'This is a meta-crisis. I’ve talked about this before. This way of life has a time limit on it. It has a countdown clock now. When that runs out, I don’t know. Probably after I die, but it’s happening. It’s getting worse now.

Rome didn’t collapse overnight. It took hundreds and hundreds of years. This way of life is collapsing because it is unsustainable to begin with. Even going back to Mesopotamia six to eight thousand years ago, it was already unsustainable then. Those first cities are desert now, where there used to be cedar forests. The city of Uruk—where Gilgamesh comes from, where the Epic of Gilgamesh is set—talks about him killing the protector of the cedar forest. There were cedar trees all around. You look at a picture now, and it’s desert.

So this way of life has a death urge. I think everyone can feel that, on a conscious or subconscious level. And I think that contributes to what we call mental health disorders or crises. It depends on what you choose to do when you feel these problems.

You can shut down and destroy yourself: depression, anxiety. You can lash out and hurt other people—murder, for example. Psychopathy, sociopathy. Narcissism is essentially this culture. You can, in a way, adapt to this culture and be “well adapted” by embodying its narcissism and psychopathy. That’s how you get CEOs and billionaires, Wall Street executives, hedge fund managers—corporations that make billions of dollars cutting down forests.

But even then, I think you still have a mental health problem, even if you’re well adapted. In fact, there are multiple studies showing that CEOs and politicians have much higher levels of psychopathy, sociopathy, narcissism, and sadism—taking pleasure in the suffering of others—than the general population. They have embodied what the culture is: this death urge.

I think a lot of people struggle with this. They don’t want to have a death urge. I don’t think that’s natural for our personal well-being. And I think a lot of people know that. So it causes this great psychic, this great cognitive dissonance: we’re told to value something that we know, at the deepest level, is not right for us. That cognitive and psychic dissonance is, I think, mental health problems—mental health disorders. And we can choose how to deal with it.

Now, there’s more to that. There are genetic predispositions to some disorders, due to variations in brain function. But I would say the majority is not a genetic problem. This goes for health problems generally.

When I was a spine surgeon, people would say, “Oh, bad backs run in my family—it’s genetic.” And I’d say, “No. This is a lifestyle thing. This is a choice thing.” Unless someone had something very specific—like a genetic hypercholesterolemia so severe it blocked their blood vessels and prevented healing, or Ehlers–Danlos syndrome with extreme hyperflexibility that caused joint injury, or one person who couldn’t feel pain and wore their joints down to bone-on-bone. But that’s maybe three people out of tens of thousands I saw.

This argument that genetics causes most problems is false. The majority are choices people have made. There is that aspect to mental health—I’ll say that. But I think a lot of the mental health problems we have come from this dissonance between what is truly at the core of our nature and a culture that has a death urge.

So how does a culture get made?

Culture is made by the stories we tell each other and ourselves. Culture is made by the choices we’ve made over time, collectively. And culture changes. How does it change? It changes through the stories we tell. It changes through the choices we make for ourselves and for each other.

That’s why I make these videos. I think this culture has a death urge, and I’m highlighting that here—while also talking about mental health'.

Goobie

“The majority [of health problems] are choices people have made.”

• Issue: Normative and causal claim bundled together.

• Problem:

  • “Choice” ignores constraint, coercion, structural determinants

  • Easily read as moral blame

• What critics will say: Neoliberal individualism sneaking back in; victim-blaming.

• What would help:

• Reframing “choices” as structurally shaped behaviors

• Explicitly naming socioeconomic constraints.

gpt

Reviewer-resistant version

This is not a discrete crisis but a meta-crisis. By that I mean not a single failure mode, but a convergence of ecological, economic, psychological, and symbolic limits internal to a particular way of life. That way of life exhibits clear temporal constraints: it depends on material throughput, social organization, and narrative commitments that are historically contingent and demonstrably unsustainable. Whether its terminal point lies within a single lifetime or several generations is an open question; that it is structurally degrading is not.

