Straw media. You pay the wine
price like he is a bottle. If

you wind and told you listen to
my troubles. Welcome to conversations with friends

and strangers. I'm Maggie. I'm
the Lam in the show. We take

a closer look at the complicated relationships
in the Hulu series conversations with friends.

Will meet some of the cast and
crew, chat with experts and share our

own kind of sexy, kind of
uncomfortable, but relatable stories about the messy

relationships we find ourselves in today.
We want to know why are we so

self destructive and how do we grow
past it? Dr C Sue Carter gives

us a scientific explanation for urge to
fail, and natural selection seems counterintuitive,

right then, writer Christine Wiedenbach somehow
makes the image of a burning bridge inspirational.

Obdu and Peter Weiss dispels some myths
about endometriosis, those Pesky and doometriosis

misconceptions, and we learned that twitter
is a pretty powerful tool for getting over

a breakup. Who Know? But
first that's your cap. Francis Asks Nick

about his depression. He tells her
he was hospitalized for six weeks. They

talked about children. He meets her
mom. Francis is diagnosed with endometriosis and

she hides it from everybody. Nichtel's
Francis. He and Melissa started sleeping together

again. Francis ends up going to
Nick's birthday party. She does not handle

herself well. She storms out crying. Actually, Melissa showed body Frances a

short story. There's a confrontation and
Francis freezes. So why couldn't you show

it to me that? And then
Francis and nick meet up at a park

and they break up. Okay,
and Oh, why do we do stupid

things? Why? Why? Why? Why? Why not just be happy

all the time? This is neurobiologist, DR C Sue Carter. Because selfdestructive

tendencies seems so antithetical to survival and
evolution, we figured there must be a

biological explanation. Most of us have
sufficient food, we have shelter. So

what pushes us back into these primitive
states? Whether they be then selfdestructive behaviors,

a kind of behavior that is associated
with socalled borderline symptoms, where person

will cut themselves or use drugs or
alcohol in a selfdestructive way, or even

suicide, which makes not much biological
sense, but which, from an emotional

point of view, may seem at
the moment like the only solution. My

thinking is, and unfortunately we can't
fix this with hormones, but my thinking

is that the old system pushes its
way through under conditions of acute stress.

The main benefit of love when it's
working well as a sense of safety,

not only consciously but also in our
bodies. And the minute the relationship starts

to shift out of safety, maybe
in one partner as unhappy and wants to

leave, these things somehow create a
kind of vacuum in our nervous system and

it's very common for people to try
to fill that chemically with drugs, with

substances, with excitement, anything they
can do to get out of that sense

of loneliness, which has now been
very well established to be one of the

worst things that can happen to people. Feeling alone is a kind of ultimate

sense of of threat and danger,
and that puts our bodies into a different

physiological state, one or we feel
vulnerable, physiological state in which we don't

know, sometimes just don't know what
to do. Our cognitive functions seem to

get a little out of whack and
that that's a huge problem. It's especially

a problem for people who experience lack
of safety in early life. That safety

seems to lay down the foundation and
that foundations based, in my thinking,

on the receptors for oxytocin and bits
of person and you start to see that

system caliber rted. So then when
something happens later, those individuals with what

we might call a band management or
trauma histories are very disruptive. They have

a hard time being by themselves.
Sometimes you'll see what's called borderline personality UPP

here. I don't think that's a
disease. I think that's a state.

But for some people, if you're
in that if you're in that state all

the time, it's very hard to
get it anything done, because your body's

kind in a in a constant state
of uncertainty. Can you tell us a

little bit about your experience with selfdestructive
behavior? Oh my goodness. Well,

you know, get into the right
place. This is writer Christine Wheedenbach.

She actually got her MF and creative
writing at the same place as my mom.

Dead. Part of me thinks it's
boredom or like I know I am

have like I've been diagnosed with bpd, as a creative person. You know

you kind of destruction is kind of
a form of creation. So, you

know, it makes me feel it
one with and one with my element to

you know. So how do you
see it come up in in relationships?

So people will get ever so close
to me and that at some point,

like I maybe rely on them too
much or maybe there's like some sort of

like individualistic thing going on there.
But like I could only get so close

to people before I just like,
let's let's burn this bridge. How could

we burn this bridge? Obviously I
assume some kind of like protection method.

But but obviously you know your sacrifice
a bit in that protection. There's a

reason that you end up doing that
and it's like you have to kind of

deal with the reason before you can
deal with your arson. It's good advice

and it's a very visual phrase to
I'm imagining a poster, you know,

one of those inspirational ones that hang
up in a guidance counselor's office. There's

a picture of a bridge engulfed in
flames and then maybe like block letters or

even Nice cursive that says you have
to deal with your reason before you can

deal with your arson. And how
do you burn those bridges, particularly,

if I may ask, basically becoming
obsessive or jealous or that, because that

could look like a number of different
things with a number of different people right,

kind of like letting the relationships hour
as a means of preserving yourself.

