believed that they needed to have a sex change didn't because they realized it was a non-problem. And they they were, you know, I I wasn't I wasn't discouraging them from being, you know, atypically presenting. You know, they might have looked how I looked when I was when I was a student. Yeah, I if you look at pictures of me as a student, I I probably looked transvestile, to be honest. But I wouldn't for me it wasn't about gender. So, you know, I encourage to be people to be subversive. You can wear what you want, you can wear makeup, that doesn't mean you're the wrong sex.

You know, my point is nobody is wrong. You can do what you want. And I wanted them to increase their repertoire of what it was to be male or female. You know, if you look if you're a man and you like doing anything, therefore that's that's manly because you're doing it and you're a man. Doesn't mean you're wrong. You didn't change yourself to, you know, it's like in the beginning of my book, the one you haven't read, um, I said how um when growing up as a little brown person in in North Wales, when I came back from school, I think on the first day, and I said to my mother, Mummy, I think I should be white like everyone else. And the task my mother then wasn't to say, Oh yes, you're trans ethnic.

We're going to take you to the um ethnic cleansing clinic and we're going to make you into the white person like you think you are. Task was just mummy to help little as realize actually he could be anything he wanted to be, doesn't matter what what shade of beige he was. So it's a bit like that. It's they may say that they want or don't want to be something, but they're children. And and as the adult, but we've we've created this false condition.

False condition, and then when I think about parents, you know, having children in in these situations growing up, and they want to be supportive and totally, and so we've created um Frankenstein.

Have you read Frankenstein? I've only read it recently, and I always thought it was a book about a monster with bolts coming out of his neck. There's nothing to do with that. It's it's once it I I loved it. I wish I'd read it before because Frankenstein is a beautiful book coming being narrated by someone who believes that they're a bit like me as a child, on the edge of society. So Frankenstein is it's a it's a metaphor, isn't it? It's someone who feels that they're not part of society. They're on the liminal, they're on the edge, looking in as someone who they feel doesn't fit in.

So the monster thing is a, yeah, Hollywood goes with the monster thing, but the the monster is just the the outsider who's not part who's a who's who who perceives themselves to be not compatible or reject from that society. So um, yeah, so so we've we've created this this monster of a condition. I'm not saying that people are monsters, the condition is a monster, and it's gathered momentum. So, you know, if so parents have been brainwashed by only all the media ever talks about is people trapped in the wrong body, and now they're woman they always wanted to be, or believe they they there's nothing gender critical or critiquing of the ideology on mainstream media, most mainstream media.

And you know, those who those who are gender critical are vilified. I mean, I think this I mean this is the medical scandal of our lifetime. It's worse than lobotomies, because that there was some evidence for lobotomies minimal and it's bad evidence, but there's no evidence that that chemical castrating children is a good idea. Because you know, the idea of informed consent, yeah. So informed consent means you have to be able to understand the information to make an informed choice to have an intervention. So if you're giving a pre-pubescent child chemical castration, which then leads to cross-sex hormones and surgery, that child hopefully has never had been sexually active or had a sexual orgasm.

The risk of gender reassignment is they will never have an orgasm. No child could consent for never having an orgasm as an adult and never being able to have a child. They can't have a child. I mean the other the other way of looking at it is if you're a parent who has facilitated your child doing that, it must be really difficult to doubt it, because then you realize what you've done to your child or allowed to happen to your child.

That would be terrible.

So so you have to buy into it really, you know. Um so yeah, that's the biggest medical scandal, is why why we're doing this to children. And you know, in my book, D Trans, there's there's chapters by detransitioners, and um, it's horrific. You know, that they're they realize what what had been done to them. And you know, the um there's there's chapters by Richie, who's very open, he's on the internet, and and you know, he he talks about all the difficulties he Had is with various mental health problems, which as soon as he said, Oh, I think it's my gender, was totally overlooked.

He was just sort of the gender clinic. It was totally the wrong thing for him. And now, you know, he's a young man. Now he goes, he's got to go through his life with his body he hates, and that's the bit you never see. So that's the you know, that's that's the bit that aren't allowed to get into the mainstream media.

