Ten Percent Happier with Dan Harris - 238: You Don't Have to be Alone to be Lonely | Former Surgeon General Dr. Vivek Murthy

Episode Date: April 13, 2020

Our guest this week gives a bracingly candid account of loneliness - one made all the more remarkable by the fact that he is a former surgeon general. Even before the current coronavirus pandemic, we were in the midst of another, quieter pandemic: loneliness. The term sounds somewhat unpleasant, but make no mistake: loneliness is, in fact, a deeply pernicious and insidious state, both psychologically and physiologically. And now, with all the social distancing we're doing, the loneliness problem is on steroids. This problem touches those not only people who live alone, but also those of us who may be surrounded by family. Loneliness doesn't require you to be alone. As you will hear, it's more about the quality of your relationships. Our guest, Dr. Vivek Murthy is, as mentioned, the former surgeon general. He has just published a book about loneliness, called "Together." We're doing this episode in a bit of a different way. We actually interviewed Vivek twice. The first time I spoke to him was right before the pandemic truly took off in the U.S.. He gave an incredible interview that we were excited to post. But then things really went haywire with the virus, so we wanted to have him on to talk about that. So we'll do this episode in two parts. First, you'll hear the newer interview - which is more topical. Then you'll hear the earlier interview, where he goes into greater depth. Where to find Dr. Vivek Murthy online: Website: https://www.vivekmurthy.com/ Book: https://www.vivekmurthy.com/together-book Social Media: Twitter: https://twitter.com/vivek_murthy Facebook: https://www.facebook.com/DrVivekMurthy/ Instagram: https://www.instagram.com/drvivekmurthy Other Resources Mentioned: RULER at YALE http://ei.yale.edu/ruler/ruler-overview/ Additional Resources: Ten Percent Happier Live: https://tenpercent.com/live Coronavirus Sanity Guide: https://www.tenpercent.com/coronavirussanityguide Free App access for Health Care Workers: https://tenpercent.com/care Full Shownotes: https://www.tenpercent.com/podcast-episode/vivek-murthy-238 See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Before we jump into today's show, many of us want to live healthier lives, but keep bumping our heads up against the same obstacles over and over again. But what if there was a different way to relate to this gap between what you want to do and what you actually do? What if you could find intrinsic motivation for habit change that will make you happier instead of sending you into a shame spiral? Learn how to form healthy habits without kicking your own ass unnecessarily by taking our healthy habits course over on the 10% happier app. It's taught by the Stanford psychologist Kelly McGonical and the Great Meditation Teacher Alexis

Santos to access the course. Just download the 10% happier app wherever you get your apps or by visiting 10% calm. All one word spelled out. Okay on with the show. Hey y'all is your's your girl, Kiki Palmer. I'm an actress, singer, and entrepreneur. On my new podcast, Baby This is Kiki Palmer. I'm asking friends, family, and experts, the questions that are in my head. Like, it's only fans only bad.

Where did memes come from? And where's Tom from, MySpace? Listen to Baby, This is Kiki Palmer, on Amazon Music, or wherever you get your podcast. Hi, buddy. Hi, I am just recording a podcast. You want to stay in here? Can you crawl into the chair so that I so we can close the door? I'll close fuck down. Okay, George. Last time I didn't. Yeah, it's all bad. Yeah, it's all bad. Okay, can you be quiet for like 30 seconds?

Okay, thanks. From ABC, this is the 10% happier podcast. I'm Dan Harris. Okay, quick item of business. If you want it, my first book called 10% Happier is available at a discount for a limited time through Monday, April 20th. 10% Happier is on sale for 199 as an ebook

and 699 as an audio book. The idea was to put this on sale at a time when people may need some information about meditation. So the ebook is available through Applebooks, Barnes & Noble, Google Play, and the audio book is available at Amazon, Applebooks, Barnes & Noble, and Google. I think it's a terrible book. I don't recommend you read it, but if you do it, maybe it'll help you fall asleep. Okay, the episode this week are guest today, as you will hear, gives a bracingly candid account of loneliness.

One made all the more remarkable by the fact that he's a former surgeon general of the United States. Even before the current coronavirus pandemic, we were in the midst of another quieter pandemic, loneliness. The term sounds only somewhat unpleasant, but magno mistake, loneliness is in fact a deeply pernicious and insidious state, both psychologically and physiologically. And now with all the social distancing,

we have to do, the loneliness problem is on steroids. This problem touches not only people who live alone, but also those of us who may be surrounded by family. As you can hear, I'm surrounded by my son. Loneliness does not require you to be alone as you will hear. It's more about the quality of your relationships. Our guest is Dr. Vivek Murti. He is, as mentioned, the former surgeon general. He's just published a book about loneliness, incredibly timely, called Together. We're actually doing this episode in a bit of a different way. This is interesting.

We interviewed him twice. The first time I spoke to him was right before the pandemic truly took off in the US. And he gave an incredible interview that we were really excited to post. But then things really went haywire with the virus. So we wanted to have him back on to talk about that. As a consequence, we're doing this episode in two parts. First, you'll hear the newer interview, which is more topical. We talk about coronavirus and all the societal implications there.

And then you're going to hear selected bits of that earlier interview where he goes into greater depth about his own story and about loneliness in general. So here we go, Dr. Vivek Morthy. Thank you, Vivek, for doing this really appreciate it. No, of course. It's good to talk to you again, Dan. Yeah.

So I've been thinking about this situation we're in right now as, and I'd love to see if you could fact check me on this, but this strikes me as perhaps the largest mental health challenge we've faced as a culture in memory, the combination of a pandemic and an economic, I don't know if you want to call it a crash or a steep decline. Do you think I'm in the right ballpark there? Well, Dan, I think it's right up there.

You know, I think about the big crises we faced over the last century. And 9-11 was a very difficult one and really impacted people's sense of safety and well-being. There were a few others like that, but I would put this right up there with an experience it has really rocked people's sense of normalcy, has turned their lives upside down, and has injected an extraordinary amount of uncertainty in their lives about how long this will last. All the while, they're struggling economically, they're struggling to figure out how to make things work with their kids and their family. This is an extraordinary stressful time.

It really is. Just as with the virus, nobody's immune. So I'd be curious to hear about how you're doing in the midst of all of this. Well, thanks for asking Dan. You know, like everyone else, I'm trying to figure out how to make this all work. You know, normally in my life, I live in Washington, D.C. with my wife and two small kids,

and I have a flexible schedule that I can design, you know, around key projects and work with organizations and, you know, things are busy, but they're controllable in some way. Now, everything is upside down. You know, we're in Miami right now, I'm with my wife and my kids, but also with my parents, my grandmother and my sister and brother-in-law. We are trying to figure out how to take care of them and all of our work has been turned upside down. And we're just trying to figure out how to take care of our kids most of all because we don't have the usual supports, day care, and other types of help that we have in Washington, DC. So I think it's been more stressful than I

had thought. It would be or that I had realized it was. And I think there's sometimes a lag at least in my own body I realize between how much stress I think I'm under and what I'm actually experiencing. And every now and then my body will sort of perk up and tell me, hey, you know, you're, this is not good. You need to do something differently in terms of how you're handling stress. And so it's been a tough period. I think especially not knowing how long it will last. Uh, that I think has been, that's been difficult because obviously hard to plan. And you know, they're one of the hardest things that Dan has been seeing, uh,

and hearing from friends, uh, who are fellow doctors and who are also in the healthcare, setting his nurses and respiratory therapists who are right out there on the front lines and who don't have the protection they need. And to be honest with you, I feel some guilt not being at my old hospital up in Boston, which I worked at for many years, and feels some guilt not being on the front lines with them. So yeah, you know, it's been a tough adjustment, but I want to do what I can to be useful during this time. And that's, I think, from both my wife, Alice and I, that's, I think, one of the questions that's on our mind the most is, what can we do to help during a time like this? I really appreciate your candor about the guilt.

And it lands for me because I live with a woman who is double board certified in pulmonary and critical care. But she hasn't been working for the last few years and is now trying to figure out, does she go back to work in what capacity, how much risk is she willing to take? She's survived breast cancer. Is it the right thing for her to do to go back onto these COVID wards? And yeah, it's excruciating. It's excruciating.

So I really, yeah, I appreciate you being candid about that. And I also resonate a lot with just the feeling of, you know, I don't have my parents in the house with me as you do, but you, I'm surrounded by my family all the time. And it is stressful as much as I love my family. It's stressful to try to do my work and to be a good husband and dad. And the final thing you said that really landed with me because I've just, I've seen this in my own experience, is your body sometimes knows before your conscious mind does.

