You Must Be Some Kind of Therapist

Swell AI Transcript: 140. Jaco Van Zylmp3.mp3
Jaco van Zyl:
What gets idealized as the golden standard in treating genodysphoric kids in particular is as pathological to the core, is as anti-therapeutic, anti-developmental, anti-maturational to its foundations. It is a foundational, a fundamental violation of psychoanalytic understanding of these issues. You must be some kind of therapist.

Stephanie Winn: Today I have the pleasure of speaking with Jaco van Zyl. He is a South Africa-trained clinical psychologist in private practice in Ireland. He's also the co-host of the CTA podcast that stands for Critical Therapy Antidote, which many of you are part of, the therapists in the audience, along with Christine Siefen, who has also been a guest here on my show. Yoko has a special interest in personality pathology, trauma, gender-related distress, eating disorders, and addiction. He's also interested in the psychology of large groups and the role of ideology in radical movements, gleaning from his own experience growing up in South Africa. Although I've known Jaco for a while, I invited him here today because he recently published a paper that I'm excited to discuss with you, which is called Formulating Gender Dysphoria as an Affective Perceptual Disturbance Involving the Body. This paper was published this year, 2024, in the journal Psychodynamic Practice. And according to Jaco, it's beginning to cause quite an uproar. So I just read the paper and I'm excited to discuss it today with Jaco. Today is going to be more of a clinical jargony type of day, but we're also going to break it down for the non-therapists in the audience to discuss the practical implications of the concepts in this paper. So Jaco, welcome. Thank you for joining me.

Jaco van Zyl: Hi, Stephanie. It is so nice to be here. Thank you for inviting me.

Stephanie Winn: All right, so let's see, where should we begin? Maybe you can just sort of tell people more broadly what your paper is about to start, and then we'll get into some of the specifics.

Jaco van Zyl: Yeah. All right. We all know that gender dysphoria and transgenderism over the last few years have really been formulated in terms of activist and philosophical rhetoric, rights-based philosophical rhetoric. And there's been very little discussion in terms of the psychodynamics or the psychology undergirding this phenomenon called gender dysphoria. Also, with this recent upsurge in gender dysphoria diagnoses within a specific cohort of adolescents, predominantly females, it really sparked an interest in me to want to know what is actually going on, to organize my thoughts around understanding gender dysphoria. and to look at psychoanalysis as a possible theoretical basis for formulating genodysphoria and what it actually entails. So, yes, I would say from my own practice, I did my internship in 2016 back in South Africa. And because we in South Africa hadn't really been hit by the transgender, the gender dysphoria situation that America and Europe had been dealing with. We were really, as a clinic, as a hospital, we were really true to the psychoanalytic understanding of what we were dealing with in the clinic. And during that year, I encountered my first two patients that had issues with not only genodysphoria, but also a related phenomenon called autogynephilia. they were both adolescent boys. And since then, you know, patients have come my way, parents have sought help to, you know, help dealing with this phenomenon, and right from the beginning I was clear that I am I do not perform affirmative practice. I'm not an affirmative practitioner. I do exploratory psychoanalytic psychotherapy with gender dysphoric teens.

Stephanie Winn: And it also feels like an important piece of your background that I forgot to mention earlier, but I learned on another podcast with you, that you are an openly gay man who wrote your dissertation on conversion therapy, on abusive conversion practices. And it was in that context that when you learned about this concept of sexual orientation and gender identity change efforts, that messy acronym, that it was just so shocking and disturbing to you. I feel like we could probably do a whole episode on that because I actually really want to circle back to that topic now that since I've been in the public eye for a while I've had a lot of ex-gays reach out to me asking me to change my stance on gay conversion therapy and that's been kind of shocking so I would really love to hear your thoughts on that another time. I just needed to bookmark that. Yeah, I just kind of forgot to mention in the beginning. So I just feel like this is such an important piece of the context, too, that you, if anyone understands what gay conversion therapy is, it's probably the guy who wrote a dissertation on it. And so what was the moment in your career where you learned that people were taking the concept of conversion therapy, which you had studied, and applying it to gender?

Jaco van Zyl: It was the strangest thing. So it was about, maybe into my first or second year of private practice, that I noticed that people were applying this conversion therapy term to gender identity and gender dysphoria. And it was clear to me that this was concept creep right from the beginning. And obviously, they were gleaning from the sentiments associated to conversion therapy as sexual orientation change efforts. to use the aversion to that as fuel for their ideological push to prevent people from thinking about gender dysphoria and transgenderism. So I noticed this as a rhetorical and maybe even as a propaganda trick to get people to just see this as bad, to terminate thinking around this altogether and to just affirm. And we're talking about gender identity. We're not talking about sexual orientation. It's just so strange that people, even psychologists, who know that these two things aren't identical, they would still apply the conversion therapy trope to gender identity.

Stephanie Winn: It really is such a parasitic movement, you know, just capitalizing on the gains, you know, women's rights and gay rights and all these things and saying, we're just like you and like, no, actually, maybe you're a threat to other vulnerable groups with some of the things that you're demanding. But anyway, let's talk about your paper though. So you start off discussing basically the psychological experience of the infant. So can you describe some of those concepts associated with how an infant formulates a sense of identity and their bodily sensations?

