On Building Structures To Create Love In The World

Starting with the most hurting and unhelped people

If you’ve read some of the book found here, The Structure of Love, you might wonder how I plan to apply my ideas in the world beyond my personal life. I finished writing it in the summer of 2024 and then I pivoted to work full time on my current project of starting a mental health charity that works with people in poor countries that have zero mental health care in their community.

It’s been an amazing process for the last nine months or so. I now have nine or ten team members because with volunteers new one’s join and others drop out, and we have our first official pilot going now in the Philippines. It takes time to get funded, and so that’s been a big part of the process, but we’re building as we fundraise.

So here’s the basic idea: 1 Billion humans on this planet suffer from a Common Mental Disorder (CMD) like depression, anxiety or PTSD. That’s 1 out of 8 humans. It’s surprising for many people to learn that now the #1 health disability on earth is depression. That’s a lot of people taken out of normal life and unable to get their kids to the doctor, or help them with homework, or start a new business when the opportunity comes…it really hurts local communities and of course, most of all, the family. So when you help a mother overcome her depression and regain her footing into normal life, you really boost the whole community. It’s a tremendously impactful way to do your bit in the making the world a better place. In fact, its been shown to be 6x more effective than direct cash transfers.

So the world has this problem affecting 12.5% of us, but the current solution is to go to expensive therapy with someone trained for a decade, and there’s just not enough of those highly trained professionals to meet the growing need for care, this is called the treatment gap. In the seventies’ pioneers started toying with the idea to train somebody for a few weeks in various versions of what is essentially empathic listening, and see if that would be enough to help people effectively, and amazingly it was. I got trained in empathic listening to become a “Student Listener” when I was a 14 year old Sophomore in 1978. Now there have been over 100 RCT’s (Random Controlled Trials) proving lay therapy to be as good as or even better than traditional professional therapy.

Further research in the professional therapy world to try to understand what makes the most effective therapists, accidentally uncovered the reason why lay therapy can be so effective. It turns out that of all the factors that go into a therapy session to determine effectiveness—the number one by far is empathy ability. Some people just have it more than others. It doesn’t matter the style of therapy, or the years of experience, or any other thing, it all just comes down to how good you are at empathy. You can go to school for twelve years and not be as good as someone with two weeks of training who has a higher empathy gift than you.

All these years of various schools of psychology trying to figure it out and it really doesn’t matter how much you know about superego’s or id’s, attachments or structures, cognitions or behaviors, whether to talk as well as listen, to give advice or refrain, where you sit in relation to the ‘pation (it rhymes), or how you waltz with your gestalts.

All that matters is empathy.

It must really suck to study for 12 years and finally start getting paid hundreds of dollars per session and only then discover you have no real gift for empathy and therefore you are always going to be one of the lower percentile therapists. It’s kind of like how they say 50% of medical doctors graduated in the lower half of their class.

And that’s why so many RCT’s on lay therapy conclude that it is “as good as or even better than professional therapy”. That reflects the key that some lay therapists are high empathy and so they are better than any pro’s, unless the pro is also high empathy, and conversely sometimes the lay therapist might have been low empathy and scored lower than even average pro’s.

So really the whole pro therapy world should make admission to their educational programs based on pre-screening for empathy ability. Make it a bit more like sports and prove you can play before you get on the team. And there is such a screening thing. And we are going to use that to screen our lay therapists for hiring, so we could end up with one of the most effective therapy org’s in the world because we only hire high empathy people.

Speaking of hundreds of dollars an hour, the sad reality is that from the very beginning the vast majority of people that have had access to any form of therapy are rich people. In Europe with so many countries having nationalized healthcare, it’s quite available to get mental healthcare. In the USA there’s been a trend toward more insurance coverage, but there’s a long way to go and still lots of people don’t have medical insurance and can’t afford therapy. But those are still both wealthy places. In most of the world, the lower and middle income countries, outside major cities there is nearly zero mental health care available, no therapists, no clinics. And even in the cities where there are university programs and some therapists, it’s still for the rich and the treatment gaps are huge.

I lived in the Philippines for five years and I saw people suffering terrible anxiety and depression and just not have anything available to help them. It’s really sad that with all the progress we’ve made in mental health, it’s simply not available to most of the people who need it. And this whole time we’ve had lay therapy all studied up and ready to go but it just never really has been uptaken and deployed much into the world. As the WHO says, there are islands of good activity of it in the world, but these few islands are in the greater sea of neglect where there’s nothing available. So we really are at a place where the #1 disability in our world has a totally tractable cure, but it simply has not been deployed in any serious way.

To do that seriously you need two things — a scaling effort to deploy many local teams doing therapy in their communities, and a research lab to really develop this undeveloped thing to it’s full potential to make it more effective and available to groups anywhere wanting to help their local community. So that’s what I’ve created “Lay Therapy Research Lab” (LTRL) to do. Instead of the traditional therapy play, we’re going to throw a lateral and try something new, and seeing as LTRL looks like Lateral, that’s what we’re going to call it. Lateral.

I’ll give you the pro level philanthropy elevator pitch; Lateral will scale many local therapy teams into the field. Then we’ll stack all those teams into a giant social science research laboratory guided by a Central Science Team. We’ll start using already proven forms of lay therapy, and then begin to run experimental pilots of new forms. Our local teams will do therapy and collect data, then send that into to our Central Science Team (CST) for aggregation and analysis and then return that in a report to all the teams. Then the teams will do multiple levels of “Brainstorming-Collective-Intelligence” (BCI) to try and come up with some new way to make that therapy form a little better, an iteration…an innovative iteration. Then they’ll do more therapy with that new iteration, collect more data and repeat the process until we consider it a complete and proven therapy or it fails and we trash it. Then we’ll keep putting the good one’s into a basket of proven therapies and make them available to any local community therapy org’s that want to use them. And in this way we hope to become a generative backbone to an expanding global lay therapy movement.

We’ll do this in poor countries that have no mental health care available. Nowadays we use the term, lower and middle income countries (LMICs). We’ve already started in the Philippines and hope to expand to other countries soon.

To imagine mothers distressed by life’s challenges who’ve fallen into that dark pit of depression, but are now being helped to climb out and back up to normal life is what I dream of as I build. Their kids get better lives, their community gets back that meaningful contributor…five mothers in a village climb out and the village springs back to life, a thousand villages in a country and you can see the huge effect.

To help someone climb up out of the pit of depression is an act of love. Just as any act to heal another is. And if you peruse my book chapter one you’ll see how making a pizza is an act of love, as all work to benefit others is. Lateral is my work.

Thanks.