So maybe I'm just feeling utterly exhausted and depleted. I don't, I can't figure out why. And that can be your body's way of saying, dude, wake up, you've got an issue here. I think that's exactly right. That hits home for me too. I think a lot of people are going through a great deal of stress right now. And interestingly, if you compare this to another type of stressful event, let's say a hurricane or tornado or another natural disaster that may sweep through and change our lives

in an instant. I think what is perhaps slightly different about this episode compared to those experiences is with those experiences is a little bit more predictability while there's still a lot of uncertainty you know okay the event happened now it's over and now we can start to rebuild and recover from it. And that can be very stressful. But I think the uncertainty of how long this will last. I think is really troubling to people. They know once it's all over, once we're able to resume our lives, that there will be a process of recovery that begins then, economic recovery, psychological recovery, but I think it's almost like we're in the midst of a hurricane and we don't know when the hurricane

is going to be over. And I think that is, that's really troubling. I think also many people may be hard on themselves in this moment and say, okay, you know, I should be able to figure this out. I should be able to figure out how to tell a work and how to homeschool my kids. I should be able to just adjust and move forward and just make the best of this new normal. But it's not always that easy. And I think one of the things that's happening now is there's a flatening of the hierarchy, if you will, where people who are, you know, extremely privileged and

people who are not so privileged are finding themselves in similar boats in that they are all struggling. They may be in different economic situations. They may have different levels of family support, but everyone is enduring a lot of change right now. I think it's important that we be gentle and compassionate with ourselves, recognizing that this is not something that we're trained for. This is not something that we have experienced before. Our country hasn't been through a pandemic like COVID-19

in over 100 years. And so I think this is a moment for ourselves. So just pause and be gentle both with ourselves and each other, just recognizing the extraordinary stress that we're enduring. I agree. Just to pick up on the boat metaphor, we're all in boats in a raging sea right now,

but some of us have bigger boats and you reference that. And my wife and I were looking just this morning at the infection rate per thousand in different neighborhoods in New York City and how our neighborhood is less than 50% of the infection rate of the less affluent neighborhoods and the outer burrows in New York City. And really notice just taking in the two of us that these are folks who often don't have the choice to work from home. They're living with many more people, the population density is higher and public health messages may not have penetrated as deeply. And so in many ways this crisis is also exposing the profound inequalities in our society. I think that's right. And unfortunately, we find that whenever a stressor that's applied to society, that it pushes us in

profound ways and pulls the curtain back on things that were broken, that we're not working and particularly on the inequities in society. And I think what we're finding right now is that it is the most vulnerable who are once again the most affected by this economically as well as in terms of their health. And so I think once this is all over, there's a much deeper reckoning that we'll have to

come to terms with as a society and some questions, important questions we'll have to ask ourselves about what does it truly mean to be all in together? What does it mean to have a true social safety net? And are there holes in our net? And I think the answer is yes, there are. And there's going to be a deeper question of, are we committed to fixing that? Recognizing that in moments like this, all of us can be vulnerable. Although there are some who are chronically more vulnerable than others. And when we look at the lack of, for example, paidly, when we look at the difficulties with access to healthcare, when we look at the dramatic variation in quality of healthcare across our country, we start to realize that these are real liabilities.

Because in a moment like this, you might think, okay, well, I've got resources, I live in a great neighborhood, and I have access to really good healthcare, so I'm okay. But it turns out that if somebody else does not have access to good healthcare, if they are more exposed, and the disease spreads in their community, they can quickly spread to yours as well. So this is a moment where our interdependence is heightened, and the idea that the well-being of one of us depends on the well-being of all of us is, I think, really emphasized in a moment like this. Indeed.

Let's get to the issue of loneliness because that's the subject of your new book. That's the theme of both of the interviews we're posting on the podcast today with you. I just, I wonder how universal a problem is loneliness because you and I began this discussion talking about the fact that we're surrounded by people and really cannot escape. And I've been making this joke. It reminds me of the title of one of my favorite Indie Rock records from the 1980s or 90s by the band Dinosaur Jr. and the title of the record was, You're Living All Over Me. And so I feel at times I'm experiencing the opposite of loneliness.

Oh, no. Well, I'm glad for you that you're not experiencing loneliness per se. But you know what's really interesting about loneliness, Dan, is that it's not always connected to the number of people around you. And what it is more directly connected to is how many relationships or do you just period have relationships where you feel you can be fully yourself and where you feel like you can bring the entirety of who you are to the table. And the truth is that there are many people who have quote unquote friendships, you know,

online and in other contexts, but they don't necessarily feel like they can be themselves in those relationships. And that really matters. So when it comes to loneliness, loneliness is a subjective feeling. It's not an objective description of how many people you have around you. And because it's subjective, it's really dependent on how you feel both about your relationships with other people and the quality of those relationships, but also about how you feel about your connection to self. And I want to say word about what that actually means. When you're deeply connected to yourself, you understand that you have value,

you have a strong sense of self-worth. When you're disconnected from yourself, in that sense, it's actually harder to focus on your relationships with other people. You may find yourself approaching them from a place of insecurity and fear and anxiety. And one of the concerns I have, particularly when I look at younger people, folks who would consider themselves to be in Gen Z or even millennials,

is that much of the culture that surrounds all of us, but that particularly bombards them on social media, is a culture that tells them constantly that they're not enough, tells them that they're not thin enough, not good looking enough, not popular enough, not rich enough, not famous enough. And the truth is, if you go through your life, constantly confronted with messages that tell you you're not enough, then you begin to doubt yourself worth.

You find yourself chasing sources of self-worth and meaning which are attached in our society, most often to wealth, to reputation, and to power. Whereas in reality, it is our relationships with each other that are one of our greatest sources of strength, and power, and meaning, and healing. Yet, I worry that because of the sort of cultural forces that are pulling us in a different direction and telling us that we're not worthy, that we end up feeling seated disconnected from ourself, and that makes it harder for us to focus on and bring ourselves fully to our relationships with other people.

So let me just see if I can unpack up that a little bit. We can be surrounded by people, but if we are not truly comfortable with those people, we may be susceptible to loneliness. And given the current environment in which we exist, where we're bombarded by messages about our innate insufficiency, which is essentially untrue, but we can start to believe by comparing ourselves to others on social media that we are somehow insufficient. Even if the people around us are loving and supporting, we may not be comfortable enough with ourselves to show up in those relationships in ways that would stave off loneliness. That's right, Dan.

Yeah, that's right. Because the thing is, if you think about it, if you are feeling again, that you are not enough all the time, if you're feeling that somehow you're inadequate. You bring that insecurity to your interactions with other people. It may lead you to focus excessively on yourself to put a lot of pressure on the interaction. It may lead you to try to be somebody that you're not. And the thing is that people may not necessarily

be able to put their finger on it, but we can often sniff out authenticity. And people really respond positively to authenticity conversely when they sense that we're not being who we are. It affects the quality of our connection with them. And what all of this, to me, really emphasizes and reminds me of is that, you know, all of us have some core human needs, regardless of what station of life we occupy or where we came from. We all want to be seen for who we are. We all want to know that we matter and we all want to be loved. Those three things are essential

to every human being. And if we're not living in a place where we have those basic needs met, then we don't feel good, we don't feel safe, we don't feel fulfilled, and it affects the quality of our connections with ourselves and others. So this loneliness is like the other pandemic. Yeah, you know, it is quite widespread. It's a lot more widespread than I had appreciated then. You know, I thought early on when I was experiencing loneliness, my self-dirt childhood and during my adulthood, when I was seeing loneliness on the frontlines in hospitals, when I was experiencing loneliness myself, during childhood and during my adulthood, when I was seeing loneliness on the front lines in hospitals, when I was caring for patients

and realizing just how many people were coming in during critical moments of illness and had nobody to support them. I thought in all of these instances that perhaps what I was seeing was unique to my own experience, but it was only when I was surgeon general and began traveling around the country

and talking to people in different corners of life that I began to realize that loneliness was far, far more common than I thought. And part of the reason it was hard for me to see, I think, originally is that loneliness looks like different things. It doesn't always look like a person sitting in the corner of the room, not talking to anyone. But loneliness can look like depression. Loneliness can manifest as addiction. Loneliness can also manifest as irritability and anger and a temperamental mood. It has different ways that it shows up in our life. And that's not to say that every time you're angry, you're lonely, or that everyone who struggles with addiction is primarily lonely.

It's not to say that, but loneliness I found is an important root contributor to many of these states. And so, you know, it's more common than we think and also more consequential than I had appreciated before. And so, what is happening right now as we are dealing with the COVID-19 pandemic and as we're being asked to physically distance ourselves from other people,

and to, in some cases, the sever are traditional social ties. It's pulling back the curtain on a deeper well of loneliness that existed long before COVID-19 came. And I think many people who are experiencing loneliness are finding a deepening of that, and those who perhaps had not, are getting a taste of what it might be like to be more lonely than you're comfortable with. And the real question now in front of us is, how do we deal with this?