How important is uh how we grow up and um and and and also the identity, uh, you know, is it is it something we're trying to identify ourselves with, with one or the other gender? Uh I mean being being artistic, how how important is the the identity and growing up?

But I think if if you're growing up, and I think it's totally fine to be and do whatever. The problem is when people tell you that that's not allowed. You know, I think I had like 26 dolls as a child. Like, it doesn't mean I was a girl. So it you know, you you so I think anything the child does or is fine. You know, if he wants to wear a fairy costume or she wants to be a tank driver, or it's fine. That doesn't mean they're wrong. You know, they're the wrong sex. So I encourage my patients to be more subversive, you know, just be a little more creative and just expand the repertoire of what and the rules don't exist.

So anything you do is fine. The rules don't exist. That's a social construct. Anything you do is fine. So it's so from a parenting thing, it's to allow everything without inviting them to think that there's a problem. So I've got friends who say that that um their children who may be, you know, a bit tomboy or a bit camp or whatever, are invited by the teachers. These are eight, ten-year-old children, invited to consider whether they should be trans. Because the teachers have been brainwashed. So a teacher's saying to a child, Do you think you should be a boy? Because you like football and this, that, and the other.

And they're implanting these ideas into the children's head. You know, that's what I'm saying. It's like tr it's like Munch Housing by Proxy, trans housing by proxy. You're creating problems. If you just leave the children alone, they're fine. We we know there was an unfortunately titled City Boy study in 1977-76 by Professor Green, who showed that actually most people with most children with gender problems grow out of it. Fine. But if you make it officially a problem, then it gathers momentum.

Yeah, I think now about other cultures, for example, where it completely denied. Yeah, so there is only male, female, and that that that's it. You cannot be gay, you cannot be.

Well, sexual is different because sexuality you don't choose. You know, you fancy what you fancy. And um, which brings me on to perversions and transvestites. So I've talked about transsexuals. Transvestites, so they get some excitement by temporarily living in the external vestiges of the opposite sex. So the vestiges may be clothing or they may be women's spaces. So they don't they know that they're not women.

Yeah.

It's a bit like they're the short-term rental rather than the the the buying. They don't want to buy into the body, they just want to temporarily reside in it. And um there was everyone always says it's very old-fashioned. There's the lovely paper, 1976, by psychoanalyst in the Portman Clinic, Moving Lasser, uh, analysis of the fetishistic transvestite. And he described that the typical situation. I mean, everyone's different, but this does exist because I've had loads of people who fit this description, where this um a boy has had a very smothering, overpowering mother, claustrophobic, you know, mother, who then as an adult finds that he can get some sort of confidence, power, and excitement by putting his mother on and taking his mother off.

And there's a there's a there's a certain group, they all they always look like um sort of hyacinth bouquet when they turn up. They look like sort of middle-aged sort of rotary club sort of um, you know, um, but they and they they very much describe this thing of putting mummy on. They don't talk about mummy, but they but when you track back, and I had someone who so the the core of all sexual perversions is trauma. You know, we we we you know we we come off trauma all the time in various things, but um if something horrible happens to you, there are different outcomes.

Either nothing, or you're a bit upset by it, and then you're okay afterwards, or you get something on the PTSD spectrum where because the data is so difficult and horrible, you can't process it, it keeps returning again and again to a data processor, and it's manifest as nightmares, flashbacks, and you have the typical PTSD response. A rare option, I say option, you don't choose it. A rare outcome is for the trauma to be triumphed over by sexualizing it.

And that's what a sexual perversion is. Every sexual perversion can be tracked back to a trauma which has been sexualized. And this is beautifully depicted by um have you heard of Dennis Nielsen, the seal killer? So Dennis Nielsen was this otherwise boring man in North London who when he was a little boy, his closest person was I can't remember his uncle or his grandfather, I think his grandfather, and um he grandfather died when he was like six or something, and he was he was taken in to see him lying in state, dead.

