Good Life Project - A Radically-Simple Approach to Getting Well | Julia Hotz
Episode Date: August 2, 2024Did you know doctors are now prescribing activities like art classes, nature walks, and community gardening to treat loneliness, lack of purpose, and other modern ills? In this fascinating episode, Ju...lia Hotz discusses the power of "social prescribing" outlined in her book The Connection Cure: The Prescriptive Power of Movement, Nature, Art, Service, and Belonging. Learn how reconnecting with these ancient wellsprings of human health and happiness can provide an antidote to the soul-draining effects of our frenetic, disconnected lives. If you've been yearning for more meaning, joy, and community, this conversation may be just what the doctor ordered.You can find Julia at: Website | Instagram | Episode TranscriptIf you LOVED this episode you’ll also love the conversations we had with Robert Waldinger about the role of relationships in our ability to live good lives.Check out our offerings & partners: Join My New Writing Project: Awake at the WheelVisit Our Sponsor Page For Great Resources & Discount Codes Hosted on Acast. See acast.com/privacy for more information.
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It's hearkening us back to the things we need to be healthy. We need to count on other people.
We need to have people we can call at 3 a.m. in a crisis. And we like to do that in return for
others. And so these social prescriptions that enable us to hold other people accountable and
be held accountable are, I think, just some of the most beautiful expressions of humanity.
This is what we do. We try to make it through together.
We count on each other.
We notice when we're not there and we celebrate when we are.
So you know how so many of us go to the doctor
and leave with a prescription for whatever ails us,
usually in the form of a pill or capsule or shot or serum.
What if your healthcare provider looked you in the eye,
then wrote you a prescription for dancing or nature or serum. What if your healthcare provider looked you in the eye, then wrote you a prescription for dancing
or nature or making art, often with others?
You'd probably look at them like they lost their minds.
And yet some physicians are starting to do just that.
It's called social prescribing
and the results have been astonishing.
My guest today is Julia Hotz,
and she offers a powerful re-prescription
for what ails us and robs us of truly living good life.
In her groundbreaking book, The Connection Cure,
The Prescriptive Power of Movement, Nature, Art, Service, and Belonging,
she introduces this radical concept of what she calls social prescribing,
addressing our deep human needs
through powerful antidotes like community gatherings, art classes, nature immersion,
volunteer service, and physical activity now being prescribed by doctors. Julia is a solutions-focused
journalist based in New York. Her stories have appeared in New York Times, Wired, Scientific
American, and more. She helps reporters bring new ideas to light at the Solutions Journalism Network.
And with The Connection Cure as her first book, she's at the forefront of an emerging
health revolution that could transform how we really view wellness and living a good
life.
So if you've been yearning to experience more meaning and joy and belonging, those
essential ingredients for a life well lived lean into this conversation.
Julia's insights into the prescriptive power of reconnecting through movement, nature,
art, service, and community, and how that's actually starting to be prescribed literally
in the medical profession may just start to provide the antidote that your soul has been
craving.
So excited to share this conversation with you.
I'm Jonathan Fields, and this is Good Life Project.
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Mayday, mayday. We've been compromised. The pilot's a hitman.
I knew you were going to be fun. January 24th. Tell me how to fly this thing.
Mark Wahlberg. You know what the difference between me and you is? You're going to die.
Don't shoot him. We need him. Y'all need a pilot. Flight risk.
You know, it's interesting. As we have this conversation, the world is in such an interesting
state. And we as human beings, as individuals are in another quote, capital I interesting state. And
there's a lot that ails us on any given day, psychologically, physically, emotionally.
It seems like so often when we're feeling something, some kind of discomfort in our lives, we reach
for the quick fix.
If we go to traditional medicine, we're often prescribed some version of like, what is the
easiest, fastest way for this to go away?
What is the pill, the thing I can take, the instant thing I can do?
And not to say that that isn't appropriate in a number of different situations.
Thankfully, that exists for a lot of different things. But you introduced this sort of like alternative approach to exploring
our condition that I think is really fascinating that you describe as social prescribing. Take me
into this. When we're talking about social prescribing, what are we actually talking about?
Sure. Thanks so much, Jonathan. Great question. We hear social prescribing and we hear the social, so we must think, okay, social
prescribing is about prescribing friendship. Actually, the name social prescribing comes
from the fact that a good portion of our health, some studies suggest 80% of it, is determined by
social factors in our environments. That includes things
like, do we have food to eat? Do we have safe housing? But it also includes things like,
do we have people we can call at 3am in a crisis? Do we have outlets to cope with the sadness and
the loneliness of being human? Do we have a sense
of meaning that wakes us up in the morning? These are all our social determinants of health.
Social prescribing is about addressing those. It's a way for doctors to prescribe us activities and
resources in our environments the same way they prescribe pills and therapies. So we could include
everything from fresh food, housing assistance, to an art class, or a cycling group, or even a
sort of community potluck, anything that gives us a sense of joy, meaning, and belonging.
I'm curious also, because this is an, I think a lot of us, when we hear about just the notion of,
oh, if I get involved in this, that, or the other thing,
I'll probably feel better.
But when you wrap that in this word prescription,
I think it gets really interesting.
Where does this come from originally?
Right.
Because it seems like in the research that you've done,
this is maybe a newer concept for us,
but maybe not so much for
a lot of other places. That's right. I mean, let's be honest, social prescribing this idea
of addressing our social determinants of health, this is a very old idea. My introduction talks
about how some of these ideas are present in writing from the Buddha or Hippocrates or Razzies of
Persia, texts going back thousands of years. It's also very present in community healthcare,
which has existed in the United States and elsewhere for a long time. It's present in
art therapy and nature therapy. I think the discipline of social prescribing is about
combining these ideas and practices under one roof and making it mainstream in healthcare.
