Transcript of When Life Falls Apart: How To Break Old Patterns, Rewrite Your Inner Scripts, and Find Purpose | Dr. Suzan Song

But that, of course, is not how the world works. And so my guest today is going to talk about how we can have a different relationship with uncertainty, with change, which all ladders up, of course, to resiliency. My guest is Suzan Song. She's a Harvard and Stanford-trained psychiatrist, and she's got a new book which is called "Why We Suffer and How We Heal." Dr. Song, welcome to the show.

And I was sitting in hiding in this room in Burundi, and I thought to myself, like, how the hell did I get here? I am a Korean American woman, now in hiding for my life from former child soldiers in a small country that nobody really knows. And the first realization that I had was, oh, it's Dad. So when I was 15 years old, my family owned a liquor store outside of Baltimore, and one of the robberies had gone too far.

So my father was assaulted. He was carjacked in an attempted murder, and he later died. So as a teenager, I didn't really think it affected me that much, honestly. This was a time when I didn't go to therapy. I didn't really talk to anybody about it. You just kind of keep going. And the thing that I knew I needed was just stability. Like, I needed to keep my grades up, to keep doing my activities so I could get to college, and just keep working and achieving.

And that would lead to a very stable life that would protect me in some way from what I don't really know. And so I did. I worked my three jobs. I went to college, med school, grad school, all the things. And it really wasn't until this almost two decades later that I'm in Burundi, and I realized I had essentially recreated another scene of violence. This time it was towards me. And so now I would have the ability to stop the violence, to have a different ending.

And I think that really led me to a lot of this work and trying to understand, like, what is it? How do we people actually not just thrive and not just survive, but how do we engage in the world? Like, what happens to us after we experience major instabilities, and how do we connect the dots of all the experiences in our lives to create something of meaning and understanding?

He, what I found out actually only recently in writing this book, I had always thought that he was murdered. When I was writing this book, my agent actually said, you know, "Tell me more about your father." And so I went back and I started looking up if I could. I mean, he died pre-internet, so I was trying to find anything I could. And I found this small Baltimore Sun article, and it gave me the dates. And actually, his attempted kidnapping was a full year later before he had actually passed away.

And I thought he had died immediately. And so I asked my mother. I said, "How do you make sense of this? There's a whole year gap in between." And she said, "No, no, he came home after the assault. He lived in our house. Like, you played violin for him. You made dinner for him." Now, I did not remember that entire year. That's all out of my memory. And so the memory, like, our brains do something very protective for us. The problem is, is when we never really address what had happened, when we have these fragmented stories, these fragmented narratives, and we don't have a way of understanding what's happened, it has a way to repeat itself.

That same theme will repeat itself, subconsciously, unconsciously, in the future, in other aspects of our life. So for me, it was recreating another scene. But this happens all the time. You know what? It's not uncommon that I'll have someone who comes and they say, you know, it's a woman who says, "I will never marry anyone with an alcohol addiction because my father was an addict, and I don't want to deal with that." And so she marries, and the guy is not an alcoholic, but it ends up that he has a work addiction, and she has the same feelings, and she's trying to win back his love in the same way that she did her father.

Right? We all have these patterns. Even in the workplace, this happens. So I was working with someone who is kind of C-suite, and this is her third job where she's second best. And I asked her, like, "What is the pattern here? When's the first time you experienced this being second?" She kept saying it was second best. And her brother had an addiction when she was growing up, and so the family always focused on the brother. And so she always felt second best. And now here it is, playing out in her workplace. So it's these patterns that we have, and we don't quite understand them, as I didn't understand the relationship between Burundi and my father.

We have to sit back and actually even, like, map out the experiences to say, like, "Is there a pattern here? And what's driving that?" And oftentimes it's this repetition compulsion.

And so the problem is, is that that rarely is the case. We never really get the outcome that we're wanting, and it just repeats itself until we cause awareness. We bring the unconscious to the conscious so we can say, "Okay, there is a pattern here. Let me pause and think about this."

How can I be in this relationship again where I'm married and it's, like, someone with an addiction?" I told myself I would never do that again. And so we say, like, "We're tired of all these life instabilities." But actually, it's our brain wanting to not have a predictive error. Our brain is wanting to know, like, what is predictable? What can I control? What can I manage? And so it's going to keep giving you the same lesson, and you have to just learn it at some point.

And yet we want it so badly. How do we explain this tragic mismatch?

And that is the social narrative that we're all absorbing so that if success is stability, it's supposed to protect you from the major life challenges. And of course, we know that's just not the case. But if that's the foundation, then anytime some major disruption happens, like illness or divorce or our kids aren't doing well, we almost want to get away from it as fast as possible. So we want to just get over it and just keep on moving and just go past it.