And that that was traumatic fain. And then as an adult, he picked up some bloke in a bar, took him home, and when the when the man was was laying emotionless sleeping, the the whole trauma of the grandfather came back, but it was exciting because he had it in a it he had he was in the company of this and he just wanted that to last forever. So he killed him, he left him there. But when he started rotting, he had to then get a new one, and get a new one. So he so if you've got a strong constitution, I would strongly encourage you to read his biography, autobiography, which they only allowed to print a couple of years ago after his death, because they didn't want him to get, but it is a wonderful example of um how trauma can get sexualized into a sexual perversion.

So his his his career of like one previous biography called it Killing for Company was he he had this sexualized thing about inanimate people who are dead. And there are even scenes in the book which you think you're reading a love scene, then you realize it's actually talking about a corpse.

Does it matter what type of trauma someone experiences?

Yeah, so so for every for every person with a urine fetish is someone who's wet themselves embarrassingly as a child. For every, you know, one of my colleagues, I specialized in gender and and trans stuff. Um, one of my colleagues at the clinic, there's only about 10 of us in the clinic, one of my colleagues specialized in um shit fetishists. And um, you know, she'd have people who would fill a bath with feces and then immerse themselves fully and then have an orgasm. Every coprophilic is the correct term. For every coprophilic, there's someone who has soiled their pants at a dinner party as a child and were humiliated, but they've sexualized it.

And the transvestites, there's some sort of trauma, but it's it's sexualised. So the one of my patients was a man who dressed up as a transvestite, and he was a man, quite a bad transvestite, but that was also important because the bad transvestite often wants to be humiliated because there's a sadomaschistic thing. Um, and he and his partner had this um double latex contraption, two sheets of latex. You put the vacuum cleaner onto it, and only when he was cross-dressed in this latex chamber, asphyxiated, would he have an orgasm.

Very unusual, that's it. I mean, he's not like, you know, how do you find anyway? So that's what he was doing. But when you take a careful history from him, when he was, I think he was nine, when he was nine, he he um went into the kitchen and found his mother dead with a head in the oven, having having gased herself. So you've got the the the trauma of a of a of a dead mother which gets sexualized into a transvestite trans transvestite auto asphyxiation fetish. And you can see how that so for every, you know, if you if you take a detailed history, for every perversion can be tracked back, and by perversion, I don't mean people going to Ann Summers and wearing furry handcuffs.

I mean something which they realize is bizarre, but they can't help it. They they they're they they're drawn to it more than anything else.

And how would you work with these type of uh patients? Um what type of treatment do you offer and does it help?

I'm not sure it does help. So the clinic was purely an analytic clinic, it didn't offer anything else. But, you know, as they recently found with sex offender treatment programs in this country, they didn't work. If if your sexuality is fixed, you can't, you know, you can't like we found that out in the 60s and 70s. You can't give uh gay people therapy to make them straight. You know, you can't. So, you know, if you unfortunately, I mean, one of my one of my colleagues um ran a group that was on the surface quite controversial. It was a group, analytic group for victims and perpetrators of child or sexual abuse.

So, not children, but adults who'd been abused as children, mixed in with paedophiles in the group. And people say, How could you do that? This is this is how awful to mix uh adult child sex abuse victims with paedophiles. As she said, every one of the perpetrators was abused as a child. And what we found was that the the sexualization of the trauma of the sexual abuse they'd had resulted in their sexualization of children. And I'm not saying that everybody who's been sexual abused becomes a pedophile. I'm not. It's it's it's it's one option for the trauma. Most would just have the other options that I said, of PTSD or whatever, or nothing.

But for some people with a trauma, it's sexualized. And that's when you get so you know, for every paedophile, you can probably find a victim of childhood sexual abuse. And we found that the median age was nine in terms of the the age of the person that they were attracted to or the age that they're abused. So it's, you know, so ever every perversion can be tracked back to trauma.

I mean, I clearly didn't know about these things. Most people don't. Uh most people don't. You have been working with them. So what do you suggest to to the parents or to the individuals?