And can we turn it around from a weakness and something that may worsen our loneliness to a moment where we can more deeply appreciate and even strengthen our relationships. So how do we do that? Well then I think the first step is for us to recognize that we are all hurting right now and that one of the reasons we're hurting is because we don't have the same social connections that we used to have. There's a lot of focus right now on the direct health impact of COVID-19 and on the economic impact that it's already having on millions of people.

That's appropriate. These are two incredibly important sources of pain that we have to deal with. There's a third source of pain, which is the social pain that's resulting from ties being cut and organically weakened because of lack of physical contact and proximity. That I worry could potentially spark a social recession, where people become a more deeply lonely because of prolonged periods without contact. So the first thing to recognize is that one, this is happening to us, and it's happening this social pain because our relationships really matter.

I think the second thing then to focus on is to ask the question, what can we do to strengthen our relationships in a time like this? And this is where I think we're very fortunate that this is happening in age when we have technology. When the Spanish flu pandemic took place in 1918, we didn't have ways to video conference with each other to see each other's face, hear each other's voice despite the fact that we might be quarantined or understated home measures. But now we do. And I think that there are a few steps that we can take in this moment, as hard as it is, to make sure we're staying connected with people.

We can, for example, use the time that we had, even if it's five to ten minutes a day, to reach out to someone we love each day, to ideally video conference with them, so we can see their face and hear their voice or just to call them on the phone or even it was just to write them and tell them, hey, I'm thinking about you. I want to check on you and see how you are. The other thing we can do is we can make that time count. We can improve the quality of the time that we have with each other. And the way we do this is by reducing distraction. In our day to day lives, we've all become accustomed to multitasking.

And there's a great myth around multitasking that we tell ourselves, which is that we can pay attention to two things at the same time. And for that reason, many people, myself included, and I'm not proud to say this, I've had the experience where they're catching up with a friend on the phone, but also refreshing their social media feed and looking at their inbox and googling a question that I'd put us pop that into their head. And we're doing all these things at once and convincing ourselves we can still pay attention. Science very clearly tells us that we cannot, that we don't simultaneously pay attention to two things, but we switch between tasks very rapidly.

This is a moment, I think, when we can re-examine the quality of those interactions, because just five minutes of high quality conversation with somebody can be much more impactful both for you and the other person than 30 minutes of distracted conversation. And so I think this is a chance for us to be disciplined about spending that time with other people to focus on making that time really count. And finally, Dan, there's a piece around service here that is really important, which is that one of the things that I came to learn in the writing of this book,

when looking at the research and hearing stories from people all over the country and the world, was that service that turns out is a very powerful backdoor out of loneliness. When we serve other people, two very important things happen. One is that we build an immediate connection with somebody through a very positive experience. We're providing something of value to them.

The second thing that happens is that we remind ourselves that we have value to bring to the world, and that itself is really powerful because when you get lonely and when you stay lonely for a long period of time, you can start to convince yourself that you're lonely because you deserve it, because you're not likable, because you're not lovable, because something is wrong with you. And acts of service, just reaffirmed to us what is right about us, and they give us that feeling in the form of a very tangible connection to somebody else. So these are ways right now that we can start to refocus and strengthen

our relationships. And the service piece is so important because a lot of people are hurting right now. It may not look like that on the outside. If you look at the pictures they may be posting on social media or if you haven't heard from them, you just assume they're fine, they're always bounced back, they're probably doing great. I wouldn't make that assumption in a moment like this because the truth is if you called up a friend and said, Hey, I know this time is hard for everyone. It's been hard for me. How are you doing?

I want to check on you. My guess is that you'll hear that they have been struggling too. So this is a moment where we can step up, help each other, serve each other, service is more than volunteering at a soup kitchen. It's reaching out to a neighbor or a friend who may be struggling and is dropping food off to a colleague from work who might be struggling to telework and raise their kids and school them at the same time. Acts of service can be simple yet incredibly powerful and strengthening our human connection. I love that. Let me go back to distraction for a second because I will admit

I am really bad at this. My day now consists of often back to back to back to back Zoom calls. I think it's great to have that face to face interaction, but if I'm being honest, it's not uncommon that I try to get slick and check my email while I'm on these calls, especially if there are several people on the call. What are your thoughts on how to improve the quality of these interactions, given the siren call of Twitter, Slack, and email while you're on these calls? Appreciate you being so honest about that, Dan.

And I'll be honest, I struggle with this too. I find that even though I know it's really important to focus on people when I'm talking to them, I'll just find almost unconsciously I'm reaching for my phone. There's almost this twitch to try to refresh my inbox and I have to really fight that. One of the ways I've found it to help push back against that tendency is to be really explicit with people on the phone and say, hey, while we're all talking, can we make

a pact that we're just going to focus on each other for the 10 or 15 minutes that we have, that we're not going to check email, we're not going to do anything else. And let's keep each other for the 10 or 15 minutes that we have, then we're not going to check email, we're not going to do anything else. And let's keep each other to that. And just making it explicit, I think gives everybody not only permission, but also I think added motivation to be focused not just for yourself, but really for each other. So the truth is that everybody is struggling with this. I don't think we're bad people because we find ourselves reaching for that phone or trying to, you know, check the text messages just came through.

It's partly these devices are very compelling and they're designed to be that way. It's partly because this is how we've just been the last few years. We're in this period now where we have an opportunity to re-examine the nature of our social interactions and to bring an intentionality to it. And I think a focus to it that we perhaps may not have otherwise done if we were just continuing with our routine life. and I think a focus to it that we perhaps may not have otherwise done if we were just continuing with our routine life. So that I think is the great opportunity. The opportunity I hope we can take advantage of so that we can ultimately come out of this great struggle and this

difficult period with COVID-19 more connected than we were before it all began. I love that. If there's going to be a positive impact here, hopefully there are many positive impacts from this nightmare, but one of them could be if we start thinking more about the value of social interaction and the quality of those interactions. Let me just go back to, you know, the point you make quite eloquently was that this rolling dumpster fire that we're in right now is shining a light on and exacerbating an underlying loneliness problem in our culture. And I wonder, you know, in thinking about that, whether this loneliness problem is actually going to make the pandemic worse in some ways, there are two ways that come to mind.

One is, is it possible that given what loneliness does to our nervous systems and our physiology that people are going to be more vulnerable to the virus and are going to fare worse once they get sick? And then the other question is, will loneliness spur people to disregard the public health recommendations around social distancing? Will they get desperate and go out and do things that are irresponsible? Well, that's a good question, Dan.

What we do know is that any form of chronic stress can have a negative impact on our immune system and make us more susceptible to infection. I do worry about the overall stress load that people are experiencing right now, including the stress they may be feeling from being disconnected for now in extended period of time. I think also that when it comes to seeking out social connection and perhaps breaking the rules, if you will, around physical distancing, I think that's important to consider because our desire to connect with other people is deeply ingrained. It's part of who we are. We can't just turn it off with a switch. And so we know that we crave connection. And so the question that we have to ask ourselves is how can we

fill that need in a safe way at this moment? And I found that people are approaching this in different ways. Some are really leaning into the use of technology to make sure that they are seeing and hearing from people on a regular basis, who is before in their life. They may have just called when they had time. They're really being disciplined about that and saying, you know what, in the same way, that I need to keep some structured time where I make sure I can get my work done, where I'm brushing my teeth, where I'm eating my meals, when I'm making sure my kids are learning. I've got to make sure that I have some structured time in my day, even if it's just for five or

10 minutes, where I'm connecting deeply with someone else, where I'm just talking to my best friend, or talking to my spouse just for five or 10 minutes, the two of us just uninterrupted. And so I think that that is incredibly important right now. I think the other thing that we have to keep in mind is that in this moment where we're asked to physically distance ourselves from each other and be alone, this is a strange and unusual moment of solidarity as well because we're all doing this together. And I think there's some comfort that people can take in knowing that it is not just you who's experiencing this, but this is happening to everyone. One of the challenges with loneliness, Dan, is that you often feel like you're experiencing

it just by yourself. Because of the stigma around loneliness, people don't talk about it. You look around at the world, especially through the filter of social media, and you see people just having a wonderful time and going to parties and celebrating birthdays and having incredible weddings. And you just feel like, gosh, am I the only one who's struggling here? But this is a moment where it has become more clear than ever that we're all struggling with figuring out how to rebuild connections in our life.

And so, I think when we recognize this as a moment of solidarity and shared experience, when we lean into connecting with people through technology and with regularity and consistency, I think we'll find that even though it's not the same as being able to reach over and hug a friend or to sit down with a group of your best friends for brunch, it does help fill some of the need for human connection that we all have. So in other words, if you're feeling lonely and that's you think pushing you in the direction of being tempted to do something you probably shouldn't do, maybe, maybe think hard about it and look at the alternatives, which aren't quite as good, but can be very powerful. We are going to go much deeper into all the aspects of loneliness in the interview that you and I recorded.