But I'd like I know I've done
like that, you know, way too

many texts, just like total rational
fighting for no reason. I liked that

a lot when I was young.
So where are you at now, like

in in terms of like you're old
own like reflections on, you know,

the way the things have got in
the past and then how you want to

move things forward in the future.
I'm the happiest I've ever been. M

I was able to I was fortunate
enough to lay down some roots. I'm

doing a career that works for me. I'm like achieving my goals and I

kind of like a bit of a
solitary life. I like, I like

people in my life, but I
like them only so much because I'm you

know, I just like being alone
and I like that time is kind of

sacred to me. I like my
life right now. Yeah, that's where

I'm at right now. That's amazing
to hear. I don't think that,

like, I don't think that I
would have recognized myself if I was like

what if I went back and like
my twenty year old Self Sambi today?

I don't think she'd recognize but I
think that in the end I'm glad I

was her, you know, like
it all worked out in the end,

but Dang, I bumps along the
wood. Yeah, and also, like

things continue to work out right,
like you know, things you know at

thirty. I I'm thirty two,
for example, and I know that,

like things are going to continue to
change. weirdly enough, like you know,

I'm I feel much better about where
I am now in my life as

a thirty two year old than I
did as a twenty five year old.

I was a lot more like fucking
totally falls apart, not that I'm not

falling apart every day now, but
stiffer part of frobably a watch less dire

way. And I also stylize now
very you know, doing about I think

it was more stylized back then.
I think it was a lot of effects.

Everything was like hotter back I don't
know, everything was hotter. Yeah,

like, I don't know. I
think about it's like and I was

really doing something exactly, but at
least now it's a little bit, you

know, the this waters a little
shallow, or maybe you know and like

moving forward. I'm like, okay, so I haven't necessarily figured it out,

but I know that, like,
things are going to change. Yeah,

life is so adapted, but just
keeps re creating other ways to make

things work. But I think what
most of us are interested in is some

kind of optimal wife, some kind
of world in which we are not anxious

all the time, in which we
feel some degree of safety, ideally inside

of ourselves. Okay, so that
we can then interact in a healthy way

with other humans. and that's tall
order. That's a hard thing to do,

because we are so well designed to
be on the alert for danger.

Our minds and our bodies are very
strange. Let's take a quick break and

when we come back, a crash
course in endometriosis with Dr Peter Weiss and

a very creative and not destructive way
to cope with heartbreak. Welcome back.

Today we're talking about selfdestructive behavior and
how to go past it, and in

this episode of conversations with friends,
Francis gets a diagnosis that kind of turns

our world upside down. I tell
patients at endometriosis is like real estate.

It's all about location, location,
location. So some people it's debilitating,

others there's no problem at all.
This is Dr Peter Weiss. I'm born

certified obgi in. I graduated the
University of Michigan School of Medicine. The

CO founder of the Rodeo Drive Women's
Health Center. Also, he may or

may not be my uncle. Endometriosis
is a fairly common disorder. It's found

in about ten percent of reproductive age
women. It's ninety nine point plus percent

non malignant and it can cause what
we call this minorrhea, or very painful

periods, heavy periods, pain with
sex and have chronic pain. Really what

it is? It's a little bit
harder to explain, but the lining of

the uterus is called the endometrium.
It's only a few cell layers thick and

that's where those cells are supposed to
live, but when those cells sort of

move out and go to different parts
of the body, that's what we called

endometriosis. And really what endometriosis is
it's an inflammatory response. So it causes

inflammation in those areas and those cells
live. They take the blood supply,

nutrition for whatever part of the organs. They sort of invade into it.

And I've heard that endometriosis is really
hard to diagnose. Why is that so?

First of all, you talking about
microscopic cells, so it's hard to

diagnose things with microscopic cells. There's
no blood test. The old days we

used to diagnose endometriosis doing what's called
a laparoscopy. We stick a tube into

woman's belly and we look, but
it's progressed so far that we no longer

do that. That we can diagnosis
by symptoms and it's somewhat of a diagnosis

by exclusion, even though we do
include certain things. And then we would

treat it, because the treatments are
relatively mild unless you get towards surgery.

So we don't need to do surgery
just to diagnose what we think is there.

And how do you treat it?
Is it's a wide range and is

very simple and sometimes it's just taking
nonsteroidal such as I'd be proven. Another

simple way of doing is birth control
pills. Estrogen and projection pills also work.

The simple things like acupuncture, because
that's pain control. You can do

progester and only pills, no estrogen. There are injections, something called Gnrah

Agon is something like Lupron, which
sort of puts you in a pseudo menopause.