Historical analogies are necessarily imperfect, but they are instructive. Large-scale social formations rarely collapse abruptly. Rome, for example, disintegrated over centuries through cumulative stresses rather than sudden catastrophe. What matters here is not the analogy itself, but the general pattern: systems can persist long after their internal contradictions have become decisive.

From its earliest urban expressions—Mesopotamia is a paradigmatic case—this way of life already bore the marks of ecological overshoot. Archaeological and environmental records indicate that regions once capable of sustaining dense populations and rich ecosystems were progressively degraded. The Epic of Gilgamesh is not evidence in a strict historical sense, but it is revealing as a cultural artifact: it registers, symbolically, an early awareness of extraction, domination of nature, and irreversible loss. Today, the deserts where forests once stood are material residues of that trajectory.

What I am calling a “death urge” should be understood analytically rather than diagnostically. It names a recurrent cultural tendency toward practices that undermine the very conditions of their own continuation—ecologically, socially, and psychologically. This tendency does not require conscious endorsement, nor does it imply uniform subjective experience. Rather, it operates through incentive structures, norms of success, and dominant narratives that reward short-term accumulation, domination, and abstraction from consequences.

There is substantial reason to think that prolonged exposure to such contradictions produces psychological strain. A growing body of work in psychology, psychiatry, and the social sciences shows that distress is not merely an individual malfunction but often a rational response to chronic dissonance between lived experience, moral intuition, and socially enforced values. What we categorize as “mental health disorders” frequently emerge at this intersection—not as purely endogenous pathologies, but as expressions of a misalignment between human needs and the conditions imposed by a given culture.

Individuals respond to this strain in different ways. Some responses are inwardly directed: withdrawal, depression, anxiety, self-erasure. Others are outwardly directed: aggression, domination, instrumentalization of others. Importantly, certain traits associated with the latter—reduced empathy, grandiosity, callousness—are not only tolerated but systematically rewarded in contemporary institutional contexts.

Research on corporate and political elites consistently finds elevated levels of what psychologists describe as dark triad traits—subclinical narcissism, Machiavellianism, and psychopathy—relative to the general population. These are not diagnoses, but statistically significant tendencies. The point is not that such individuals are “mentally ill” in a conventional sense, but that a culture can select for traits that are socially functional while remaining ethically and psychologically corrosive. Being well adapted to such a system does not imply well-being; it may indicate the opposite.

Many people experience this as a form of cognitive and moral dissonance: they are instructed to value ways of living that conflict with their embodied sense of what sustains meaning, connection, and continuity. This dissonance is not accidental. It is constitutive of a culture that requires individuals to participate in practices they often recognize, at some level, as harmful—to themselves, to others, and to the future.

This does not mean that all mental health conditions are socially produced. Genetic predispositions and neurobiological variation are real and relevant. However, heritability does not imply determinism, and gene–environment interaction is the dominant explanatory framework in contemporary research. Across both physical and mental health, the preponderance of conditions commonly encountered in clinical settings are strongly shaped by lifestyle, environment, stress exposure, and social organization.

In my own clinical experience as a spine surgeon, the appeal to genetics was often a way of obscuring this fact. Except in relatively rare cases—specific connective tissue disorders, extreme lipid metabolism conditions, or congenital insensitivities—most chronic conditions reflected patterned behaviors and constraints rather than inherited inevitabilities. The same caution applies to mental health: biology matters, but it does not absolve a culture of responsibility for the conditions it normalizes and enforces.

Primordially, many contemporary mental health crises can be understood as symptoms of a deeper conflict: between basic human capacities for attachment, meaning, and continuity, and a cultural system oriented toward extraction, acceleration, and disposability. If that system exhibits a self-destructive trajectory, it is unsurprising that those living within it experience disorientation, distress, or fragmentation.

Culture is not an abstraction imposed from nowhere. It is produced and reproduced through the stories we tell, the values we normalize, and the choices we make collectively over time. Cultures change when these stories and choices change—often unevenly, often under pressure.

That is the purpose of this intervention. To name a destructive tendency where it has been rendered normal, and to insist that what is treated as individual pathology may, in fact, be an intelligible response to a way of life that is itself pathological.

gpt