Most of us, when we go to the doctor, we aren't asked about what matters to us and we aren't given
options to be prescribed things and resources, activities in our community. But increasingly, that's
changing. And the origin story, this started off in the UK in the 1980s, actually came from a very
sad fact, the fact that one in five people in the UK were going to their doctor for purely social reasons. And you think about it in a place like
the UK where healthcare is nationalized, it's public, everybody buys in, everybody gets out.
There's a real incentive to reduce pressure on the healthcare system and make sure that the people
seeking social care can get it so that those seeking clinical care don't have to wait on a
wait list or struggle to find a hospital bed. So I would say that the pressure points to actually
make this mainstream are coming from both the pressures in healthcare, but also the medicine that movement, nature, art, service, and belonging can deliver us
has effects on par with traditional forms of medication.
I want to make sure I understand this too. So you were saying one in five folks in the UK
were going to their doctor's office, I mean, through some combination of loneliness or like basically it was more about the social interaction than the sort of like the need for true clinical care.
That's right.
And usually it's a combination of things.
When I say social, I mean, sure, in part it's social interaction.
You know, my book tells the story of a man who would go to the emergency room every Friday night because the thought of being alone on the weekend was just unbearable.
So it's certainly that, but it's also social as in social determinants.
People were going to the doctors because they needed fresh food or they were so stressed that they couldn't make their rent.
So it's a combination of all those things.
And I think when we go to the doctor, most of us, our earliest healthcare experiences are,
we go to the doctor for something like strep throat, and that's a clear bacteria. We get
prescribed an antibiotic, boom, we're treated, it's done. But as we get older, our health becomes much more complicated by these
social determinants, by being disconnected from these basic needs, but also psychological needs
for joy, meaning, and relationships. And so social prescribing is about addressing all of that. It's
about being able to be prescribed food and an art class in the same visit.
Yeah. I mean, it's so interesting, right? Because I think anyone who's been around long enough knows that the boo-boo you had in your kid where a Band-Aid took care of it, like the strep throat where you got your bill and a couple of days later, you're good. You get further into life. And there's a lot that tends to drop into our lives that we struggle
with. And so often it falls into this category of quote, non-specific, where a physician kind of,
or it falls under a category of a quote, syndrome. It's kind of like largely medical speak for we can
identify your symptoms, but we're really not entirely sure what the cause is. So it's a syndrome because it's a collection of symptoms,
but it's not super helpful. And oftentimes those are the things that are most prevalent in our
lives, right? But also the hardest to treat through like traditional clinical means. So it's
so fascinating that you're sort of coming back to this notion of
what else might be going on here that doesn't necessarily require a procedure or a pill or
something like that. Where else have you seen this? I mean, the UK is a really interesting example.
And it also strikes me that in that example, there is a kind of a business use case for this
also, because if 20% of the people who are showing
up for this, you're taking up 20% of their time in a publicly medical system, that's an issue.
Yeah, that's definitely an issue. I think you're absolutely right. One of my favorite catchphrases
of social prescribing comes from this professor of health equity, Michael Marmot, who says,
why treat people and send them back to the conditions that made them sick? Otherwise,
you know, we're just keeping people on this like factory almost. If we want to treat a person,
we need to treat the whole person and the environment in which they live. So you're
right. This started in the UK. It's had the most institutional investment
in the UK. But for our American listeners, you might be wondering, well, of course it works there
because they have national healthcare or they're a smaller country, whatever the reason might be.
Believe it or not, this is also happening in the United States increasingly. And it's happening
mostly on a state byby-state level through the
power of local pilots and models. But to your point about it being a business case, I think the
same holds here. Sure, we might not have a national healthcare system, but there's a deep need for
more preventative healthcare in this country. And we even see that some insurance companies are
starting to get on board with this. This is why, for example, some insurance companies have started
to invest in gym memberships. The logic being that if a person can use their gym, work out on their
own, maybe that will lead them to be healthier down the line, require less medication, require less therapy and expensive care.
Increasingly, the same logic is being applied to social prescribing.
Believe it or not, in our former shared neighbor here, New Jersey, they've created a pilot in which one of the private insurers, Horizon Blue Shield has partnered with the New Jersey Performing Arts Center to prescribe their members six months of art prescriptions in the community.
So concerts, glassmaking workshop, the idea being that maybe if we invest in these things the same way we invest in a gym membership, this will lead them to make those life-sustaining connections,
find sources of joy, get them out of the house,
and rely less on medical care.
It just makes so much sense when you think about it. And it's so much more enjoyable also.
It's like bringing things back into our lives
that I think so many of us have walked away
as we strive for sort of like this modern conception
of, quote, success. It's like you know we move further away from people we work longer hours
we do all these things in the name of what we're told is supposed to be success and then we wonder
why we're not feeling the way we want to feel and it's kind of like a return to as you're describing
it's like oh so basically you're saying being a kid again. Yes.
Because it's a lot of what it is. It's like, all right, so everything we knew when we were six pretty much is the right way then, which is kind of fascinating.
Gosh, you totally get it. I did a reading last night and that was exactly the reaction of
everyone. I had people write down what they might like to prescribe themselves, asking variation of the social
prescribing question, which is what matters to you. So I asked them questions like,
when was the last time you experienced awe, the feeling of just being totally transcended by an
experience? Or when was the last time you experienced a glimmer, something that sparked
your joy and your calm? And so I had them write this down on
like a literal prescription pad. And people said things like playing Frisbee in the park,
learning a really hard board game, going to a concert and dancing with the crowd,
things that are just so intuitive for kids to do, right? We think about these things,
movement, nature, art,
service, belonging, that's pretty much a kid's life. It's pretty amazing that through social
prescribing, we rediscover that in adulthood. That's the common refrain I've heard from
people I've interviewed in Japan, to Portugal, to Canada, all the 30 countries where this is happening. It's about returning to our childlike
state of wonder and joy and search for meaning and relationships.