And we're gonna talk a lot about your personal history with loneliness in the interview that we recorded right at the beginning, right before the crisis started to get really severe. But before we take a break and dive into that other interview, are there other aspects of loneliness as it pertains to the current crisis that I should have asked you about but failed to do.

One thing I think that's particularly important right now during COVID-19 is to recognize the importance of solitude in moments like this, because when everything is turned upside down in our life, the noise level is just incredibly high right now. We're stressed internally. We have voices inside telling us we have to figure out x, y XYZ. You've got information coming from the news 24 or 7 telling us all the things that we have to be worried about. We have people who are worried around us in chat rooms and emails on social media who are just showering us with the information about what we should be concerned about worried about, etc. There's a lot of noise around us right now. And what we need in these moments is to make sure that we have at least a few moments of solitude, where we can let that noise quieten, where we can focus on ourselves, and where we can just be.

And I think the reason this is so important is not only to help manage our overall stress level, but if we want to deeply connect with other people, the more centered we are, the more grounded we are, the easier we're able to do that. And you can center yourself in some fairly simple ways. You know, Dan, you've been a great teacher and facilitator of meditation for so many people. And I think this is a moment where meditation is more important than ever before. But there are other ways also that people may choose to find that centeredness. You know, you can simply sit outside for five minutes and just feel the wind against your face and just let yourself breathe. You can take five minutes to remember three things that

you're grateful for in your life. They could be people, they could be opportunities or experiences, or you could take this time to meditate for five minutes or to pray. That solitude is the calm that we need in the middle of this great storm. It's what allows us to both check in with ourselves and be honest with ourselves about what we're going through, But it also allows us to put both feet on the ground and to plant ourselves firmly. And when we reach out to other people from that place of groundedness, we'll often find that we can be more present with them, that we can listen more deeply, and that the quality of the interaction when we're grounded is higher as well.

of the interaction when we're grounded is higher as well. So, you know, if you look overall at the COVID-19 pandemic, despite all the extraordinary disruption that it is causing and will continue to cause in our life, think it's also giving us this opportunity to re-examine how we live, to re-examine how we've ordered our priorities, and to consider that there may be a way that we can derive even more fulfillment and enrichment out of life if we're able to double down in focusing

on the quality of our relationships and making that the center around which we build the rest of our lives. Yeah, and that includes our relationship with ourselves. And I hope you're right. More 10% happier after this. Life is short, and it's full of a lot of interesting questions. What does happiness really mean? How do I get the most out of my time here on Earth? And what really is the best cereal?

These are the questions I seek to resolve on my weekly podcast, Life is Short with Justin Long. If you're looking for the answer to deep philosophical questions, like, what is the meaning of life? I can't really help you. But I do believe that we really enrich our experience here by learning from others. And that's why in each episode, I like to talk with actors, musicians, artists, scientists, and many more types of people about how they get the most out of life. We explore how they felt during the highs and sometimes more importantly, the lows of their careers. We discuss how they've been able to stay happy during some of the harder times.

But if I'm being honest, it's mostly just fun chats between friends about the important stuff. Like, if you had a sandwich named after you, what would be on it? Follow life is short wherever you get your podcasts. You can also listen to Add Free on the Amazon Music or Wondering Up. Okay, so that was our recent conversation, our most recent conversation with Vivek, specifically focused on loneliness in the midst of the pandemic.

Now we're gonna transition to the conversation we had with him in late February. The insights in this interview on the topic of loneliness were really profound. We did not want this stuff to get lost. So that's why we're combining the two interviews here. One thing to note is that his suggestions, some of them, which you'll hear were offered before we entered the world of social distancing. So here we go with part two with Dr. Vivek Morthy. I guess I'm just really curious why you got interested in loneliness, not as a

medical professional, but as a human being. What is it about your life that made this issue so salient for you? Well, I had experienced loneliness from an early age and still have actually during my adult life. And that I think is what made me sensitive to the issue when I began hearing it so often in the stories of people I met around the country when I was a surgeon general. But when I was young, I remember often getting dropped off at school and feeling this sinking pit in my stomach. That was not me being scared

about teachers or exams. It was this fear that I was going to be alone, you know, the playground, and the cafeteria. And it wasn't that I didn't want to hang out with people. I actually really enjoyed hanging out with others and playing team sports. But I was really shy and I was worried also that I didn't quite fit in. And so that stuck with me for a long time. It's funny how these experiences from when we're young can have such a lasting imprint on our lives. Years later, I ended up being able to find great friends in high school and I cherish those friendships.

Now all this isn't to say that I was lonely at home, and this is what's so interesting about loneliness is I think it can be compartmentalized to different parts of one's life. At home, I didn't feel lonely at all. I had loving parents, my sister, who's a year older to me, was like a second mom. And we all loved each other,

took care of each other, spent lots of time with each other. And I felt quite content at home. Outside of home though, it was a different issue. Did you experience it with me around in your life as well? Loneliness? I did. There were certainly a transition times in my life, many bouts of loneliness.

When I started college, again, being shy, it took me a while to make friends. But those were lonely times, especially that first year, when I was there. There were also other times later in life when I didn't know what I wanted to do professionally after residency training in medicine was one of those times. And I found those to be quite isolating experiences because it felt like everybody around me knew

what they wanted to do. And I felt like something was wrong with me because I just hadn't figured it out. I hadn't gotten my act together. And so I found myself partly out of a sense of shame, isolating more and more and becoming more and more lonely. And that's one of the dangers and great costs of shame. Is shame, whether it's founded or not, and it's usually not well-founded, pushes us to distance ourselves from other people, often precisely at the time where we need the company

and compassion and perspective of others. So that has certainly happened to me at multiple times during my adult life. we need the company and compassion and perspective of others. That has certainly happened to me at multiple times during my adult life. And interestingly, it happened to me when I was Surgeon General as well, which is ironic because I was surrounded by so many people when I was Surgeon General.

There was literally hardly a moment I could get where I wasn't with people, whether it was members of the public or members of my team or other folks in the administration. But what's interesting is that loneliness isn't about how many people you're around. It's about the quality of your connections with them, which in part has to do with you and where you are emotionally at that time. And one of the things that had happened to me when I became Surgeon General is I had

convinced myself that this was such an important opportunity that I had to make the most of it and do as much as I could to be of greater service during the time that I had. And I didn't know how long that was going to be. I knew I had about 2.5, 2 years in change left in the administration and I didn't know what would happen after that. And so, you know, I sidelined a lot of things in my life to just focus on work. And those included my relationships with close friends and even to some extent with family.

And I realized now in retrospect that that was a mistake because we can always find a reason to prioritize work. Even with the best of intentions, with the desire to be of service, you know, to others. But when we do so at the cost of our relationships, we end up eroding the foundation on which we're built. And we end up not being able, I believe, to perform as well, to show up as well in the workplace. And that was part of what happened to me, too.

Why do you think we're afraid to talk about it? What is it with the stigma around this word? And the misunderstanding, too. Well, the stigma comes from feeling that if you're lonely, that must mean that you're not likeable. And that's how I felt when I was a kid. I even to this day never told my parents that I was struggling with loneliness as a child at the time I didn't because I was ashamed. I didn't want them to somehow think that I wasn't likeable enough or I wasn't capable of making friends. No, I need to day like me, but it would be different. I didn't want to feel like I was somehow socially deficient. And that is that way, I think how people feel when they say that they're lonely. I think that's what they worry about in terms of how they might be judged as somebody

who is in an outcast or a misfit, somebody who is broken in some way. But the reality is when you look at the science and the evolutionary history behind our species, you come to understand that there's nothing broken about people who are lonely. In fact, loneliness is a natural signal, like hunger or thirst, that we have evolved to experience, a signal that's something that we need for survival, in this case social connection, is missing. I think often that we don't feel embarrassed to say that I'm thirsty, I need some water, we don't feel embarrassed to say I'm hungry,

I need to break for lunch. But we do feel embarrassed to say I'm lonely, even though it stems from a similar evolutionary need on that our systems have. So I'm just thinking about my own situation, which is not dissimilar to yours. The situation you describe when you're surge in general, not that I've achieved such lofty heights, but like you, I'm married, you've a couple young kids, although they may have

come kind of late in your tenure at a certain general or after one during my time and one right after. And you're surrounded by people all the time. So you can have all of this going on and yet be lacking social connection. Yes. Because if you think about it, what really matters is the quality of those connections. And the connections that are often the most fulfilling to us are the ones where we can truly be ourselves, which means where we can be open and vulnerable. Many people at work don't feel like they can be open and vulnerable with those around them. They feel like if they do, then somebody might use something against them later or perceive

them as weak in some way. And unfortunately, what that leads to is many people, even though they may have pleasant interactions at work, they don't necessarily have friendships, deep friendships at work, or at least the have friendships, deep friendships at work, or at least the kind of friendships where they can be truly open in themselves. This actually comes at a pretty significant cost in the workplace because we now know from now multiple studies,

including some work from Sigal Barseid, who's a professor at Wharton at the University of Pennsylvania that when people struggle with loneliness at work, it impacts their engagement in the workplace, it impacts their productivity, it even impacts retention in the workplace. And so if you are a manager or if you own a company and you want your workplace to be a place where people want to stay, where they do good work, where they have good relationships with other people, then you should care about whether your employees feel lonely in the workplace or not.