Jaco van Zyl: So let me just say this first, that the reason why we study infants is because infants are so honest. They blab out who they are. They just, they show you what they're experiencing. And what we also find is when some of these earlier experiences are not resolved, that those earlier experiences tend to be carried along with subsequent developmental phases of a person's development. So when we sit with someone who's maybe traumatized or someone with severe personality pathology, you oftentimes find kernels of early infant distress and infant trauma and systemic dysfunction still present within their presentation. But when we, if we understand the infant's experience or our conceptualization of the infant's experience to distress and how they cope with that distress, then we have an idea of what the person in front of us, even if the person were an adult, what this person in front of us needs in order to unfreeze themselves and continue with their psychological maturation, even if they were, say, in their 20s or 30s or 40s or 50s. So the understanding of the psychological development of an infant comes from, obviously, first of all, Sigmund Freud, but then also subsequent theoreticians within the Freudian tradition of psychoanalysis, such as Melanie Klein and Wilfred Bion. And it's mainly from their tradition that I glean my concepts. So, right in the beginning, Sigmund Freud said that our psychological health depends on our prowess or the extent to which we navigate two opposite poles of experience, namely the pleasure principle and the reality principle. And if we don't adequately navigate those two forces, it could lead to our own personal human civilizational extinction. All it says is we have instincts, we have impulses, we have ideas because we are imaginative, but we still need to account for external reality. If we don't adequately account for external reality or integrate it into our ego, and our ego refers to the aspect of ourselves that really tried to balance these two forces. If we don't adequately integrate reality into our ego, then we will run into trouble. So how this gradual integration takes place is, when the infant is very, very, very small, they get born, or they're being born, and they're very, very vulnerable, and they're heavily dependent upon the interventions of mother. And right from the beginning, they start noticing, and remember when we use words or language that has certain meanings to us as adults, we cannot assume that these concepts have the same meaning to infants. So when an infant is born, there are certain misalignments with what their preferences and their needs are. And that is the first time they start encountering the harshness of reality. From temperature variations, loud sounds, hunger, thirst, mother not being on time, circadian rhythms, sensations in the body, winds, etc. And those are the earliest misalignments between their wishes, and reality. And those misalignments cause frustration. Now, an infant still has what we call a body ego. So what they experience as distress, they experience bodily, and you see it in their responses to frustration. They're kicking and screaming. slight deviations in preferences are really experienced as a threat to their survival. So these earlier experiences of the infant is called paranoid schizoid experiences. In other words, it's paranoid in that it is all or nothing. It is all good or all bad. It is all comforting or all threatening. That's paranoid. And also schizoid in the sense that a part of mom or a part of their environment is experienced as the totality of it. So schizoid means just fragment. So the fragment of an experience is experienced as all-encompassing. But with the interaction with mom, what mom provides is an understanding of what the infant experiences. A soothing voice, a comforting voice, singing, talking, repeatedly tending to the infant's needs. All these interactions lay down a memory trace. And this memory trace then forms a type of bias about the world. If there's been neglect, the infant will enter the world with this bias that the world will be neglectful. If there's been trauma, same, the memory creates expectation or bias. where there is a good enough mother, the memory trace will create an expectation of some good enoughness. When I refer to a good enough mother, it's a mother that tends to the infant's needs most of the time, but also from time to time fails the infant. That failure is necessary. The failure is necessary because in failing the infant, in experiencing the mother as a failing object, but an object that returns, the infant learns that later in life, that even should they go through difficult experiences in life, that bias has been laid down, that expectation has been laid down. Namely, eventually some relief will come. So in this repetitive interaction attuned to the infant's needs, the infant's experiences, all engulfing embodied distress, gradually gets transformed. Wilfred Bion formulated these early distressing experiences within the body as beta fragments. And what Mab then does is she converts beta elements or beta fragments into what he calls alpha elements. All this, you know, what this means is, so alpha elements provide the opportunity for the infant to think about their experience. It is not just a stress, it is not just something that they want to get rid of and discharge into their environment. But gradually the infant starts thinking about, maybe I can soothe myself through a pacifier. Maybe I can imagine my distress away. I can recall that mother has returned in the past, so she will return again. And these are rudimentary fragments. Remember what I said, we're using these concepts, but these concepts are not one-to-one applicable to an infant, because we're adults. But these are rudimentary fragments of mental operations that the infant gets the opportunity of and that they eventually elaborate as they go through the rest of their psychological development. So gradually, bodily sensations, bodily distress gets elaborated and converted from beta elements to alpha elements. Mom, we say, acts as the alpha function. So mom acts as the machine, as it were, as the program. how mom converts the distress into proportionate experiences of it that the infant gradually internalizes and learns so that the infant can take with them as they develop through life. And eventually what is converted into more thinkable experiences experiences they can feel, they can classify, they can feel in proportion. In other words, I'm just hungry now, or that sound was just a door, or I am thirsty now, as opposed to I'm being destroyed. That enables them to further conceptualize their experiences as they go through life in the form of language and in play, as they grow older, young children playing, as they tell stories, so imaginative exploration of different worlds. And it's in this exploration, language, play, that the young child more and more integrate the demands of reality. And when we talk about reality, we're not only talking about hard, objective reality, like I said, sounds, sharp surfaces, colds, heat, etc. I'm also referring to realizations in terms of biology. Reality of difference. Difference in sexes, difference in generations, difference in species. Because when it comes to difference, difference means loss. If I am a boy, I am not a girl. It's experienced as loss. If I'm a child, I am not an adult. Not yet. And when I become an adult, I won't be a child anymore. That's an experience of loss. I am human, but my pet doggy is a dog. We're not identical. We're not the same. So the encountering of difference is also a source of great frustration. And then biologically, we grow up. We grow older. We discover certain abilities about ourselves. We cannot fly like Superman. We cannot perform magic like Tinkerbell and Peter Pan. We cannot. We can imagine doing that. And in the imaginative play, we imagine what it must be like doing that. And in that exploration, we also gradually integrate what we can and cannot do. But there is a clear distinction between our mental faculties and what reality dictates. And that the infant then also learns, and I know I'm repeating myself, gradually integrates. There is one other aspect that I might also discuss because it's relevant to the idea of gender dysphoria, and this is a Kleinian concept. I didn't articulate it as clearly in my paper, but it's the concept of symbolization. Symbolization means that in my interaction with the world, I create a concept of it. And that concept is loaded with projections. Initially, the projections are experienced as inseparable to the object. In other words, let me give you an example of that. So that is called psychic or symbolic equivalence. If this pen was given to me by my father, and I have unresolved issues with my father, and I still operate on the plane or the level of psychic equivalence. I would, for instance, treat this pain as if it were my father, as the thing in itself, and I would enact my aggression onto this pain. So that is psychic equivalence. But psychic representation or symbolic representation is, I know my father gave me this pen. Yes, there are maybe some unresolved issues with my father, but I can appreciate that my pen and my father are two different things. I do not have to enact my projections onto this object as if it were the thing in itself. So, that is also something that the infant gradually learns as they develop. And if they have difficulty developing out of symbolic equivalence to symbolic representation, such as with severe personality pathology, autism, trauma then we see this difficulty where they treat the thing they feel uncomfortable about as if it were not endowed with projection the thing they feel uncomfortable about as if their experience were objectively true and accurate whereas in reality their experience is deeply contaminated with projective material. Okay, so that's a lot that I said. So how about we un-tease it if you want to.

