Playboy: Are you concerned about any other celebrities?
Pinsky: I'm interested in what's really going on with Angelina Jolie. I've never seen someone remit heroin completely. You're either still on heroin, OxyContin or something else. You're on methadone, Suboxone or some other replacement therapy, or you're in recovery. Unless you're dead. Is she still using something? Is she in recovery? By the way, if she's in recovery, I don't see any evidence of it, because people in recovery invest themselves in simple, selfless acts of service, not global self-serving acts. So that intrigues me. I mean no disrespect. I don't disrespect any of these people. Everybody's just struggling. But I don't like distortions and dishonesty when things are passed off. It drives me crazy when 23-year-old celebrities go into the hospital for "exhaustion." For Christ's sake, football players perform on the gridiron in 120-degree heat, and they don't have hot flashes or dehydration. That does not exist.
Playboy: Okay, this is too good. Who else intrigues you?
Pinsky: Of course Mel Gibson intrigues me a lot because I admire his work. I love his movies, so I have great admiration for the messages he puts into them even though I don't philosophically align with him. What I find interesting about Gibson is he pushed on all the ethnic and religious fronts. That's where he got off the track. But he's a straight-up alcoholic. I would love to see him get sober. If he does and can really embrace the program, he would be right back at the top of his game.
Playboy: Who gets the Dr. Drew seal of approval?
Pinsky: Well, Craig Ferguson, the Late Late Show guy, is a huge hero of mine. He talks about his recovery gently but clearly and is a great model. Robert Downey Jr. is another guy I greatly admire. Severe addict. Severe. With severe issues from childhood. I've never treated Downey, but we've talked and I've supported him over the years. When he was just getting sober, he asked me one of the toughest questions I've ever been asked. He said, "Should I ever work again?" And I thought, Here's a guy who gets it. He's fully aware that being famous and in that environment could actually kill him. Clinically, the clearest answer would be "No, don't ever work again because it will jeopardize your sobriety." But should I deprive the world of one of its greatest artists? I told him I just couldn't answer that. I figured he would negotiate it, which he did. He took two years off, and that was smart. The most important thing you can do in recovery is lead a simple life. I know that goes against everything we're made to believe we want in Hollywood, but the reality is, in order to get well, no matter how rich or famous you are, no matter how many Escalades you have, you have to remake your life so it's simple. Otherwise the temptations are too great.
Playboy: This year you allowed cameras to follow a group of recovering celebrities through their addiction treatment on Celebrity Rehab. How do you respond to critics who say you were just cashing in on their misery?
Pinsky: [Long exhale] Here's the difference, and I hope I'm not splitting hairs. First, everyone offered their consent, and as celebrities, even as fucked up as they were, they were fully aware of what granting consent means. Mary Carey summed it up best when she said, "After what I've done on camera, this is nothing." But I also felt very strongly that people need to see what the disease of addiction is, and that's what Celebrity Rehab is really about. Cameras certainly climb into every other aspect of medicine, whether it's cancer surgery or plastic surgery. Just because addiction is a brain disease, we have a problem with it. But a brain disease is no different from others. All diseases make us miserable. There's also a myth that rehab is a spa treatment or some kind of publicity stunt. I thought it was really important to show the reality: These people have family histories and medical histories, and the process of getting sober is fucking hard.
Playboy: But this wasn't exactly Frontline. In one episode you had a wet T-shirt contest.
Pinsky: I wasn't there for that, but allegedly that wasn't encouraged. Allegedly. Listen, this was the best I could do based on the limitations of television, and thank God we created a show that lots of people want to watch, so we're going to have an impact with this material. What I've learned about television is this: Doctors don't make good TV. The 12-step program and hospitals are boring. If you want to address these important issues in a way that will get more than 200 people to tune in, you have to piggyback onto people who understand entertainment. The public needs to hear from physicians more than anybody because there are so few of us out there. We stay aloof; we're too holier-than-thou for all that. But you have to find a way to talk about these things, even if they're weird and uncomfortable. That's what we've been doing on Loveline, after all.
Playboy: You've hosted Loveline longer than most of your callers have been alive. Aren't you tired of harassing kids to use condoms?
Pinsky: No, because I don't really have to anymore. The awareness of these issues has increased immeasurably since I started. Back then the word chlamydia had never been heard before. Gonorrhea was some kind of weird term. The kids had no idea what I was talking about. I'd literally have to start with "You know, there are these bacteria that can be transmitted from one person to another. When you get them, they grow and cause a discharge or pain with urination." Now callers have grown up knowing about AIDS. They're aware there's an HPV vaccine that can help fight STDs. Hell, they know what STDs are, which is a vast improvement. By the way, people always say the oral contraceptive pill was responsible for the sexual revolution. I think antibiotics were. Think about this: Throughout human history, if you got a sexually transmitted disease, you died. Not just syphilis or gonorrhea but a urinary-tract infection. You died. Pregnancy -- you died. So in every encounter, sexuality presented the prospect of death. Then antibiotics came along and we were unhinged from that threat. For the entirety of human history we were afraid and then, boom, no longer. Yes, oral contraceptives added to that. We no longer feared childbirth, which had been killing 20 percent to 30 percent of women. Those two factors unhinged us from our biology, and narcissistic behavior has been flowering ever since.
Playboy: What kind of reaction did you get from higher-ups when you started out in radio?