But this is a key piece of it, and it comes down to a word that we haven't mentioned, but I think it's worthsing explicitly, which is a word vulnerable. Well, when we feel like we can't be vulnerable with people, that puts limits on our connection with them. And I think as human beings, we all have some common needs. I think we all want to be understood for who we are. We all want to know that we matter, and we want to know that we are loved.

And if you don't feel that you have that in the social relationships in your life, then you're likely to feel lonely. Interesting what you were saying about work. I think about the cliche that we deploy internally at the Temperson Happier Company, which is, we want you to feel comfortable bringing. I think about the cliche that we deploy internally at the Temperson happier company Which is you know, we want you to feel comfortable bringing your whole self to the office Yeah, and I was unaware that there's actual data to show that if people feel that they need to put up a front all the time

Then they're not gonna function as well Yes, and it's interesting because it not only affects them But it affects the people around them So when you look at people who struggle with loneliness in the workplace, it's not just that it reduces their engagement, but it changes how people feel about them and makes it others less likely to engage with those individuals, which then creates a worsening spiral of loneliness. I have to imagine this is worse for women because the modern work was created by men.

And so many women, at least from what I've read and being married to one, feel that in certain circumstances, they need to act in stereotypically masculine ways, which may not be true to how they are, you know, genuinely organically, authentically. So I would imagine that this death spiral you're describing is one that might resonate with some of, resonate with some, particularly with some of our female listeners. You know, I think that you're right that we have constructed workplaces that tend to be historically at least quite masculine in nature, and we take women and we effectively tell them

that they need to be like men to succeed in the workplace, whatever that means. But what's interesting for men too is I think many men, perhaps an equal number of men, struggle with loneliness in the workplace, but I actually think that they are less aware of it than women are. Now, traditionally, and I'm stereotyping here and generalizing, and obviously we know these stone holes true for everyone, but women generally tend to be better at maintaining relationships in their life. They also, in my own experience, tend to be more aware of their emotional state.

Whereas for some of us guys, it takes us a bit longer to catch up and to fully see what we're experiencing and to admit it to ourselves. Especially if it's a challenge in our emotional state, which we may in traditional social terms perceive as weakness in some way. And so even though we have built workplaces that are historically speaking, not focused on friendships and not focused on vulnerability, men haven't need for that just as much as women do. And when they don't have workplaces that support them

in being open and developing friendships and in bringing, as you put it, their whole selves to work, then I think they suffer. They may suffer in silence, they may suffer in ways that they don't even fully realize or relate it to loneliness. And what's interesting in men is that, you know, in our current culture, men are raised to believe that emotions are largely off limits in terms of what you display. With one exception, the emotion of anger. So if you are a man in your feeling lonely or you're feeling frustrated, it is seen as

socially acceptable for that to come out as anger, even though that has massive negative consequences for you and the people around you, but you're not seen as less masculine, if you're displaying anger, versus if you are tearful or if you are sad, then somehow in traditional masculine culture that's not seen is favorable. It's seen as a threat or challenge your masculinity. So I think what's interesting is if you look at the data around loneliness, who's you know, and if you're asking the question, who struggles more as a men or women, the data shows that the numbers are roughly equal in fact in terms of proportions of men and women. But I actually think that I wouldn't be surprised if we searched to see more data showing that in fact

men have more issues with loneliness than women because I, I think there's an awareness issue and an inside issue that more affects men than women when it comes to even recognizing that this is an issue for them. Yeah, all that really lands for me. So, okay, we've covered a bunch of things, not in any particular order. So let me just reset for a second. We talked a lot about your personal road to writing this book about loneliness and then we branched off into a few other topics. Let me just reset and get you to talk about why not just from a personal standpoint, but from a professional standpoint as somebody who's deeply concerned about public health, why loneliness hits your radar in such a prominent fashion.

Well, you know, it started to hit my radar when I finished my college experience and began medical training. And there, for the first time, I began to see that loneliness was an issue for the patients I was caring for. Now, this is not something that I learned about in medical school. It wasn't part of the curriculum.

It was not something that I even appreciated when I was growing up and watching my father, who's a medical doctor and my mother who managed his office care for patients. I came to appreciate the power of community and connection, but I hadn't recognized at that time how many people are struggling with loneliness. But I went into an internal medicine training program, and I assumed that the majority people I'd be caring for would have diabetes and heart disease and cancer and infections, and

that's what I would spend my time thinking about. But I started to quickly see that many people would come into the hospital for disease, and cancer, and infections, and that's what I would spend my time thinking about. But I started to quickly see that many people would come into the hospital for care and have to make some pretty tough decisions about whether to take certain treatments or go down certain investigation pathways, and they were making these decisions alone. And so I would often ask them, is there somebody who would like me to call or should I ask your family to come in so we can all discuss this together?

And quite often people would say, no, there's no one to call. It was just them. It was also the case so many times that at the end of life, when people ultimately passed away, that I found that the only ones who were with them were me and my colleagues, the nurses and doctors who worked at the hospital. We were the only ones there to witness so many people's last moments. And in those moments I kept wondering myself, where are their friends, where are their families? And I started to realize very quickly that there is this larger undercurrent of loneliness that my patients were struggling with that I had not learned about and felt utterly unequipped to address as a doctor. And I'll tell you one of the worst feelings as a doctor is to see a problem that your patients have and to feel utterly unequipped to address it.

Most of us went into the profession wanting to relieve suffering and help people. And we trained in as many skills as we could to be able to do that. But I realized that there was a huge gap in my medical training. Now, before I became Surgeon General, I was unsure of my experience, was just peculiar to the patients I was seeing, or if it was more broadly representative, but what was happening around the country and around the world. But when I was searching generally, even then, even though that was in the back of my head, I didn't list it as a high priority issue,

like when I began my time in office, and when I went through the Senate confirmation process and had to testify before the Senate about, among other things, my priorities, this was not one of the issues I listed, because I didn't think it was gonna be a high priority issue. But I began my time in office with the listening tour just going to communities all across the country asking people how we could help. And I tried to just sit back and listen to those stories. And that's where I started seeing the behind so many of the stories of

addiction and violence and depression and anxiety and chronic illness that people were struggling with. and violence and depression and anxiety and chronic illness that people were struggling with, were actually threads of loneliness. And no one ever came in and said, hi, my name's Dan, I'm struggling with loneliness. But undeniably those threads were there. So I started to surface them more explicitly, and I would go to town halls and small group meetings as I were to ask people. People think that loneliness is a problem. Is it something that's affecting their lives or their loved ones? And I'll tell you, Dan, what was so interesting is I could see these almost immediate flickers of recognition in people's eyes.

It was this visceral response that people had that was quite different from almost any other issue that I talked about or dealt with. And so that was another signal to me that there's something much deeper and much more pervasive happening here than I had really come to appreciate. And then after that, as I started to delve into the science around loneliness and came to understand not only is this far more common than I thought, but it's also consequential. It has a profound impact on our health.

All of those together led me to realize that this is an issue that I want to do something about because it's something that we're not doing enough to address, but that we have All of those together led me to realize that this is an issue that I want to do something about, because it's something that we're not doing enough to address, but that we have the power to address through the power of human connection, and also addressing the Linus is not something that that you have to be a doctor to solve. You just need to be a human being with the heartful of compassion and the willingness to reach out to others who may be struggling. So I want to talk about how to address it in a second, you know, full some manner, but first let's talk about the consequences that you referenced.

What happens to the human psyche and physiology under loneliness? So loneliness puts our body in a state of stress. And to understand why, you just need to think about how we lived several thousand years ago when we were hunter-gatherers, in those circumstances when we were under threat from not just predators, but also a lack of a consistent food supply. One of the things that helped us survive was having trusted relationships with other people. When you were connected with other people that you trusted, you could take turns watching at night to make sure the group was safe.