Stephanie Winn: I love the way you laid all of that out. I'm just soaking it up. I mean, I studied psychodynamic theory in grad school, but it's really been a long time since I heard anybody describe these concepts so clearly. And I really feel like you're doing exactly what I was hoping for in this interview, which is bridging the gap between the incredibly theoretically dense paper that you wrote, which is really for other psychodynamic clinicians, And what this means for people who maybe aren't so, you know, aren't so heady or maybe don't even work in our field, but are just trying to understand where we're ultimately going in this conversation, which is an understanding of gender dysphoria. And I can feel where you're going there towards the end. And it's so interesting. for me because, you know, as I mentioned before we started recording, I just got back from visiting my elderly mother who's, you know, becoming increasingly frail and has fractured her hip a couple times. And I'm noticing like even some of these themes about psychic versus symbolic, excuse me, psychic or symbolic equivalence versus representation. I was noticing when I was visiting her in her own attachment to objects, you know, which is one of those things that elderly people are oftentimes working through because they want to downsize, they don't want to have so much stuff, but their stuff is imbued with memories and unprocessed emotions. So I was even witnessing that in my own mother recently with how she was dealing with, you know, not wanting to throw certain things away. But where I know you're going with this, and you know, pardon me if I'm sort of jumping ahead for you, but is towards what could be called like the scapegoating of body parts, which is, you know, sort of the related to the title of my interview with Bob Withers from a year or two ago, the scapegoated body, where he also takes a psychodynamic approach to understanding gender dysphoria. And so you're talking about, you know, I guess as you were talking, I was thinking about things that the parents I consult with have relayed to me that their kids have expressed about how they feel towards their own scapegoated body parts. And it's very much that what you would call psychic or symbolic equivalence, right? It's my breasts are the problem. There's no insight there about, let's say, the mother wound. For example, a woman who was adopted at birth and maybe had the most loving, adoptive parents, but never knew her biological mother. So there's that mother wound, and she was never breastfed by her own mother. And then in adulthood, in young adulthood, develops this intense hatred. of her breasts and desire to be rid of them. And there's that lack of insight that, as you said, it's a projection, that there's something unprocessed, unsymbolized, something that I'm not conceptualizing through language and the ability to think and imagine. that is just kind of literal, right? I'm interpreting in this very literal way. And of course, our concerns as gender critical clinicians is that there are grave consequences for, you know, a whole system that just supports people with this literal interpretation of their projection without questioning, is it really that the cause of your psychic distress is the fact that you have breasts? Is that really true? Can we really know that removing them will remove the distress? Or could something else be going on here? Do you have an adolescent or adult child who is at risk of heading down a path of medical self-destruction in the name of so-called gender identity? The ROGD Repair course and community for parents is a whole new toolkit that will be a game changer for you. ROGD Repair is an interactive and ever-expanding toolkit of psychology concepts and communication skills curated specifically for parents like you, based on what has actually worked for my clients who were desperate to improve their relationships and save their kids. ROGD Repair is designed based on my theory of the trifecta of social contagion. Gender ideology doesn't operate in a vacuum, but in a perfect storm along with wokeness and cluster B personality traits. This trifecta is perfectly designed to take advantage of every psychological vulnerability in your child. Fortunately, that's where ROGD Repair comes in. ROGD Repair is designed with your child's psychology in mind, too, even if they're an adult. ROGD Repair teaches you to work with, rather than against, their present state of mind, using psychology concepts and communication skills that are uniquely suited for your situation. So stop overwhelming yourself with horror stories and worst-case scenarios and more medical information than you need. Start working smarter, not harder. Start equipping yourself to repair the way the gender crisis has impacted your family today. Visit ROGDRepair.com and you can use promo code SomeTherapist2024 at checkout to take 50% off your first month. That's ROGDRepair.com.

Jaco van Zyl: Exactly that. Exactly that. So, like you said, that's also very eloquently stated. So, their distress remains unrepresented. unrepresented, and if we follow certain ideologies that prohibit us from thinking, ideologies that are essentially thought-terminating ideologies, it actually forecloses thinking and exploring and feeling what these projections and associations are. In other words, they take the experience as the thing in itself and just think about it. Something that gets idealized as the golden standard in popularized, activist-driven gender-affirmative practice. I don't call it gender-affirmative therapy, by the way, because it's not therapeutic. It's gender-affirmative practice. What gets idealized as the golden standard in treating gender dysphoric kids in particular is as pathological to the core, is as anti-therapeutic, anti-developmental, anti-maturational, to its foundations. It is a foundational, a fundamental violation of psychoanalytic understanding of these issues. Because they treat the manifest content as a thing in itself, as opposed to exploring the latent content. Like you said, the unexplored, the unfelt, the unthought, the undreamt, the unrepresented.

Stephanie Winn: So Jaco, now you're kind of jumping to page 10, right, which we were talking about before we started recording, which is this comparison between what psychoanalysis considers healthy or unhealthy versus what is encouraged as the ideal by queer theorists like Judith Butler. In between the beginning where we talked about the psychological development of the infant and this chapter where you're criticizing these ideologies, there is a section where you compare gender dysphoria to other body-focused disorders like body integrity, identity disorder, and things like that. So maybe we'll circle back to that part in the middle. But let's go with this. So this comparison of the aims of psychodynamic theory and psychodynamic practice, which, as you described earlier, is helping the individual integrate the pleasure principle and the reality principle. And you articulated the foundation of that in childhood, which is that we get pleasure from the gratification of our needs, such as being nursed and being held and warm as a baby. And then the reality is mom's not always there, and sometimes we're hot, and sometimes we're cold. And this serves a template for our ability to tolerate all of the more complex forms of struggle that will present themselves later in life. So you articulated that the goals of psychoanalysis would be a mature integration of pleasure and reality. So, and what were you beginning to say about queer theory and the ideas of Judith Butler and how those contrast?

Jaco van Zyl: So, like I said in the beginning, so there is this clash, this conflict between pleasure and reality. And part of negotiating these two poles is to gradually integrate reality, like you said, but part of the maturation is not just gratification, what the child needs, but also providing structure to the child. And that comes from certain prohibitions. Mother knows best. And eventually when dad gets into the mix, dad knows better than the child. Safety structure is essential in almost binding the anxiety together, binding the instincts together. Now, of course, the instincts want to disavow, want to push back against the prohibition and the negation that comes from reality. Now, in psychoanalysis, there are three structures. The first is neurotic. The other extreme is psychotic. So neurotic means that there's conflict, but we work towards integrating reality. The other extreme is psychotic. It's a foreclosure of reality. In other words, whatever I dream up, that I accept as true and it can shape shift, it can become whatever I'd like it to become. But right here in the middle, there is this aggressive, sometimes even sexual instinct to disavow, to undermine, to subvert reality. And that is the perverse structure. Now, when you read queer theory, every queer theorist, most of them explicitly state it. Queer theory is an elaborate, ideological, philosophical sophistication of what psychoanalysis calls polymorphous perversity or perversion. When you read Judith Butler, she alludes to it. Gail Rubin, same story. There is Shulamith Firestone, she's a radical feminist. All of these people get their inspiration from the psychoanalytic concept of perversion. And that they then formulate in this this theory that's just embellished philosophical sophistication of perversion. And that is what I write. I say, it's actually page eight, sorry. It says, what psychoanalysis considers pathological. namely, the disavowal of natural and cultural realities Butler and her fellow queer theorists encourage as ideal. The disavowal of the differences of the sexes and the generations is psychoanalytically formulated as polymorphous perversity. So Butler explicitly states it in her book, Gender Trouble, And a lovely French psychoanalyst, Jeannine Chassagay Smagel, she's written a lot on perversion, really nicely elaborated. And yes, temporarily there may be, I don't know, joy and pleasure and ecstasy in this omnipotence that you feel, in disavowing what may be prohibited. But it's only a matter of time until reality catches up with you, and then there will be trouble.