That there are other people which will
which have more patients than me.

And Diet Control. If you eat
foods high in omega, three fatty acids,

they tend to be anti inflammatory,
reducing red meat, increasing fruits and

vegetables. And then here comes the
hardest part, is limiting caffeine and alcohol.

So those do help some benefits but
doesn't work with everyone. So that's

the wide range. And then the
last one is surgery. That's the one

that we usually send to a special
surgeon that meticulously go through the lapses of

those tubes and they peel off the
endometriosis wherever you can. Now remember that's

not curing it, that's just reducing
the amount of endometriosis and hopefully reducing the

pain m so it sounds like all
of the treatment is really just pain management.

Is that accurate exactly? That's sad, but most indometriosis will resolve when

you go into menopause. It doesn't
always go away, but it's much much

better, does does endometriosis resolve on
its own without menopause, or is it

more of a life long experience?
I tend to tell people it's a chronic

illness. They'll be ups and downs
like anything. Anywhere from thirty to fifty

percent of women with endemy shows has
can have fertility issues, but it's I'm

not trying to imply that if you
have in endometrioses you will have a problem.

Again, it's about the locations.
So some endometriosis could be mild and

you have real, significant problem getting
pregnant. You could have significant endometrioses and

have no problem. And if you
think about endometriosis being estrogen dependent, you

have more estrogen over those greater number
of years because the if you have multiple

births you have less chance of endemy
shows has. But remember you're not having

your cycle, you're not having that
estrogen push for those times while you're pregnant,

in nursing, so things like that. So pregnancy can ease endometriosis basically

in some SASS, because it's similar
to if I put you on a pill

the turn off your periods completely.
That's what a pregnancy would do. You're

not getting your periods. HMM,
I'm not so you guys were pregnant.

Now. My uncle definitely told us
to get pregnant. You are over thirty.

I am. But what I really
want to talk about is what the

doctor tells Francis. Have you heard
of Endometrios has, Francis? It's a

condition where cells from inside the US
risk grow elsewhere in the body. These

cells are benign as in their nonconsrous. Both endometriosis is complicated. It's difficult

to diagnose on there's no cure as
such. It's not a common. One

in ten women suffer from it.
There are surgical interventions, but they're only

really necessary and particularly severe cases.
So a focus right now is pain management

and preventing it from becoming debilitating.
There's one other thing right unfortunately, this

can lead to fertility issues for some
women. Right bus, there's much more

we can do about that now.
This really doesn't mean what it used to.

Can I ask if you're trying to
conceive or planning to in the near

future? I mean, that's not
something currently, and so you and I

reacted to this differently, quite differently. I think that this doctor was not

very fair to Francis. To be
fair, in the book it's even worse

when you were in a doctor's office
and you're alone and then you hear your

words like uncurable and pain management and
high risk pregnancies or whatever. I would

be spiraling to. Yeah, I
think that's interesting that you took from that

interaction with the doctor the exact same
thing that Francis did, whereas when I

watched it, I guess maybe because
I'm more familiar with Endometrios's, I was

like, it's okay, it's not
the end of the world, you don't

know anything yet. What I saw
is I my Jewish mother side kind of

came to fight and was like no, Francis, it's okay, she's not

telling you everything. I feel like
there's so many things that she could have

told her that she didn't that I
want to tell Francis, that I think

we should let Dr Weiss Tell Francis. So a true physician is where you

show compassion and caring and not try
to scare the shit out of somebody.

Hell, yes, you are at
a higher risk of having fertility issues,

but it absolutely does not mean you
cannot get pregnant or will not get pregnant.

I every patient comes to me out
of ten patients, one person will

have an easier chance to get him
pregnant than another and some will have a

harder chance. I don't know who
those are. And just because you have

endometriosis doesn't mean you will have a
problem. Do you have any tips for

people talking to doctors about these subjects? What I always told patients and I

teach the residence the patient has to
have all her concerns answer. When ever

I leave a room after I see
a patient and I always ask have I

answered all your questions? The bad
thing is most people will say yes,

yes, even if I haven't.
So I'll do have tell page to look.

If I gave you a lot of
information. Let's say you're the first

time Maggie. You came in.
I told you sadly you have endometriosis and

you have a lot of questions and
concerns. I would tell you to do

some research. So you go to
a respected healthcare site that will give you

honest information, not false information,
about endometriosis, and you can go the

very basic ones like from the Mayo
Clinic, Cleveland Clinic, Hopkins. You

pick your economic institution of choice that
will help you sort of guide you along

the way to be careful of a
lot of the sites out there, because

I'm sure you could find it a
site which will claim it. Endometriosis will

cause you to roll a third leg. You still want children. That's off

the time. You don't know,
studio, I think you'd be a great

at you have a kind nature that
you're very loving. The endometriosis news hits

Francis especially hard, I think,
because she's attached a lot of her self

worth and her relationship with nick to
her ability and her willingness to have kids,

and so this is her one kind
of bargaining chip. Of like,

but I will have your babies.
It's what she has to make her argument

for her role in Nick Life.
I see what you're saying. I just

don't think that she's plans ahead that
much. I think it's a genuine love

thing with with Francis. I don't
mean it to say that she's calculating.