You could pool your food so that everyone had some food on every given day and you wouldn't have periods of starvation. You could also do things like share in child rearing and in spreading the workload of the family responsibilities so that people could go out and hunt and gather. So there was tremendous value, survival value, to being connected to other people. Now over thousands of years, I became baked into our nervous system. And what would happen is that if you were separated from the group in those times,

you knew that your chances of survival would drop. And so that immediately puts you into a threat state. Now what happens in a threat state? When a threat state, you take something that may only have a 1% chance of being bad or being a threat, and you want to treat it like it's a potential threat because if you're wrong and it actually is a problem and you think it's benign, then I could cost you your life So you'd much rather air on the side of assuming it's a threat than saying it's benign

Now here's a problem is if you if you recognize that that's how our nervous systems evolved We are effectively that same creature, you know in modern day, you know our genes are very similar our nervous system is very similar. So even though we're no longer hunter-gatherers, if I'm separated from the group in modern day world, which the equivalent would be saying, I feel lonely, then I automatically go into a stress state, where two important things change. One is my threat perception, shifts, such that I perceive many things as a threat that may not be. And the second thing that happens is my focus shifts from being on other people to being predominantly on me. And you can understand this because again, if you're lost in the tundra, you know, way from your group, you want to be paying attention primarily to yourself.

You want to know, like, am I, did I get injured? You know, am I hungry? Am I starving? You know, are my instincts going up that somebody else, you know, might be coming out to get me or an animal or a predator might be coming after me? But these two adaptive features of, you know, shift and threat perception

and a focus on self, when loneliness is chronic, these two features can become incredibly detrimental because imagine that, you know, you're feeling lonely and the people are coming up to you saying, hey, do you want to come have lunch together? Now normally you would say we make sense to say, yes, okay, I'm feeling lonely. Let me have lunch with somebody. But if you're in a state of chronic loneliness, you may start to think, hey, is that person really want to have lunch with me?

Are they just taking pity on me? Are they going to have lunch with me and then make fun of me or ridicule me and make me feel bad? It was like, I don't need that. Like a double bind. Did you? It's a vicious cycle. It's a vicious cycle. And the other thing is because your focus is so much on yourself, sometimes I can be a turn off to other people, right? When you're interacting with them. Now, I mentioned this because understanding this has taught me that I need to be more compassionate also when I engage with people who might seem like they're overly focused on themselves or might seem a little awkward, who may not

be resistant initially to my outreach. Because I realize that this is not just them being annoying or silly. This is them actually behaving in the way that our nervous systems evolved to behave, even though it's counterproductive in the modern world. So this is actually why, in a really interesting way, loneliness actually puts us in a stress state. Now, this is where the consequences come from our fur health. When you're in a temporary stress state, that can actually be quite helpful to your performance. So the night before a big exam or a big speech, you might feel, hey, I've got this adrenaline

flowing through my system. I feel a bit stressed, but it pushes you to perform better and get more out of yourself. The problem is when that stress lasts for a long period of time, then you have elevated levels of cortisol and other stress hormones that are flowing through your body, which can increase inflammation, damage, tissues, and blood vessels, and ultimately increase your risk of heart disease and other chronic illnesses. And with loneliness, what's interesting is you see this. You see that people who are lonely have a strong association with an increased risk for premature death, for heart disease, for depression, for anxiety, for dementia.

Their sleep is more fragmented, which means the quality of their sleep is lower even if they're sleeping the same amount of time. Their immune response seems to be blunted and their wound healing seems to be impaired. One by one, as you go down the line, you see that the chronic stress that's caused by loneliness has real consequences to our health. And how consequential is it? Well, it turns out pretty substantial. So Julianne Holunstedt, who's a researcher at the Brigham Young University, and done a really interesting meta-analysis, pooling a number of studies from around the world, and she helped show that the mortality impact, the amount

by which one's life is shortened, the mortality impact of loneliness is similar to the mortality impact of smoking 15 cigarettes a day. It's greater than the mortality impact of obesity or sedentary living. And I think about how much a surgeon general I spent talking about smoking and about obesity and about the importance of exercise, compared to how little I spoke about the importance of cultivating strong healthy relationships in our lives. And I realized there was an imbalance there based on what the data is telling us about the health consequences of loneliness.

Are we, as a society, seeing elevated levels of loneliness and if so, why? So it's a bit of a tricky question to answer in part because we don't have nearly as much data on loneliness as we have in other areas like diabetes or high blood pressure. But a couple of things we do know from the data. We do know that loneliness is really common. So even if you take a conservative end of the spectrum and look at data from the Kaiser Family Foundation and the Economist from their 2018 study, they peg loneliness rates in adults in the United States around 22%. The UK and Australia, their rates are around 25%, but there are plenty of studies, especially recent studies from SIGNA, a major health teacher here in the US, which have pegged

those rates quite higher. They're also indicating, as other studies have, that there is a spike in loneliness that happens in adolescents and young adulthood. So millennials and Gen Z members are actually lonelyer than people who are in their 60s, 70s and 80s. Again, not entirely intuitive, but the data seems to pair that out. It's intuitive, if you think about social media and people driving people toward anti-social behavior. If you're all you're doing is sitting in your bedroom looking at other people's lives on Instagram, which I think is something that a lot of people do

young and old, then your happiness may well go down. That's right, lonely just may go up. That's right. So what's really interesting about technology is that, and this is the most common question I get from people about loneliness in the community, is they want to know, is technology to blame, and social media in particular, the cause of this. And what I would say is that technology in the end is they want to know is technology to play, and social media in particular, the cause of this.

And what I would say is that technology in the end is a tool. How we use it is what determines whether it's strengthens or weakens our connection. There are ways we can use technology and social media to strengthen our connection. So if I'm coming to New York City to do a podcast with Dan, and I post on Facebook to my friends who are in New York City. Hey, I'm going to be in New York. Anybody want to meet up for dinner? This way of using social media as a bridge to offline connection can be quite helpful.

Even on the other hand, I'm feeling lonely on a Friday night. And I think, well, let me just go on Facebook and look at what my friends are doing and then I feel connected to them that way. Well, let me see what they've posted on Instagram and I'll feel like I have a bond with them or I'll be reminded of my friendship somehow. That tends not to work. And to happen is you actually feel worse about your own life because the experience of social media for so many people is comparing other people's best days to your average days and you always end up coming up short. So it can be really challenging in that way. So the

other piece of it is that what you mentioned is the cannibalization of time is when you're right now the latest stats from common sense media tell us that it's somewhere around seven to seven and a half hours a day the young people are spending on average in front of screens outside of their educational work. So that's at a schoolwork. If you're spending about seven and a half hours on the screen, if you're sleeping about eight hours, you're in school about six plus hours a day, that's not a whole lot of time left for face-to-face interaction with friends and other family members. That's undistracted. And this is a really important caveat here. Because if you ask people, do you have FaceTime with people? They'll say, oh, yeah, I do. But then if you ask them, is it undiluted FaceTime? Are they focused on the other person? Then the answer shifts.

Because what the other impact of technology has been that it has diluted the quality of our interactions with people. So how many folks do we know? And I've done this on plenty of occasions, which I'm embarrassed by, but it has happened. How many people have brought their phones to the dinner table with their families and with their friends? And we tell ourselves, hey, if it's face down, then I won't be distracted by it. Or if I just put it on silent, then I won't be distracted by it.

But we know, I mean, from hard data, that when we get distracted, it takes us many, many minutes to actually re-engage and focus conversation. We also know that we have a terrible tendency to overestimate our ability to multitask. And think things we want to distract as we can talk to our friend on the phone and catch up, but also be checking Instagram at the same time on our phone and we'll be able to pay attention. But the data shows that we can't. We can only switch from one task to another. So this, I think, has been the consequence of how we use social media predominantly now. Is it's taken time away from face time with loved ones.

I think it substituted lower quality connections for higher quality connections, and it's also diluted more often than not or in-person interactions. So let's talk about what we can do about this. And I'd like to start on the individual micro level and you already sort of help fully brought us there when you talked about our relationship with ourselves.

So would you say that's step number one for dealing with this? I think it's right up there with one of the first things that I think we should think about and focus on. Because our connection to ourself is not something that many of us are told we should pay attention to. We're often in fact told that it's self-indulgent to think too much about ourselves and we should be thinking about other people. Where the question that comes up in my mind when I hear connection to myself is what does that even mean?