Stephanie Winn: So I think you've spent a lot more time studying psychodynamic theory in great depth than I have. But I want to kind of compare and contrast your deep understanding with my perhaps more superficial understanding. And so when you were talking about the three structures, neurotic, psychotic, and this third thing, where I thought you were going to, yeah, so you called it perverse. And where I thought you were going to go or what I thought you were going to call it was borderline. Because in my training, we were taught that the term borderline was originally used to describe that boundary between neurotic and psychotic. And that when we look at something like borderline personality disorder, that term originally came from an understanding that people with VPD were not quite, you know, clinically insane in the sense of being completely detached from reality in the sense of delusions or hallucinations, but that they had, they were not quite stable enough to be considered neurotic. And that, you know, among the symptoms of borderline personality disorder, we have, I think it's called in the DSM, transient stress-induced paranoia. So that at their worst, not consistently, not all the time, but at their worst, people with a borderline personality structure do really struggle to have a basic grounding in reality. So again, it's not considered a psychotic disorder. These are not people having hallucinations. Whether some of their beliefs might be considered delusional is, you know, subjective and variable. But that's where I thought you were going with it. And so I want to invite you to comment on that.

Jaco van Zyl: Okay, so you know that there have been various theorists around, you know, within psychoanalysis. The old Freudians used to categorize the three main structures as neurotic, perverse, and psychotic. And this was later taken over by Lacan, Jacques Lacan, who also formulated the three main structures. from a different line of Freudian thinking, they would include the perverse somewhere within this continuum, but not as a separate categorization as the old Freudians would have. I would say that it's more the object relations folks that would take this other continuum where you have greater reality contact within the neurotics and then this gradual reality loss where you go to the labile mood because of impaired symbolization, because symbolization is there is also a loss of reality contact. You see the occurrence of micropsychosis or micro hallucinations and delusions to eventually full-blown psychosis. So I would say it is, depending on which tradition you follow, but I do think though that perversion does fit in within this other continuum of neurotic, borderline, and psychotic. It is just formulated maybe more in object relations terms, but still gets adequately realized or expressed in formulation if you look for it, yeah.

Stephanie Winn: I want to talk about this idea of arrested development. So let me kind of frame up the issue now. Anyone who's been listening to my podcast recently has probably heard me talk a few times now about my idea of the trifecta of social contagion. So my course, ROGD Repair, is formulated with this framework in mind, that gender identity ideology works in combination with woke beliefs about social justice and cluster B personality traits and behaviors, and together they form the perfect storm. if we're trying to help these young people, whether as therapists or parents, we need to understand how these things work together and complicate the picture. And we need an approach that addresses all of them. That's why I bring in things like moral foundations theory to address the social justice component and secondary gain and understanding grandiosity to address the cluster B component. So when we talk about borderline, We're talking about a cluster B personality disorder. We're also talking about, again, traits and behaviors, right? So I'm not saying we diagnose people. I'm saying we look at the traits and behaviors. But we're also sort of talking about stages of development, which is one thing I really appreciate about your approach is you're talking about stages of development from very early infancy all the way to adulthood. And I think it's tragic that people end up in this sort of arrested development because, you know, it's not predetermined. Yes, you mentioned in your article that there are certain temperamental traits that are genetically predetermined, but it's by no means predetermined that someone will grow up to have a personality disorder. We would love to, I think, have an optimistic view that these things are preventable and treatable. But as we're maturing, we go through you know, this idea of primitive defenses, right, these more immature coping mechanisms, and hopefully we grow out of them in this process of reckoning between the reality and pleasure principles, right? So what I'm really concerned about is that there are people who maybe had some vulnerability to developing, let's say, a borderline personality structure. But it's by no means written in the stars that they would have to be that way for the rest of their life. And being that way for the rest of their life comes with terrible consequences for their, you know, capacity to form healthy relationships and hold jobs. And so I think most people would agree that it's very unfortunate If in the process of normal development of someone being immature when they're young, if there are factors that contribute to a person getting stuck or reinforced in those immature coping mechanisms rather than eventually maturing. You know, I often sort of joke that, you know, show me a teenager without some traits of a cluster B personality disorder. You know, we all have, you know, I was very grandiose as a 16 year old. It was it was a defense mechanism. So so it's it's that that people are potentially because of these social factors getting stuck in these problematic patterns of personality development rather than eventually growing out of them and being able to get to a place like I am where I could say, wow, I was a wreck as a teenager. Good thing I've learned how to integrate reality.

Jaco van Zyl: But most people are a bit of a wreck when they go through puberty and adolescence. It is just not accurate. It is just confabulation or it's just a loss of some of the struggles that we may have had growing up in our memory. I don't know, it's a distortion of our memory to imagine that puberty and adolescence was just fun and it was joy and it was just great. It is not true. To by far the most people, it's a very, very difficult period of life. And sorry, I just want to hook on to what you said in terms of certain risk factors, but there are also protective factors. So even though very early on there might be neglect, if there are protective factors, and when we think of protective factors, we're not only talking about relationships. Yes, suppose there was a difficult relationship between infant and mother and there have been impingements, but later on in development there may have been an aunt or even a nanny growing up in South Africa, and talking from my own experience, I think of two African mothers that I had that really helped with fending off and with repairing some of the early distress and the early traumas I had to deal with. So those personalities, stable, comforting, stabilizing personalities, Pets, don't underestimate the effects pets have on children. Those can add to the repair and to the resumption, the resuming of psychological development. Another great factor, okay, teachers too. Another great factor is culture. Because culture is a form of sense making. Cultural rituals, dividing life into certain phases, helps a lot. Rites of transition, for instance. In some traditional cultures that still happens. It helps to structure life and it helps with the resuming of psychological maturation. And then luck. Luck. If you grow up with some dysfunction, you find yourself in a very unsupported country, it's going to be difficult. If, however, you find yourself in a different country with a different culture, if there's no warfare, well, it's just the luck of the draw, you see. And those are all factors that are actually completely out of our control.