Pinsky: It wasn't good. Younger physicians understood, but my superiors were outraged. I remember an article about me came out when I was an intern, and the director of my residency program freaked out. He called me into his office and was screaming and spitting, and I was mortified. "You're sick," he said. "There's something wrong with you for doing this. Stop or else." But I thought it was important. I had to remind myself that this was something worthy, even though there was no blueprint for this sort of career.
Playboy: Did you stop?
Pinsky: I stopped for six months. But those were the six months when HIV really broke. It's when the term safe sex was coined. It's when the condom push came on. All of a sudden it looked stupid not to be raising awareness like this. So I came tiptoeing back, secretly doing more. Fast-forward to my becoming that guy's chief resident and teaching partner. About two years later I remember him saying, "Are you still doing that radio thing? How about I take over once in a while?" Really? Hmm.
Playboy: What new issues have you heard about from callers?
Pinsky: I am amazed at people's inability to understand how dangerous medications are. I'm not talking about hard drugs but rather what's in the medicine cabinet. Pharmaceutical abuse is out of control, and it's because kids have grown up watching their friends take psychostimulants like Adderall or Ritalin since they were eight: "They seem fine. Mom's got Vicodin left over from her tooth extraction, and I took Paxil for a few years. What's the big deal? It didn't hurt me." They just don't understand that medicines are incredibly dangerous. I am very concerned about how far we've gone with the notion that everything can be solved with a pill.
The other huge issue is binge drinking. Kids have always drunk, but now it's sort of extreme drinking and usually based on the hookup. The hookup has become the organizing experience of college life. In order to find somebody, connect with that person quickly and get them into bed, you have to drink -- heavily -- or smoke pot. Men do it to numb their feelings of anxiety and fear of rejection. Women drink to make their feelings go away because they don't want to get attached to a guy they know they may never see again.
Playboy: But since the dawn of time people have been self-medicating to boost their confidence with the opposite sex. What's the alternative?
Pinsky: Lately, one thing I've been discussing with guys is the idea that a male thinks foreplay means genital contact -- not necessarily intercourse but some form of genital contact. I try to make them understand that, for a woman, foreplay is dinner conversation and all that. Guys hear this, and they say, "Talking? What the fuck does that have to do with sex?" But of course the data show the best way to evoke the sexual drive in women is through intimate conversation. So you talk a little and maybe you go for a walk or have something to eat, and the focus shifts and the nervousness starts to go away. And then you have sex. We actually have a name for that type of interaction. It's called a date, but dating is dead in America.
Playboy: What about all the dating happening by way of Match.com, Facebook, MySpace, etc.?
Pinsky: Online dating quickly becomes a pseudorelationship unless you get off the wire quick and into the flesh. Mostly I see people infusing their online persona with so much fantasy and bravado that the people you connect with end up being false leads. But here's where guys have a real opportunity to create a situation that will get them laid: Women want to go on dates, and that will arouse them. Make it happen. Plan a night, be present or at least pretend you are, and allow that to be a part of the whole experience of foreplay. The sex will take care of itself, don't worry.
Playboy: What's your analysis of Eliot Spitzer? How could a guy like that make such a stupid mistake?
Pinsky: If we all agree men are the way they are because of certain biological commonalities and genetic impulses -- that we all crave diversity, that we're driven by our sexuality -- then the real surprise is that stories like this are not more common. Why don't more men cheat? In fact the reason more men don't cheat is because they have other priorities that supersede the impulse. Every man understands the desire. I certainly get the impulse. But I would never cheat. It would be intolerable. You don't put yourself in situations in which that train could leave the station. It would be so shattering to me.
In Spitzer's case I have a few basic theories. One is he's severely narcissistic and part of him is walled off, a part he can never show to his wife. But because he's narcissistic, he had to express it somehow, and it was easiest to rationalize doing it with a prostitute. Somehow that made it a special case. Another possibility is he and Ashley Dupré were involved for a while as part of this prostitution ring and he actually fell in love with her and couldn't stop himself. That's the most romantic spin. The Freudian analysis may be that Spitzer was reacting to his father, who is known to be a harsh person -- a guy who came from nothing and clawed his way to success. Here Spitzer is outdoing his dad. But those guys often have a selfdestructive impulse that doesn't allow them to stay on track without guilt or remorse. They would sooner obliterate themselves than surpass what Dad did.
Playboy: Let's turn our attention to pornography. Not long ago industry giants were raking in big bucks putting porn on the Internet. Now on sites like RedClouds and YouPorn, amateurs show it off for free. What's your take on all these citizen pornographers?
Pinsky: It's weird. I don't think people are anticipating the consequences. Those videos stay up forever. You're 18 and stupid now, but what will you think in 20 years when your kids find it? It has something to do with how we all shove video cameras in kids' faces from the time they're, like, one, and every second of their life is in front of the video or cell-phone camera. It's as though you don't exist without being on video. Couple that with the desire for fame -- and people have no limit to how far they'll go for fame -- and you begin to understand why all these celebrity sex tapes are popping up. The motivation for fame is autonomous and deep.
Playboy: How is the proliferation of porn changing sex?
Pinsky: It has totally changed things: The young male's expectations of how women will respond to sex, what women want and how they want it are way off from the reality of who women are. A lot of kids have grown up watching porn, and one expectation is that women like physically rough, aggressive penetration. They don't. Another is that women are as sexually charged as their male partners. They're not. And let's not even talk about anal sex.