But then we miss this opportunity to really say, "Well, wait a minute. What is our natural way of engaging with hard things?" Like, we all have very individualized ways of coping through things. So what is that for us? Because if we learn that now, that will help us the next time something major comes along. And it will. So I think the more that we understand that stability really is an illusion, the more we can take a step back and say, "Okay, given that, how do we actually engage in the world?"

Like, I work with refugee camps, and I'm always surprised because people can be displaced and living in a refugee camp, they can also love, they can laugh, they can learn new skills, they can contribute to the community. So how is that? They're living in these times of chronic instability and unrest, and yet they can still engage meaningfully in the world. Like, I think that is beautiful, and I think it's very compelling. That's actually why I wrote the book.

Like, how were they able to do that?

And at some point, there was an eight-hour ceasefire called, and everybody went shopping. It's like the urge for normalcy just reasserted itself in such a powerful way.

Right? It's this disconnect between, like, where our reality is and what we want our life to be. And normally, we want our life to be stable because then we can control it. We can predict what's going to happen. And as we see right now, I mean, look at right now. We've got, like, AI threatening everyone's jobs. We have climate crises, political turmoil going on. I mean, we are living right now in times of chronic unrest. And so I often find myself saying, like, "Oh, I can't wait for life to be stable again."

But then we, like, put off living. Like, we can still learn to engage in the world. And so these examples, like, of yours and these war zones and the people I've worked with, I don't know. I feel like if you want to learn something, you learn from the most extreme. And these are people who are living in some of the most extreme settings possible, and they're still able to thrive and engage.

And that suffering is oftentimes the gap between what's going on right now and just what we want. Like, the world is not as we want it to be, and that's causing the suffering. And that should hopefully give us a lot of hope because it means that we have a lot more agency in our suffering. I think so many times we think, like, our despair is just, "Oh, things are so bad, and that's just how it is." But actually, we do actually have a lot of control over whether or not we suffer.

Insight isn't enough. We need something for behavioral change. So the rituals come in because rituals embody our insights into practice. They give us movement. They connect us to ourselves. They connect us to people across time and space. And then purpose is what gives us direction. So purpose is something of meaning that's larger than ourselves that tell us how to use our time, our resources, and our energy. And I call them the three friends because one of the things that I've learned in my work abroad is that healing is relational.

It's not like, Americans, we're very, very individualized in our suffering and in our healing. Like, if someone loses a loved one, they get a week off of work. They're told to go talk to a psychiatrist or a therapist, do a one-on-one insight therapy, and then to come back and to be productive, like, be good now. And it's very individualized. What I see in other contexts is that healing is very much relational. It's through a sense of belonging.

It's through being needed. It's through mattering to another person. And I think we lose out on some of that. The three friends of winter in and of itself is an Asian art motif. They're bamboo, pine, and plum blossom. And so these are these three very hardy winter plants that thrive in the harshest of environments.

Like, we can tell a different story that's more empowering?

I feel really guilty if I take that time for myself. Like, this is extremely common. And so that's hard because the narrative that she's telling herself is she understands the logic of it. Right? I know that I need to take care of myself in order to take care of my child. She understands what she needs to do. Like, I know I want to go to the gym or have an hour break for myself. But the guilt is getting in the way. Well, what's that guilt about? And oftentimes, it's this internal script that she has absorbed from culture, from society, from the way she was growing up about what a mother should, what a good mother should be, what she should look like, how she should act.

She should be self-sacrificing. That's like martyrdom of motherhood. And so that internal script is running her life. It's like someone else wrote the script for her, and now she's playing it out, and she's confused because it's not working for her. We all have these internal scripts of what does it mean to be, you know, good at work for me? Like, what does it mean to be a good physician or a good, you know, parent? And once we understand what our internal scripts are, then we can say, "Okay, is this working for me?

Is this what I really think? What do I think a good mother should be?" And we can even, like, write that out to start rewriting some of the narrative to reclaim some of our own actions and our own, you know, values and beliefs.

And what is that role? We write it out. So maybe it's, you know, worker or whatever it is. We write that out so we can start to understand what is this role about? Who wrote this? Where did I get this from? And what do I want to be like? I mean, we think about who am I, but who do you want to be? And that will give us some direction to how we want to live our lives.

So people who believe themselves to be very good at the technical aspect, and they didn't think they would be very good managers, of course, they had a really hard time leveling up there. And so even if they took the job and they wanted the job in the managerial position, they kept thinking, "Well, I am known as being good technically." And until they rewrite the script and say, "Okay, I can actually be a manager," but then they iterate and they try it out.