Yeah, it's so fascinating. It's like we leave it behind at a certain point once we buy into the
sort of social expectation of what it means to be a responsible grownup. And then we spend the rest of our lives trying to effectively buy our way back to that state
that we left behind.
And we work harder and harder and harder often
in the name of, so we can get back there faster,
not realizing that we're also deepening into the damage.
So true.
Yeah, we're weird.
If there's one thing I've learned,
in a lot of it,
Good Life Project is a dozen years old now, it's like universally we are strange. But I think we're all just trying to make sense.
I want to deepen into some of the different areas with you, because you brought up these
different areas, movement, nature, art, and a couple of others we'll drop into.
And I also want to tease out a distinction here,
which is the distinction of saying yes
to certain types of activities
and doing them in solitude versus doing them in community.
So I want to deepen into sort of what you actually mean
with the word social here,
because I think, and this was what I said
when we started a conversation,
I was like, oh, so it means like socialization.
That's not really what you're talking about, if I'm understanding properly.
It's a good question because it's a little bit confusing.
Socialization is a social determinant of health, but not all social prescriptions have to involve
these sort of group experiences.
Many of them do. But for people who are introverts,
for example, for people who might really thrive off of one close connection in a very controlled environment, we don't want to discount them either. I think introverts will especially find
a home in arts prescribing, creating and consuming art. It's an intensely
individual experience versus the movement prescriptions for things like cycling groups
and sea swimming classes or community potluck dinners. So it's a range. And like we've said,
you've had Dr. Robert Waldinger on here, tremendous researcher who's demonstrated that your relationships are one of the most powerful predictors of your health and happiness in the long term.
That is one pillar of these social determinants in our environment, but it's also sources of joy and sources of meaning. I think when we have social prescribing and there are other people present or even that
it's not even so much about other people, but that it's at a time, a place, there's
an expectation that you'll show up.
That sort of holds us accountable more than, say, a doctor saying, you should try to get
75 minutes of exercise a week, or you should really go try to make some friends.
This is giving people a vehicle to do that, but on the terms that make the most sense to them.
So just as one example, one of the case studies in my book is this man named Jonas. Jonas grew up,
back to that childlike wonder, as this amazing explorer of other worlds. He loved fantasy
novels. He loved computer games. And as he got older, he had some experiences in the real world.
He was bullied a lot where he withdrew from his environment and developed severe anxiety disorder,
generalized anxiety disorder, agoraphobia. He would get
panic attacks when he would think about socializing. So you could imagine how for Jonas,
a doctor saying, hey, Jonas, you need to go and meet friends. Maybe that'll help with your social
anxiety. That wasn't going to be the way in for him. Instead, his health worker really got to know what he liked
as a kid and prescribed him what are called culture vitamins. And these are group activities,
but they're pretty individual experiences. They're structured. So a culture vitamin included
a shared reading session at the library where people could just come and listen. They didn't
necessarily have to participate or joining a concert or going to a film night or going to a
museum, right? I think that the range of socialization really depends, but I think
what's powerful about social prescribing is that it is an official thing in the community as opposed to just a
recommendation that kicks the burden of figuring out where and how to do that back to the patient.
Yeah. Thanks for teasing that out. It's helpful for me because my default was to just keep going
back to like, oh, this is a thing that happens or you do with other people, but it's more broad.
It's more, this is a thing that we engage
in that is sort of like non-traditional medical prescription
that brings us closer to joy, to meaning,
to all these childlike experiences, to wonder, to awe.
And probably the level of actual social interaction
that you're bringing to it,
it's gonna depend on your social orientation.
What feels nourishing to you?
For some people, it may be a giant crowd in a club. For other people, it may be being in an art class
where you actually never talk to another person, but you're all kind of in there. You feel their
beings, but you're each doing your same thing, which again, brings it back to kids. Like toddlers
go through this phase. Any parent knows that it's called parallel play. You've got like two itty bitty
kids sitting next to each other playing, but they're not actually playing with each other,
but they're enjoying the presence of each other. Like they feel it, they sense it. And there's a
certain joy that comes from that. Did I get that right? Oh, I love that. I'm going to have to look
into that. Yes, absolutely. For someone who is not seeking social connection necessarily,
that's a beautiful way to put it because it's still connecting them to the play element of it.
It's about changing their environment so that they can change their perspective,
which can then translate to some real changes and symptoms as well. So that's exactly it.
Yeah. I love that. It's funny as you're describing that also. So I'm a writer and I have learned that over the years, I actually
like to write in public spaces. I like to write in cafes, but I don't want to talk to people.
So I'll be in this, when I was in New York City too, I'm in a cafe and everyone's elbow to elbow
in there. I've got a tiny little piece of a table in the corner and I would have noise canceling headphones on listening to something. So, but I wanted to hear
enough of the noise around me and I wanted to be around people. But I didn't necessarily want to
be, there was something about just the energy of being around them that allowed me to drop into
a really generative, creative space much more quickly and deeply than if I'm sitting
at home in my own completely controlled environment. And I'm an introvert also. So it's
interesting the way you're sort of like teeing this up and the way that we can step into social
context without actually being social. And that's still being something that we yearn for.