Yeah. So when I think about connection to self, I think about self- and self compassion as being the two critical components of that. To be connected to oneself is to be comfortable with oneself, which means I understand who I am, and I also understand that I have value and worth to contribute to the world around me. Now, self knowledge is not always easy to come by, like in the current world, because we get a lot of self-knowledge by reflecting on our experiences. And much of the white space in our lives has disappeared. When we have a few minutes to spare here and there,

we pick up our devices and check our inboxes, or we check social media, or we check the news. So much of the, those cracks in our life have been filled. The other thing that I found is really important is, especially as the pace of life increases, and the inputs and the signals that we're getting in terms of from media and advertising everything increase. We need spaces in our life where we can let that noise soften and where we can just allow ourselves to observe both what is around is but also how we are reacting

to the world. And that's where I think meditation can be a very powerful tool for people. Now, I have my own experiences with meditation, which I'm happy to talk about, but I think that there's more and more data telling us about the power of meditation, but I think it has a particular use here when it comes to strengthening our own connection with self. The self-compassion piece is also very important. We can come to know ourselves, understand our tendencies better, but if we don't have compassion for ourselves, and we risk being in a position where we're constantly blaming ourselves,

which I think many of us are apt to do myself included, it's something I've been trying to unlearn for years and years in my life now, but I have found that the loving kindness, meditations, the metameditations, the meta meditations, particularly is taught by Jack Cornfield, have been extremely helpful to me and I know to many others, and reminding us that it is a compassion that has to be a part of rebuilding like our connection with self. Through self-knowledge and self-compassion, once we have a strong connection to self, then I think we can start thinking

about how to strengthen our connection with others. It's worth also saying, though, that building connection to self is not just something that we do in isolation. It has to do also with the people around us. I think all of us know from our experiences that sometimes a good friend who knows us really well can actually remind us of who we are when we forget. They can help clarify for us what is so beautiful and valuable that we have inside of ourselves that we've always had, that we bring to the world and to our relationships. And we all need those reminders. I think of good friends in that sense like mirrors that show us truly who we are when the fog of life just clouds our own glasses.

And so connection itself is, you know, can be built through the practices that we do in meditation and gratitude through the use of solitude, but also by ensuring that we have time with people who truly know us. How we build connection then to others, after that I think can be facilitated through a few things. Think one, and this is something that was more surprising to me than I realized when I wrote this book, was I started coming across story after story where people's pathway out of loneliness

was actually through service. And it turns out that service is profoundly helpful whether you are serving your community by volunteering at an organization or whether you're serving people at work or people in your school by helping those who are struggling. And partly why it's so powerful is that, remember, we earlier we mentioned that two of the unfortunate tendencies we have when we're chronically lonely are to focus on ourselves

and to have an elevated threat perception. And service actually bypasses both of those. It automatically takes our focus off ourselves and puts it on someone else, the person that we're helping. And it allows us to do so through a pathway where we are reminded that we have value to give, that we have something of meaning to deliver to someone else.

And that can be very self-affirming that actually allows us and encourages us to open up and engage more. And so service is extremely powerful. The second thing which I've started doing in my own life is to take 15 minutes a day and just dedicate at least 15 minutes to having a conversation with somebody that I love.

It could be calling my mother, it could be making sure that I'm actually present while I'm talking to my wife. It could be texting a dear friend or an old mentor just to say I'm thinking about you. But just 15 minutes. The third thing I think it's really helpful for individuals is to think about the quality of your time with people. Even if you only have five minutes with someone, if you are focused when you're with them,

that can mean so much more and give you so much more gratification than half an hour of distracted conversation. And more often not than not, what this means is, don't multitask when you're talking to someone, put your devices away and just focus on what they have to say. Those things I think are extraordinarily important and these are simple tools that can be powerful in helping us to connect with others. But I would also, you know, I try to remind myself often that there's a fourth piece here, which is the small things, as I think about them, the small interactions that we have with

strangers, with others in our lives, where a simple smile, a simple greeting can do an extraordinary amount to make us feel better. Now, this might seem counterintuitive. Like, how can a five-second interaction really have a significant impact on my life? But it's actually there's some interesting studies done on this one that was done I believe at the University of Pennsylvania where they actually took a group of people who were walking on a busy Busy street and they had some folks who were planted who in some cases made eye contact with folks as they walked by and in other cases did not and then they stopped people afterward after they passed this sort of experimental zone. And they asked them, how do you feel?

And they found that people who had received eye contact felt significantly less lonely in those moments and people who had not received it. Now, we all have the power to do these things, but they had benefit not just the recipient but the giver as well. And so I try to remind myself that every day as I walk through life, when I was on the Amtrak train, when I'm in this studio, when I'm on the streets, you know, walking around, that they are opportunities to interact. It doesn't mean I have to interact with every single person I come across. They're pausing every now and then to make sure at least I'm interacting with a few people with a simple smile or a hello can make a big difference.

Yeah, there's data that I've seen on interactions and elevators and with your barista that show boosts in happiness for the people. Absolutely. You just said a ton of things that are really interesting. I want to react to some of it. One of the things I think about in terms of reducing my own loneliness or just boosting my own happiness level, which is basically saying the same thing in some ways. Over the last couple of years,

I too came to realization similar to the one you arrived upon when you were a surgeon general, which is that I had been devaluing my social connections, be it family or just my larger group of friends and colleagues. So I've really made it a priority to go to lunch with my friends regularly or accept social plans, even if it's kind of inconvenient, or to really make sure that I make time for mentoring around the office. And I found that that has been incredibly rewarding.

I remember a couple of years ago when I was first getting into this, my wife and I, we had said no to so many social engagements larger because I was so busy. And some friends of ours were colleagues of ours here at ABC News, we're leaving. And mutual friend was throwing a Rebecca Jarvis, a well here at ABC News, we're leaving. And mutual friend was throwing a Rebecca Jarvis, a well-known ABC News correspondent, who hosted a massively hit podcast called

The Dropout, was throwing a party on her roof deck. And we had a bunch of ABC News folks and we brought our kid and other people brought their kids and were just sitting around talking. And it was like a weekend, and I work early mornings and the weekend, and so I'm often very tired. So that's another reason why I don't often go to these social events. We got in the car and I was super tired, and our kid was being whiny,

and I looked to my wife and said, why am I in such a good mood? And it's because it was just simple thing of just going to this party. Nobody was looking at their phones. We were all just making fun of each other and eating food. And so I found that just that little tweak, and it's not a little tweak, at this party, nobody was looking at their phones. We were all just making fun of each other and eating food.

And so I found that just that little tweak, and it's not a little tweak, that meaningful tweak of prioritizing human interaction has been really helpful for me. The other thing I'll say about communication, which you talked about sort of boosting the quality of your interactions when you're having them is that I have had some communications coaching and It's really taught me how to be a better listener and to reflect back things that people are saying Which forces me to listen and also makes them feel really good because they feel like they've been heard and validated and That has really helped me you know my my phone's not on the table in front of me, at least one of my better days. And that's just been really useful.

And then the final thing I'll say is I just noticed even last night, I was, I had printed it out in front of me. I have this printout of my ace producer, Samuel John's, compiles research and sends it to me. And usually I read it the last minute. And last night I was multitasking. My son had come home from his afternoon activity. He's five years old.

It was about six in the evening. And I was, I sort of camped out on the living room floor while he was walking around playing with his toys. And it was reading this content all about loneliness and it's discontent, et cetera, et cetera. And I realized, well, I've got this kid right here in front of me that I'm not paying attention to.

And I put it down. I said, Alexander, he paused for a second. He said, sure. And I said, can I have a, and he came over and sort of lay on top of me for a while. Oh my goodness. Delicious. And you can just see it in your mind. It's not, it's not complicated.

You can just see how your mood elevates in moments like that. Anyway, I've just had a lot all in defense of your thesis, but I'll stop talking and see if you have any response. Well, I love what you just shared about your son in particular. And I can relate to that as a dad who far too often has a multitasked when I'm with my kids. And I do it almost unconsciously sometimes. I'll just somehow, my phone slips out and I pocket it.

I'm checking my inbox when I literally have no need to, but it's just a habit. But one of the beautiful things I've appreciated about kids is that they are on apologetic reminders of what's important. And my son, if he sees I'm distracted, will call me out on that and say, Papa, where are you? And you know, it's actually a really deep question. Where are you? I'm physically present, but I'm not emotionally present. Yes, I need to be more present. And that's one of the extraordinary things about them, is I think children are, they're incredibly present.

They're there. They're looking at the dot on the wall and wondering about it. And they're looking at the small bug crawling outside the window with fascination. And that appreciation and that, as I think of it, gratitude-based approach to life is something that they remind me of so often that I I realized that I think many of us were born knowing so much of this, knowing so much of what we talked about, like intuitively understanding

their relationships matter, wanting no more than just to spend quality time with people. Like my son and daughter don't care about how fancy our house is or isn't. They don't care about the fact that we don't have a car. They don't care about how fancy they're closer. They don't care about any of that. They just care about the quality of time that they have with the people they love.

And I think what happens over time is that life just gets complicated and culture sets in and tells us that a certain other set of values matter. And then we start changing our entire life and focus and time and energy toward living according to those values. And to me, this is one of the fascinating things about trying to build a more connected life and a more connected world, is that it's not trying to transform us into someone that we're not or that we haven't evolved to be.