They try different things, and you say, "Okay, well, this is working. This one's not." And so it's this iterative process to changing how we behave and changing our roles and responsibilities in that identity.

Right? At the same time, I was working and living in these other countries and contexts where there are no therapists. Right? Sierra Leone, Liberia, Burundi, they all have, like, one psychiatrist for the whole country, and there are no therapists. There is a lot of suffering there, but many people are doing okay. So how are they healing if they don't have the same relationship with their thoughts and they don't have therapy as the main intervention of healing? And that's when I really realized that when we get outside of ourselves, because people that live in these, like, relationally interdependent communities, their identities and their self is defined not by the individual.

It's defined in relationship. So if I go to, let's say, I remember I was going, I was doing this evaluation in Sierra Leone, and I ask people, like, "How are you doing?" And they say, "Good or bad?" And I say, "Okay, like, really, how are you doing?" And they'll say, "Well, I'm bad because I can't get a job for my family. I can't provide for my family." It's all in relation to their roles. And here in the U.S., I think we're very focused on our thoughts, our feelings, our experiences. That's not necessarily the same case in many, many cultures around the world where, yes, they're still ruminating, and they still have thoughts that they're constantly churning in their mind, but it's not as much of an evaluation.

Like, we do a lot of self-evaluation. It tends to be pretty negative judgments. So there's still rumination, but the content is very different. It's very focused on outwards, on other, because the whole concept of self is enmeshed and embodied in another.

These are all questions that get outside of our individual experience. We still acknowledge it, and we're not ignoring it. We're just also bringing in a whole nother community, like, a whole nother sense of our identity as being connected to humanity at large.

But an equal question I think we need to be asking is, how is a person living? Because I know plenty of people that have mental health symptoms, depression, anxiety, and they're also able to love and to belong in a community and to engage and participate at their kids' school. Right? And I know a lot of people who have really no mental health symptoms, and they're isolated, and they can't actually engage in the world at large.

So just because we're feeling better doesn't mean that we are being well. Right? There's a difference there. And so the more we can take ourselves out of ourselves and remind ourselves that we are part of something larger, and we actually get a lot of healing and kind of agency when we embed ourselves in other relations around us.

And now you have thousands and millions of neurons, like, playing tennis with each other. They become more efficient. And there is a saying that's, like, the neurons that fire together, they wire together. So the more efficiently they play, the more easy it is to retrieve and recall this memory. But if you and I are playing tennis and I just had an argument with a friend or I felt sick the night before, I'm not going to play as well. And so all these external factors are going to affect how I remember, how I recall this memory.

In the same way, when we're all telling a memory of something that's happened, yes, there is the true facts of the event of what happened, but there's also the story and the emotional valence we put on the memories that change constantly. And so memories are this process of reconstruction. They're very suggestible. And so this is why so many couples are arguing of, like, what actually happened, right? Or in the workplace, like, people are fighting because they don't remember the same event in the same way.

And that's because we all see and remember stories that are aligned with what we need to be true. And sometimes that's really hard. That's one of the things that really gets in the way of our ability to rewrite a narrative or to engage with a changed memory is that oftentimes we need these narratives to be true. And if there is some new information, either a memory or someone telling us some feedback that we don't really like, it threatens our sense of self, of who we know ourselves to be.

That's really hard. It's hard for us to change our and update our narratives.

And then when we get tired of that, we then defend ourselves. And we say, "But also, I've been really busy at work," and I have all these things. And we go into, like, what's happening at work now to deflect. So what's happening is, one, we might have the memories of the past that are coming into play, and we also then have the sense of the information that's coming at me is threatening who I know myself to be as a good partner. There's this late psychoanalyst, Selma Freyberg, who had this coined this term that I love.

She said, "A mother cannot hear her child's cries until the mother's cries are heard first," something like that. And it's really that when we're feeling threatened, when our core identity of who we are, the stories of who we believe ourselves to be, when there's a threat to that, we are not able to hear it. We can't update that. We can't change our story until we're feeling safe and protected in that.

So what we do, and I call it the porcupine, like, these porcupine quills go out. And so we want to attack or we defend or we blame the other, all because that soft underbelly is really vulnerable. And so the more that we can go to that underbelly and we say, "Okay, look, I know you're a really good partner." Right? This is where the validation comes in first. We validate what is the story that they need to be true about themselves. We validate that.

"You're a good person." And then we ask for change. This is a whole dialectic, right? Validate, and then you ask for change. And I think that's kind of the prerequisite from in order to, like, help someone change their own stories.