Definitely. Wow. You've just, between that and the parallel play, I think that's a beautiful
example and illustration of it. You're totally right. And I think a lot of that has to do with
the way we evolve. We evolve to live in groups and that doesn't necessarily mean we're always
chatting with the group about the weather
and how their day was, but we just evolved to exist in community. And I think you're tapping
into something very primal and real there that we are the most human when we exist alongside
other people doing their own human thing. And we'll be right back after a word from our sponsors. It's the fastest charging Apple Watch, getting you eight hours of charge in just 15 minutes. The Apple Watch Series 10, available for the first time in glossy jet black aluminum.
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Mayday, mayday, we've been compromised.
The pilot's a hitman.
I knew you were going to be fun.
January 24th.
Tell me how to fly this thing.
Mark Wahlberg. You know what the difference between me and you is? You're going to die.. January 24th. Tell me how to fly this thing. Mark Wahlberg.
You know what the difference between me and you is?
You're going to die.
Don't shoot him.
We need him.
Y'all need a pilot.
Flight risk.
Let's drop into some of the specific prescriptions.
You've referenced a couple, but one of them that you teed up early on is movement.
And we've all heard, you know,
like, quote, exercise is good for you. It's important. We've all seen the data, all the
signs, signs, signs, signs, signs. You take a more interesting kind of holistic approach to this.
For sure. I mean, as I'm going through all the studies suggesting that movement is one of the
best preventative health things you can do. We should get 150 minutes of activity a
week. I'm imagining the reader saying, yeah, yeah, yeah, yeah. I know this. I know this.
We've been told this from when we were kids, right? It's why we took those like gym tests
in school. But my book also talks about how the joy has kind of been sucked out of movements.
Like if we think even back to those gym class
tests at my school, we had to do pushups and sprints and run back and forth to this beeper.
That is coming from a strong sort of capitalistic push to move in order to be fit for the military.
We've also seen how movement has become very commoditized. Like,
you know, gym memberships cost money. Joining a sports team often costs money. And there's some
real data showing that there is a huge access gap between people who can have free spaces to move.
It's very much determined by what you can afford. So what I love about social prescribing to
movement is, number one, those logistics are covered. Like I talk about a cycling group prescription where everybody who's prescribed this gets says, I loved riding a bike, but I haven't done that in 50 years. So his Dr. Ollie
says, I've got just the group for you. They teach a cycling confidence course. It's for people like
you who are over 50 and are maybe a little scared to ride a bike. So what social prescriptions for
movement do is anticipate those barriers also
of maybe being insecure about your body or your ability level. And it's been found that, of course,
movement is great for our physical health, our cardiovascular health, all that's true.
But what I loved and was surprised to learn is also incredibly effective for our mental health.
Some studies suggest that running, movement, something that gets your heart rate up,
any kind of activity like that releases serotonin in the same way that SSRIs or
antidepressants do. It's why movement is increasingly being prescribed as an additional therapy to an antidepressant because of these very
real effects. So that one came through a sea swimming prescription. Again, 50-year-old woman
hasn't been swimming since she was a kid and let alone in the cold open sea in the wintertime.
But this group actually trains people some basics of sea safety, meets early morning and gets them moving their bodies together. So those are just two, but I'm sure your listeners could think of where we move beyond just saying, oh, go exercise to say like, no, this is a social prescription for movement is you're anticipating the potential
barriers to doing this thing and saying, okay, so how can I think about what are the most
common barriers?
And then how can we actually set somebody up for success along the way?
And that's unique in this scenario.
Yeah, absolutely. Because I think it harkens us back to the whole purpose of social prescribing. It's about really understanding someone's
environment, shifting from what's the matter with them to what matters to them. And within the
elements of what matters, that also includes a person's introversion, extroversion, what they can afford, what they have access to, what insecurities they have. Social prescribing is really a vehicle for that more holistic form of care that sees us as people with flaws and fears and limitations, but also builds their strengths and assets and interests.
Yeah, that makes so much sense to me. I have a background in the fitness industry and then in the yoga world. And I remember always going deep into the data because I want to understand
one of the consistent data points was always something like 85% of adults in the US at least
know that they should be exercising. They want to be exercising, but they will never join or stay a member of a sort of traditional commercial health club. And I was always like,
what's going on there? And then you start getting deeper into the research and you realize people
are terrified by so much of the environment. I've had a number of conversations you probably have
also. I'm curious whether this came up at all in some of the research you were doing,
where people would say some version of the phrase, I want to go to the gym, but first I need to get a little bit fitter. I need to lose a
little bit more weight. I need to like check this box so that when I first show up in this place
where I'm supposed to actually like feel better and get healthier, I need to be able to show up
in a certain way because I'm terrified I'll be judged if I don't. And there are so many barriers rather than just facilities. And I think there's like a newer wave
of solutions in the industry that are anticipating that. I think doing a better job of inviting
people in and saying, it doesn't matter where you are. We will take you as you are. Show up,
we've got you. We'll take you by the hand. We'll introduce you around. This is for you.
But I think that's still the outlier in this space. Absolutely. I'm so glad you said that. The book talks a lot about this
phenomenon of gym intimidation. It's this catch-22 where working out would make people healthier,
but because they're already so ashamed of their body image, they won't go and work out.
So I love it because social prescribing is about addressing that. The
cycling group I mentioned has a firm rule. Nobody's allowed to wear Lycra, you know, like,
and that's just a silly thing expressing their very real commitment to all sizes,
all abilities. It's not about going fast. It's about cycling together.
And the second thing where I think this distinguishes social prescribing a little bit from, for
example, recommending somebody go to a gym, even if it is an inclusive gym, which is great,
but is this bit of accountability.
For Frank, who took this cycling course, they had a meeting time every Tuesday, 10 a.m.
If it's 10.05, Frank's getting a text.