I just mean it to say that
that she's attached some self worth in it.

I think it has to do with
her own lack of self confidence and

self esteem. Yeah, totally so. Yeah, it hits her very hard.

Then the news about the end of
matriosis because of everything that he hears,

that the doctor says, it what
she takes from it. Yeah,

and then when, by the end
of episode, when Bobby comes along and

the conflict between them happens, it's
just it's a lot, it's a it's

a lot, it's a lot,
it's a lot. And I also,

you know, I wonder if it
would have been an opportunity for Francis to

be a little bit vulnerable with bobby
if bobby hadn't found out about her short

story at this exact moment. You
know, would she have come home and

would francis have been like, I
just got this crazy news and I'm feeling

kind of freaked out about it,
because she sometimes shares with Bobby, you

know, not always, but sometimes. Yeah, there are tender moments in

which she opens up to Bobby.
Bobby can definitely open her up more than

anyone else, but she has a
bad track record with sharing news and a

timely matter. She just doesn't fucking
share anything. Just doesn't share, it's

true, especially when she's feeling attacked. Yeah, she's just freezes and she

definitely gets attacked in this fight.
Oh Yeah, and you know what,

I think she kind of deserves it. She does with contempt, and whatever

she wants she can have. It's
fiction, so why couldn't you show it

to me then? What is wrong
with you? I'm sorry, I don't

think you think anyone else is real. Francis, standing in front of all

those people at that party, all
fucking wounded, kissing me and then writing

this shit instead of communicating anything.
Even now you can't your self. Obsession

is exhausting and it's hurtful and it's
fucking boring. Bobby is so brutal with

Frances in this scene doing something,
but she's not wrong. You know,

it comes from a very raw place
and it hits hard because it's just fucking

true. Yeah, and Francis knows
it. She apologizes multiple times, but

not not really. I mean she
says like sorry, but says I'm sorry,

I'm sorry, kind of make the
situation stop. Maybe. I don't

know. I don't know what I
will do in that in that situation.

Yeah, yeah, I I know. I definitely wouldn't think of anything intelligent

to say, but there's that thing
about when you're in a relationship, in

a breakup or in a fight and
after they leave, after the confrontation you

have all these things that you want
to say to them. I think I

know what I talked about. I
get very defensive and then after I get

defensive and send an email or say
a lot of things, I have,

all night long, or maybe four
weeks or four years, centuries, have

all of the things that I should
have said and how I should have said

them. I think at this time
I was like twenty four, hundred and

twenty five. This is Rachel Bell, but like a small press put out

a scene that I did called loss, and it was I had another break

up and it was a little serious
relationship and after we broke up it was

like, okay, we're not going
to talk and I had so much that

I wanted to say to him,
and so I made a private twitter account

called things I want to text let's
call him Joe, and no one could

follow it. But anytime I wanted
to text him, instead of sending the

tax I typed it in into a
tweet and just like sent it to no

one. It was nice to have
a repository like it was. It was

basically just a coping skill, and
so the book is entirely those in chronological

order. So you can kind of
just like watch me go through the stages

of grief and then eventually feel okay
at bed. I didn't start it with

the idea of, you know,
productizing it or publishing it ever, but

I was like, damn, this
is so real. And I was talking

to somebody recently about like what being
a successful artist means, and to me

it's like, obviously it's great to
receive renown or acclaim, but if somebody

who's like lived a totally different life
than me can read some work I made

and like feel something or empathize with
it, that's success to me. And

that was one of the ones that, like it wasn't very widespread, but

when people reach out to me about
it, it was like hey, this

like really helped me go through a
breakup, and that is just like one

of the best feelings I can think
that Rachel's work is available on her website,

Rachel Bell Dot Info. Will also
link it in the show notes.

How a show, and this show
is hosted and produced by me, Maggie

Bowls, and me, no,
I'm Gadweiser. It's written and edited by

me, with assistant editing by NWAM
are. Supervising producer is Ryan Tillotson,

with help from Tyler Nielsen, Frank
Driscoll, Nick Bailey and the entire Straw

hut team. The music is by
Maggie Glass and square fish, and big

thanks to Aria A, shy,
Lauren Thorpe, xavior Salas and the Humu

team. Than a little SI's mess, misconceptions sky tell me trios, misconceptions,

conceptions, this skinsky and drew less
skins and me trust, misconceptions and US PSKY