This is about trying to bring us back to our roots, as people who have evolved over thousands of years to need each other, to depend on trusted connections. And I think we know it when we feel that we have that in our lives, and when we don't, we sense that knowing feeling, which we may or may not call loneliness, but which is often a swaged by true authentic human connection. Yeah. The other thing that crossed my mind, just to build on your point, listening to you talk about loneliness, is my concern coming into this interview was, well, is this a niche concern,

you know, loneliness? Clearly it's not. Some data would suggest that half of us are, as you said before, are suffering from this, and 100% of us are vulnerable to it. And what this interview has suggested to me is that if you can clearly identify this as a universal risk and something that should be prioritized, it will force you to reorganize your life. Yes. That's absolutely right. And I think that reorganization is good

because it's not just our individual lives that need to be reorganized. It's a society that really has to reflect more deeply on how we're organized. And we have to think, have we really organized society to focus on what really matters in life? When I think, Dan, about the patients I cared for who were dying, and when I think about the conversations I was so privileged to have with them in those final days and final hours,

very few people, if any, ever talked about the positions that they had achieved or the wealth that they had accumulated, what they talked about were the relationships in their life, the ones that had brought them great joy, the ones that had broken their heart, the ones where they wished they had invested more time. That's what matters to us at the moments of greatest clarity in our life, our relationships. And the challenge that we have today is to figure out how to not only build our individual lives, but structure our workplaces, our schools, our government and our public policy, as well as our public dialogue around the fact that connections

matter and that we need to build is a people-centered society. In a massive dereliction of duty, I as somebody who hosts a podcast, that's ostensibly about meditation. I didn't ask you at all, but your meditation practice. But so in our remaining time here, let's let's talk about that because I know it's been part of your life since very, very early on. Yeah, I was blessed to have a mother and father who exposed me to spirituality and to religion from a young age. And a big part of that was was meditation. So, both my parents meditated during my childhood and they still do today. And probably around from the age of at least as far back as I can recall from the age of seven

onward I remember meditating regularly. Your parents were immigrants from India? From India, yes. And they both practiced in the Hindu tradition. And so I remember from the age of seven on, we're meditating regularly. When I was in middle school and early high school, I was meditating for an hour a day. You know, it was just a regular part of my practice. We were very different high school students.

Well, the story changed, it didn't quite last. But there were different types of meditation I was brought up with. Some were more chant-based meditations that I would do with a japa mala similar to a rosary. Others who are more breathed meditations. They were wonderful. They brought me peace and they gave me a sense of centeredness. But I ran into some trouble later in high school where suddenly, well, what felt like suddenly

to me, these practices started speaking to me less. They became actually more frustrating as I found my mind wandering when previously it used to be quite focused. And despite reading all the teachings that you shouldn't judge your mind for not focusing, it's more about awareness than about focus. CLI found myself unable to break from that compulsion to just focus, focus, focus. And it got to the point where I just couldn't, I was trying, you know, for hours a day to meditate without any sort of fulfillment.

And so I remember in my freshman year of college, at the end of one of these extremely unfulfilling meditation sessions, calling my father on a Friday night. And he was in the middle of a dinner party where he and my mom were entertaining people at home. I just went out that I also in college never meditated on a Friday night or any other night carrying on. Well, this would be the end of that because in that conversation, he sensed just how distressed I was.

I need just said to me, he said, just let it go. He said, you don't need to do this right now to feel fulfilled. You'll find your way again, but give yourself the permission to let the practice go. Sun, stop meditating. Go to a cake party. Something like that. Yeah. So that began a several years search for me for a tradition that mattered. It was in the years that followed that I was fortunate to meet Jack Hornfield and to attend

one of his meditation classes at Spirit Rock in California. Now he wouldn't remember that time because, and I was just one of the many, many fans at Spirit Rock who admired his teachings, but I got so much from that in terms of an introduction to mindfulness-based practice. And, you know, over time, I also, you know, when I was in Surgeon General, I actually was introduced to TM to Transcendental Meditation by a teacher. We, in fact, had offered meditation training to everyone in our office when I was a Surgeon General, because we knew just how important it was to when we had a group

of people who were so mission oriented who were burning the candle and both ends who were working around the clock to make sure our campaigns were executed. They were burning out. We wanted to do something to help ground people and strengthen them. So in our office, we often used to meditate together. Many people would meditate on their own as well, but it became part of our practice. But when I had kids, things shifted, and I'm still trying to figure out how to shift them back to a good place, but my morning time slot for meditating evaporated, as my kids got

up with me and also would get upset if I left the bed early. They would somehow seem to know. And my usual evening time slot became sort of occupied with bed time. So I'm still figuring out how to in a more consistent way build meditation, like into my life in a regular way. But I will say that my belief, not just looking at the science behind meditation, but from my own lived experience and through the teachings of people like like Jack Cornfield have, my belief is only grown

that meditation can be an extraordinarily powerful tool for grounding us in our life. One last thing that's worth mentioning, Dan, is at the very end of my time in office, I remember our office had become so engaged and enthused about the idea of focusing on emotional well-being. The we organize the convening with people from around government and actually from the private

sector as well to come together to help us start thinking about how to build a larger movement to improve emotional well-being in America. Recognizing that meditation was an important component of that. It was actually the first time that I got to meet a man I had deeply admired for a long time, John Kabatzen, and whose books I had read, but you know, I had never met in person. But we also brought all kinds of other folks together, leaders in business, you know, leaders from the Veterans Administration from hospital systems. And what was really striking to me there was, there was such a hunger from all of these different quarters to invest in emotional

well-being. There was such a recognition that so much of what is sapping our health, our vitality, our productivity, and our kids' future is our failure to invest in and really even understand the importance of emotional well-being. And meditation is an important tool for enhancing our emotional well-being, although it's not the only one. But that's one of the reasons why I wanted to focus on an issue like loneliness,

is I think when I think about all the different ways that we can enhance our emotional well-being, our social connections are an incredibly important and rich part of that. Our connection with each other is the fuel that allows us to be more and to do more. And as a doctor, I've written so many prescriptions for medicines, antibiotics, and other medicines. But when I think back on it, the most powerful medicine I believe that we have is the love and compassion that we can offer to each other and to ourselves.

And we do that in the form of genuine authentic human relationship. That's why I believe so deeply that we can be healers to each other. That's why I feel optimistic about the future because I think this is about harnessing those abilities that we've been given that there's a part of our birthright, the ability to heal each other. It's about harnessing that power,

about making us aware that we have that power and then applying it to strengthening the relationships in our lives and hopefully society more broadly. Well said. In closing, can you just plug, I ask all of our guests to plug, can you plug your new book unabashedly if you don't do it, I'll do it, and anything else, any other ways we can learn more about you, any other projects you're involved in that you want people to know about the floor as yours. Well, that's very kind of you. I'm terrible about plugging my own ventures,

but I am grateful to have worked on a new book that will be coming out in April of 2020, called Together, the Healing Power of Human Connection and a Sometimes Lonely World. It's a summary of this extraordinary experience of discovery that I've had over the last few years that brings together the science-alout human stories to put forth a case for how we can build

a more people-centered world and why that will make a profound impact on our health but also on the health more broadly of our institutions and society. So it's been a learning experience, but I'm very excited to share it with the world. And if people want to learn more about the book or about the work that we're doing, you can certainly go to my website, vivacemorty.com. And part of what we're working on now and thinking about is how to accelerate a broader

conversation in this country and around the world on human connection, how to make it real and how to enable people to share their experiences of strengthening connection with each other. Dr. Thank you very much for doing this. Thank you so much Dan. It was so much fun to be with you and what a pleasure to have this conversation. Likewise. Big thanks to Vivek, really appreciate him coming on twice to share his wisdom. His new book is called Together, the Healing Power of Human Connections in a sometimes lonely world. It's available for pre-order on Amazon

and other booksellers. Before I let you go, reminder, every weekday at three Eastern noon Pacific, we're doing this really awesome new kind of experimental thing. We call it TPH Live or 10% Happier Live. It's a live sanity break. We bring on one of the world's greatest meditation teachers. We do five minutes of meditation. Then we take your questions. You can join us at 10% .com slash live. I'll put a link to that in the show notes. It's a great way to

find a little calm and a little community in the middle of a pretty tough time. Big thanks to the team who helped put this together. That's Samuel Johns. He's the head of this big operation. Big thanks to Samuel Johns. And Matt Boyden at Ultraviolet Audio is our editor, Maria Wartelle is our production. It means that we're gonna be 60 seconds.

Yeah, okay, but I'm well, I told you to count to 60 and you count it so fast. So we're gonna, let's say 75, because I'm really almost done. That's my son Alexander again. Maria Wertel is our production coordinator and we derive a lot of wisdom additionally from colleagues such as Ben Rubin, Jen Poehl

and Nate Toby at 10% happier. Also big thanks to my guys at ABC Ryan Kessler and Josh Cohan. We'll see you all on Wednesday for another episode. And Alexander, before we go, you have anything to say to the audience. Bye. Bye. Can you shout that louder?

Bye. That's my son. Very proud. See you soon. Hey, hey, prime members. You can listen to 10% happier early and add free on Amazon Music. Download the Amazon Music app today. Or you can listen early and add free with Wondery Plus in Apple Podcasts.

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