The driver of repetition compulsion are the feelings that were never dealt with. They're the feelings that were pushed under the rug: helplessness, vulnerability. I didn't have power or control. I felt unloved. Those we need to pull back because that's what's actually driving the repetition compulsion. So we identify the pattern. We identify what the feelings were that were completely ignored. Once we bring it to light, it starts to lose its power.

And then we sit with that emotion, whatever it may be, and we say, "Okay, I was so scared of it before. That's why it has so much power over me." But now, with almost like exposure therapy to the emotion, well, now I realize I have more control over it. I'm not dying from this emotion. And then we can say, logically, how do I want to engage with this pattern? Do I want to break it? And if so, how?

So in my work, for example, you know, let's say with this woman who is now married to someone who has this work addiction. We can say, "Okay, what's the pattern? What were the feelings you're experiencing with it? Now feel the feelings. You have control. So you're diluting the power of that. Now what do you want to do?" Right? "How do you want to engage in this?" It doesn't mean she has to leave her husband. Right? There are lots of different options there. So she can talk to her husband and say, "Hey, I've noticed this pattern in me, and I'm having a hard time with it."

Or she can say, "I want a different type of relationship." In her basket, she can put out all these different possible solutions. And just expanding that is a way of breaking the cycle. And then she gets to choose one and try it out and see what happens. When we bring it to conscious awareness and we say, "I'm going to intentionally deal with this," it starts to lose a lot of power.

It doesn't seem like it's relevant to my life.

Steph Curry does a tunnel shot before his games. Like Serena Williams, I think she bounces the ball five times before her first serve, two times before her second serve. Like, these are all just rituals that help us find more control, predictability, and they regulate. So they can do, they can help with emotion regulation. They can also help with emotional scaffolding during the times when things are just so hard we can't think through anything. We think about losing a loved one. A lot of times when we've lost a loved one, time stands still.

We don't know what to do with ourselves. Like, where do we go? Who do we talk to? What are we supposed to be doing? So most every culture has some sort of ritual around how to go through the grieving process. And that ritual is important because it connects us to others. Kind of it's this community telling us, "Okay, we're all in this together. We've all experienced loss before." And also, it helps to guide you when, like, we really can't think about what to do.

Rituals can also help us when we reintegrate into life. So let's say either it's after a divorce. Like, I think after a divorce, so many people go off and they have their new rituals or hobbies that they do or people going through the change of retirement, right? Like, sometimes we need some kind of a marker to ritualize that. Or people returning from military service, they need to do a ritual to help them kind of engage. Even in my work sometimes, the days are hard, like dealing with kind of, you know, torture survivors, hostages, and also, like, CEOs.

And it's just a very emotionally complex day. When I then go to see my kids, I need a ritual for me to reenter that home life. And so I, before I go back home to see kids, I do a 10-minute walk. I don't think about the day or about what I need to do. It's just I actually think about, like, draining my head from my brain to my toes. And I imagine just, like, flowing out. And I wait until it used to be a bucket.

Now it's a big swimming pool until it's full. And then I go back home. And that's my ritual just to reintegrate back into my normal life.

How do you mark the beginnings or the ends of things? Like, we have so many rituals or we used to have. I think we're in a ritual deficit right now, our society. But rituals are so important in just regulating all of us, our society. And because they connect us to other people, they remind us, they embody all of our insights, our values, our beliefs. So they're really useful for our society in just kind of grounding us in our home of who we know ourselves to be.

So if you want to include more rituals in your personal life, I think think about where are the transitions in your life, either the daily transitions or over time, and what do you want to do for those? Right? So I work with college kids. When school is out, the last day of school, do you want to have a ritual that kind of marks the end of, you know, a good academic year and going into the summer?

It's around being needed. And oftentimes, I see people when they're at the peak of their career, they've already accomplished all the things, and then they come to me and they say, "You know, I just feel really dissatisfied. I'm not sure why. I mean, I've accomplished all these things," and they can still accomplish more goals. All they do is, like, set a goal. They'll reach it. But they'll say, like, "I don't feel fulfilled." And that's because they've lost their purpose. It's not that they didn't find it. Most people are already living out your purpose.

So if you think in your life, like, where am I feeling resonant in the world? Like, where do I have coherence? Where am I just, like, vibing with the world? Where are my thoughts, my actions, my values? They're all in alignment with what I'm doing. Maybe it's like you're in the flow of something. That's going to give you some signal to where your purpose is. So maybe it's someone at work who's, like, working on a meaningful project, or it's when you're volunteering at your kid's school and you're just like, "You know, this feels really right." That's a signal to your purpose.