Where are you, Frank? So some people in
the group said to me, I showed up, they compared it to getting a dog. They're like, just as, you
know, you can't let the dog down. You can't let your fellow cyclists down. They're counting on
you to be there. And that's where the socialization bit comes into. It turns out this cycling group
realized they actually had a lot in common.
They'd meet up at the weekends for tea and holiday parties.
And that also made it more fun and inviting, more exciting to be moving your body, not
just this thing that we're told we should do or once I had a bad experience with in
the eighth grade gym class.
Yeah, I love that. I think cycling is such an interesting example too, because
there are built-in windows for not being social within the actual activity. So no matter how
social you are, how introverted, extroverted, and perverted you feel, you have the activity itself
built into it is the opportunity to choose the social context you want. And when you have like the activity itself built into it is the opportunity to kind of like
choose the social context you want.
And when you're on the road, when you're cycling with people, sometimes you're in a
group, sometimes you're one in front of the other and there are windows where built into
the activity, there's quiet.
You know, there's a certain amount of solitude, even though you're surrounded by people.
So it's such an interesting example.
And the notion of accountability, I think is really fascinating too, but not accountability like somebody who's like going to shame you or be like, you committed to this or you paid money for
this. It's like, there are people who are counting on you, you know, like you need them and they need
you. And you kind of want to honor that commitment because these are people that, you know, you feel
like you want to be good in their eyes and you want them to be good in your eyes.
Absolutely. That's exactly it. You know, it's hearkening us back to the things we need to be good in your eyes. Absolutely. That's exactly it. It's hearkening us back to
the things we need to be healthy. We need to count on other people. We need to have people
we can call at 3 a.m. in a crisis. And we like to do that in return for others. And so these
social prescriptions that enable us to hold other people accountable and be held accountable are, I think, just some of the most
beautiful expressions of humanity. This is what we do. We try to make it through together. We count
on each other. We notice when we're not there and we celebrate when we are.
I love that. You also talk about the social prescription for nature, which to me is fascinating.
I spent 30 years of my life in New York City.
Three and a half years ago, moved out to Boulder, Colorado, where now I walk out my front door
and I'm surrounded by the most breathtaking nature.
And I'm in nature all day, every day.
And I've always said my entire life, this is in me.
This has to be a part of my life.
Yet for the 30 years or so I was in New York City, I was kind of like, I'll get to it. I'd sneak into Central Park or I'd go for a walk along
the Hudson and that helped, but it's different. So take me a little bit into the notion of nature
as a social prescription. Totally. Well, as a fellow New Yorker, I can relate. I'm a little jealous. So nature is kind of like movement, a pretty intuitive one.
We know that we should move our bodies and we know that we evolved to be in nature. We evolved
to specifically pay attention to nature. If we knew which fish were in the river or which bird
were in the trees, that was very advantageous for our survival. So there's a deep primal part of us that has evolved to be in nature. And these
amazing researchers in the 1980s came up with a theory to encompass this. They called it the
attention restoration theory. And this is the 1980s. So they were working from a context of,
you know, constant distraction, video games, movies, neon signs, you know, all these things were capturing our attention and leading to something they power of nature, they hypothesized that there's something about nature that enables us to pay attention to it and it doesn't give us that directed attention fatigue.
It actually restores our attention the same way that a good night of
sleep restores our energy. And they said, this is because we evolved to pay attention to nature and
it invites something called soft fascination. We're intrigued by it. And when we come away from
it, not only do we feel less stressed, you know, I know you've had Robert Sapolsky on here, less stressed, more calm, but you
also feel better at judging the stressors that you came in with.
And this has been shown that doses of nature are incredibly effective for kids struggling
with ADHD.
Some studies have found that walking in nature versus a walk in a busy cityscape, there's less activity, there's less neural activity after the walk in nature in the part of our brain, the subgenual prefrontal cortex that's associated with rumination.
In other words, I'm picturing you out in your beautiful mountainscape and you're experiencing all the opposite state of rumination.
That's very real down to the neurochemical level. So that's a bit about nature. And my book talks
about people who are prescribed nature for stress and the symptoms of stress, chest pains, insomnia,
and a man who's prescribed a fishing group for his ADHD. And I don't want to spoil it, but
based on what I've just told you about the science, I'll tell you that this was
incredibly effective for both of them. Yeah, I can imagine. It's just a transformative
experience for me. I hike three or four days a week now, which is just a stunning blessing.
And it's funny because, and it's built
into my calendar. If my team looks at my schedule, they'll say like hike 90 minutes.
And it's generally in the middle of the day. And for a while I was framing that as,
you know, oh, I'm like, I'm not working. What I realized was that this 90 minutes was so essential to, yes, to my well-being,
to my physical and emotional well-being. It got me moving, got me exercising. I didn't care. I
didn't know. I was working really hard. And it really helped reset my mental health. If I was
spinning, if I was stressed out, I would go on the trail. Somehow everything was so much better when I got back. But I also
realized that I would come back and I would sit down and whatever problem I had been focusing on,
whatever creative task or thing that I was working on, or maybe I was stuck, I would come back with
new ideas and feeling less stuck. So there was a business use case for this saying like, this
actually should be in my calendar on a regular basis. I'm not slacking off. I'm not stepping away. It's not just about nature prescribing for stress and they think,
what? I don't have time for that. This is why I'm stressed. I don't have time for nature.
But you're exactly right. That investing in that attention through nature is actually a really
wise investment because you will come back better focused, better at concentrating, calmer, right?
A lot of studies show that, you know, we reduce our cortisol production. And just a really quick
anecdote about one of the first places to really systemically embrace nature prescribing. This was
in Japan in the 1970s. You know, their economy post-World War II grew so quickly. People were so productive.