Uh I mean the idea of that therapy is by having an understanding as to how you got there might influence your relationship to that perversion. But I'm not sure it did, you know. So um, well, I think it does sometimes. Like my transvestites, they they, you know, once they understood what they were doing and what then, you know, once they were clear that they weren't bold the wrong body, the worst thing you do is a transvestite have a sex change because you don't really want the other body. So, you know, they they know it for what it is. And societally it's really unusual because now we just call them all trans.

It doesn't matter whether you're transvestite, drag queens. And, you know, I had someone with quite a high high-powered job, and he was clearly a transvestite. He thought he was transsexual, but we ascertained between us that actually he wasn't because he was very happy with his penis.

But is this identification now I'm that or that? Does it does it matter for them at the end?

Or is it just well no, but I suppose it does because you don't want them to have bits chopped off if they really shouldn't have them chopped off. Yeah, so you know, this this transvestite, part-time transvestite, part-time, because you know, he's just like it was like it was like me having a cigar, you know, some uh or me having a you know drink or something. His his tipple was to dress up as a woman in his home. And then he one day he said, Um, oh, I've told I've told everyone at work, I've told the company, and he's quite happy in the company, and I said, What what did you tell them? Because we're only just working it out ourselves. And he said, Oh, I told them I like um that I'd like um I'm trans.

And they said that um I can come to work one day a week as a as as Mary. I was going, why? He said, Oh, because I like it. And what happened there was very perverse, because even though we'd ascertained that this isn't because he's going to have a sex change, because he thinks he's a woman, he just gets off on it. So what he'd done was he had said to the company, I'm trans, which is very vague. Their understanding is, oh, you believe you're the opposite sex, you're going to have a sex change. Okay, well, you we can facilitate you coming to work sometimes as a woman. They were thinking it was transsexual.

Actually, it was just he was, you know, he was sexually excited at work.

Yeah.

It's a bit like someone saying, Oh, well, you know, um I get turned on by um, you know, flashing being naked and and being allowed to go to work naked once a week. You know, why would you, you know, it's it's when the person's clear that they're getting off on it, but they say, I'm trans, the understanding is, oh, well, you could have a sex change, we'll facilitate it. Which is why the, you know, the the hoo-haw about um literally getting their knickers in a twist, about the not being allowed into women's toilets and changing rooms, trans people. I mean, you know, give women their spaces, allow them to just women.

Um if you if if you read if if you were trans and don't want to go to the men's, it just gives the disabled. There's always a disabled day, you know. But the but the the massive uproar about no, I demand, I need to go. Go back to transvestite. The vestiges can be the clothing or the spaces. No one gets that bothered or that excited about going to women don't get excited about going to the women's toilets, you know. But but you see various videos on Twitter of like all these excited transvestites going, I'm in the ladies, filming themselves. And you know, it's it's too much of an exciting day out for it to just be going to the toilet.

So that's another example of the transvestism, the vestiges of women that they've got into and it in this almost like a rapacious thing. They've got in without consent and they're uh luxuriating in that in their achievement. Do you think across history this has been increased? Again, it's been a solution for different problems. So if and and you know, also in the in if you look at other cultures like the Middle East or other cultures where it's societally almost incompatible to be gay. So um it's it's you know people are having sex changes in order to not be gay, you know, not because they think they're women, but because they just want to survive and have relationships with the same sex.

So that that is a thing in the Middle East, and that's the thing in various cultures. And I had a patient who grew up in you know 1960 South Africa, and his mother said to him, There's no way you're growing up in South Africa being gay, you're having a sex change.

I mean, clearly you come out of your own experience working with this, but when we think about the society as as such, um to come up with solutions for for let's call it a problem um of understanding what what uh transgender go through and and how we should address that. What are your suggestions um to to have like an evidence-based uh decision uh base?