And then we can ask ourselves, you know, sometimes our purpose is through a corrective experience. It's needing to repair something of the past. Also, not uncommon to have someone who grew up in, like, relative poverty and their life's work is working for, like, a very mission-driven organization, right? It's like we're trying to repair something we didn't get in our childhood. You know, the person who grew up with very critical or unemotional or emotionally unavailable parents, their purpose in life is to make sure that their child feels listened to, that they're attuned to their kids, right?

That's their life purpose. It's this corrective experience. And then we can ask ourselves, "Well, gosh, who do we matter to right now?" And if we answer that, that's probably telling us something about our purpose. And if that's not who we want it to be, we can say, "Well, who do we want to matter to?" It doesn't have to be one person. It could be a community or a culture. Like, where do we want to make a difference? Where am I needed in the world? And I tell you that, especially for older adults who are dealing with the loss of the structure of being needed, like in a job, let's say, or the grandchildren have grown up now and they don't need them as much, it can be very, very hard to lose that structure of meaning and of being needed.

And so when we can insert that and say, "Okay, where are you needed?" I have seen that save a life, right? That really can be so powerful just to say, like, "You are needed. You belong here."

So I don't know how to explain that. And then also tons of trauma around being at summer camp and feeling trapped and abandoned. I needed my parents and they weren't there and I couldn't get out. And so where do I feel like I matter the most now? And where do I feel the most energy, parenting and being kind of like a connector socially in my world? I have six, seven, eight recurring lunches and dinners with different groups of friends that I'm central to organizing, some of them around the Dharma and Buddhism and some just a bunch of people I like getting together.

And so that you can pretty much draw a straight line from feeling abandoned, unmoored, disconnected, anxious to engineering community, belonging, and mattering now as a grown-up when I have control.

Well, now maybe I can do that too." I mean, that's what I'm hearing listening to you. I'm like, "Oh my gosh, that's brilliant. I'm going to do that too. I want to have." And so it spreads. It becomes contagious.

And I think my problem with the term resilience really came from I used to be medical director of this foster care clinic. And it was a clinic for people, children with very, very high needs. So they're in and out of foster homes, sometimes like five or seven placements in one year. And so it was very emotionally demanding work. There was a lot of staff turnover, and new staff would come in and inevitably somebody would say, like, "Oh my gosh, these kids are so resilient." And I could not stand that term because it makes me question, well, who is defining that?

Who gets to call someone resilient? And who is benefiting from that? Because these children are just enduring. They're just enduring a system and a structure that is not working for them. And when we call someone resilient, it's almost like we're absolving the system of having to deal with it and having to manage it. I mean, there was another time early, early in my life when I first started working with survivors of torture. There was one guy and I just said something about, like, "Oh, you're so resilient."

He became very quiet. He looked down and he said, "I'm not resilient. I just didn't die." I thought, like, yeah, that's actually true. Like, a lot of times we're just enduring and we're just one foot in front of the other, enduring a system that might not be the best system for us. So I think true resilience is when we can actually engage with what's really going on at hand and not lose ourselves within it. We stay grounded, we find a sense of mastery, and we engage in the world in a meaningful way through the instability.

What made me feel loved is actually, you know, I have a friend who sent me a song when they were thinking about me. I think that definitely made me feel very it was a beautiful song and that made me feel loved. What made me smile, my son, he's nine years old. I got him a hoverboard. I also make him do chores. So he hoverboards around the kitchen with a mop so he can mop around. And it's so cute when he does it. So that makes me smile. And then what inspires me, I have a couple of friends who are very active and they kind of organize protests.

And I love seeing people live out a moral compass. They live out their values. That, to me, is very inspiring. So those are mine from last night.

And I find it very helpful. But that's not my what's good. So my what's good is much less grand and profound than yours. It's just a record that came out recently that I love. And just to say, you know, we were talking about emotion regulation. There's some data to show that one way to regulate emotions, and Ethan Cross, the scientist from University of Michigan, has talked about this on the show. One great way to regulate your emotion is through music. My primary use case for music is when I'm working out.

I like to lift weights or run or whatever. And so I tend to pick high-octane music. And there's this young woman, I think she might be British. Stage name is Frances of Delirium. And I think her actual name is Jana Barić. Anyway, she's got a new record. It's called Run, Run, Pure Beauty. And it's got it actually has just a ton of pure beauty in it. It is a beautiful she has a beautiful voice.

She's a really talented songwriter. And it's got enough of the sort of propulsion and aggression that I like for workout music. And I highly recommend this record. So not quite as profound as Dr. Song's Little Nighttime Ritual, but I like it nonetheless.