Stephanie Winn: Well, I really appreciate you using the word luck. It's not something we use very often, but actually, have you read a book called The Luck Factor by Richard Wiseman?

SPEAKER_02: No.

Stephanie Winn: It's a great book, pretty easy read, although I do most things on Audible, so that affects how I read. But luck has been studied. And Richard Wiseman, in his work on luck, found that there are certain traits and behaviors and attitudes that we can adopt that actually enhance our perception of how lucky we are. And not surprising to the therapists in the audience who study personality psychology, high openness is one of those traits and low neuroticism. I believe those were the two major traits because I think so much of it is getting out of your own way in terms of allowing good things to come to you, recognizing, you know, like they look at the personality traits and behaviors of those who recognized money on the ground and those who passed right by, right? And things like that. And so how open is your perception? You know, extroversion, extroversion really helps, of course. And again, when we're looking at these social dilemmas that you and I both have critical perspectives on, I think some of the patterns that I'm concerned about are discouraging these traits and behaviors we can adopt that, as you say, would be protective factors. So even something like luck, which we think of as being out of our control, well, you can actually become a luckier person by being more open to luck and by believing that good things will happen to you. So when we have ideology, which is one of your interests, right, that teaches you to look at everything through the lens of how oppressed you are and what a victim you are. You're not gonna be very open to seeing that $5 bill just laying there on the sidewalk, are you?

Jaco van Zyl: No. You see, Melanie Klein, the theoretician upon which Wilfred Bjorn elaborated his theory, she has written a lot about envy and gratitude. Now, envy says I see you have something that I wish I had. I don't have it. My awareness of your having something that I don't creates anger and panic and resentment in me. So I destroy what you have so neither of us have it. That's envy. And that is what critical theory encourages. To go around, to have this perception that I am oppressed, the other person by certain identity markers, that other person by default has more than I have. They owe me. What I need and what they have is something that I am entitled to. And if I can't get it, I will destroy what the other person has, so that neither of us have it. Or, that other person must be withheld from being selected into a university. just for the sake of equalization. It is deeply envious, it's deeply pathological. It prohibits maturation to develop into a grateful personality. So gratitude, on the other hand, says, I might not have the thing that I see the other person have, but wait a minute, I have something else. I have something else. And even after wishing that the other person didn't have what I wanted, I can forgive myself for having destructive wishes and destructive fantasies. And it is okay. And there is reconciliation. That person is just fine. So there is this reparative movement in gratitude that we don't see in envy. And that is the basis for a more mature and a healthier personality. You said luck as an attitude, in other words, greater openness, low neuroticism, greater extroversion. I like that. I'm high in openness, I'm actually high in neuroticism. So, I tend to have a proclivity not to see all the good around me. I just need to be aware of that all the time. I tend to be a bit more extroverted too. But when you appreciate the fullness within yourself, and that is not just a cognitive thing, it is a developmental thing. You feel it in your gut. And to have that thankfulness, that gratitude, that does take you a long way. The problem with grievance studies, the problem with all these, this whole family of critical theories, including queer theory and gender theory, is that it actually induces disrespect, envy, lack of gratitude, and this entitlement and destructiveness that we see around us, yeah.

Stephanie Winn: I was really relating to what you were saying. I've been seeing another psychodynamic clinician posting recently as they're reading a book on these things, and it might be a Melanie Klein book. And I remember reading a quote that they'd shared that that healing and maturing from envy involved a few things, and one of them was recognizing and accepting that others are enviable, right? That people have capacities that you lack. Or another way that I would frame that is admirable. And how lonely and overwhelming must it be to live in a state where if you can't possess every every virtue and every wonderful thing there is to have that nobody should have it. Because it feels like such a better feeling to live in a world where there are people who have qualities that you lack. And I think there's also in the way that you were describing India, I was also hearing a lack of empathy for the other person, a lack of mature perspective taking skills that we don't know what it took for that person to achieve what they've achieved. You know, for me, like, for example, I'm very fortunate to be in a very loving relationship, but I really struggled to get there. I learned a lot of things the hard way to bring me to a point where I was really ready to recognize and appreciate a loving, secure partner when I found one. And knowing that there are people who could see me in a happy relationship, being well-loved, and envy that without empathizing with the journey it took me to get there feels tragic to me. Because if they could empathize, they'd see in me a relatable human being. And they might also see that maybe some of the things I learned the hard way to help me get to a place where I have a loving partner are lessons that could benefit them if they see themselves as my equal, not as being higher or lower to me.

Jaco van Zyl: Right. So there is this, with more envious people, there is this entitlement, and this entitlement to have simply because you are you. Simply because of who you are, you are entitled to have what you see the other person has. Whereas this developmental trajectory that you're describing, that developmental trajectory was necessary not only for the other person but also for yourself. So you're not as perfect, you're not as idealized as you'd imagine, you'd imagined you were. You're just human like the other person. It requires some work on your part too. And that is, you know, that is a, it's a narcissistic wound, you said. You know, cluster B, cluster B personality traits. Narcissism, there's high envy in narcissism. Borderline personality is the hysterical personality too. And that it just comes with appreciating that you are as human and as subjected to factors as every other human is. And you've got to work towards certain maturities and obtaining certain things.

Stephanie Winn: I was talking with a certain mentor of mine who I don't have many people in this world that I look to and I see I would trade places with them or I would make similar choices to the life choices they made. So this particular mentor, I won't say who she is, but I was very grateful when she was willing to become my friend because I'm like, I need role models like you. I really relate to you and look up to you in so many ways. You know, she and I were talking about this because although we've had very different life trajectories, there are some similar themes in terms of heading into the unknown and going through some sort of crucible where for a chapter of her life and a chapter of my life, it was like, what's going to happen with my career? Am I going to be able to continue? Am I going to be ripped to shreds in the public eye? She and I both had the experience where while going through that chapter of our lives, we had no idea what was going to come next. And we had to find something internal to propel us to continue doing what we felt was the right thing to get through it. And now that I'm in this place where I'm relatively successful as someone who has, you know, uttered heresy, every now and then I'll have, you know, therapists who are considering some kind of career change or things like that reach out to me. And my mentors had similar experiences where people are like, you know, tell me what to do, right? And, and sometimes it seems like people are hoping that based on the lived experiences that I have or that she had, that we can then tell people, here's how you do it without risk. Here's how you become a, you know, here's how you make a living through coaching or through something like this as a, you know, a public figure with a reputation. without going through what I went through. And, you know, maybe that's an unfair characterization. And it's also a general summary of not any one particular individual who's come to me, but just a kind of theme I picked up on in several individuals who've come to me. And it's not that I can't sympathize with wanting that, but I don't have that answer because the only way I could have possibly gotten where I am with all of its ups and downs is through the crucible of not knowing what was on the other side.