I think if you have a child who's confused or worried or upset about an aspect themselves, the normal thing is to say, really, what tell me about it? That you know so um you just want you just want them to have a warm, empathic, nurturing, inquisitive person who can help think with them about it. You know, it's it's you know, you can call it analytic therapy, but actually it's it's just you know, it's just normal common sense. And I teach medical students and I say I I I say to them, look, if your little brother comes in to you and says, Oh, I think I'm actually um a girl, what do you what do you say?

They they and they say, Oh, I'll say, how long? I said, No, you don't. Really? What do you really say? What you really say is, what do you mean? What on earth are you talking about? What do you mean? You know, that's the normal thing to say. That's basically what I was saying to them, you know. There's this thing called affirmative therapy. It's not therapy, it's collusion. So if a child says, Oh, I think I'm a penguin, they go, Oh, yes, you are a penguin, yeah. And they collude with the with the false notion. So it's it's a misnomer. It sounds good, affirmation sounds good and positive, but it actually just means collusion. And because it's called therapy, people think it's a good thing.

Whereas normal therapy, which is really, why do you think you're a penguin? Or really, why do you think you're a girl? So what is a girl? That is erroneously called conversion therapy because you're not confirming the you know, when when we have depressed people who say, I really should be dead, my life be better I'll be dead, we don't go, yes, you're right. Or when we have an anorexic who's who's really skeletal and they think, I'm fat, I need to lose weight. We don't go, oh yes, we'll help you do. No, we don't. We challenge we're comfortable in challenging some things as psychiatry, but we become petrified of challenging other things.

You are a trained psychiatrist and psychotherapist, you are the expert in in challenging this, but as a as parents and siblings, that's uh I suppose what I'm saying to parents and siblings is be normal.

So so retain being nice, warm, empathic, understanding, and caring whilst being curious. And what I say to people is um rather than getting into a yes you are, no, you're not situation, yes, get into a okay, well, I can see how you've come to that conclusion, but because I I haven't got there yet, can you show me how you got there? Yes, you know, so it's you're I don't understand how you're asking them to help you. Yeah. Yes or no? So help helping you as somebody who doesn't get it, help help you to get it so they can teach you. So you're just that's what you want.

You want them to explain how they got there. So rather than go into a no, you're not real boy, shut up. You can go into a my god, really? How did you get there? So just help me understand how you got there, and then they'll show you they're working through. And what what I find really interesting is sometimes you have people who came to that erroneous conclusion as a child, and then they're locked onto that as a as a correct answer. And then you see them as an adult, and they haven't revisited it. And because nobody asks them. Nobody asks them. They just say, Oh, really, that's nice. They say, What are you talking about? And so when I then go, Okay, well, fine, explain to me how you got there.

And they come, and but because they were like 10, when they they come up with this 10-year-old operating system way of thinking, therefore I was a girl. And they um just by them explaining it, you can see how they realize I haven't revisited this, I've just stayed with the solution. I haven't actually revisited how I got there. It's a big topic.

I think we are not going to solve this now.

The thing is, I was I so I was the first openly gender-critical psychiatrist in the UK. And um I was I was I was writing about talking about this 25 years ago, way before it was fashionable. And it's just now that it's a big thing that you know. But I I've been saying this for 25 years.

And college going, why you why why do you think has this has your view changed over these decades?

It's become more nuanced. So at the beginning I I had an um a proxy understanding, but then through the work, as always, in any field, you get informed by more data, more patients, more patients. And I was taught everything I think and understand by my patients. You know, you you read papers that are written years ago by clinicians who've seen one, two, three, four, or five patients, and they say, it is like this because of this. And once you once you got to patient 100, you realize, no, actually, that you didn't see that many people. The more you see, the more complexity you see, and it refines your understanding.

So I owe it to my patients for what I understand, because that they've taught me.

Yes. What do you wish to happen?

What I want to happen is for people to be able to go back to thinking normally. So not medical schools teaching that there are a hundred genders. Not saying that not saying pregnant people, not saying chest feeders or cervix owners, you know, allowing women to be women and men to be men, and that people can. Have various presentations. You know, like I said, when I was a goth, I probably looked like transvestites, but I wasn't trying to be a woman. So allow people to look how they want to look whilst not being uh not colluding with false solutions.