People were pouring into cities. And yet you ask a doctor who was alive at that time,
and you saw increasing rates of heart disease, increasing rates of mental illness,
increasing reports of stress. So much so that there was a new term coined around this time
karoshi meaning death by overwork or even more tragic karujitsu which is suicide by overwork
so the government realized we have a real crisis on our hand yes people are working harder smarter
faster or they're working harder and faster but they're not working smarter. And our nation's health is really faltering because of it.
So what did they do?
They invested in this government campaign for forest bathing.
Forests have been something revered in Japan's ancient Shinto and Buddhist traditions.
But because people were leaving the cities or leaving the country to pour into the city,
a lot of them
abandoned that essential part of their culture. And so this was a big campaign. It was called
Shinrin-yoku, forest bathing, to actually send people back out into the forest, immerse with
their full five senses into it, and then see, does this actually have a medicinal effect on stress? And sure enough, I interviewed Dr.
Ching Lee. He's one of the leading forest bathing researchers in the world. This helps with so many
things. It increases our NK cell, natural killer cell activity, which helps boost our immune system.
It lowers our cortisol and adrenaline production. It lowers our heart rate. It lowers our blood pressure.
And it just goes to show that to exactly your point, you know, how could it be that these
totally busy Japanese businessmen would get on board with something like forest bathing?
Well, because it was an investment in their health and attention in the long term.
Yeah, it just makes so much sense to me. I read a lot of that research also. I'm sure you're more
up to date on it than I am, but when I was reading it, and this was many years ago now,
I was working on a book actually. And at that point, the research was showing, yes,
we can identify all these benefits, but they were struggling to identify the mechanism.
They're like, we can't tell you exactly why this happens, but we know when people go into the woods, it happens. Have you seen more updated research that in some way
can identify the actual mechanisms at all? Or is that still a bit of a mystery?
Yeah. I mean, I think all of this stuff is like all of our mental health is a little bit of a
mystery. I think on the other hand, a lot of it is very primal. We evolved to be in nature, but I think a lot of it comes back to that attention restoration theory, the research in
the eighties. It's really interesting that all forest bathing attention, restoration theory,
biophilia from EO Wilson, all of this came out around the same time. And I think the mechanism is this idea of soft fascination, restoring our attention
without taxing it. And certainly in the 40 years since then, there have been many, many, many,
many empirical studies showing that time in nature is so good for the traditional biomarkers of
stress, but also of attention.
Like another one of my favorite studies, a little bit after the 80s, came out where they
compared patients' gallbladder surgery recovery.
Patients whose hospital rooms were overlooking a brick wall versus those who were overlooking
a naturescape.
And sure enough, they found that the patients who were overlooking a naturescape. And sure enough, they found that the patients who
were overlooking the naturescape recovered faster, had a better mood. The healthcare staff reported
that they were easier to work with, less cranky. So I think to your question, it's a little bit of
a mystery. It's a little bit intuitive, and it's a little bit down to this science of nature being incredibly powerful for restoring our attention.
Yeah, I totally agree. And we'll be right back after a word from our sponsors.
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One of my fascinations around this also,
I'm so curious what your take is on this,
is there will be times in people's lives where they literally cannot get into nature.
Maybe they can bring a little bit of nature in,
they can put plants in,
and there's some interesting research around that,
but there'll be times where there'll be just folks
who really, you can't get there.
Or maybe you're struggling with, you're ill, you're injured, you're bed bound or you're room bound, right? I'm so curious now with the advent of not just AI, but AR, can we actually have somebody put on a pair of goggles that will allow them in a small fixed space to have the tactile and the visual experience of navigating nature? And would that have the same
effect on them? Or do you actually really have to be there? I haven't seen anybody exploring that
yet, but I think it's a fascinating question in my mind. That is such a fascinating question. I
would love to see that research. Two things I can say is that let's go back to forest bathing. For example,
this is about engaging all five senses in the forest. Dr. Ching Lee, before I left Japan,
he gave me this like block of wood. I still have it. It's in my kitchen.
And it releases the scent of the Hinoki trees and on which, you know, really common in Japan
because it's been found that this scent alone
triggers in our mind, oh, okay, we're in a forest, we're around nature, that's good,
we can calm down. That's very true and real. I don't think it's as rigorous. I don't think it's
been as rigorously studied as actually being in nature. But that's one point. But another,
I think you make a really important point about
those of us who might not have such easy access to nature. And that's very real. And that is why
doctors, I'll shout out one, Nushin Razani in San Francisco, again, anticipating all the barriers
that could come up about why wouldn't kids and adults be able to access nature, she's organized programs that actually bus kids out to a nature experience
from the inner city for the weekends.
Because I think a true social prescription, you know,
takes into account all of a patient's social determinants.
And that access barrier, even if you have a car,
if you live nearby, is very real.
It's so fun learning about all these different things where
people are like, how can we solve not just for part of the problem, but for a much fuller part
of the experience? You talk about art also as an interesting social prescription, which always
fascinates me. As somebody who's both at various points in my life has been an artist with different
media and different domains, but also who
has found myself in tears standing in front of a painting at the Guggenheim.
So it feels like this is one of those prescriptions also where somebody may immediately like the hair
on the back of the neck. I'm not an artist. This isn't going to work for me. But it's bigger than
that. It's more about the, it sounds like the way you're teeing it up. It's more about just
the experience of what art can do around and with us. Absolutely. You're not alone.
I'm definitely with you. I almost teared when I heard your voice today because your podcasts
have moved me so much and there's something very real about that. But yeah, I think a person is
absolutely right to have a little bit of hesitation saying, I don't want an art prescription. I'm not an artist. I think there's two kinds of art
prescriptions. One of them is about creating art. My book focuses on the story of a woman named Kuhn
who had always loved art. She's an aspiring novelist, but grew up in a really harsh environment,
developed PTSD, developed anxiety, developed depression,
and had always had this voice in her head that she wasn't good enough. She hears her mother's
voice telling her all the time, you're not good enough, you're not good enough.