Jaco van Zyl: In one of the interviews I had with someone else, I said, that is unfortunately one of the voids the loss of religion has left. Because when you're religious and you go through a difficult time, you have an internal good object that you can reach out to. It is so much more difficult when you don't have that, when you really have to remember where you're from, when you recall not only the bad but also the good experiences you've had, when you remind yourself of the good people in your life, people who believe in you, when you phone them, when you look in their eyes, you can see their love and you encounter their perception of you. And many times, because they're loving people, their perception of you is an accepting, is a loving, is a nurturing perception. And those are the internal objects that that really help us and carry us through trials and trying times, especially in this time of such hostility towards those who believe and proclaim heresy, like you and I do. And many of us, or many, have suffered much, much worse than you and I have. But it is … I mean, it is … I think of James Esses, for instance, in the UK, and Maya Forstatt, and so many others who've really gone through difficult times. But it is by holding on to these internal good objects and remembering who you are, what you stand for, and why, and to do that moment by moment as you go through your ordeal, And if you're religious and if you're a Jungian psychologist and you have a different experience of the numinous, to reach out to that to carry you through the difficult times.

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SPEAKER_02: Yes.

Jaco van Zyl: Even during my training, I noticed that there was a clear inconsistency, not only in the formulation, but also in the treatment of genodysphoria, in that that was just after the DSM-5 had been released, and the affirmative model was pushed in so many different contexts. But I noticed a few things. That in the other body image disorders, there is no affirmation. Why affirmation in gender dysphoria? And why this, almost this exclusivity or the idealized status of gender dysphoria, whereas we don't idealize any of the other body image disorders? And when I talk about the other body image disorders, We're talking about, like you've mentioned, body integrity identity disorder, or apotemnophilia, and that is this unease with a certain body part or a limb, or even with certain senses, like vision, for instance, and the urge to want to get rid of this body part, and the strong identification with the imaginary body without this body part. The same with body dysmorphic disorder, eating disorders like anorexia nervosa, pseudosiesis, pseudosiesis or false pregnancy is something we don't really encounter in the West, but it is quite prominent in certain very traditional non-Western, in certain traditional Western societies. false pregnancy, this intense wish to be pregnant and almost this manifestation of a kind of a pregnant condition because of this fixation on having a child or just the fixation on being pregnant. Then muscle dysmorphia and then the other one then is genital dysphoria. And in all these manifestations there is this imaginary ideal of what the body would look like if it were different. And this extreme identification with the ideal body without the perceived flaws. Not only from my own experience and from reading the literature, but also from talking to different people also working in this field, I've noticed that in all these manifestations, there was first of all emotional distress, and because of this emotional distress, there were perceptual distortions. And now keeping in mind that developmentally we need to integrate reality, we see that people who develop any of these body image disorders, they have a wish to look a certain way, they are dissatisfied, some of them have psychological distress and some of them have things in their past like trauma, sexual abuse, some of them have autism, and because of this impairment in symbolization, their experience of the distress and the manifestation of their distress is still body-bound. where they experience the body not only as the source of their distress, but also as the target. In other words, if they could modify the target, the source of their distress, then miraculously the emotional distress would evaporate. But we know that never happens. That never happens, because the issue is not The body, the issue is emotional and the meaning making that goes on in how they appreciate, how they perceive their own bodies, their own biology and certain body parts. If we can just, if we just think about puberty and adolescence, not only Did we, not only do young people experience immense emotional turmoil by default because of puberty and adolescence, there's also immense bodily and physiological changes that take place that need to be integrated. Integration as in about which meaning needs to be made. There is sexual awakening, there is sexual development, there are growth spurts, There's this awareness that you might be also the object of sexual desire. You running to sexual desire yourself. Fertility, in the case of females, physical vulnerability. So there is a huge shift in identity. Who am I with my sexual desires, with my sexual development? Relationally, how will I relate to the other person? Sometimes there is even transient homoerotic feelings. What does this say about me? The idea of pleasure, suddenly all these different sensations. And these are all things that the person needs to, that a young person needs to navigate without necessarily having a frame. that would help them with meaning making. Like I said, we're living in a postmodern world, beyond tradition. In many of these cases, there is no tradition to adequately explain to us what is happening and why this is happening. Not only that, what becomes ideal is what young people see in social media. And they lose their youthfulness, they lose the pre-pubital body. It is a major loss. And where it comes to loss, there's also frustration. And if this frustration isn't adequately symbolized, then we tend to resort to primitive defenses, like the denial defenses, as well as the projective defenses. Denial defenses as in, this isn't happening, this isn't what I want, and if I can't get rid of it, I'll try and modify it. That's why with genitosphoria, and even with body dysmorphic disorder in boys, you notice shaving. Because they don't want a hairy body, they don't associate themselves with growing up. Or there have been complicated identifications with a same-sex parent. Disidentifications with a same-sex parent and things like those. Or there might be latent or transient homosexuality, in many cases just full-blown homosexual orientation that will develop. That introduces new difficulties for the person. These are complex, complicated experiences. They need time, they need space and certain relationships, certain structures to process Many of these young people do not have that. They need to achieve, achieve, achieve, achieve at school. There's pressure to live up to certain ideals. And then the candy merchant arrives. Right. Who was it? Was it Plato? Was it Socrates? Plato, who said, if the populace had to decide between the bitter medicines of the physician or the candy of the candy merchant, they will probably settle for the candy of the candy merchant. And so for struggling adolescents, the allure of gender theory or gender ideology is too good to resist. And gender ideology says in its perverse and its queer form is, what you decide to be, you are. Disavow biology. Disavow these oppressive structures. These oppressive structures, by the way. It's thanks to these so-called oppressive structures that the person has flourished and developed and lived the life they have. We see this resentment. It's so easy to induce resentment and envy and bitterness. And they find it too good to resist and the so-called solution to their distress, namely, you must be gender diverse or you must be transgender, that gets offered as the solution. And like you've said before, The actual issue, in other words, distressful meaning making, the actual issue may be unresolved historical issues of trauma, maybe some autism, whatever the case may be, those never get looked at. Instead, the person gets pushed to follow what they imagine to be their ideal body. So other than say anorexia nervosa, where we do not give a person liposuction, restrictive diets, et cetera, other than apotemnophilia, where we do not send a person to get the unwanted limb amputated. In gender dysphoria, the unwanted breasts, unwanted penis, testicles, et cetera, those do get chopped off. Unlike muscle dysmorphia, where we do not feed the young, well-built young man steroids and creatine and put them on a gym regime, we break that rule where it comes to gender dysphoria. And what we do see is many of these young kids do have psychological distress There is an impairment in symbolization. They have symbolic equivalence when they think about their sex bodies growing up as a man or a woman. their homosexual desires, what it means to be a man or a woman. Maybe they're non-conforming. They might be slightly effeminate as a man. They might be a bit tomboyish as a girl. So there are such complex, difficult, meaning-making processes that need to be resolved as opposed to just affirming and feeding them hormones and giving them surgery.