What type of clients do you work with today?

So completely different ones. So having gone having worked with rapists, murderers, paedophiles, and and then all the complexities of gender, um now I see people who are very much like me. They are middle class professional people with um anxiety, depression, trauma, but not sexualized, um, and OCD. And most of my patients have got burnout.

Yeah.

So they're hardworking people who work, sleep, work, sleep, work, sleep, often not much sleep. And they do that because they think they have a they haven't got a choice. And then they just implode and they come and see me. And it's a bit like when I was a child watching Formula One on television, and I was thinking, why is that car having a pit stop? He's wasting time, he's being overtaken. Then you think, well, they need pit stop because otherwise they go. It's a bit like our patients are hard-working professionals who don't give themselves pit stops, and then they implode.

What what are the moments or what what happens exactly when they implode?

The erosion of your resilience results in your your bar, what you can tolerate, put up with your resilience becoming really low. So before you know it, the slightest thing overwhelms you, and you're emotionally exhausted and physically exhausted. You've been functioning on adrenaline and cortisol, and even those are sort of like a struggle, and that's when you reach rock bottom. And um you know, I I was I was speaking to someone this week, and she's a young person, and she says she leaves work, leaves work at 2 a.m.

Sometimes 4 a.m. Goes home and has two to three hours sleep and then goes back to work. How can you function? Well, that's what I was trying to ask her. And she said, No, I need to do it. I said, Well, you can't. I said, you you'd be more efficient if you were to get more sleep. You know, the the less sleep you have, the less efficient. She said, No, no, I take more time to do things. I've got ADHD. It's like, well, it would be better if you actually you know, and the so there's a perceived need to do things that way. And uh one of the one of the bits of advice I give all my patients is um watch minus TV.

Because all my patients who are like hardworking burnout people, they think lazing on a sofa watching minus TV is a waste of time. It's not. When you go home, if you just work, eat, sleep, that's a recipe for burnout.

Yeah.

What I say that the the best thing you can do is always have at least one and a half to two hours of minus TV before you go to bed. Always. It doesn't have to be doesn't have to be TV. It could be anything like anything where you're not taxing your brain, or so so your your brain's on, so it's not asleep, but it's not having to think about anything. So if someone says to you, What did you do last night? I watched TV, what did you watch? I can't remember. Great, brilliant.

It could be music, watching a podcast, or uh yeah, I just call it minus TV. Does it matter what we watch? No, horror movie, or again, very as long as you as long as you're not having to think too much.

You know, because you you need that, you know, you need that sort of gradual unwind of mental decompression before you go to sleep. You'll have a better sleep, better quality sleep, and you'll you're much less likely to have burner. So I I encourage I encourage all my patients to watch Mindest TV. If you watch Mind TV all day and don't do anything else, obviously that's not a good idea.

What do you do personally to uh not accept watching TV to stay in balance?

So I think it's really important to have a life work balance. So I I I work and then I don't work. What I don't do is work, work, work, or check all my emails, say that I'm quite disciplined. And um and and for me, I punctuate it by things like going to the gym or personal trainer. So you know, I got personal training five times a week. Um, and for me, keeping a degree of physical health and fitness is essential.

Um, and um switching off. So I'm probably prone to having a cigar and a small whiskey after work. I shouldn't say that, should I? That edit that bit out.

That that's that's your way of keeping balance.

Um well I know after that I'm not going to do any work. And there's Buster. Yeah. And what I say to people is apart from watch more TV, is be more dog, and especially be more buster, because he's not troubled by the past. No, he's not a good thing. He's thinking in the moment, and he's also not worrying about anything, but he focuses on the important things which are the important attachment relationships in your life.

I will have this as a mantra be more a dog. As thank you very much for taking the time and joining me here today for this uh interesting topic. I hope it was racy enough. Yeah, we can have another session, probably. Thank you so much. Thank you.