So she was really scared to try this art prescription that she was given. And the
facilitators of this, Caitlin Marshall and Lizzie Rose, they run a great program called Creative First Aid in Australia, were very intentional about making sure that nobody was forced to do the art.
Here again, you're anticipating all the barriers, all to the thing we're afraid of, to the thing that's giving us anxiety't want to really go to this, told herself she wasn't good
enough, ends up becoming this extraordinarily prolific artist, ends up filling her home with
plants, which she considers a form of art, even though she grew up having a really negative
association with plants, her mother always criticizing her for when they weren't doing well.
So that's one form is when we create the art. And that's, we know for any art therapists listening,
incredibly effective for our trauma because it invites us to create sort of a new story about our trauma and access it without verbally accessing it. Another one has to do with
consuming art. And maybe this will resonate with
you when you're listening to that song that brings you to tears. Art, just like movement in nature,
is something that we evolved to do. We evolved to share stories with one another because this
is a way we cope with all the emotions that come with being human. And for some methods of consuming art, one way is
bibliotherapy, being read a story in which the character maybe reminds us of our own struggles.
That's incredibly effective for treating anxiety because it allows us, again, to just sort of
softly identify with the story without having to fully expose ourselves
to that story. In other words, it's a way for us to explore our emotions without having to
fully reveal them to a therapist, for example. And so for someone like Jonas, who was prescribed
culture vitamins, literally that's what it's called, for his
severe anxiety, you know, those shared reading sessions where he could read about other people
who dealt with anxiety was incredibly powerful for him. And yeah, I think that art just gets
into art, by the way, comes from the etymology of the imitation of nature. So I think when we create
and consume art, we are on some level being the most human we can be.
Yeah. Also just to tease it out a little bit more, when you talk about art, I think a lot
of people immediately, oh, they're like, they think visual art. You're talking more expansively,
writing, music, like all these different aesthetic experiences that in some way evoke something in art, right? You're talking more expansively writing music, like all these
different aesthetic experiences that in some way evoke something in you, right?
Absolutely. I'm talking about anything that could be a method of telling a story, whether we are
the creators of that story through words or paintbrushes or cartoons, whatever it might be.
These are just some of the social art prescriptions
that I investigated. Or we are the consumers of that story. We're going to a concert. We're going
to the library to be read to. We're going to a museum to learn sort of the art of the
civilizations that have come before us. All this, anything that immerses
us in a story is what I would consider art. But that could be a whole book. I mean, what is art,
right? Exactly. The other thing that occurs to me about art is that I've been thinking about this
recently. I'm curious what your take is. It's one of the experiences that allows me to time travel.
If I hear Pink Floyd's Dark Side of the Moon,
I can tell you exactly where I was when I was a kid,
lying on the floor of my basement with headphones on,
listening to that just completely gone,
transported somewhere else.
And when I hear that song now, I'm back there again.
And I would imagine if you were measuring
all sort of these physiological indicators in my body that you would see a really meaningful shift in them.
And for me, music tends to be the thing that really allows me to time travel, but also visual art as well.
I wonder if that's something you've thought about or explored at all.
Definitely.
Can definitely relate both to the artist and the experience.
I think a couple of things are happening there. Number one, in your story, you are being transported to a time in your life that you associated with a lot of joy
and meaning. And not only does that kind of just feel good physiologically, but I think subliminally,
it's also a reminder of how good things can be. If we turn to art when we're feeling really low,
especially I think Susan Cain talks a lot about this when we're listening to sad music,
we are just reminded of the depths of being human. And if we're feeling some of that sadness or
anger, we find comfort in the fact that, wow, this artist is expressing that. I can feel that.
I think that's exactly it. It is connecting us to our most deeply human states. And here's the
spoiler alert with social prescribing, whether it's movement, nature, art, these are just gateway
drugs for us to shift our perspective on things,
whether that's telling ourselves that it's going to be okay. This thing you're feeling right now,
it's going to be okay. This stress that you're experiencing, we're going to make it through.
This exhaustion and lethargy and sadness that feels so unbearable, we're going to get to the
other side of that. And social
prescriptions, I think, can help us get there faster, especially art. I have a soft spot for art.
Yeah, you and me both. And there's something about it. You also write about service and you
write about belonging as one thing. But if you zoom the lens out in all five of these different
categories, like service, belonging, art, nature, and
movement, there is this opportunity to step into all of them in a way that makes you feel
less alone, I think.
Like you were just describing, even if you're not in the presence of other people, you can
listen to a song or see a work of art or read a paragraph in a book that was written by
somebody else and you are alone in your room consuming it,
but there's something about the act that makes you feel less alone, which is amazing.
Isn't it amazing to think that these five ingredients that have sustained our civilizations
for thousands of years are the same ingredients we can turn to today and feel a sense of connection to these people
and to one another. I don't know if you had this experience with the Good Life Project or the
writing you've done, but sometimes you discover your reason for writing it or doing it while
you're doing it. And that was true for me. I didn't realize how lonely I was and how frustrated I was and unwell I was until
I realized that it's true that I might not be able to relate to the depths of depression and anxiety
and chronic pain that other people I talk about have experienced. But all of us, by virtue of being
human, can relate to the experience of being a little bit unwell. And I think that is extremely
connective. I think that is extremely hopeful that all of us can find some amount of healing
in some combination of these ingredients because they remind us,
especially now in our times of intense division, that we are all going through these ups and downs
together. And I really needed to hear that, but I needed to write a book to prove it.