Stephanie Winn: That was beautiful. Let me comment on a portion of that, right? So you're talking about what we could call an untested hypothesis. The untested hypothesis is I will feel better when this part of my body that I hate has been changed, permanently altered, right? Yes. As I like to kind of explain things from the ground up sometimes, I compare, in the course somewhere, this untested hypothesis with testable hypotheses and genuine self-knowledge. So as mature adults with life experience who know how to take care of ourselves, we can make predictions based on things that have happened in the past about how we will resolve distressing feelings. So, I'm tired and cranky, but I will feel better after I get something to eat and take a nice hot shower. Or I'm upset today because of this thing that happened at work, but I will feel better after a walk and a talk on the phone with my friend. you know, our ability to take care of ourselves is based on hundreds if not thousands of iterations of things that are testable, right? So that by the time in midlife we say, I will feel better after a meal, a shower, a talk with a friend, a workout, whatever it might be, we know that that's true because it's always been true because we've done it and there's no harm in doing it again if it's within our capacity. And so that's genuine self-knowledge. That's how we take care of ourselves, is by developing that knowledge of how to respond to distressing emotions and sensations. And this is in stark contrast to, I will feel better when I have my breasts cut off. which is something that's never happened before. It can, by definition, only happen to me once, and once it's happened, it can't be repeated. It's an untested hypothesis with very high stakes. And what happens if it's wrong? So I think about this from a neuroplasticity perspective, because those testable hypotheses, they are how we self-regulate. So there's a feedback loop where we know this will rebalance, you know, I can feel my stress hormones going out of control and I haven't had any pleasurable feelings, but after this happens, you know, my cortisol will come down and my endorphins will go up, right? But in terms of the neural pathways and the associated emotions and brain chemistry and hormones and everything of these untestable hypotheses, It becomes a sign of this vicious cycle and this trap because it becomes I think a self-fulfilling prophecy. If you've told yourself a story so many times that I'm stuck with this thing that I find excruciating and it's on my body or it's in my body and it needs to be removed from my body, in order for me to have any shift in my mental state, well now there is a secondary gain associated with the mental distress. So in the course we talk about concepts like secondary gain and, you know, egocentronic versus egodistonic, and I break down what those mean for laypeople who are parents in terms of understanding their kids' gender distress. because a lot of parents are bewildered that they can't just say to your kid, hey, good news. There's a non-invasive treatment for this. You can feel better without doing any of these things. We can just find the right therapist, a therapist like Jaco, right? And what they're met with is not, oh great, you mean there's a solution to my problems that's non-invasive and won't shorten my lifespan? Okay, wonderful, sign me up mom and dad. That's not the response that you get. The response you get is further digging in the heels because of the attachment of the sense of self and the ego and identity. to this belief that this is who I am and this is the only way to make it make me feel better. And so as you were talking, Yoko, I was thinking about the incredible difficulty of helping a young person who's sort of dug themselves into this hole mentally of convincing themselves that this is the nature of their distress. This is the explanation for it. This is the treatment pathway for it. to be able to convince them that it is in their heads, really. You know, this is a mental problem with a mental solution. And that's not to judge you. It's not to say you're psycho. It's not to say it's all just in your head. It's a compassionate message. But to convince them of anything else when they're in that incredibly concrete state of mind, and like you said, autism can really play a role with the sort of inability to symbolize or to understand when they're projecting. I think it's just such incredibly difficult and delicate work for careful clinicians. And you know, I'm not practicing myself. So I'm just curious if you have anything to say to the therapists out there about this process of helping young people without without triggering their defenses too much, you know, helping them get to a point of even openness to the idea

SPEAKER_02: You see, I think it is a difficult period of time that we're finding ourselves in.

Jaco van Zyl: Somewhere in my article I also quote Janine Shazeges-Mijel who says that in certain periods of time when collectively the masses of have endorsed certain ideologies, it is not always possible to work successfully with your clients. And it is what it is. So I think just to liberate yourself that if you have difficulty with your clients, it's not necessarily because you do something wrong. The forces out there, the seduction of the candy merchant is maybe just too powerful. And it is what it is. Okay? Sheer luck or bad luck is the period of time we find ourselves in. It is what it is. It doesn't mean that you shouldn't try your utmost and that you shouldn't stick to what you believe to be true. And we have strong support to have a fairly good idea of what is true. So I think just to liberate yourself from undue pressure, it's not your job to change the other person's opinion. That's by the way not the stance of exploratory psychotherapy. Exploratory psychotherapy is when that young person says, I have made my decision, I want my breasts removed. You say, ah, When you said breast, I could hear your aggression. What's that about? There you start exploring. There you start introducing the alpha function. When you said breast and I could hear that aggression, maybe some thought, maybe some image came up. What is that? What was that? Maybe some sensation. Maybe some memory. What's that all about? You will find that some of the clients are very reluctant to talk about these associations because they're so accustomed to, again, psychic retreats, avoidance defenses, and sometimes they run circles around you. Let them run. But she will mention breasts again, and you will say, I could hear the regression again. Or you can say, I can tell that you're avoiding it. I wonder why you're avoiding the topic like this. Or you can say, I can imagine a topic which you avoid so consistently and so persistently, this topic must be extremely, extremely painful to you. That's just an example of how we slow down our therapy. We don't engage in debates. There's nothing to achieve in trying to outsmart your client. You're not trying to change their minds in any way. You have a formulation in mind. And all you do is you apply the methods available to you to help your client think about the way they have made sense of the things they find distressing associated with their sex bodies. And sometimes your clients go into it. And sometimes they would tell you, yes, the image that I had in my mind was something traumatic or the image that I had in my mind was this celebrity and she has perfect breasts and I'm too tomboyish or I'm too hairy or I'm overweight. I may be lesbian, or I have fleeting erotic thoughts, same-sex thoughts and desires, and it causes distress for this or that reason. Boys might say, I don't know how I will be when I'm a man. I don't know how to be a man. I'm a computer geek. My father is a medical doctor. We hardly see each other. Who am I? I don't know who I am. Or my father's an alcoholic. I don't want to be associated with him. So we see the psychic or the symbolic equivalence. I will develop as the one that I have such a revulsion for. So I treat my physical body with the same revulsion as I treat the one that I have such a revulsion for, namely my father, my alcoholic father. I don't want this. I have a deep fondness for my mother. I want the curviness, I want the loving, warm, soft touch of my mother. I want to become her. You see again the symbolic equivalence. And I can because if they can just put me on puberty blockers, cross-sex hormones and give me the surgery that I want, I won't be suicidal anymore. News flash, you will remain suicidal. The best research, the best evidence indicates that there is a slight drop in dysphoria right after surgery, during that honeymoon phase, and then the dysphoria returns. Those people remain obsessed with their appearance. There is a slight drop in suicidality and slight improvement in mood only when the honeymoon phase passes. And then the suicidality and the acting out urges and the low mood and the labile moods return. Because the issue was never your biology. The issue was something else. What was the something else? I don't know specifically. Every person has their own symbolic profile, as I call it. And when we explore that symbolic profile, we see what their associations are, and we see how closely they equate their associations with their physical bodies. And when we can revisit those, and when we can resolve whatever pain-causing associations may be present there, and we slow down, then hopefully we can develop out of a state of symbolic equivalence to a state of symbolic representation. And the person can develop as an individual themselves. In other words, they become their own person regardless of those associations, regardless of the negative associations. Those don't need to be you. You outdevelop, you outgrow those negative associations and you become you with the body that you were born as. And with psychological maturity you also gain so many other different skills. So not only will you hopefully outgrow this proclivity towards symbolic equivalence in relation to your body, you'll also outgrow this proclivity towards psychic equivalence in relation to everything else in your life. In other words, there would be also a reduction of maybe some personality pathology that you might be battling with. But it takes time. And the best cure, and this is what's nice, and last year at the GenSpec conference here in Killarney, one of the detransitioners actually said it. She said, the best cure for gender dysphoria is completed adolescence. Go through your adolescence, go through it. That's the best cure for gender dysphoria. Because you discover yourself, you mature, it takes time, you engage with your body all the time. There are shifting associations, there's maturation not only physiologically but also psychologically. And there is, hopefully with the right support, also development towards symbolic representation as opposed to equivalence.