That has been like every book that I've written, it's always been scratching my own itch. It's
like, and I don't really know what the itch, I think I know what it is going into it. And then halfway through you're like, oh, right,
this is about something entirely different
and it's about me.
And hopefully this will be interesting
and valuable to other people too.
But you also bring up a really interesting point.
This is something that I've noticed,
which is that nobody talks about this.
I'm really curious about it.
I have found that one of the most powerful
connecting energies is commiseration. And we don't like to think about it because we don't
all want to have some sort of shared suffering or angst. So we don't talk about that in general.
And yet, if we go back to art as an interesting example, you can have two people standing in
front of a work on a wall, and maybe the work
represents something where it's keying them both into a similar loss that they've experienced
to profoundly different people who have different beliefs, different faiths, different upbringings,
different histories, different politics. But in that moment, they're having this shared experience
and that whatever that loss is, that is being being a vote is triggering all the emotions that goes around it and simply seeing them next to each other, knowing they're experiencing that same thing, which is a form of commiseration.
To me, it's such a powerful source of connection that we rarely ever acknowledge, I think, because it's just an uncomfortable thing to acknowledge. Absolutely. That's so beautifully said. And I'm sure we can
all relate to when we are commiserating, whether the source of that is the loss of a loved one,
or a breakup, or something really frustrating happening at work, whatever it is,
we feel, our environments make
us feel like we are the only one that is going through this. We are so in our own heads and
that's what rumination is, right? We're dwelling on these negative thought patterns and we're
convinced that it's not going to get better because again, our environments are encouraging
this. But what I think is so powerful about social prescribing is that it reconnects us to some other thing that takes us out of our head, brings us to other people, like we said, with parallel downs. That is the only thing that will get us through them.
And, you know, I want to be careful because I think there's definitely a place for medication.
I think there's definitely a place for therapy.
This is not about replacing those forms of medicine.
But I do think that sometimes those medicines are designed to just treat the
symptom and make it go away when actually that symptom is telling us something about our
environment. It's telling us that this pain that you're feeling right now is real and you are going
to be okay. You are resilient. You have evolved to get through this and to help you get to that
understanding faster. A social prescription can help you get to that understanding faster.
A social prescription can help you feel like you are not alone in your commiseration.
If somebody is listening to this conversation right now and they're kind of nodding along and they're like, yeah, this makes total sense to me. Where do I even begin? Obviously reading
your book is a great place to begin. But if somebody's sort of thinking about the first
step in, what might you offer them? Totally. Well, I think I know you have a big global audience. I imagine most are in the
United States. So you might be frustrated that this doesn't really exist quite yet in our healthcare
system mainstream. The good news is that this is coming. There's a great group, Social Prescribing
USA, that's determined to make these available to every American by 2035. And if you're a health worker listening, you can
get involved with them. If you're a researcher, a policymaker, definitely go get involved with them.
But in the meantime, for the everyday person, the other good news is that you probably live
in a place where there are communities doing this work.
There are communities delivering art prescriptions, nature prescriptions, movement prescriptions,
service prescriptions, belonging prescriptions.
The only difference is that a doctor or a therapist might not be prescribing it to you.
You have to prescribe it to yourself. Of course, I hope people read this book, but I hope that they participate in both joining
some of these local community groups and contributing them themselves.
You know, you might have a listener who leads their own Saturday nature walks or cycling groups or art classes. socialprescribing.co that organizes these kinds of social prescriptions by ingredients,
free or donation-based, because again, this is all about not creating barriers to
things that should be free, where people can go and prescribe themselves these things in
the meantime. And in the back of the book, there is something we call the crowdsource DSM, which will help you direct yourself to what kind of social prescription might be especially valuable based on what you're feeling.
So if you're feeling stuck and sad, movement is a great antidote to that.
If you're feeling burnt out, stressed, can't focus, nature, great antidote to that. If you're feeling worried
and anxious, great antidote. If you're feeling really frustrated, angry, self-pitying right now,
service to your community, volunteering, great antidote. If you, like many of us,
are feeling lonely or feeling alone in that commiseration. Belonging, groups
with an intentional purpose of creating a sense of belonging can be really medicinal.
Love that. I love all the resources that you put together as well. It feels like a good place for
us to come full circle. So in this container of Good Life Project, if I offer up the phrase
to live a good life, what comes up? To live a good life, I think is to be extremely present in your life, to reconnect with the
sources of joy, meaning, and relationships that have been sustaining us for thousands of years.
That's a good life to me.
Thank you.
Thank you so much, Jonathan. Such an honor.
Hey, before you leave, if you'd love this episode, say that you'll also love the conversation
we had with Robert Waldinger about the role of relationships in our ability to live good
lives.
You'll find a link to his episode in the show notes.
This episode of Good Life Project was produced by executive producers, Lindsay Fox and me,
Jonathan Fields.
Editing help by Alejandro Ramirez, Christopher Carter crafted our theme
music and special thanks to Shelly Dell for her research on this episode. And of course,
if you haven't already done so, please go ahead and follow Good Life Project in your favorite
listening app. And if you found this conversation interesting or inspiring or valuable, and chances
are you did since you're still listening here, would you do me a personal favor, a seven second favor and share it maybe on social or by text or by email, even just with one
person, just copy the link from the app you're using and tell those, you know, those you love,
those you want to help navigate this thing called life a little better. So we can all do it better
together with more ease and more joy. Tell them to listen. Then even invite them to talk about what you've both discovered.
Because when podcasts become conversations and conversations become action, that's how we all come alive together.
Until next time, I'm Jonathan Fields, signing off for Good Life Project. Apple Watch Series 10 is here.
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January 24th.
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