Stephanie Winn: I want to clap. Jaco, that was so eloquent. I'll just I'll share my thoughts with you and and with the listeners because this episode will be coming out December 16th, 2024. And I think that we're going to go out with a bang this year. I feel like this I don't know how many listens this will get because it's a more intellectually challenging episode. And sometimes the ones that are a little bit more niche for therapists don't get as much exposure. But personally, this is one of my favorite interviews that I've done all year. It's just so many moments that were just, you know, that you I can't imagine anyone saying it better than you said. And so I'm just feeling really grateful that this is basically I think I'm going to publish this as my last interview of the year. I publish episodes every single week. But after December 16th, we have the 23rd and the 30th. And I've been thinking it's really not fair to any of my guests to publish their episodes so close to the holidays because it might not get as much exposure. So I think I'm just going to publish like really brief solo episodes for those two weeks. And so this is actually, I'm just going to announce it right here and now, this is my last interview of 2024 and I really couldn't be more pleased to wrap up on this note because I think you've done an incredible job both in your paper and in our conversation today of I'm putting a very fine point on some particular psychological dynamics that are driving this issue that's so concerning. And I really hope that your work reaches people and helps people and maybe is even kind of that keystone piece of understanding that unlocks something for some of our listeners or your readers, whether it's a therapist that is bravely doing this challenging work or a parent who has a high tolerance for listening to really theoretically dense conversations and has a good degree of interest in psychology and who heard something that you said today and is not going to forget it when they approach their child. So I really thank you for this and I'm excited for what's to come with your career. I know this is not the first paper you've written and it's probably not the last. Is there anything you'd like to share about what else you've been up to or will be up to?

SPEAKER_02: Yes. So we've been working closely with the Open Therapy Institute in New York.

Stephanie Winn: And when you say we, you mean Critical Therapy Antidote?

Jaco van Zyl: critical therapy antidotes, some of the members of the critical therapy antidotes, some other members too, with compiling certain training materials that will gradually be rolled out. So that's going to be quite a challenge. a dense and a packed syllabus of training that the OTI will gradually roll out. We're also looking forward to starting our own set of training in the later future. Maybe, I'm not too sure whether I can mention it yet, but I have also contributed to a chapter that will hopefully be released sometime next year. I won't say too much about that yet, where I give, again, a psychological formulation of critical social justice. And I do this from three perspectives. Then what else? And we will continue interviewing people on our CTA podcast. There's a lot of work to be done. I'm just happy to see that there are so many therapists and thinkers in our field that have really come out of, I don't want to use the expression, but really come out of the woodwork and actually taking the courageous stance of thinking together, of talking together, and explore this topic with greater boldness. And that is what we want. We don't have all the answers. We think together, like I said. Some of these topics are really difficult to conceptualize, and we also need to be able to tolerate the discomfort within ourselves while we allow these concepts to form. And let's continue doing it. Ideology is thought terminating. Ideology has all the answers. It's the end of it. Well, it's perverse, so it promises … gratification and indulgence, and that's really the end of it. Reality is way more exciting than that, because reality is always unfolding. We always discover so much more. Yeah, let's continue doing it. Talk together, think together and work together.

Stephanie Winn: Beautiful. Well, I hope to have you back in 2025 and thank you for all that you do. It's really been a pleasure today.

Jaco van Zyl: Thank you. Thank you for having me.

Stephanie Winn: I hope you enjoyed this episode of You Must Be Some Kind of Therapist podcast. To check out my book recommendations, articles, wellness products, guest episodes on other podcasts, consulting services, and lots more, visit SomeTherapist.com or follow me on Twitter or Instagram at SomeTherapist. If you'd like to go deeper, join my community at somekindoftherapist.locals.com. Members can dialogue with other listeners, post questions for upcoming podcast guests to respond to, or ask questions for me to respond to in exclusive members-only Q&A live streams. To learn more about the gender crisis, watch our film, No Way Back, The Reality of Gender-Affirming Care, at nowaybackfilm.com. Special thanks to Joey Pecoraro for our theme song, Half Awake. If you appreciate this podcast and want more people to find it, kindly take a moment to rate, review, like, comment, and share on your platforms of choice. Of course, just because I am some therapist doesn't mean I'm your therapist. This podcast is not a substitute for medical advice. If you need help, ask your doctor or browse your local therapists online. And whatever you do next, please take care of yourself. Eat well, sleep well, move your body, get outside, and tell someone you love them. You're worth it.